弥漫性轴索损伤后胶质反应及生化标记物的研究进展  

Advances in research on glial response and the biomarkers associated with diffuse axonal injury

作　　者：宋锦宁[1] 赵永林[1] 

机构地区：[1]西安交通大学医学院第一附属医院神经外科,陕西西安710061

出　　处：《西安交通大学学报（医学版）》2015年第1期1-10,共10页Journal of Xi’an Jiaotong University（Medical Sciences）

基　　金：国家自然科学基金资助项目(No.30471774);教育部新世纪优秀人才支持计划资助项目(No.NCET-05-0831);陕西省自然科学基金资助项目(No.2003C1-16)~~

摘　　要：弥漫性轴索损伤(diffuse axonal injury,DAI)后胶质反应与继发性轴索损伤、轴突再生及患者的预后密切相关,而且DAI后一些特异性生化标志物可以发生明显的变化。目前的研究表明,DAI后胶质细胞既能通过胶质瘢痕形成、炎症反应、髓鞘丢失等多种机制参与DAI后继发性损伤的发生,又能通过释放神经营养因子、清除细胞碎片、阻止病损蔓延等促进轴突修复和再生,胶质细胞之间、胶质细胞与神经元之间的相互作用是最终导致DAI后神经元死亡以及轴突继发性断裂的主要原因;DAI后β淀粉样蛋白、神经微丝和微管相关蛋白等特异性生化指标能更早期、更准确地显示DAI的发生与发展,将弥补影像学及临床特征诊断的不足。这些研究不但为DAI后神经保护及轴突再生提供治疗靶点,也为进一步研究并寻找新的DAI相关生化标记物提供理论依据。进一步阐明DAI后胶质细胞激活、胶质细胞与神经元相互作用、胶质细胞之间相互作用的相关分子机制及其复杂的病理生理过程,以及深入揭示DAI相关生化标志物的意义,对减轻DAI后脑损伤、促进轴突再生、提高DAI诊断及治疗水平具有重要意义。Glial response has been proved to be closely related to secondary injury, axonal regeneration and prognosis of patients, and several specific biochemical markers reveal significant changes after diffuse axonal injury （DAD. The existing studies show that glial cells are involved in secondary axonal injury by glial scar formation, neuro-inflammation and loss of myelin; and also in promoting axonal repair and regeneration by releasing neurotrophic factors, clearing cell debris and preventing the spread of lesions after DAI. The interactions of glial ceils with glial ceils and glial cells with neurons ultimately result in the death of neurons and secondary axonal injury. Specific biochemical markers, such as β-amyloid precursor protein, neurofilament and C-tau, can indicate the occurrence and development of DAI earlier and more accurately, and will make up for the defects of diagnostic imaging and clinical features of DA1. These studies not only provide therapeutic target for nerve protection and axonal regeneration after DAI, but also benefit further studying and looking for new DAI-related specific biochemical markers. Further exploring the molecular mechanisms of activation of glial cells, gliat-glial interaction and glial- neuron interaction, revealing the evolvement of these complex pathophysiological processes and the potential function of DAl-related biochemical markers are of great significance in reducing brain injury, promoting axonal regeneration and improving the ability of diagnosis and treatment of DA1.

关 键 词：颅脑损伤 弥漫性轴索损伤 胶质反应 生化标记物 

分 类 号：R651.15[医药卫生—外科学]