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帕金森病和代谢性脑病中中枢神经系统对肾上腺酪氨酸羟化酶的调节

CNS Modulation of adrenal tyrosine hydroxylase in Parkinson's disease and metabolic encephalopathies.

作者信息

Riederer P, Rausch W D, Birkmayer W, Jellinger K, Seemann D

出版信息

J Neural Transm Suppl. 1978(14):121-31.

PMID:39974
Abstract

Tyrosine hydroxylase (TH) activity was assayed radioenzymatically in various regions of post-mortem brains of human individuals without neurologic disorders (controls), with Parkinson's disease, senile dementia, hypertensive encephalopathy, hepatic and diabetic coma, liver cirrhosis without coma, and hepatic coma treated with parenteral administration of L-valine. In addition TH activity of the post-mortem adrenal medulla was assayed in controls, in Parkinson's disease, senile dementia and hypertensive encephalopathy. In Parkinson's disease TH activity was significantly decreased in the nigrostriatal system, and less severe in other brainstem areas, while the raphé-reticular formation and limbic system showed normal values. In addition, there was significant decrease in the TH activity of the adrenal medulla, suggesting that Parkinson's disease is a generalized disorder not limited to distinct CNS areas, and that impairment of the dopaminergic niggro-striatal system may involve the TH activity in the adrenal medulla, thus inducing disorders of the peripheral sympathetic system. Senile brain atrophy showed no definite changes in brain, except the striatum, and adrenomedullary TH, while in one case of hypertensive encephalopathy due to long-term corticosteroid treatment normal TH activity in the adrenal medulla was opposed by decreased striatal TH activity, probably due to cerebral ischemia. TH activity in the caudate nucleus of individuals with both hepatic and diabetic coma were within normal ranges, suggesting a sufficient energy supply of the brain during such metabolic catastrophes, while reduced brain TH activity in patients with hepatic coma who died of acute gastrointestinal bleeding is probably due to severe final cerebral ischemia. No correlative data on brain and adrenomedullary TH activities in metabolic encephalopathies are available so far.

摘要

采用放射酶法测定了无神经系统疾病个体(对照组)、帕金森病患者、老年痴呆患者、高血压脑病患者、肝昏迷和糖尿病昏迷患者、无昏迷的肝硬化患者以及经胃肠外给予L-缬氨酸治疗的肝昏迷患者尸检脑不同区域的酪氨酸羟化酶(TH)活性。此外,还测定了对照组、帕金森病患者、老年痴呆患者和高血压脑病患者尸检肾上腺髓质的TH活性。帕金森病患者黑质纹状体系统的TH活性显著降低,在其他脑干区域降低程度较轻,而中缝-网状结构和边缘系统的TH活性值正常。此外,肾上腺髓质的TH活性也显著降低,提示帕金森病是一种全身性疾病,不限于特定的中枢神经系统区域,多巴胺能黑质-纹状体系统受损可能累及肾上腺髓质的TH活性,从而导致外周交感神经系统紊乱。老年脑萎缩除纹状体和肾上腺髓质TH外,脑内未见明确变化,而1例因长期使用皮质类固醇治疗导致的高血压脑病患者,肾上腺髓质TH活性正常,但纹状体TH活性降低,可能是由于脑缺血所致。肝昏迷和糖尿病昏迷患者尾状核的TH活性在正常范围内,提示在这种代谢性灾难期间脑能量供应充足,而死于急性胃肠道出血的肝昏迷患者脑TH活性降低可能是由于严重的终末期脑缺血所致。目前尚无关于代谢性脑病脑和肾上腺髓质TH活性的相关数据。

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