胶质细胞源性神经营养因子对神经组织缺血性损伤的保护作用及其在脊髓损伤修复中的应用前景

目的:总结胶质细胞源性神经营养因子对神经组织缺血性损伤的影响,以及微囊化技术发展情况,探讨该种营养因子用于脊髓损伤修复的可能性。资料来源:检索Medline1996-01/2000-10与胶质细胞源性神经营养因子和神经组织缺血性损伤、脊髓损伤及其与微囊化技术相关的文章熏检索词“glialcellline-derivedneurotrophicfactor熏ischemiadamagetonervetissue熏spinalcordinjury”熏并限定文章语言种类为English。检索万方数据库2001-01/2004-10胶质细胞源性神经营养因子与神经组织缺血性损伤、脊髓损伤关系及其与微囊化技术相关熏限定文章语言种类为中文熏检索词“胶质细胞源性神经营养因子,神经组织缺血性损伤,脊髓损伤,微囊化技术”。资料选择:对资料进行初审,选取包括处理组和对照组的文献,根据数据库文献摘要提供的信息,筛除明显不随机的研究,对剩余的文献开始查找全文。纳入标准为①随机对照研究;②实验或临床研究包含平行对照组。排除标准:重复性研究。资料提炼:共收集到300篇关于胶质细胞源性神经营养因子与缺血性损伤和脊髓损伤的随机和未随机研究文章,15个实验或临床研究符合纳入标准。排除的285篇文章中,264篇为未随机研究或重复性研究,21篇为综述类文章。资料综合:胶质细胞源性神经营养因子对大鼠中脑多巴胺能神经元有营养支持作用;可使多巴胺神经元细胞死亡减少,轴突再生。胶质细胞源性神经营养因子可使脑梗死大鼠大脑半球免于自由基、钙超载等缺血性损伤,阻止缺血后一氧化氮的产生及再灌注损伤,是对抗缺血性损伤的有效保护因子。微囊化技术在内分泌疾病和神经系统疾病等治疗方面,显示出良好前景,营养因子可能在微囊化技术中发展重要作用。结论:胶质细胞源性神经营养因子对神经组织缺血性损伤起到保护作用,微囊化技术的发展促进该种营养因子发挥作用;胶质细胞源性神经营养因子在临床脊髓修复方面具有良好前景。

Protective effect of glial cell line-derived neurotrophic factor against ischemia damage to nerve tissue and its application prospect in repair of spinal cord injury

OBJECTIVE: To summarize the effects of glial cell line-derived neurotrophic factor (GDNF) on ischemia damage to nerve tissue and discuss the possibility of GDNF in repair of spinal cord injury based on the development of microencapsulation technology.DATA SOURCES: A search of Medline from January 1996 to October 2000 was performed for the English articles related to GDNF, ischemia damage to nerve tissue, spinal cord injury and microencapsulation technology by using the key words "glial cell line-derived neurotrophic factor, ischemia damage to nerve tissue, spinal cord injury". Meanwhile, we retrieved Wangfang database for search of the related articles in Chinese by using the same keywords in Chinese.STUDY SELECTION: Articles including intervention group and control group were selected after first review, and those which were significantly non-randomized researches were excluded. Then, the full-texts of the enrolled articles were retrieved. Inclusion criteria: ①randomized controlled study; ②the experiment/clinical research including horizontal control group. Exclusion criteria: duplicated researches.DATA EXTRACTION: Totally 300 articles were selected but only 15 were in coincidence with conclusion criteria. 285 articles were excluded, 264 of them were duplicated and non-randomized researches, and 21 were review articles.DATA SYNTHESIS: GDNF can provide nutrition to dopamine nerve cell in rat's middle brain, so as to decrease dopamine nerve cell's death. Also GDNF can protect dopamine nerve cell in cerebral infarction rats from ischemic injury, inhibit the produce of nitrogen monoxide and reperfusion injury after ischemia. GDNF is an effective protective factor against ischemia damage. Microencapsulation technology has a bright future in treating endocrinopathic neural diseases, and GDNF can play a great role in the development of microencapsulation technology.CONCLUSION: GDNF is a protective factor against ischemia damage to nerve tissue, which can be enhanced by microencapsulation technology.There is a bright future for the research on GDNF in the clinical repair of spinal cord injury.