Stewart S S, Appel S H
Department of Neurology, Baylor College of Medicine, Houston VA Medical Center, Texas 77030.
Annu Rev Med. 1988;39:193-201. doi: 10.1146/annurev.me.39.020188.001205.
Recent studies suggest that diffusible factors released by neural targets enhance the survival, growth, and differentiation of neurons both peripherally and in the central nervous system. Evidence for such trophic factors exists for many of the neural systems involved in the degenerative neurologic diseases Alzheimer's disease, parkinsonism, and amyotrophic lateral sclerosis. It is our hypothesis that for each of these disorders there is both a primary insult and a secondary effect. The primary insult may have multiple etiologies, but the secondary effect is the result of retrograde degeneration. Such retrograde degeneration occurs because of an impairment of trophic factor function or an inadequacy of trophic effects to keep pace with the primary destructive process. Accordingly, it may be possible to exploit such trophic mechanisms to define further the pathobiology of neural degeneration and to develop specific treatments for currently incurable illnesses.
最近的研究表明,神经靶标释放的可扩散因子可增强外周和中枢神经系统中神经元的存活、生长和分化。在涉及退行性神经疾病如阿尔茨海默病、帕金森病和肌萎缩侧索硬化症的许多神经系统中,都存在这种营养因子的证据。我们的假设是,对于这些疾病中的每一种,都存在原发性损伤和继发性效应。原发性损伤可能有多种病因,但继发性效应是逆行性变性的结果。这种逆行性变性是由于营养因子功能受损或营养作用不足以跟上原发性破坏过程而发生的。因此,利用这种营养机制来进一步明确神经变性的病理生物学并开发针对目前无法治愈疾病的特异性治疗方法可能是可行的。