Brünner Y F, Benedict C, Freiherr J
Klinik für Diagnostische und Interventionelle Neuroradiologie, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
Nervenarzt. 2013 Aug;84(8):949-54. doi: 10.1007/s00115-013-3806-8.
The assumption that the human brain is an insulin-independent organ was disproved with the discovery of insulin receptors in the central nervous system in the year 1978. Evidence has been provided for a high density of insulin receptors in brain regions responsible for cognitive memory processes (hippocampus) and for the regulation of appetite (hypothalamus). Accordingly, in animal studies an increased insulin level in the central nervous system leads to an improvement of hippocampal memory function and a decrease of food intake. Similar results were obtained in humans using the method of intranasal administration of insulin. Intranasal insulin reaches the brain and the cerebrospinal fluid via the olfactory epithelium and olfactory nerve fiber bundles leading through the lamina cribrosa to the olfactory bulb. Thus, this method renders the investigation of specific insulin effects in humans possible. The therapeutic potential of an intranasal insulin administration for the treatment of diseases for which an imbalance of the central nervous insulin metabolism is discussed (e.g. Alzheimer's disease, diabetes mellitus and obesity) can only be estimated with the help of further clinical studies.
1978年在中枢神经系统发现胰岛素受体后,人类大脑是一个不依赖胰岛素的器官这一假设被推翻。有证据表明,在负责认知记忆过程的脑区(海马体)和食欲调节的脑区(下丘脑)存在高密度的胰岛素受体。因此,在动物研究中,中枢神经系统中胰岛素水平的升高会导致海马体记忆功能的改善和食物摄入量的减少。在人类中,通过鼻内注射胰岛素的方法也获得了类似的结果。鼻内胰岛素通过嗅觉上皮和穿过筛板通向嗅球的嗅神经纤维束到达大脑和脑脊液。因此,这种方法使研究人类特定的胰岛素效应成为可能。鼻内注射胰岛素治疗中枢神经胰岛素代谢失衡相关疾病(如阿尔茨海默病、糖尿病和肥胖症)的治疗潜力,只能通过进一步的临床研究来评估。