脊髓损伤后神经营养因子及干细胞治疗对轴突再生的影响:国外基础和临床研究新进展
척수손상후신경영양인자급간세포치료대축돌재생적영향:국외기출화림상연구신진전
Effect of neurotrophic factor and stem cell therapy on axonal regeneration after spinal cord injury: Overseas progress in basic and clinical researches
  • 万方数据
    中国组织工程研究与临床康复 중국조직공정연구여림상강복
    JOURNAL OF CLINICAL REHABILITATIVE TISSUE ENGINEERING RESEARCH
    2007年 14期 2787-2791,2796 ,共6页

    臧大维%刘娟%Surindar Cheema

    장대유%류연%Surindar Cheema

    脊髓损伤%神经系统/细胞学%干细胞%轴突%神经生长因子类 脊髓損傷%神經繫統/細胞學%榦細胞%軸突%神經生長因子類
    척수손상%신경계통/세포학%간세포%축돌%신경생장인자류
    背景:近几年国外学者在脊髓损伤的病理机制、损伤后神经元的保护、少突胶质细胞的再生及神经干细胞的移植治疗等研究方面取得了实质性地进展.介绍国外近10年来对脊髓损伤的新认识,最新研究成果及未来的科研和治疗方向.资料来源:应用计算机检索Medline数据库1987-01/2006-10脊髓损伤的相关文章,限定文章语言种类为English,检索词为"脊髓损伤;神经干细胞;轴突;神经营养因子;动物模型",进行不同组合,选出相关文章.资料选择:对资料进行初审,选择脊髓研究中的与神经干细胞及神经营养因子有关的研究文献查找全文.纳入标准:①脊髓损伤中以探讨其机制及新治疗方法的文章.②探讨脊髓损伤后轴突再生,生长锥作用,引导再生方向的靶点,突触再形成及功能重建的文章.③神经营养因子和内源性神经干细胞治疗的文章.排除标准:①未被SCI收录的文章,相类似的研究.②无英文摘要的文章.资料提炼:共收集到相关文献1 166篇,按上述标准纳入101篇,实际采用61篇,脊髓损伤机制相关文献12篇,轴突再生相关文献14篇,增长锥作用相关文献8篇,少突胶质细胞相关文献8篇,神经干细胞相关文献7篇,神经生长因子相关文献12篇.其余文献均被排除.资料综合:①脊髓损伤功能恢复的基础:损伤的轴突再生及增长;轴突穿透损伤瘢痕区的能力;轴突朝着正确的靶区方向再生;轴突增长到一定程度后停止,终端形成突触,与神经元相接;神经传递功能重建及运动功能重新恢复.②脊髓损伤的神经病理分析:脊髓损伤后的原发性损害、继发性损害.③脊髓损伤的分子生物学机制包括3个方面:对于成年人中枢神经系统损伤后的神经元的发展、再生,神经元通路的建立起着重要的作用轴突增长锥;对轴突的再生起到抑制作用中枢神经系统髓鞘蛋白;细胞膜和细胞内信号传递.④脊髓损伤中起重要作用的细胞和因子:少突胶质细胞,白血病抑制因子和Minocycline,内源性神经干细胞.⑤脊髓损伤动物模型:最常使用的模型是全部离断、部分离断模型和挫伤模型.⑥脊髓损伤研究的前景:已经开始把动物实验中神经营养因子和神经干细胞治疗发现用于临床,如白血病抑制因子在国外已经开始临床Ⅳ期实验,对内源性神经干细胞的诱导调控增殖研究也已经越来越受到重视.结论:神经营养因子干预治疗及神经干细胞治疗使脊髓损伤后的功能恢复成为可能.进一步探讨神经营养因子引起轴突再生的机制,将是脊髓损伤研究领域的未来方向,了解引导调控神经干细胞的增殖和分化方向,将在修复脊髓损伤方面发挥巨大的作用.
    배경:근궤년국외학자재척수손상적병리궤제、손상후신경원적보호、소돌효질세포적재생급신경간세포적이식치료등연구방면취득료실질성지진전.개소국외근10년래대척수손상적신인식,최신연구성과급미래적과연화치료방향.자료래원:응용계산궤검색Medline수거고1987-01/2006-10척수손상적상관문장,한정문장어언충류위English,검색사위"척수손상;신경간세포;축돌;신경영양인자;동물모형",진행불동조합,선출상관문장.자료선택:대자료진행초심,선택척수연구중적여신경간세포급신경영양인자유관적연구문헌사조전문.납입표준:①척수손상중이탐토기궤제급신치료방법적문장.②탐토척수손상후축돌재생,생장추작용,인도재생방향적파점,돌촉재형성급공능중건적문장.③신경영양인자화내원성신경간세포치료적문장.배제표준:①미피SCI수록적문장,상유사적연구.②무영문적요적문장.자료제련:공수집도상관문헌1 166편,안상술표준납입101편,실제채용61편,척수손상궤제상관문헌12편,축돌재생상관문헌14편,증장추작용상관문헌8편,소돌효질세포상관문헌8편,신경간세포상관문헌7편,신경생장인자상관문헌12편.기여문헌균피배제.자료종합:①척수손상공능회복적기출:손상적축돌재생급증장;축돌천투손상반흔구적능력;축돌조착정학적파구방향재생;축돌증장도일정정도후정지,종단형성돌촉,여신경원상접;신경전체공능중건급운동공능중신회복.②척수손상적신경병리분석:척수손상후적원발성손해、계발성손해.③척수손상적분자생물학궤제포괄3개방면:대우성년인중추신경계통손상후적신경원적발전、재생,신경원통로적건립기착중요적작용축돌증장추;대축돌적재생기도억제작용중추신경계통수초단백;세포막화세포내신호전체.④척수손상중기중요작용적세포화인자:소돌효질세포,백혈병억제인자화Minocycline,내원성신경간세포.⑤척수손상동물모형:최상사용적모형시전부리단、부분리단모형화좌상모형.⑥척수손상연구적전경:이경개시파동물실험중신경영양인자화신경간세포치료발현용우림상,여백혈병억제인자재국외이경개시림상Ⅳ기실험,대내원성신경간세포적유도조공증식연구야이경월래월수도중시.결론:신경영양인자간예치료급신경간세포치료사척수손상후적공능회복성위가능.진일보탐토신경영양인자인기축돌재생적궤제,장시척수손상연구영역적미래방향,료해인도조공신경간세포적증식화분화방향,장재수복척수손상방면발휘거대적작용.
    BACKGROUND: Now, progress has been made in understanding the pathomechanisms, protection of injured neurons,regeneration of oligodendrocytes and transplantation of neural stem cells. This paper is aimed to introduce the decade progression, latest research and novel therapies in the area of spinal cord injury internationally.DATA SOURCES: Related articles published from January 1987 to October 2006 were chosen from the America Medline Database, and the language was limited to English, with the search keywords of "spinal cord injury; neural stem cells;axon; neurotrophic factor and animal model".STUDY SELECTION: After the primary trial, the full versions of the articles related to neural stem cell and neurotrophic factor were reviewed according to the following criterias: ① experiments investigating the mechanisms and novel therapies of spinal cord injury. ②papers revealing the axon regeneration, function of growth cone, targets for inducting the regeneration direction as well as synapse and function rebuild. ③ papers reporting neurotrophic factor and endogenous stem cell therapies. Excluded criteria: ①papers with lower impact factor in SCl or studies with similar results.②papers without English abstract.DATA EXTRACTION: A total of 1 166 papers were found in Medline, 101 papers accord with the above criteria, 61 papers were cited in this review, including 12 papers for the mechanism of spinal cord injury, 14 papers for axon regeneration, 8 papers for the function of growth cone, 8 papers for the oligodendrocytes, 7 papers for neural stem cells and the left 12 papers for neurotrophic factor. Other articles were deleted.DATA SYNTHESIS: ①Base of functional recovery after spinal cord injury: The regeneration and elongation of damaged axons; The capacity of axons to penetrate the scar; Re-growth in the direction of appropriate target .regions; Cessation of axonal growth, formation of terminal arbors and formation of synaptic contacts with target neurons; The restoration of functional neurotransmission and the recovery of function.②Neuropathological analysis of spinal cord injury: the primary and secondary damage after spinal cord injury.③Molecular biological mechanism of spinal cord injury: The growth cone is important for the establishment of neural circuitry during neural development and regeneration in the adult CNS after injury; Central nerve system myelin protein is inhibitory for axonal growth; cell membrane and intracellular signal transmission. ④The important cells and cytokine of spinal cord injury: oligodendrocyte, leukemia inhibitory factor,minocycline and endogenous neural stem cells. ⑤Animal models of spinal cord injury: The most common models are total transactions, partial transections and contusions. ⑤Prospect of researches on spinal cord injury: The therapy of neurotrophic factor and neural stem cell has been transformed to clinical practice, for example, the leukaemia inhibitory factor has been applied on clinical experiment at Ⅳ phase, and the research of the induction and proliferation of ndogenous stem cells has been paid much more attention.CONCLUSION: The regeneration of spinal cord after injury is becoming possible using the therapies of neurotrophic actor and neural stem cell. It would be an ideal direction in the near future to investigate the mechanisms of axon regeneration induced by neurotrophic factor intervention in the research areas of spinal cord injury. It would also play a vital role to reveal the proliferation and differentiation of endogenous neural stem cells in repairing the injury of spinal cord.
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