• 来稿:陈琳   北京市虹天济神经科学研究院

  • Alzheimer Dis Assoc Disord. 2005 Oct-Dec;19(4):226-39.

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  • Neuroprotection and neurodegenerative  diseases: from biology to clinical practice

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  • Akwa Y, Allain H, Bentue-Ferrer D, Berr  C, Bordet R, Geerts H, Nieoullon A, Onteniente B, Vercelletto  M.

  • INSERM U488, Le Kremlin-Bicêtre, France.

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  • Neurodegenerative diseases and, in  particular, Alzheimer disease, are characterized by progressive neuronal loss  correlated in time with the symptoms of the disease considered. Whereas the  symptoms of those incapacitating diseases are beginning to be managed with a  relative efficacy, the ultimate objective of therapy nonetheless remains  preventing cell (neuronal and/or astrocytic) death in a neurocytoprotective  approach. In biologic terms, in the light of progress at basic research level,  three strategies may be envisaged: (1) antagonizing the cytotoxic causal events  (excess intracellular calcium, accumulation of abnormal proteins, excitotoxic  effects of amino acids, oxidative stress, processes related to inflammation,  etc.); (2) stimulating the endogenous protective processes (anti-free radical or  DNA repair systems, production of neurotrophic factors, potential cytoprotective  action of steroids, etc.); (3) promoting damaged structure repair strategies  (grafts) or deep brain or cortical neurostimulation with a view to triggering  (beyond the symptomatic actions) potential 'protective' cell mechanisms. The  clinical transition of the various strategies whose efficacy is being tested in  animal and/or cell models, experimental analogs of the diseases, and thus the  objective demonstration in humans of pharmacological and/or surgical  neurocytoprotection, is currently the subject of considerable methodological  debate (What are the right psychometric assessment criteria? What are the most  pertinent laboratory or neuroradiological markers, etc.?). A number of clinical  trials have been completed or are ongoing with drugs that are reputed to be  neuroprotective. Thus, elements of the response are beginning to be generated  with a view to determining whether it will soon be possible to effectively slow  or even stop the neurodegenerative process whose etiology, in most cases,  remains obscure.

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干细胞治疗颞叶性癫痫展望
脊髓损伤修复:海潮前的涟漪,或我40年的研究是如何进行的

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神经保护与神经退行性疾病:从生物学到临床应用