McIntosh T K, Juhler M, Wieloch T
Department of Neurosurgery, University of Pennsylvania, Philadelphia 19104-6316, USA.
J Neurotrauma. 1998 Oct;15(10):731-69. doi: 10.1089/neu.1998.15.731.
The mechanisms underlying secondary or delayed cell death following traumatic brain injury are poorly understood. Recent evidence from experimental models suggests that widespread neuronal loss is progressive and continues in selectively vulnerable brain regions for months to years after the initial insult. The mechanisms underlying delayed cell death are believed to result, in part, from the release or activation of endogenous "autodestructive" pathways induced by the traumatic injury. The development of sophisticated neurochemical, histopathological and molecular techniques to study animal models of TBI have enabled researchers to begin to explore the cellular and genomic pathways that mediate cell damage and death. This new knowledge has stimulated the development of novel therapeutic agents designed to modify gene expression, synthesis, release, receptor or functional activity of these pathological factors with subsequent attenuation of cellular damage and improvement in behavioral function. This article represents a compendium of recent studies suggesting that modification of post-traumatic neurochemical and cellular events with targeted pharmacotherapy can promote functional recovery following traumatic injury to the central nervous system.
创伤性脑损伤后继发性或延迟性细胞死亡的潜在机制尚不清楚。实验模型的最新证据表明,广泛的神经元丢失是渐进性的,并且在最初损伤后的数月至数年中,在选择性易损脑区持续存在。延迟性细胞死亡的潜在机制被认为部分是由创伤性损伤诱导的内源性“自毁性”途径的释放或激活所致。用于研究创伤性脑损伤动物模型的先进神经化学、组织病理学和分子技术的发展,使研究人员能够开始探索介导细胞损伤和死亡的细胞和基因组途径。这些新知识推动了新型治疗药物的开发,这些药物旨在改变这些病理因素的基因表达、合成、释放、受体或功能活性,从而减轻细胞损伤并改善行为功能。本文汇总了近期的研究,表明通过靶向药物治疗来改变创伤后神经化学和细胞事件,可以促进中枢神经系统创伤性损伤后的功能恢复。