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脊髓损伤:可塑性、再生及转化药物开发面临的挑战

Spinal cord injury: plasticity, regeneration and the challenge of translational drug development.

作者信息

Blesch Armin, Tuszynski Mark H

机构信息

Department of Neurosciences-0626, University of California, San Diego, La Jolla, CA 92093, USA.

出版信息

Trends Neurosci. 2009 Jan;32(1):41-7. doi: 10.1016/j.tins.2008.09.008. Epub 2008 Oct 30.

Abstract

Over the past three decades, multiple mechanisms limiting central nervous system regeneration have been identified. Here, we address plasticity arising from spared systems as a particularly important and often unrecognized mechanism that potentially contributes to functional recovery in studies of 'regeneration' after spinal cord injury. We then discuss complexities involved in translating findings from animal models to human clinical trials in spinal cord injury; current strategies might be too limited in scope to yield detectable benefits in the complex and variable arena of human injury. Our animal models are imperfect, and the very variability that we attempt to control in the course of conducting rigorous research might, ironically, limit our ability to identify the most promising therapies in the human arena. Therapeutic candidates are most likely to have a detectable effect in human trials if they elicit benefits in severe contusion and larger animal models and pass the test of independent replication.

摘要

在过去三十年里,人们已经确定了多种限制中枢神经系统再生的机制。在此,我们探讨 spared 系统产生的可塑性,这是一种特别重要且常常未被认识到的机制,它可能在脊髓损伤后“再生”研究中对功能恢复有所贡献。然后,我们讨论了将动物模型的研究结果转化为脊髓损伤人体临床试验所涉及的复杂性;当前策略的范围可能过于有限,无法在复杂多变的人类损伤领域产生可检测到的益处。我们的动物模型并不完美,而我们在进行严谨研究过程中试图控制的变异性,具有讽刺意味的是,可能会限制我们在人类领域识别最有前景疗法的能力。如果治疗候选药物在严重挫伤和大型动物模型中产生益处并通过独立重复测试,那么它们最有可能在人体试验中产生可检测到的效果。

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