Gudi Viktoria, Grieb Paweł, Linker Ralf A, Skripuletz Thomas
Department of Neurology, Hannover Medical School, Hannover, Germany.
Department of Experimental Pharmacology, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland.
Neural Regen Res. 2023 Dec;18(12):2599-2605. doi: 10.4103/1673-5374.373671.
Multiple sclerosis is a multifactorial chronic inflammatory disease of the central nervous system that leads to demyelination and neuronal cell death, resulting in functional disability. Remyelination is the natural repair process of demyelination, but it is often incomplete or fails in multiple sclerosis. Available therapies reduce the inflammatory state and prevent clinical relapses. However, therapeutic approaches to increase myelin repair in humans are not yet available. The substance cytidine-5'-diphosphocholine, CDP-choline, is ubiquitously present in eukaryotic cells and plays a crucial role in the synthesis of cellular phospholipids. Regenerative properties have been shown in various animal models of diseases of the central nervous system. We have already shown that the compound CDP-choline improves myelin regeneration in two animal models of multiple sclerosis. However, the results from the animal models have not yet been studied in patients with multiple sclerosis. In this review, we summarise the beneficial effects of CDP-choline on biolipid metabolism and turnover with regard to inflammatory and regenerative processes. We also explain changes in phospholipid and sphingolipid homeostasis in multiple sclerosis and suggest a possible therapeutic link to CDP-choline.
多发性硬化症是一种中枢神经系统的多因素慢性炎症性疾病，可导致脱髓鞘和神经元细胞死亡，进而造成功能残疾。髓鞘再生是脱髓鞘的自然修复过程，但在多发性硬化症中往往不完整或失败。现有的治疗方法可减轻炎症状态并预防临床复发。然而，目前尚无在人体中促进髓鞘修复的治疗方法。胞苷-5'-二磷酸胆碱（CDP-胆碱）这种物质普遍存在于真核细胞中，在细胞磷脂合成中起关键作用。在各种中枢神经系统疾病的动物模型中已显示出其再生特性。我们已经表明，化合物CDP-胆碱在两种多发性硬化症动物模型中可改善髓鞘再生。然而，动物模型的结果尚未在多发性硬化症患者中进行研究。在本综述中，我们总结了CDP-胆碱在炎症和再生过程方面对生物脂质代谢和周转的有益作用。我们还解释了多发性硬化症中磷脂和鞘脂稳态的变化，并提出了与CDP-胆碱可能的治疗联系。
