浅谈胶质细胞在帕金森病中的双重作用

帕金森病是中老年人常见的中枢神经系统变性疾病.胶质细胞与帕金森病相关,一方面,它能促进神经元的存活;另一方面,它又参与多巴胺能神经元的变性,促进帕金森病的发生和发展.该文就胶质细胞在帕金森病中可能发生的保护和毒性作用及其机制作一综述.     

帕金森病与胶质细胞

帕金森病是中老年人常见的中枢神经系统变性疾病.胶质细胞与帕金森病相关,一方面,它能促进神经元的存活;另眄一方面,它又参与多巴胺能神经元的变性,促进帕金森病的发生和发展.该文就胶质细胞在帕金森病中可能发生的保护和毒性作用及其机制作一综述.     

胶质细胞与细胞因子在帕金森病病理变化中的作用

帕金森病(Parkinson’s disease，PD)是一种以中脑黑质多巴胺能神经元进行性变性丧失为特征，同时伴随有小胶质细胞与星形胶质细胞的增生。目前许多研究证明胶质细胞增生的同时，会产生许多炎症原细胞因子，如：IL-1β、IL-6、TNF-α、IFN-γ、IL-10、iNOS以及一些神经营养因子等。而这些细胞因子在帕金森病中可能促进神经变性，而神经营养因子可能对神经元起着保护作用。     

NLRP3介导神经炎性反应在帕金森病中的研究进展

帕金森病(Parkinson disease, PD)是一种神经退行性疾病, 主要病理表现为中脑黑质多巴胺能神经元的变性、死亡导致纹状体多巴胺缺乏, 以及细胞内出现α-突触核蛋白(α-synuclein)聚集体。中脑黑质小胶质细胞过度激活介导的NLRP3炎性小体活化引起的炎性反应促进了多巴胺能神经元的退变, 在PD的发生发展中具有关键作用。α-synuclein聚集、线粒体功能障碍、自噬及多巴胺受体缺陷是小胶质细胞NLRP3炎性小体激活介导的黑质神经元退行性变的关键调节因素。本文就小胶质细胞NLRP3炎性小体激活及调节的分子机制在PD中的作用进行综述, 并探讨主要的靶向NLRP3炎性小体激活机制的潜在PD治疗靶点或方法, 以期为PD治疗提供理论依据和启示。     

帕金森病与炎症相关的研究进展

帕金森病是一种进展性的中枢神经系统变性疾病,主要病理特征是黑质多巴胺能神经元变性死亡和脑干神经元内α突触核蛋白积聚形成路易体。其病因主要为遗传因素和环境因素。该病主要会引起静止性震颤、运动迟缓、肌肉僵直等一系列的运动症状。然而其发病机制并不明确,主要可能与线粒体功能障碍、氧化应激、蛋白质改变及炎症反应相关。小胶质细胞与炎症反应密切相关,而小胶质细胞过度激活是帕金森病发病的病理生理基础。血清炎症因子升高与帕金森病有关,可用于早期诊断并预测疾病预后。目前抗炎治疗成为帕金森病新的研究热点。该文主要综述帕金森病的炎症机制、相关的炎症因子及抗炎药物的研究进展。     

α-Synuclein诱发的小胶质细胞激活在帕金森病发生发展中的作用

帕金森病是一种进行性的神经退行性疾病,主要病理学特征是黑质致密部多巴胺能神经元死亡和胞质内出现以聚集化的α-Synuclein为主要成分的路易小体。在帕金森病发生发展过程中有以激活的小胶质细胞为主要特征的炎症反应发生,但是,此类炎症反应的具体机制目前还不清楚。最近的一些研究表明,单体、聚集化、突变、硝化的α-Synuclein可以激活小胶质细胞,激活的小胶质细胞通过释放细胞毒性因子,最终对多巴胺能神经元产生细胞毒性。该文尝试总结α-Synuclein诱发的小胶质细胞激活与帕金森病发生发展之间的关系,并探讨其可能的作用机制。     

小胶质细胞激活在多巴胺神经元变性损伤中的作用

帕金森病（Parkinson’s disease,PD）的主要病理特征是黑质纹状体通路的多巴胺（dopamine,DA）神经元退行性变性和缺失。研究表明,小胶质细胞（microglia）激活在DA神经元变性损伤中起关键作用。在受到各种病理因素刺激时,小胶质细胞大量激活,产生前炎性细胞因子和神经毒性因子,启动或加重神经元损伤,导致DA神经元进行性变性死亡。文章综述了近年来关于小胶质细胞激活对DA神经元损伤作用的研究进展,以期对PD发病机制及治疗药物研究提供参考。     

α-Synuclein诱发的小胶质细胞激活在帕金森病发生发展叶的作用

帕金森病是一种进行性的神经退行性疾病,主要病理学特征是黑质致密部多巴胺能神经元死亡和胞质内出现以聚集化的α-Synuclein为主要成分的路易小体.在帕金森病发生发展过程中有以激活的小胶质细胞为主要特征的炎症反应发生,但是,此类炎症反应的具体机制目前还不清楚.最近的一些研究表明,单体、聚集化、突变、硝化的α-Synuclein可以激活小胶质细胞,激活的小胶质细胞通过释放细胞毒性因子,最终对多巴胺能神经元产生细胞毒性.该文尝试总结α-Synuclein诱发的小胶质细胞激活与帕金森病发生发展之间的关系,并探讨其可能的作用机制.     

血红素加氧酶在神经系统疾病中的表达

HO-1基因非常敏感,常被氧化剂等刺激而上调表达,在阿尔茨海默病的老年斑、神经原纤维缠结、淀粉样体的神经元和胶质细胞HO-1免疫反应明显的增强,在帕金森病中HO-1修饰受侵犯的多巴胺神经元的路易小体,并且在黑质的星形胶质细胞大量的表达,在多发性硬化、梗塞、出血及其他的变性或非变性神经系统疾病的神经胶质细胞,HO-1基因也上调表达。     

人参皂甙Rg1保护多巴胺能神经元的实验研究

帕金森病(PD)是中老年人常见的一种中枢神经系统变性疾病,其特征性病理变化是中脑黑质多巴胺能神经元变性坏死。近年来许多证据显示氧化应激反应增强是导致帕金森病黑质多巴胺能神经元凋亡的主要因素。传统的帕金森病治疗包括多巴胺替代疗法、抗胆碱能药物等,近年神经元保护治疗也逐步成为新的治疗热点。人参皂甙是从祖国传统中药人参中提取的有效成分之一,已有的研究提示,人参皂甙Rg1可保护大鼠大脑皮质神经细胞,防止细胞凋亡的发生。但是,人参皂甙 Rg1对多巴胺能神经元是否也有保护作用,     

基于帕金森病早期诊断的定量嗅觉检测应用分析

目的:对定量嗅觉检测在帕金森病早期诊断中的应用价值进行评价分析。方法:随机抽取在2009年5月～2012年5月间我院收治的帕金森病患者病例36例和同期健康体检者50例作为研究对象,对2组研究对象分别展开嗅觉定量检测,并对比分析检测结果。结果:统计发现,帕金森病组患者的嗅觉阈值明显高于健康组(P<0.05),且帕金森病患者的年龄、病程、H-Y分级、UPDRS等同嗅觉阈值之间无显著相关性。结论:对帕金森病患者展开嗅觉定量检测能够准确反应患者的嗅觉功能,对于早期诊断具有重要意义。     

Vim thalamic stimulation for tremor

Chronic stimulation of the ventral intermediate nucleus (Vim) of the thalamus is highly effective for the treatment of tremor. Patients with tremor associated with Parkinson's disease and essential tremor appear to respond best. Patients with cerebellar tremors may also respond but to a lesser extent. Although tremor is improved, Vim DBS does not substantially improve the daily living activities of patients with Parkinson's disease. This is related to the lack of effect on rigidity, bradykinesia, and gait and postural disturbances associated with Parkinson's. For this reason, the majority of patients with Parkinson's disease who require surgery are better treated with interventions in the globus pallidus or subthalamic nucleus, targets that allow improvement in all cardinal features of Parkinson's disease. In contrast, Vim DBS has unequivocal functional benefit in patients with essential tremor, this is likely to remain the major indication of this form of therapy. The mechanism of action of thalamic DBS is not understood and remains a research priority.     

帕金森氏病患者的记忆和情绪障碍

目的 探讨帕金森氏病患者记忆功能和情绪变化。方法 采用韦氏记忆量表及抑郁焦虑评定量表调查３９例患者,并与正常对照组比较。结果 帕金森氏病患者中记忆功能损害者占６６．６７％。抑郁５１．２％,焦虑５４．８％;焦虑、抑郁与临床症状严重程度,社会支持满意度有密切相关。结论 焦虑、抑郁是帕铆钉林氏病常见的症状,同时可出现记忆功能下降。对此类患者应给与小剂量抗抑郁焦虑剂,并加强心理治疗。     

Use of complementary therapies and non-prescribed medication in patients with Parkinson's disease

Patients with Parkinson's disease resort to complementary therapy and non-prescribed medication in the hope of improving their quality of life. In the US 40% of patients with Parkinson's disease reported the use of at least one form of complementary therapy for Parkinson's disease. Data for the UK are limited. A structured questionnaire was administered to consecutive patients attending a Parkinson's disease clinic. Patients were excluded if they were cognitively impaired, if they were living in an institution, or if they declined to take part. The participants were asked about current and previous use of complementary therapy in general and Parkinson's disease in particular and were presented with an extensive list of complementary therapies and non-prescribed medications. The response rate was 90% and 80 patients met the inclusion criteria. Fifty four per cent (n=44) reported the use of at least one form of complementary therapy or non-prescribed medication either for Parkinson's disease or for some other indication, of whom 31 (38.7% of the total sample) used it solely for the treatment of Parkinson's disease. The most commonly used complementary therapies for Parkinson's disease were massage (n=9) and aromatherapy (n=8). Non-prescribed medication was mainly used for indications other than Parkinson's disease and the commonest drugs used were simple analgesics (n=7), cod liver oil (n=5), and multivitamins (n=4). The use of complementary therapy for Parkinson's disease correlated significantly (Pearson's r=0.44, p=0.01) with a younger age at diagnosis of Parkinson's disease. Comorbidity correlated significantly with complementary therapy use for indications other than Parkinson's disease (Pearson's r=0.29, p= 0.01). The use of complementary therapy for Parkinson's disease in this UK based clinic closely mimics that in the US. Non-pharmacological complementary therapy is mainly used for Parkinson's disease, while non-prescribed medication is more commonly used for other indications.     

Parkinson's disease and anxiety

There has been a recent surge of interest in the subject of anxiety in patients with Parkinson's disease. Up to 40% of patients with Parkinson's disease experience clinically significant anxiety. This anxiety may be a psychological reaction to the stress of the illness or may be related to the neurochemical changes of the disease itself. Antiparkinsonian drugs may have a role in the pathogenesis of the anxiety. The anxiety disorders in Parkinson's disease patients appear to be clustered in the panic disorder, phobic disorder, and generalised anxiety disorder areas. The degree of comorbidity between anxiety and depression in patients with Parkinson's disease is in excess of that found in patients without the disease and anxiety in combination with depression may represent a specific depressive subtype in Parkinson's disease. As yet, there is no trial evidence as to the treatment of anxiety in patients with Parkinson's disease.     

帕金森病震颤研究进展

帕金森病是一种常见的由神经系统退行性病变所引起的疾病,其以运动症状为主要临床表现。震颤作为常见的运动症状之一,极大困扰帕金森病患者,并严重影响其生活质量。临床治疗中,震颤也是帕金森病最难治疗的症状。有关震颤的发病机制,国内、外尚无定论,本文将对帕金森病震颤的发生机制作相应评述,冀望能为帕金森病震颤的诊疗提供一定思路。     

Is Parkinson's disease a homogeneous disorder--what is the burden of Parkinson's disease in India

Movement disorders are common neurological illnesses among the elderly. These include essential tremor, Perkinsonian disorders and chorea of different aetiologies. Parkinsonian disorders can be divided into two major groups of disorders--classical idiopathic Parkinson's disease and Parkinson plus syndrome. The most common and important cause of Parkinsonism is idiopathic Parkinson's disease. Idiopathic Parkinson's disease is most confidently clinically diagnosed if we follow the United Kingdom Parkinson's Disease Society Brain Bank Diagnostic Criteria for Parkinson's disease. The most common degnerative diseases, which minic idiopathic Parkinson's disease are collectively called Parkinson plus syndrome. The most important diseases comprising Parkinson plus syndrome are: progressive supranuclear palsy, multiple system atrophy, cortical-basal ganglionic degneration, diffuse Lewy body disease and Parkinson-dementia-ALS complex. In India the prevalence of Parkinson's disease varied markedly from one study to another. The prevalence rate is high among the urban Parsi community of Mumbai. Incidence and prevalence of Parkinson's disease increase with increasing age. Some risk factors for Parkinson's disease have been narrated briefly. As the number of cases of Parkinsonism is likely to increase along with increasing population, the general practitioners or consultant physicans should have to play a greater role referring the cases to attend neurologists or movement disorder clinic early.     

帕金森病分子病理机制研究进展

帕金森病（Parkinson's disease,PD）是一种中老年常见的神经系统退行性疾病,PD的主要病理特点是黑质致密部的多巴胺能神经元丢失,进而使纹状体内的多巴胺水平降低。目前,PD的发病原因尚不完全清楚,本文从遗传因素、环境因素、线粒体功能障碍、氧化应激、氮化应激、免疫炎性反应异常、细胞凋亡学说和神经递质失衡等方面系统总结了近年来PD的病理机制,深入了解 PD 发病机制,为PD的进一步研究提供理论依据。     

老年帕金森病患者智能和生活质量状况的对照观察

目的 了解老年帕金森病患的智能和生活质量状况。方法 采用龚耀先修订的《韦氏成人智力量表》、诺丁汉健康问卷和生活满意度Z量表评定42例老年帕金森病患的状况，与45例老年非帕金森病患和健康老人对照。结果 老年帕金森病患的智能和生活质量差于老年非帕金森病患和健康老人。语言、操作及智商各项均显低于老年非帕金森病患组及老年健康组；生活质量差主要表现在躯体活动、性生活、家务、嗜好和社会活动方面；生活满意度也以老年帕金森病患为差。结论 老年帕金森病患存在明显的智能障碍，生活质量和生活满意度均低于老年非帕金森病患组及老年健康组，心理干预有利于改善老年帕金森病患的生活质量。     

A community survey of Parkinson's disease.

In a rural community of 80,000 people 69 patients were identified as having a diagnosis of Parkinson's disease. After interview and examination we found that 55 met the generally accepted diagnostic criteria for Parkinson's disease, 4 had possible Parkinson's disease, 6 had essential tremor, 2 had dementia and 2 had other conditions. The patients with Parkinson's disease had clinical and epidemiologic characteristics similar to those of patients in previous, mainly hospital-based, studies. These characteristics included mean age at onset (63 years), frequency rate of dementia (20%) and presence of postural tremor (11%). The pattern of treatment varied, some patients receiving more medication than is usual for the severity of their illness, and some patients receiving less than is usual. Parkinson's disease can be difficult to diagnose and manage because of the clinical variation between patients in presentation and response to treatment.