创新背景

鼻腔给药方便药物避免胃肠道和肝脏对药物的影响，直接进入人体循环，可以提高药物效用和利用率。胰岛素鼻腔给药减少了酶对胰岛素的破坏，以往医学中胰岛素往往用在治疗糖尿病上，近几年鼻腔胰岛素给药让科学家们进行了新的假设和研究，认为大脑中的胰岛素功能可能与认知功能有关。

创新过程

2015年，美国威克森林浸信医学中心通过对接受过鼻腔胰岛素给药的60名因为年龄认知功能受损的患者进行21天追踪观察研究，发现一种人造胰岛素鼻腔喷雾运输装置或可有效改善轻度认知损伤及阿尔茨海默病相关的痴呆症个体的疾病。研究结果证明了科学家们的假设，胰岛素鼻腔给药将药物直接送入大脑，调节大脑中的胰岛素信号，对认知功能起作用，而不影响糖尿病的胰岛素治疗。

糖尿病的胰岛素治疗最常用的是皮下注射胰岛素，减少血液中的葡萄糖，增加消耗，在一定程度上纠正各种代谢紊乱，从而降低血糖，达到治疗作用。

在认知能力损伤疾病相关的阿尔茨海默病、缺血性脑卒中研究中，研究人员发现鼻内胰岛素给药可以提高脑内胰岛素浓度，改善胰岛素抵抗通过AKT/糖原合酶激酶3β信号通路减轻神经功能损害，并改善携带阿尔兹海默氏症易感基因APOE-e4的MCI成年患者的记忆力，进而改善患有该症状患者的认知能力。

在此基础上，中国川北医学院附属医院蒋国会团队进行了胰岛素鼻腔给药的新作用实验，考虑这种方法能否为脑出血进行神经保护。研究发现，鼻内胰岛素给药可能通过AKT/糖原合酶激酶3β信号通路减轻实验性脑出血小鼠的神经和病理损伤，为脑出血后的神经保护治疗提供帮助，研究将进一步发现其中的作用和潜在机制。

胰岛素通过鼻腔给药对大脑疾病和认知功能的治疗为相关医学治疗和药物开发提供了新的方法和途径，对医学发展具有重要意义。

创新关键点

改变胰岛素给药方式研究大脑疾病治疗新方法。

New ways of insulin intake | Effect of nasal administration on cognitive abilities

In 2015, Wake Forest Baptist Medical Center in the United States conducted a 21-day follow-up observation study on 60 patients with cognitive impairment due to age who had received nasal insulin administration and found that an artificial insulin nasal spray delivery device may be effective. Improves disease in individuals with mild cognitive impairment and Alzheimer's disease-related dementia. The findings support the scientists' hypothesis that intranasal insulin delivery delivers the drug directly into the brain, modulating insulin signaling in the brain and acting on cognitive function without affecting insulin therapy for diabetes.

The most commonly used insulin treatment for diabetes is subcutaneous insulin injection, which reduces glucose in the blood, increases consumption, and corrects various metabolic disorders to a certain extent, thereby reducing blood sugar and achieving therapeutic effects.

In Alzheimer's disease, ischemic stroke studies associated with cognitive impairment disease, researchers found that intranasal insulin administration can increase insulin concentration in the brain and improve insulin resistance through AKT/glycogen synthase kinase 3β signaling The pathway reduces neurological impairment and improves memory in adults with MCI who carry the Alzheimer's susceptibility gene APOE-e4, which in turn improves cognitive performance in patients with the condition.

On this basis, Jiang Guouo's team from the Affiliated Hospital of North Sichuan Medical College, China conducted a new effect experiment of intranasal insulin administration to consider whether this method can provide neuroprotection for cerebral hemorrhage. The study found that intranasal insulin administration may reduce the neurological and pathological damage in mice with experimental cerebral hemorrhage through the AKT/glycogen synthase kinase 3β signaling pathway, and provide help for neuroprotective treatment after cerebral hemorrhage. Effects and potential mechanisms.

The treatment of brain diseases and cognitive function with insulin through nasal administration provides new methods and approaches for related medical treatment and drug development, which is of great significance to the development of medicine.