Hermann D M, Buga Ana Maria, Popa-Wagner A
Department of Neurology, University Hospital Essen, Germany;
Rom J Morphol Embryol. 2013;54(3 Suppl):687-93.
Cerebral plasticity and neurological recovery can be stimulated in the ischemic brain by exogenous pharmacological and cell-based treatments. Neurons, neuroblasts and endothelial cells synergistically interact with each other as a regenerative triad, creating an environment in which neurological recovery takes place. Developmental genetic programs are reactivated. Brain neurons and capillary cells are enabled to sprout, and glial cells support plasticity processes. Until now, the large majority of studies were performed in young, otherwise healthy animals, which lack the risk factors and co-morbidities associated with human stroke. Recent behavioral, histochemical and molecular biological studies have shown that restorative brain responses may differ between young and old animals, and that they are also modulated by vascular risk factors, such as hyperlipidemia and diabetes, which are highly prevalent in ischemic stroke. We claim that age aspects, vascular risk factors and co-morbidities should more intensively be examined in future experimental studies. Confounding effects of age, risk factors and co-morbidities should carefully be considered in clinical proof-of-concept trials.
外源性药物治疗和基于细胞的治疗可刺激缺血性脑内的脑可塑性和神经功能恢复。神经元、神经母细胞和内皮细胞作为一个再生三联体相互协同作用，营造出一个发生神经功能恢复的环境。发育遗传程序被重新激活。脑神经元和毛细血管细胞能够发芽，神经胶质细胞支持可塑性过程。到目前为止，绝大多数研究是在年轻且无其他健康问题的动物身上进行的，这些动物缺乏与人类中风相关的危险因素和合并症。最近的行为学、组织化学和分子生物学研究表明，年轻和老年动物的脑恢复性反应可能不同，并且它们还受到血管危险因素（如高脂血症和糖尿病，这些在缺血性中风中非常普遍）的调节。我们认为，在未来的实验研究中应更深入地研究年龄因素、血管危险因素和合并症。在临床概念验证试验中应仔细考虑年龄、危险因素和合并症的混杂效应。
