甲基维生素B12对多发性硬化模型大鼠的作用

研究甲基维生素Bi2对脱髓鞘的修复作用.以实验性自身免疫性脑脊髓炎作为多发性硬化的动物模型.用豚鼠脊髓匀浆和完全弗氏佐剂诱导Lewis大鼠发生实验性自身免疫性脑脊髓炎(experimental auto-immuneencephalomyelitis,EAE),给予不同剂量的甲基维生素B12,观察体重变化、神经系统评分和组织学检查.注射甲基维生素B12(266 μg/kg,532μg/kg)增加大鼠的缓解比例,由35.7%增至60%.降低死亡率,由52.3%降为16.70%,减少体重(g)下降量,由18.9±15.6降到4.8±9.5.组织学检查证实甲基维生素B12有促进髓鞘修复的作用.提示,较大剂量甲基维生素B12对多发性硬化模型大鼠有确切良好作用.     

实验性自身免疫性脑脊髓炎和多发性硬化研究的新动向

介绍近年IFN-γI、L-12家族和趋化因子对实验性自身免疫性脑脊髓炎和多发性硬化作用的新进展。     

多发性硬化和实验性自身免疫性脑脊髓炎中的轴突损伤

本文综述了多发性硬化和实验性自身免疫性脑脊髓炎中轴突损伤的研究进展,包括疾病早期、起始阶段的轴突损伤及其机制,影像及组织学表现正常的白质内的轴突变性,多发性硬化灰质内的轴突损伤,长病程多发性硬化病变内的轴突缺失等方面,并提出可能的干预措施及存在的问题。     

Th17细胞与多发性硬化/实验性自身免疫性脑脊髓炎

多发性硬化(multiple sclerosis,MS)及其理想动物模型实验性自身免疫性脑脊髓炎(experimental autoimmune encephalomyelitis,EAE)是主要累及中枢神经系统的自身免疫性疾病.     

维生素D和多发性硬化

维生素D水平变化与多发性硬化的发生有密切的关系,维生素D受体基因多态性与多发性硬化相关。维生素D的活性形式骨化三醇可以预防多发性硬化的模型——实验性变态反应性脑脊髓炎或阻断其进展。对维生素D进行深入研究,对寻找防治多发性硬化的新药具有重要意义。     

雌激素对实验性变态反应性脑脊髓炎大鼠发病影响的研究

目的探讨雌激素对实验性变态反应性脑脊髓炎(EAE)的影响。方法将30只大鼠随机分为EAE组及大、小剂量雌激素干预组,每组10只,制作EAE模型,大、小剂量雌激素干预组分别给予皮下注射苯甲酸雌二醇1 mg/kg/d、250μg/kg/d,连续10 d,观察各组的发病情况并采用HE染色观察脑和脊髓组织病理变化。结果大、小剂量雌激素干预组的临床症状均较EAE组轻,表现为发病率减少、潜伏期延长、进展期缩短、高峰期神经功能损害较轻。病理切片提示雌激素干预组脑和脊髓炎症细胞浸润明显减少,其中以大剂量组更明显。结论雌激素对多发性硬化动物模型EAE具有保护作用,且与剂量相关。     

复方中药制剂对实验性自身免疫性脑脊髓炎小鼠神经保护作用的研究

目的 探讨自制复方中药制剂对实验性自身免疫性脑脊髓炎(EAE)小鼠的疗效及相关机制.方法 选取SPF级雌性C57BL/6小鼠36只,采用皮下注射M OG35-55抗原免疫诱导EAE模型.将36只小鼠随机分为EA E模型组、中药组和激素组,每组各12只.自造模第14天起,中药组按体重20 g/kg给予自制复方中药灌胃,激...     

雄激素在实验性自身免疫性脑脊髓炎中的保护作用

多发性硬化(multiple sclerosis, MS)及其动物模型即实验性自身免疫性脑脊髓炎(experimental autoimmune encephalomyelitis,EAE)都具有性别差异,但其确切机制仍不清楚.近年来,大量研究发现雄激素与EAE的发病和病程有一定关系.此文就EAE存在的性别差异及雄激素在其中的作用做一综述.     

Th17细胞在多发性硬化发病过程中的作用

多发性硬化被认为是Th1细胞介导的自身免疫病。近年来,一种以分泌IL-17为特征的Th17细胞被发现与自身免疫反应有关。越来越多的证据表明,Th17细胞参与自身免疫性炎症的病理过程,在实验性自身免疫性脑脊髓炎和多发性硬化的发生发展过程中发挥着重要作用。其介导多发性硬化的具体机制仍不清楚,可能与破坏血脑屏障、诱导单核细胞扩增并分化为髓样树突状细胞以及促进炎性细胞因子网络的形成等有关。本文综述了关于Th17细胞的发现、分化以及在多发性硬化发病机制中的作用。     

苦参素对实验性自身免疫性脑脊髓炎大鼠血清干扰素-γ及肿瘤坏死因子-α表达的影响

背景：大量文献证实实验性自身免疫性脑脊髓炎的发生发展与干扰素-γ和肿瘤坏死因子-α的表达增高有关。 目的：验证不同剂量的苦参素对实验性自身免疫性脑脊髓炎大鼠血清中干扰素-γ和肿瘤坏死因子-α表达的影响。设计、时间及地点：对比观察实验,于2008-07/12在河南省中医药研究院和郑州大学第一附属医院完成。材料：清洁级Wistar大鼠40只,鼠龄6~8周,体质量180~220 g,建立实验性自身免疫性脑脊髓炎模型;苦参素注射液为正大天晴药业股份有限公司产品。方法：40只大鼠随机分成4组,每组大鼠均10只。应用豚鼠全脊髓匀浆和完全弗氏佐剂制成的抗原乳剂免疫Wistar大鼠建立实验性自身免疫性脑脊髓炎动物模型。模型组以6.7 mL/（kg•d）生理盐水16d腹腔注射,低剂量苦参素组以终浓度100mg/（kg•d）16d腹腔注射,高剂量苦参素组以终浓度150mg/（kg•d）16d腹腔注射,正常对照组干预方式同模型组。主要观察指标：造模后第16天应用苏木精-伊红染色观察实验大鼠脊髓组织病理学改变;酶联免疫吸附法检测实验大鼠血清中干扰素-γ的表达,放射免疫分析法检测实验大鼠血清中肿瘤坏死因子-α的表达;自造模当日起每日进行临床体征评分。结果：与模型组相比较,低剂量苦参素组和高剂量苦参素组大鼠临床体征评分降低（P<0.01）,脊髓内的炎性细胞浸润程度有所减轻,大鼠血清干扰素-γ和肿瘤坏死因子-α的表达水平均降低(P<0.01)。结论：苦参素能有效抑制实验性自身免疫性脑脊髓炎与其下调干扰素-γ和肿瘤坏死因子-α的表达有关。     

Epilepsy and anomalies of neuronal migration: MRI and clinical aspects

Neuronal migration disorders are the result of disturbed brain development. In such disorders, neurons are abnormally located. In diagnosing these conditions, magnetic resonance imaging is superior to any other imaging technique. This enables us to improve our knowledge of the clinical correlates of neuronal migration. With reference to migrational disorder, a retrospective study of all 303 patients with epileptic seizures referred for magnetic resonance imaging during a 3-year period was performed, 13 patients (aged 12-41, mean age 27) were identified. They represent 4.3% of the entire study group. Of the patients with known epilepsy, 6.7% and of the mentally retarded, 13.7% had migrational disorders. Four patients had schizencephaly as the dominant finding, one was classified as hemimegalencephaly, 2 had isolated heterotopias, and 6 had localized pachy- and/or poly-microgyria. The clinical pictures are complex. Ectopias of grey matter are recognised foci of epilepsy, but from an epileptological and a clinical viewpoint little attention has been given to these disorders. The present study shows that malmigration is not rare in epilepsy patients, especially not in the mentally retarded.     

Classification of methods in transcranial Electrical Stimulation (tES) and evolving strategy from historical approaches to contemporary innovations

Transcranial Electrical Stimulation (tES) encompasses all methods of non-invasive current application to the brain used in research and clinical practice. We present the first comprehensive and technical review, explaining the evolution of tES in both terminology and dosage over the past 100 years of research to present day. Current transcranial Pulsed Current Stimulation (tPCS) approaches such as Cranial Electrotherapy Stimulation (CES) descended from Electrosleep (ES) through Cranial Electro-stimulation Therapy (CET), Transcerebral Electrotherapy (TCET), and NeuroElectric Therapy (NET) while others like Transcutaneous Cranial Electrical Stimulation (TCES) descended from Electroanesthesia (EA) through Limoge, and Interferential Stimulation. Prior to a contemporary resurgence in interest, variations of transcranial Direct Current Stimulation were explored intermittently, including Polarizing current, Galvanic Vestibular Stimulation (GVS), and Transcranial Micropolarization. The development of these approaches alongside Electroconvulsive Therapy (ECT) and pharmacological developments are considered. Both the roots and unique features of contemporary approaches such as transcranial Alternating Current Stimulation (tACS) and transcranial Random Noise Stimulation (tRNS) are discussed. Trends and incremental developments in electrode montage and waveform spanning decades are presented leading to the present day. Commercial devices, seminal conferences, and regulatory decisions are noted. We conclude with six rules on how increasing medical and technological sophistication may now be leveraged for broader success and adoption of tES.     

Hepatic Considerations in the Use of Antiepileptic Drugs

Summary: Virtually all of the major antiepileptic drugs (AEDs) can cause hepatotoxicity, although fatal hepatic reactions are rare. The mechanisms, incidences, and risk profiles for such reactions differ from drug to drug. With carbamazepine and phenytoin, hepatotoxicity may be due to drug hypersensitivity. Although the profiles of patients at risk have not been well-defined for these two antiepileptic drugs, it would appear from reports in the literature that older adolescents and adults are at higher risk than children of developing serious or fatal hepatotoxicity. Once hepatotoxicity develops, mortality rates are 10–38% with phenytoin and 25% for carbamazepine. The risk profile for valproate fatal hepatotoxicity has been more clearly defined. Those at primary risk of fatal hepatic dysfunction are children under the age of 2 years who are receiving multiple anticonvulsants and also have significant medical problems in addition to severe epilepsy. The risk is considerably lower for patients over the age of 2 years on valproate monotherapy. In contrast to the risk profile with other AEDs, adults receiving valproate as monotherapy have the lowest risk of hepatotoxicity. Fatal hepatic dysfunction coincident with valproate may be the result of aberrant drug metabolism. Concomitant use of AEDs that induce microsomal P450 enzymes (e.g., phenytoin and phenobarbital) may enhance the production of a toxic metabolite, and hence the greater risk of hepatotoxicity with polypharmacy.     

Vascular Malformations and Epilepsy: Clinical Considerations and Basic Mechanisms

Summary: Vascular malformations (VMs) are associated with epilepsy. The natural history of the various VMs, clinical presentation, and tendency to provoke epilepsy determine treatment strategies. Investigations have probed the mechanisms of epileptogenesis associated with these lesions. Electrophysiologic changes are associated with epileptogenic cortex adjacent to VMs. Putative pathophysiologic mechanisms of epileptogenesis include neuronal cell loss, glial proliferation and abnormal glial physiology, altered neurotransmitter levels, free radical formation, and aberrant second messenger physiology.     

Neonatal Seizures: Problems in Diagnosis and Classification

Summary: The clinical identification of neonatal seizures is critical for the recognition of brain dysfunction; however, diagnosis is often difficult because of the poorly organized and varied nature of these behaviors. Current classification systems are limited in their ability to communicate motor, autonomic, and electroencephalo-graphic features of seizures precisely and to provide a basis for uniform effective diagnosis, therapy, and determination of prognosis. Recent investigations of neonates, utilizing bedside electroencephalographic/polygraphic/ video monitoring techniques, have provided the basis for improved diagnosis and classification of seizures in the newborn. These studies have demonstrated that not all clinical phenomena currently considered to be seizures require electrocortical epileptiform activity for their initiation or elaboration. In addition, the specific clinical character of the phenomena considered to be seizures, the clinical state of the infant, and the character of the EEG indicate the probable pathophysiological mechanisms involved and suggest probable etiologies, prognosis, and therapy. Similarities between animal models that demonstrate reflex physiology and neonates with motor automatisms and tonic posturing suggest that these clinical behaviors may not be epileptic in origin but, rather, primitive movements of progression and posture mediated by brainstem mechanisms. Although not all clinical behaviors currently considered to be neonatal seizures may have similar pathophysiological mechanisms, they are clinically significant because they all indicate brain dysfunction.     

Valproate Monotherapy in the Management of Generalized and Partial Seizures

Summary: For decades, therapeutic tradition has promoted the concept of polypharmacy in the management of epilepsy. In recent years, however, studies have shown that, for most patients, monotherapy can provide comparable or better seizure control than administration of multiple anticonvulsants, while diminishing the potential for adverse reactions, drug interactions, and poor compliance. Valproate is an important monotherapeutic agent that is highly effective in the control of idiopathic primary and secondarily generalized epilepsies, and partial seizures that do not generalize. Comparative studies have found that valproate is at least as effective as phenytoin and carbamazepine in the treatment of generalized and partial seizures. Given the similar efficacy, other factors such as pharmacokinetics and side effects may therefore determine anticonvulsant selection for monotherapy.     

Carbamazepine Efficacy and Utilization in Children

Summary: Carbamazepine is effective for preventing partial and generalized tonic-clonic seizures in children. Although absence epilepsies are more common in children than adults, an estimated 80% of children with epilepsy have seizure types or epilepsies that are potentially responsive to carbamazepine. The differential diagnosis of ictal staring is an especially important issue in children because absence and atypical absence seizures are more prevalent in children than adults. Age-related pharmacokinetic differences and drug interactions are major considerations in children. On average, children have higher clearance rates of carbamazepine, shorter half-lives, and higher ratios of carbamazepine-10, 11-epoxide to carbamazepine than adults. In addition, children with severe epilepsy are more likely to require multiple-drug therapy, which can lead to complex drug interactions. When carbamazepine is administered along with valproate, drug protein binding interactions can cause intermittent side effects.     

Un nouveau cadre conceptuel de travail pour la psychiatrie

In an attempt to place psychiatric thinking and the training of future psychiatrists more centrally into the context of modern biology, the author outlines the beginnings of a new intellectual framework for psychiatry that derives from current biological thinking about the relationship of mind to brain. The purpose of this framework is twofold. First, it is designed to emphasize that the professional requirements for future psychiatrists will demand a greater knowledge of the structure and functioning of the brain than is currently available in most training programs. Second, it is designed to illustrate that the unique domain which psychiatry occupies within academic medicine, the analysis of the interaction between social and biological determinants of behavior, can best be studied by also having a full understanding of the biological components of behavior.