骨髓基质细胞源性神经干细胞体外分化及电生理特性的研究

目的探索骨髓基质细胞(BMSCs)诱导分化为神经干细胞(NSCs),比较血清、维甲酸(RA)、胶质细胞源神经营养因子(GDNF)、脑源性神经营养因子(BDNF)及2-巯基乙醇(2-ME)等不同浓度诱导条件下BMSCs分化情况,以及分化细胞的电生理特性。方法以恒河猴骨髓中分离出的BMSCs为实验对象,利用神经干细胞培养基和RA、GDNF、BDNF、2-ME等生长因子在不同血清浓度下进行培养增殖和诱导分化。Nestin、CD133抗体免疫细胞化学染色鉴定NSCs,NSE、β-tublin鉴定神经元、GFAP鉴定神经胶质细胞。膜片钳检测细胞的电生理特性。结果低浓度血清(2.5%)+RA(0.3mg/L)+GDNF(20μg/L)诱导分化效果较好,且分化的神经元样细胞较未分化细胞的膜特性[静息膜电位(RMP)、膜电容(Cm)、串联电阻值(Rs)]有了显著改变(P﹤0.01)。部分形态成熟的神经元样细胞表现出TTX敏感的快速激活、快速失活的电压依赖性的Na+通道,而未分化细胞却未记录到内向电流;两类细胞均可记录到外向的K+电流,但神经元样细胞的电流峰值强度要显著高于未分化细胞,并且包括两种电流成分:瞬时外向K+电流和延迟整流型的K+电流。结论RA+GDNF及配合使用低浓度血清能够有效诱导骨髓源神经干细胞向成熟神经系细胞分化,且分化的神经元样细胞具有快速激活、快速失活的电压依赖性Na+通道,类似神经细胞的电生理特性。     

甘丙肽在离体新生大鼠三叉神经主核神经元引发的两种不同膜电位和膜电流

运用细胞内记录和全细胞膜片钳技术 ,在 7～ 16d大鼠带三叉神经残根的 4 0 0 μm厚脑桥切片上进行研究。细胞内电流钳记录显示三叉神经主核灌流甘丙肽引发两种膜电位变化 :54.2 %细胞超极化 (3.2±1.2 )mV ;35.4 %细胞去极化 (2 .9± 1.3)mV ,两者均伴有兴奋性突触后电位抑制和膜电阻减小。电压钳实验显示甘丙肽也引致两种膜电流变化 :57.9%细胞出现外向性电流 (11.6± 6 .1)pA ,该电流可被四乙基胺所抑制 ,其反转电位为 (- 77.1± 5.3)mV ;2 7.3%细胞出现内向性电流 (10 .9± 5.9)pA ,该电流可被细胞外低钠所抑制而被细胞外高钾所增强 ,其反转电位为 (- 2 9.2± 4 .3)mV。两电流均可被甘丙肽激动剂M16所模拟 ,为甘丙肽阻断剂M35和M4 0所阻抑。上述结果提示 ,甘丙肽在突触后膜引发两种不同的膜电活动 :钾离子外流引发超极化和外向性电流 ;钠离子内流和钾离子外流引发去极化和内向性电流 ,两种反应均能抑制三叉神经主核神经元的突触传递。     

单唾液酸四己糖神经节苷脂诱导成年大鼠骨髓基质细胞成为神经前体细胞及其分化作用的研究

目的 探讨单唾液酸四己糖神经节苷脂(GMI)在诱导成年大鼠骨髓基质细胞(MSCs)成为神经前体细胞及其分化中的作用。方法 取成年大鼠骨髓基质细胞,分别以碱性成纤维细胞生长因子(bFGF)、GMI和bFGF+GM1作为诱导物诱导,3 d后行纤维连接蛋白(fibronectin)、I型胶原(collagen I)免疫细胞化学及巢蛋白(Nestin)免疫荧光染色,7 d后行神经元特异烯醇化酶(NSE)、胶质纤维酸性蛋白(GFAP)及半乳糖脑苷脂(GalC)免疫细胞化学染色。结果 经bFGF或bFGF+GM1诱导后部分骨髓基质细胞转化为神经前体细胞样细胞,继而分化为神经元和星形胶质细胞样细胞,fibronectin、collagen I染色阳性细胞明显减少,Nestin、NSE和GFAP染色阳性细胞比例明显升高(分别为35.22％±4.27％,22.28％±2.97％和26.65％±3.17％),以bFGF+GMI组更为明显(42.17％±3.65％、30.35％±3.51％和32.22％±2.68％),而单独应用GM1无明显作用。结论 联合应用bFGF与GM1后,GM1可增强bFGF的诱导作用,提高MSCs转化,并促进其向神经元及星形胶质细胞样细胞分化。     

下丘脑神经元NMDA受体通道特性研究

目的通过对正常和缺氧条件下N-甲基-D-天冬氨酸(NMDA)受体通道特性进行研究,探讨下丘脑神经元缺氧损伤的机理,为临床防治脑缺血/缺氧损伤提供实验依据。方法取材于新生SD大鼠下丘脑视前区/下丘脑前区(PO/AH)神经元,应用膜片钳单通道记录技术对缺氧和非缺氧两种状态下NMDA受体特性进行研究,观察其在缺氧和非缺氧条件下的翻转电位、电流幅度、电导特性的变化。结果神经元缺氧后其通道内向电流幅值由平均(4.501±0.980) pA(n=20,40 mV)上升为(6.000±1.750) pA(n=16,40 mV),优势电导由非缺氧组的(45.693±1.850) pS (n=16)上升为(60.206±1.750) pS(n=10),而翻电位极为接近。结论缺氧是使NMDA受体通道过度激活和Ca2+大量内流的一外因条件。神经元缺氧时,同一钳制电压下其内向电流幅度明显高于对照组,优势电导也有明显上升,可以解释为缺氧引起了神经元Ca2+超载,从而介导了细胞的损伤和死亡。     

体外定向诱导人骨髓基质细胞分化为神经元样细胞三种方法的比较

目的观察比较不同的体外定向诱导培养方法对人骨髓基质细胞(骨髓间充质干细胞)分化为神经元样细胞的影响。方法分离、扩增培养人骨髓基质细胞,分别采用人重组纤维母细胞生长因子(FGF-2)和人重组脑源性神经营养因子(BDNF)、2-巯基乙醇(2-ME)以及硫代甘油(TG)等3种不同的诱导剂,诱导骨髓基质细胞分化为神经元样细胞。用神经元特异性烯醇化酶(NSE)和胶质纤维酸性蛋白(GFAP)免疫组织化学方法对已分化的神经元样细胞进行鉴定和分化率分析。结果经3种诱导剂诱导的人骨髓基质细胞均出现神经元样细胞的分化,胞体呈神经元状,伸出较长轴突样和树突样突起且有分支。免疫组化鉴定显示,诱导分化后的神经元样细胞NSE染色呈阳性,GFAP免疫组化染色均呈阴性,其中FGF-2+BDNF诱导组神经元样细胞分化率为(68.220±5.743)%;2-ME诱导组为(50.700±3.374)%;TG诱导组为(32.240±3.800)%,3组之间差异具有显著性意义(P<0.05)。结论人骨髓基质细胞能够在诱导剂的诱导下发挥横向分化能力,3种体外诱导培养方法均可诱导人骨髓基质细胞分化为神经元样细胞。     

星形胶质细胞诱导成年骨髓基质细胞分化成神经元样细胞的实验研究

目的探讨星形胶质细胞能否在体外诱导成年大鼠骨髓基质细胞向神经元方向分化。方法采用新生鼠海马组织来源的星形胶质细胞与转染有绿色荧光蛋白基因的骨髓基质细胞(MSCs)进行共培养,并分成三组:共培养组、共培养 脑源性神经营养因子(BDNF)组、单纯碱性成纤维生长因子(bFGF) BDNF诱导分化组,在相差显微镜下每日观察、记录MSCs的诱导分化状况,并应用免疫荧光染色技术对分化后的MSCs进行鉴定,同时应用流式细胞术测定MSCs分化前后及星形胶质细胞的DNA含量。结果共培养第4天,部分MSCs已初步具备神经元形态:折光性强的锥形或圆形胞体及长的多极突起,免疫荧光染色呈微管相关蛋白(MAP-2ab)、神经元特异性烯醇化酶(NSE)阳性;DNA的含量测定结果显示诱导分化后第7天未发现有四倍体、六倍体细胞。结论(1)星形胶质细胞可以在体外诱导成年大鼠MSCs向神经元方向分化,这种分化并不是由细胞融合引起的。(2)星形胶质细胞具有调控神经元的分化、促进神经元成熟的功能。     

大鼠骨髓基质干细胞体外分离、培养及分化的相关实验研究

目的探索大鼠骨髓基质干细胞(BMSC)体外分离、培养及纯化的合适实验条件,并探讨其在体外定向诱导分化为神经元样细胞的可行性。方法通过密度梯度离心法从成年大鼠骨髓中分离出BMSC,而后通过贴壁培养法培养及纯化,观察其生长特性;对纯化后的BMSC使用碱性成纤维生长因子(bFGF)和表皮生长因子(EGF)进行定向诱导分化,并进行免疫细胞化学鉴定。结果体外培养的BMSC传4代后,纯度最高,可达(95.23±3.06)%;其诱导分化7 d后,(75.43±7.63)%的细胞表现为-βTubulinⅢ阳性的神经元样细胞,(33.01±6.73)%的细胞则为GFAP阳性的胶质细胞。结论BMSC在体外培养条件下生长良好,经bFGF和EGF诱导后可大量分化为神经元样细胞和神经胶质细胞。     

成鼠骨髓基质细胞分化为神经元的体外研究

目的 :通过一定的培养条件 ,使骨髓基质细胞 (BMSC)分化为神经元和胶质细胞。方法 :以含有 EGF、b FGF的培养液培养 BMSC,经传代、换液去除杂质细胞 ,撤掉 EGF、 b FGF并加胶质细胞条件培养液及 BDNF,待细胞分化后进行形态学观察及 NSE、 GFAP染色。结果 :撤掉 EGF、 b FGF并加 BDNF,胶质细胞条件培养液后 2天可见分化细胞 ,NSE阳性细胞占细胞总数的 38.47± 3.2 7% ,GFAP阳性细胞占细胞总数的 5 0 .73± 3.2 6 % ,GFAP阳性细胞占细胞总数的 5 0 .73± 4.6 5 %。结论 :本实验通过 EGF、 b FGF及适宜的培养液成功对骨髓基质细胞进行定向 ,使其转化为神经干细胞并最终诱导其分化为神经元和胶质细胞     

骨髓基质细胞对神经-干细胞分化为神经元的影响

采用细胞共培养方式和免疫化学染色方法,研究骨髓基质细胞对神经干细胞分化为神经元、星形胶质细胞和寡突胶质细胞的影响.实验发现,体外培养的中脑神经干细胞在与成年大鼠骨髓基质细胞共培养7 d后,在神经干细胞后代中神经元比例可达38.6%±10.8%,明显高于自然分化组20%,提示骨髓基质细胞提供的微环境可明显提高神经干细胞后代中神经元的比例.     

骨髓基质细胞对神经干细胞分化为神经元的影响

采用细胞共培养方式和免疫化学染色方法 ,研究骨髓基质细胞对神经干细胞分化为神经元、星形胶质细胞和寡突胶质细胞的影响。实验发现 ,体外培养的中脑神经干细胞在与成年大鼠骨髓基质细胞共培养 7d后 ,在神经干细胞后代中神经元比例可达 38.6 %± 10 .8% ,明显高于自然分化组 2 0 % ,提示骨髓基质细胞提供的微环境可明显提高神经干细胞后代中神经元的比例。     

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.