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利用神经发生来治疗帕金森病的可能性。

Harnessing neurogenesis for the possible treatment of Parkinson's disease.

作者信息

Lamm Omri, Ganz Javier, Melamed Eldad, Offen Daniel

机构信息

Felsenstien Medical Research Center, Sackler Faculty of Medicine, Tel Aviv University, Israel.

出版信息

J Comp Neurol. 2014 Aug 15;522(12):2817-30. doi: 10.1002/cne.23607. Epub 2014 May 9.

Abstract

The discovery of neurogenesis in the adult brain has created new possibilities for therapeutics in neurodegenerative diseases. Neural precursor cells, which have been found in various parts of the brain, e.g., the subventricular zone (SVZ) and substantia nigra (SN), have promising potential to replace the extensive loss of neurons occurring in neurodegenerative disorders. In Parkinson's disease (PD) the degeneration of nigral dopaminergic neurons and consequently the nigrostriatal pathway, which has been found to innervate proximally to the SVZ, causes motor and cognitive impairments. There is strong evidence that neurogenesis is impaired in PD, which has been related to the nonmotor symptoms of the disease. Recent evidence supports that this impairment in neurogenesis is partially caused by the lack of dopamine in one of the adult neurogenic niches, the SVZ. Thus, restoring the dopaminergic pathway in PD patients may have implications not only for motor function improvement, but for other cognitive and autonomic symptoms. Currently, there are no effective treatments that can stop or reverse the neurodegeneration process in the brain. Here we review the neurogenic process and observed alterations found in PD animal models and postmortem brains of PD patients. Finally, we review several attempts to stimulate the neurogenic process for nigral and/or striatal dopaminergic restoration by transgenic expression, exercise, or cell therapy.

摘要

成人大脑中神经发生的发现为神经退行性疾病的治疗创造了新的可能性。在大脑的各个部位,如脑室下区(SVZ)和黑质(SN)中发现的神经前体细胞,具有替代神经退行性疾病中广泛发生的神经元损失的潜力。在帕金森病(PD)中,黑质多巴胺能神经元的退化以及由此导致的黑质纹状体通路(已发现其向SVZ近端投射)的退化会导致运动和认知障碍。有强有力的证据表明,PD患者的神经发生受损,这与该疾病的非运动症状有关。最近的证据支持,神经发生的这种损害部分是由成年神经发生微环境之一——SVZ中多巴胺缺乏引起的。因此,恢复PD患者的多巴胺能通路可能不仅对运动功能改善有意义,对其他认知和自主神经症状也有意义。目前,尚无有效的治疗方法能够阻止或逆转大脑中的神经退行性变过程。在此,我们综述了神经发生过程以及在PD动物模型和PD患者尸检大脑中观察到的改变。最后,我们综述了通过转基因表达、运动或细胞疗法刺激神经发生过程以恢复黑质和/或纹状体多巴胺能的几种尝试。

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