Sretavan David W, Chang Wesley, Hawkes Elizabeth, Keller Christopher, Kliot Michel
Department of Ophthalmology, University of California, San Francisco, California 94143, USA.
Neurosurgery. 2005 Oct;57(4):635-46; discussion 635-46.
The lack of meaningful axon regeneration after central nervous system damage and poor functional recovery after serious peripheral nervous system nerve injuries have been long-standing problems of substantial interest to both neurosurgeons and neurobiologists. As an alternative to strategies that seek to promote the regeneration of adult axons, our research group has taken advantage of advances in microtechnology to develop a paradigm of direct axon repair involving the substitution of damaged axon regions with healthy segments from donor axons.
This repair methodology uses a novel combination of microtechnology, electrokinetic axon manipulation, and the well-established biological principle of cell fusion. These three fields of research have been integrated in a multidisciplinary approach to develop a solution for a significant clinical problem that currently has no specific treatment.
The findings reported here provide some initial proof of principle for the core technologies we intend to use for axon repair. Functional recovery from nerve damage of course is clinically challenging, and many obstacles would need to be overcome before such axon repair procedures can be contemplated for therapeutic use. We identify some of the clinical issues that must be addressed for microtechnology-assisted axon repair to transition from the realm of research into actual surgical settings.
It is hoped that each advance in axon repair technology will spur additional research to provide us with a comprehensive understanding on how best to pursue neurosurgical intervention at the microscale.
中枢神经系统损伤后缺乏有意义的轴突再生,以及严重的周围神经系统神经损伤后功能恢复不佳,长期以来一直是神经外科医生和神经生物学家极为关注的问题。作为促进成年轴突再生策略的替代方法,我们的研究小组利用微技术的进展,开发了一种直接轴突修复模式,即用供体轴突的健康节段替代受损的轴突区域。
这种修复方法采用了微技术、电动轴突操作以及成熟的细胞融合生物学原理的新颖组合。这三个研究领域已通过多学科方法整合在一起,以开发一种针对目前尚无特定治疗方法的重大临床问题的解决方案。
此处报告的研究结果为我们打算用于轴突修复的核心技术提供了一些初步的原理证明。当然,从神经损伤中实现功能恢复在临床上具有挑战性,并且在考虑将此类轴突修复程序用于治疗用途之前,还需要克服许多障碍。我们确定了一些临床问题,为了使微技术辅助的轴突修复从研究领域过渡到实际手术环境,必须解决这些问题。
希望轴突修复技术的每一项进展都能激发更多研究,以便我们全面了解如何在微观尺度上最好地进行神经外科干预。