1 Department of Neurological Surgery, University of Wisconsin , Madison, Wisconsin.
2 Department of Neurological Surgery, Ross University School of Medicine , Dominica , West Indies.
J Neurotrauma. 2017 Dec 15;34(24):3311-3325. doi: 10.1089/neu.2017.5175. Epub 2017 Oct 16.
Spinal cord injury (SCI) is a devastating condition affecting 270,000 people in the United States. The use of growth factors is a potential treatment for reducing secondary damage, promoting axon growth, and restoring some of the lost function post-SCI. Glial cell line-derived neurotrophic factor (GDNF) is an important growth factor, because it can affect both neurons and support cells. Here, we give an in-depth review of the previously published literature where GDNF was used to treat SCI. The effects of GDNF have been shown to decrease lesion size, improve allodynia, and regenerate axons in the central nervous system and peripheral nervous system. GDNF is necessary for early development, and lack of GDNF can lead to abnormal development of the autonomic nervous system or death. Exogenous administration of GDNF either before or immediately after SCI is most effective. Even though GDNF can be directly administered, genetically modified cells are often used as a delivery vehicle. Several different types of genetically modified cells have been used with varying success. Although GDNF is effective when used alone, it has been shown to be more effective when used in combination with other neurotrophic factors. Overall, GDNF significantly improved functional recovery, increased the number of sprouting neurons, reduced lesion size at the injury site, and had minimal adverse effects.
脊髓损伤 (SCI) 是一种严重的疾病,影响美国 27 万人。生长因子的应用是减少继发性损伤、促进轴突生长和恢复 SCI 后部分丧失功能的一种潜在治疗方法。胶质细胞源性神经营养因子 (GDNF) 是一种重要的生长因子,因为它可以影响神经元和支持细胞。在这里,我们对以前发表的使用 GDNF 治疗 SCI 的文献进行了深入回顾。研究表明,GDNF 可减少损伤面积、改善痛觉过敏,并在中枢神经系统和周围神经系统中再生轴突。GDNF 对早期发育是必需的,缺乏 GDNF 会导致自主神经系统发育异常或死亡。SCI 前或后立即给予外源性 GDNF 是最有效的。尽管 GDNF 可以直接给药,但通常使用基因修饰细胞作为递送载体。已经使用了几种不同类型的基因修饰细胞,但效果不同。尽管 GDNF 单独使用有效,但与其他神经营养因子联合使用时效果更好。总的来说,GDNF 显著改善了功能恢复,增加了发芽神经元的数量,减少了损伤部位的损伤面积,且不良反应最小。