Aoki Masashi, Warita Hitoshi, Suzuki Naoki, Itoyama Yasuto
Department of Neurology, Tohoku University School of Medicine, Tohoku University Hospital ALS Center.
Rinsho Shinkeigaku. 2009 Nov;49(11):814-7. doi: 10.5692/clinicalneurol.49.814.
Amyotrophic lateral sclerosis (ALS) is an adult onset neurodegenerative disorder characterized by the death of upper and lower motor neurons. Approximately 20% of familial ALS cases are caused by mutations in the superoxide dismutase 1 (SOD1) gene. Mutations in the fused in sarcoma/translated in liposarcoma (FUS/TLS) gene have been recently discovered to be associated with familial ALS. We found FUS/TLS mutations in familial ALS cases in Japan. Even in Asian races, ALS with FUS/TLS mutations may have common characteristics of early onset, rapid progress, high penerence trait. We developed rats that express a human SOD1 transgene with two different ALS-associated mutations (G93A and H46R) develop striking motor neuron degeneration and paralysis. The larger size of this rat model as compared with the ALS mice will facilitate studies involving manipulations of spinal fluid (implantation of intrathecal catheters for chronic therapeutic studies; CSF sampling) and spinal cord (e.g., direct administration of viral- and cell-mediated therapies). Hepatocyte growth factor (HGF) is one of the most potent survival-promoting factors for motor neurons. To examine its both protective effect on motor neurons and therapeutic potential, we administered human recombinant HGF (hrHGF) by continuous intrathecal delivery to G93A transgenic rats at onset of paralysis for 4 weeks. Intrathecal administration of hrHGF attenuates motor neuron degeneration and prolonged the duration of the disease by 63%. Our results indicated the therapeutic efficacy of continuous intrathecal administration of hrHGF in ALS rats. In addition, HGF is capable of reducing astrocytosis and microglial accumulation, and thus supports the attention of a glial-dependent mechanism of ALS progression. These results should prompt further clinical trials in ALS using continuous intrathecal administration of hrHGF.
肌萎缩侧索硬化症(ALS)是一种成年起病的神经退行性疾病,其特征是上下运动神经元死亡。大约20%的家族性ALS病例由超氧化物歧化酶1(SOD1)基因突变引起。最近发现,肉瘤融合/脂肪肉瘤中翻译的(FUS/TLS)基因突变与家族性ALS有关。我们在日本的家族性ALS病例中发现了FUS/TLS突变。即使在亚洲人种中,具有FUS/TLS突变的ALS也可能具有起病早、进展快、高外显率特征的共同特点。我们培育出了表达带有两种不同ALS相关突变(G93A和H46R)的人类SOD1转基因大鼠,它们出现了明显的运动神经元变性和瘫痪。与ALS小鼠相比,这种大鼠模型体型更大,将便于进行涉及脑脊液操作(植入鞘内导管进行慢性治疗研究;脑脊液采样)和脊髓操作(例如,直接给予病毒和细胞介导的疗法)的研究。肝细胞生长因子(HGF)是对运动神经元最有效的促存活因子之一。为了研究其对运动神经元的保护作用和治疗潜力,我们在瘫痪发作时通过连续鞘内给药将人重组HGF(hrHGF)给予G93A转基因大鼠,持续4周。鞘内给予hrHGF可减轻运动神经元变性,并将疾病持续时间延长63%。我们的结果表明,连续鞘内给予hrHGF对ALS大鼠具有治疗效果。此外,HGF能够减少星形胶质细胞增生和小胶质细胞积聚,因此支持了ALS进展的胶质细胞依赖性机制的观点。这些结果应促使在ALS中使用连续鞘内给予hrHGF进行进一步的临床试验。