Chopp M, Li Y
Department of Neurology, Henry Ford Hospital, 2799 W. Grand Boulevard, Detroit, MI 48202, USA.
Acta Neurochir Suppl. 2008;105:79-83. doi: 10.1007/978-3-211-09469-3_16.
We describe some of our studies on use of neuro-restorative agents for treatment of neural injury. We focus on cell-based therapies and select from a variety of statins. In addition, we show that cell-based and pharmacological-based therapies enhance brain plasticity and promote recovery of function after stroke and intracerebral hemorrhage (ICH). Injured brain recapitulates ontogeny. Cerebral tissue around the infarction expresses developmental genes, many of which are present only during embryonic or neonatal stages of development. Brain response to injury undergoes remodeling with induction of angiogenesis, neurogenesis, and synaptogenesis. The attempt at remodeling, although expressed as a partial improvement in patients with stroke and ICH, is clearly insufficient to promote substantial recovery in many patients. The goal of restorative therapies should be to activate and amplify this endogenous restorative brain plasticity process to potentiate functional recovery. The logic of restorative therapy is to treat intact or marginally compromised tissue and not injured or dying tissue. Thus, these treatments can be made available for all neurological injury. Once demonstrated to be effective for treatment of a large middle cerebral artery occlusion (MCAo), these restorative treatments can be applied to many types of injury, including ICH, traumatic brain injury, and neurodegenerative disease such as experimental autoimmune encephalomyelitis and multiple sclerosis.
我们描述了一些关于使用神经修复剂治疗神经损伤的研究。我们专注于基于细胞的疗法，并从多种他汀类药物中进行选择。此外，我们表明基于细胞和基于药理学的疗法可增强脑可塑性，并促进中风和脑出血（ICH）后功能的恢复。受损大脑重现个体发育过程。梗死周围的脑组织表达发育基因，其中许多基因仅在胚胎或新生儿发育阶段出现。大脑对损伤的反应通过诱导血管生成、神经发生和突触形成而发生重塑。尽管在中风和ICH患者中表现为部分改善，但这种重塑尝试显然不足以促进许多患者的实质性恢复。恢复性疗法的目标应该是激活并放大这种内源性恢复性脑可塑性过程，以增强功能恢复。恢复性疗法的逻辑是治疗完整或轻度受损的组织，而不是受损或即将死亡的组织。因此，这些治疗方法可用于所有神经损伤。一旦证明对治疗大脑中动脉大面积闭塞（MCAo）有效，这些恢复性治疗方法就可以应用于多种类型的损伤，包括ICH、创伤性脑损伤以及神经退行性疾病，如实验性自身免疫性脑脊髓炎和多发性硬化症。
