Department of Neurosurgery, Queen Mary, University of London, The Royal London Hospital, London, England.
Neurosurgery. 2009 Oct;65(4 Suppl):A74-9. doi: 10.1227/01.NEU.0000352378.26755.C3.
Peripheral nerve injury causes retrograde changes in the damaged neurons, which are beneficial to axonal regeneration. Better understanding of the mechanisms of induction and mediation of these conditioning responses would help to design strategies to invoke stronger regenerative responses in neurons in situations when these responses are inadequate.
Relevant literature is reviewed.
Experimental preparations that measure the influence of peripheral axotomy on regeneration in the central axons of primary sensory neurons are useful to examine mechanisms of conditioning neurons. Despite 4 decades of speculation, the nature of the damage signals from injured nerves that initiate axonal signals to the nerve cell body remains elusive. Members of the family of neuropoietic cytokines are clearly implicated, but what induces them is unknown. Multiple changes in gene regulation in axotomized neurons have been described, and dozens of growth-associated genes have been identified: neurotrophic factors, transcription factors, molecules participating in axonal transport, and molecules active in the growth cone. The mechanisms of interaction of a few regeneration-associated molecules with the signaling cascades that lead to actin and tubulin remodeling at the growth cone are understood in some detail. In animals, viral gene therapy to deliver regeneration-associated genes to neurons or other local measures to induce these genes can improve regeneration. A few pharmacological agents, administered systemically, have small beneficial effects on axonal regeneration.
Advances in laboratory research have provided knowledge of cell body responses to axotomy with clinical relevance.
周围神经损伤导致损伤神经元逆行变化,有利于轴突再生。更好地了解这些条件反应的诱导和介导机制,有助于设计策略,在这些反应不足的情况下,引起神经元更强的再生反应。
回顾相关文献。
用于检测条件化神经元机制的实验制剂,可测量周围轴突切断对初级感觉神经元中枢轴突再生的影响。尽管已经推测了 40 年,但启动轴突信号到神经元胞体的损伤神经的损伤信号的性质仍然难以捉摸。神经生成细胞因子家族的成员显然被牵连在内,但诱导它们的原因尚不清楚。已经描述了轴突切断神经元中基因调控的多种变化,并且已经鉴定了数十种与生长相关的基因:神经营养因子、转录因子、参与轴突运输的分子以及在生长锥中活跃的分子。少数与导致生长锥处肌动蛋白和微管重塑的信号级联相互作用的再生相关分子的机制,在某些细节上已经被理解。在动物中,病毒基因治疗将与再生相关的基因传递给神经元或其他局部措施来诱导这些基因,可以改善再生。一些全身性给予的药物对轴突再生有较小的有益作用。
实验室研究的进展为具有临床相关性的胞体对轴突切断的反应提供了知识。