Chiaretti Antonio, Falsini Benedetto, Aloe Luigi, Pierri Filomena, Fantacci Claudia, Riccardi Riccardo
Department of Pediatric Neuroscience, Catholic University of Rome, Italy.
Arch Ital Biol. 2011 Jun;149(2):275-82. doi: 10.4449/aib.v149i2.1364.
Hypoxic-ischemic injuries (HII) of the brain, optic pathways, and skin are frequently associated with poor neurological and clinical outcome. Unfortunately, no new therapeutic approaches have been proposed for these conditions. Recently, experimental and clinical studies showed that nerve growth factor (NGF) can improve neurological deficits, visual loss and skin damage after HII. Based on these studies, we report the effects of NGF administration in different lesions of the brain, optic pathways and skin. 2.5S NGF purified and lyophilized from male mouse submaxillary glands was utilized for the treatment. NGF administration was started in absence of recovery after conventional and standardized treatment. One mg NGF was administered via the external catheter into the brain, by drop administration in the eye, and by subcutaneous administration in the skin. We treated 4 patients: 2 children with hypoxic-ischemic brain damage, an adult patient with an optic glioma-induced visual loss and a child with a severe crush syndrome of the lower left limb. After NGF treatment, we observed an amelioration of both neurological and electrophysiological function of the brain, a subjective and objective improvement of visual function, and a gradual improvement of ischemic skin lesion. No side effects were related to NGF treatment in all patients studied. Our observation shows that NGF administration may be an effective and safe adjunct therapy in patients with severe HII. The beneficial and prolonged effect on nerve function suggests a neuroprotective mechanism exerted by NGF on the residual viable neurological pathways of these patients.
脑、视路和皮肤的缺氧缺血性损伤(HII)常与不良的神经学和临床结局相关。遗憾的是,针对这些病症尚未提出新的治疗方法。最近,实验和临床研究表明,神经生长因子(NGF)可改善HII后的神经功能缺损、视力丧失和皮肤损伤。基于这些研究,我们报告了NGF给药对脑、视路和皮肤不同损伤的影响。使用从雄性小鼠颌下腺纯化并冻干的2.5S NGF进行治疗。在常规标准化治疗后未恢复的情况下开始给予NGF。将1mg NGF通过外置导管注入脑内,滴眼给药,以及皮下注射到皮肤。我们治疗了4例患者:2例患有缺氧缺血性脑损伤的儿童、1例患有视神经胶质瘤导致视力丧失的成年患者和1例患有左下肢严重挤压综合征的儿童。NGF治疗后,我们观察到脑的神经学和电生理功能均有改善,视觉功能有主观和客观的改善,缺血性皮肤损伤逐渐改善。在所有研究患者中,未发现与NGF治疗相关的副作用。我们的观察表明,对于严重HII患者,NGF给药可能是一种有效且安全的辅助治疗方法。对神经功能有益且持久的作用提示NGF对这些患者残留的可行神经通路发挥了神经保护机制。