Raedt R, Van Dycke A, Vonck K, Boon P
Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, De Pintelaan 145, B-9000 Ghent, Belgium.
Seizure. 2007 Oct;16(7):565-78. doi: 10.1016/j.seizure.2007.05.003. Epub 2007 Jun 12.
For patients with refractory epilepsy it is important to search for alternative treatments. One of these potential treatments could be introducing new cells or modulating endogenous neurogenesis to reconstruct damaged epileptic circuits or to bring neurotransmitter function back into balance. In this review the scientific basis of these cell therapy strategies is discussed and the results are critically evaluated. Research on cell transplantation strategies has mainly been performed in animal models for temporal lobe epilepsy, in which seizure foci or seizure propagation pathways are targeted. Promising results have been obtained, although there remains a lot of debate about the relevance of the animal models, the appropriate target for transplantation, the suitable cell source and the proper time point for transplantation. From the presented studies it should be evident that transplanted cells can survive and sometimes even integrate in an epileptic brain and in a brain that is subjected to epileptogenic interventions. There is evidence that transplanted cells can partially restore damaged structures and/or release substances that modulate existent or induced hyperexcitability. Even though several studies show encouraging results, more studies need to be done in animal models with spontaneous seizures in order to have a better comparison to the human situation.
对于难治性癫痫患者而言,寻找替代治疗方法至关重要。这些潜在治疗方法之一可能是引入新细胞或调节内源性神经发生,以重建受损的癫痫环路或使神经递质功能恢复平衡。在本综述中,将讨论这些细胞治疗策略的科学依据,并对结果进行批判性评估。细胞移植策略的研究主要在颞叶癫痫动物模型中进行,其中癫痫病灶或癫痫传播途径是靶向目标。尽管在动物模型的相关性、合适的移植靶点、合适的细胞来源以及合适的移植时间点等方面仍存在诸多争议,但已取得了有前景的结果。从所呈现的研究中应该可以明显看出,移植的细胞能够存活,有时甚至能整合到癫痫脑以及遭受致痫干预的脑中。有证据表明,移植的细胞可以部分恢复受损结构和/或释放调节现有或诱导的过度兴奋的物质。尽管多项研究显示出令人鼓舞的结果,但仍需要在具有自发性癫痫发作的动物模型中开展更多研究,以便能更好地与人类情况进行比较。