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用于神经元修复、神经保护、轴突再生和降低眼压的电疗法、电磁疗法、超声波疗法及电子植入物。

Electrical, Electromagnetic, Ultrasound Wave Therapies, and Electronic Implants for Neuronal Rejuvenation, Neuroprotection, Axonal Regeneration, and IOP Reduction.

作者信息

Sharif Najam A

机构信息

Global Alliances and External Research, Ophthalmology Innovation Center, Santen Inc., Emeryville, California, USA.

Singapore Eye Research Institute (SERI), Singapore.

出版信息

J Ocul Pharmacol Ther. 2023 Oct;39(8):477-498. doi: 10.1089/jop.2022.0046. Epub 2022 Sep 20.

Abstract

The peripheral nervous system (PNS) of mammals and nervous systems of lower organisms possess significant regenerative potential. In contrast, although neural plasticity can provide some compensation, the central nervous system (CNS) neurons and nerves of adult mammals generally fail to regenerate after an injury or damage. However, use of diverse electrical, electromagnetic and sonographic energy waves are illuminating novel ways to stimulate neuronal differentiation, proliferation, neurite growth, and axonal elongation/regeneration leading to various levels of functional recovery in animals and humans afflicted with disorders of the CNS, PNS, retina, and optic nerve. Tools such as acupuncture, electroacupuncture, electroshock therapy, electrical stimulation, transcranial magnetic stimulation, red light therapy, and low-intensity pulsed ultrasound therapy are demonstrating efficacy in treating many different maladies. These include wound healing, partial recovery from motor dysfunctions, recovery from ischemic/reperfusion insults and CNS and ocular remyelination, retinal ganglion cell (RGC) rejuvenation, and RGC axonal regeneration. Neural rejuvenation and axonal growth/regeneration processes involve activation or intensifying of the intrinsic bioelectric waves (action potentials) that exist in every neuronal circuit of the body. In addition, reparative factors released at the nerve terminals and via neuronal dendrites (transmitter substances), extracellular vesicles containing microRNAs and neurotrophins, and intercellular communication occurring via nanotubes aid in reestablishing lost or damaged connections between the traumatized tissues and the PNS and CNS. Many other beneficial effects of the aforementioned treatment paradigms are mediated via gene expression alterations such as downregulation of inflammatory and death-signal genes and upregulation of neuroprotective and cytoprotective genes. These varied techniques and technologies will be described and discussed covering cell-based and animal model-based studies. Data from clinical applications and linkage to human ocular diseases will also be discussed where relevant translational research has been reported.

摘要

哺乳动物的外周神经系统(PNS)以及低等生物的神经系统具有显著的再生潜力。相比之下,尽管神经可塑性能够提供一定补偿,但成年哺乳动物的中枢神经系统(CNS)神经元和神经在受伤或受损后通常无法再生。然而,使用各种电、电磁和超声能量波正在为刺激神经元分化、增殖、神经突生长和轴突伸长/再生带来新的方法,从而在患有中枢神经系统、外周神经系统、视网膜和视神经疾病的动物和人类中实现不同程度的功能恢复。诸如针灸、电针、电击疗法、电刺激、经颅磁刺激、红光疗法和低强度脉冲超声疗法等工具在治疗许多不同疾病方面都显示出了疗效。这些疾病包括伤口愈合、运动功能障碍的部分恢复、缺血/再灌注损伤后的恢复以及中枢神经系统和眼部的髓鞘再生、视网膜神经节细胞(RGC)的恢复活力以及RGC轴突再生。神经恢复活力和轴突生长/再生过程涉及激活或增强身体每个神经回路中存在的内在生物电波(动作电位)。此外,在神经末梢释放并通过神经元树突传递的修复因子(递质物质)、含有微小RNA和神经营养因子的细胞外囊泡以及通过纳米管进行的细胞间通讯,有助于重新建立受损组织与外周神经系统和中枢神经系统之间失去或受损的连接。上述治疗模式的许多其他有益效果是通过基因表达改变介导的,例如炎症和死亡信号基因的下调以及神经保护和细胞保护基因的上调。将描述和讨论这些不同的技术和方法,涵盖基于细胞和基于动物模型的研究。还将讨论临床应用数据以及与人类眼部疾病的关联,其中会提及相关的转化研究报道。

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