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脑源性神经营养因子及其相关治疗策略在中枢性卒中后疼痛中的作用。

Role of Brain Derived Neurotrophic Factor and Related Therapeutic Strategies in Central Post-Stroke Pain.

机构信息

Calcium Signalling Laboratory, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore, 308433, Singapore.

Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore.

出版信息

Neurochem Res. 2024 Sep;49(9):2303-2318. doi: 10.1007/s11064-024-04175-z. Epub 2024 Jun 10.

Abstract

Brain-derived neurotrophic factor (BDNF) is vital for synaptic plasticity, cell persistence, and neuronal development in peripheral and central nervous systems (CNS). Numerous intracellular signalling pathways involving BDNF are well recognized to affect neurogenesis, synaptic function, cell viability, and cognitive function, which in turn affects pathological and physiological aspects of neurons. Stroke has a significant psycho-socioeconomic impact globally. Central post-stroke pain (CPSP), also known as a type of chronic neuropathic pain, is caused by injury to the CNS following a stroke, specifically damage to the somatosensory system. BDNF regulates a broad range of functions directly or via its biologically active isoforms, regulating multiple signalling pathways through interactions with different types of receptors. BDNF has been shown to play a major role in facilitating neuroplasticity during post-stroke recovery and a pro-nociceptive role in pain development in the nervous system. BDNF-tyrosine kinase receptors B (TrkB) pathway promotes neurite outgrowth, neurogenesis, and the prevention of apoptosis, which helps in stroke recovery. Meanwhile, BDNF overexpression plays a role in CPSP via the activation of purinergic receptors P2X4R and P2X7R. The neuronal hyperexcitability that causes CPSP is linked with BDNF-TrkB interactions, changes in ion channels and inflammatory reactions. This review provides an overview of BDNF synthesis, interactions with certain receptors, and potential functions in regulating signalling pathways associated with stroke and CPSP. The pathophysiological mechanisms underlying CPSP, the role of BDNF in CPSP, and the challenges and current treatment strategies targeting BDNF are also discussed.

摘要

脑源性神经营养因子(BDNF)对于外周和中枢神经系统(CNS)中的突触可塑性、细胞存活和神经元发育至关重要。涉及 BDNF 的众多细胞内信号通路被认为可影响神经发生、突触功能、细胞活力和认知功能,进而影响神经元的病理和生理方面。卒中在全球具有重大的心理-社会-经济影响。中枢性卒中后疼痛(CPSP)又称慢性神经性疼痛的一种,是由中风后中枢神经系统损伤引起的,特别是躯体感觉系统损伤。BDNF 通过与其生物活性同工型直接或间接调节广泛的功能,通过与不同类型的受体相互作用调节多种信号通路。BDNF 已被证明在中风后恢复期间促进神经可塑性,并在神经系统疼痛发展中发挥促伤害作用。BDNF-酪氨酸激酶受体 B(TrkB)途径促进轴突生长、神经发生和细胞凋亡的预防,有助于中风恢复。同时,BDNF 过表达通过激活嘌呤能受体 P2X4R 和 P2X7R 在 CPSP 中发挥作用。导致 CPSP 的神经元过度兴奋与 BDNF-TrkB 相互作用、离子通道变化和炎症反应有关。本综述概述了 BDNF 的合成、与特定受体的相互作用以及在调节与中风和 CPSP 相关的信号通路中的潜在功能。还讨论了 CPSP 的病理生理机制、BDNF 在 CPSP 中的作用以及针对 BDNF 的挑战和当前治疗策略。

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