Notch信号在盐酸法舒地尔诱导大鼠骨髓间充质干细胞向神经细胞分化过程中的作用

目的 探讨Notch1信号通路在盐酸法舒地尔诱导大鼠骨髓间充质干细胞（MSCs）向神经细胞分化中的作用。方法 实验分为未转染组、转染组（转染Rn-Notch1-siRNA）、阳性对照组（转染Rn-MAPK-1 Control siRNA）及阴性对照组（转染Negative Control siRNA）等4组。采用盐酸法舒地尔诱导大鼠MSCs分化为神经细胞。倒置荧光显微镜下观察MSCs转染后荧光表达情况;RT-PCR检测Notch1、Hes1和MAPK1 mRNA的表达变化;免疫细胞化学法检测Notch1、神经元巢蛋白（Nestin） 、神经微丝蛋白亚单位(NF-M) 和胶质纤维酸性蛋白（GFAP）的表达变化;MTT方法检测细胞存活率。结果 1. siRNA转染72h,MSCs荧光表达最强, 转染率可达91.3%±4.2%;同时,转染组MSCs的Notch1和Hes1 mRNA转录下降（P<0.05）;MTT提示转染组细胞存活率也显著减少（P<0.05）。2. 盐酸法舒地尔可以诱导MSCs向神经细胞分化,其中以转染组诱导效果最佳,Nestin、NF-M的表达率显著的高于其它各组（P<0.05）。结论 盐酸法舒地尔在诱导大鼠MSCs向神经细胞分化过程中,可能存在Notch信号通路与RhoA/Rho激酶通路信号的协同作用,共同促进MSCs向神经细胞分化。     

碱性成纤维细胞生长因子预诱导对骨髓基质干细胞向多巴胺能神经元分化的影响

目的探讨碱性成纤维细胞生长因子（bFGF）预诱导对骨髓基质干细胞（MSCs）向多巴胺（DA）能神经元分化的影响。方法取雄性Wistar大鼠股骨和胫骨骨髓,进行MSCs的体外培养、传代扩增及纯化。bFGF预诱导24h后,依据加入的神经营养因子不同分为单唾液酸四己糖神经节苷脂（GMl）组、胶质源性神经营养因子（GDNF）组和GDNF＋GMl组,以及对照组。倒置显微镜下观察细胞形态变化,分别在预诱导第3d、7d进行神经元特异性烯醇化酶（NSE）、神经胶质酸性蛋白（GFAP）、酪氨酸羟化酶（TH）免疫细胞化学检测。计数NSE和TH阳性细胞数,并计算阳性细胞百分比。结果对照组见少量NSE阳性细胞。实验组于诱导第3d、7d见较多数量的NSE、TH阳性细胞,GFAP阴性。bFGF预诱导各组中GDNF＋GMl组NSE、TH阳性细胞率最高,GDNF组次之,GMl组最低,组间比较差异有统计学意义（均P〈0．01）。结论bF—GF预诱导不仅可明显促进GDNF、GMl诱导MSCs向神经元样细胞分化,表达神经元细胞标志物——NSE;还可促进MSCs向DA能神经元分化,表达DA能神经元标志物——TH。     

音速波状蛋白促进骨髓间充质干细胞向多巴胺能神经元分化

目的探讨音速波状蛋白（Shh）促进人骨髓间充质干细胞（MSCs）体外定向分化为多巴胺能神经元样细胞的作用。方法体外分离、扩增和鉴定人骨髓MSCs。采用不同诱导方案诱导MSCs向神经元和多巴胺能神经元样细胞定向转化后,进行抗神经巢蛋白（Nestin）、神经元特异烯醇化酶（NSE）、神经胶质纤维酸性蛋白（GFAP）、酪氨酸羟化酶（TH）和多巴胺转运体（DAT）等免疫细胞化学染色,并计算阳性细胞百分率。结果实验组诱导后MSCs能分化为具有典型神经元形态的细胞,可见NSE、Nestin、GFAP、TH和DAT等神经细胞标志表达;对照组MSCs细胞形态无明显变化,上述特异性标志物表达均为阴性。实验2组（诱导方案含Shh）与1组（诱导方案不含Shh）的NSE、Nestin、GFAP阳性细胞百分率的差异无统计学意义,但实验2组TH和DAT阳性细胞百分率明显高于实验1组,差异具有统计学意义（P〈0.05）。结论Shh可促进MSCs分化为多巴胺能神经元样细胞。     

星形胶质细胞条件培养液体外诱导胎鼠室管膜前下区神经干细胞向多巴胺能神经元的分化

背景：在神经干细胞移植治疗神经系统退行性变及修复神经系统功能损伤过程中,有效的神经干细胞体外增殖与多巴胺能神经元的定向诱导分化尤为关键。 目的：以星形胶质细胞条件培养液为诱导剂,观察胎鼠室管膜前下区神经干细胞体外向多巴胺能神经元的分化。 设计、时间及地点：细胞学体外对照观察,于2006-12/2007-08在解放军第三军医大学新桥医院实验中心完成。 材料：清洁级新生2 d龄KM小鼠15只,孕16 d Wistar大鼠40只,均由解放军第三军医大学实验动物中心提供。 方法：采用差速黏附法和振荡分离法纯化培养KM小鼠星形胶质细胞,收集传至第3代、培养5 d的星形胶质细胞条件培养液,-20 ℃冻存待用。体外分离Wistar胎鼠室管膜前下区神经干细胞,加入含B27和碱性成纤维细胞生长因子的DMEM/F12无血清培养基进行原代培养,传至第3代后按0.5×108 L-1密度接种,设立2组：对照组单纯加入含体积分数0.1为胎牛血清的DMEM/F12培养基予以自然分化,实验组加入已制备的星形胶质细胞条件培养液进行诱导分化。 主要观察指标：免疫细胞化学染色鉴定胎鼠室管膜前下区神经干细胞,流式细胞仪检测胎鼠室管膜前下区神经干细胞向多巴胺能神经元分化的阳性率。 结果：培养的神经球细胞表达巢蛋白,可分化为神经元特异性烯醇化酶、胶质纤维酸性蛋白阳性细胞。诱导分化7 d后,实验组可见酪氨酸羟化酶阳性细胞,胞体呈圆形或椭圆形,酪氨酸羟化酶位于胞质及突起中;对照组酪氨酸羟化酶阳性细胞在数量、细胞成熟形态上均未达到实验组水平。实验组酪氨酸羟化酶阳性细胞分化率明显高于对照组（t=35.296,P < 0.01）。 结论：在体外星形胶质细胞条件培养液可显著促进胎鼠室管膜前下区神经干细胞向多巴胺能神经元分化。     

星形胶质细胞源性因子对神经干细胞分化的实验研究

目的探讨星形胶质细胞源性因子对神经干细胞分化的影响。方法分离和培养新生大鼠脑组织的神经干细胞;采用差速贴壁法和振荡法分离纯化星形胶质细胞,用免疫细胞化学染色法,胶质纤维酸性蛋白(GFAP)标记星形胶质细胞,进行细胞的纯度鉴定;将星形胶质细胞和神经干细胞在互不接触的情况下进行共培养,免疫荧光法观察神经干细胞分化后神经元特异性烯醇化酶(NSE)、GFAP和酪氨酸羟化酶(TH)的表达。结果纯化的星形胶质细胞GFAP抗体标记阳性,细胞纯度达98%;星形胶质细胞与神经干细胞共培养时,神经干细胞贴壁分化加快,NSE阳性细胞及TH阳性细胞明显多于对照组(P<0·05)。结论星形胶质细胞源性因子可快速诱导神经干细胞向神经元细胞、包括多巴胺神经元细胞分化,提示星形胶质细胞支持神经元发生。     

外源性Ang Ⅱ诱导神经干细胞向多巴胺能神经元分化的研究

目的在体外成功分离培养并扩增神经干细胞（NSCs）的基础上,研究外源性血管紧张素Ⅱ（Ang Ⅱ）对NSCs向多巴胺（DA）能神经元分化的影响。方法（1）分离培养新生1d SD大鼠脑组织NSCs,免疫细胞学方法测定NSCs特异性标志物神经上皮干细胞蛋白（Nestin）表达及其分化为神经元、神经胶质细胞的能力;（2）按培养液中Ang Ⅱ的浓度不同,分5个浓度（100、200、400、600、800nmol/L）对第二代NSCs进行诱导分化。10d后采用免疫细胞学方法检测DA能神经元标志物酪氨酸羟化酶（TH）和神经胶质细胞标志物胶质纤维酸性蛋白（GFAP）的表达,半定量RT-PCR（SQ-PCR）测定分化细胞中TH mRNA的相对表达量。结果外源性Ang Ⅱ诱导提高NSCs向TH阳性细胞分化的比率,TH mRNA相对表达量亦增加,以Ang Ⅱ浓度为400nmol/L及600nmol/L的诱导效果最明显,TH阳性细胞率分别为10.77%和11.34%,TH mRNA相对表达量分别为（0.4023±0.0515）和（0.3971±0.0319）,两组间比较无统计学意义（P〉0.05）;其中400nmol/L Ang Ⅱ组分化细胞中GFAP阳性细胞率高于对照组,有统计学意义（P〈0.05）。结论外源性AngⅡ促进NSCs向DA能神经元分化,在400～600nmol/L浓度范围内AngⅡ的诱导效能更显著;AngⅡ促进NSCs向DA能神经元分化的机制可能与同时促进星型胶质细胞（AS）分化有关。     

黄芩苷作用于脑微血管内皮细胞和星形胶质细胞对

背景：实验室前期研究表明黄芩苷可以提高体外培养的神经干细胞分化为神经元的比例。但考虑到体内实验中血脑屏障的存在,黄芩苷能否通过血脑屏障主要细胞成分而发挥诱导神经干细胞定向分化为神经元的能力还不清楚。 目的：分别将大鼠脑微血管内皮细胞、星形胶质细胞与神经干细胞共培养,观察在模拟体内复杂微环境条件下,黄芩苷能否定向诱导神经干细胞向神经元分化并促进分化神经元的成熟。 设计、时间及地点：细胞水平的体外对照观察,于2007-09/2008-03在天津中医药大学中医药研究院中药药理学重点实验室和南开大学医学院完成。 材料：取孕14 d SD大鼠,用以分离培养神经干细胞。 方法：利用Transwell装置,分别将脑微血管内皮细胞、星形胶质细胞和神经干细胞共培养。用含有10 μmol/L黄芩苷的培养基作用7 d,并设置空白对照组。以β-tubulinⅢ标记未成熟神经元,MAP-2标记成熟神经元,胶质纤维酸性蛋白标记星形胶质细胞。 主要观察指标：应用细胞免疫荧光化学染色检测神经干细胞分化后β-tubulinⅢ、MAP-2和胶质纤维酸性蛋白阳性细胞比例,以实时荧光定量反转录-聚合酶链反应技术检测黄芩苷对脑微血管内皮细胞和星形胶质细胞血管内皮细胞生长因子、神经生长因子和血小板衍生生长因子 mRNA表达的影响。 结果：与脑微血管内皮细胞共培养条件下,与空白对照组比较,黄芩苷可显著增加β-tubulinⅢ阳性细胞比例（P < 0.05）。与星形胶质细胞共培养条件下,与空白对照组比较,黄芩苷对β-tubulinⅢ、MAP-2和胶质纤维酸性蛋白阳性细胞比例均无明显影响（P > 0.05）。与脑微血管内皮细胞、星形胶质细胞共培养条件下,与空白对照组比较,黄芩苷可显著增加MAP-2阳性细胞比例（P < 0.01）。黄芩苷作用于脑微血管内皮细胞48 h,可以显著上调血小板衍生生长因子基因表达（P < 0.01）;作用72 h可显著上调星形胶质细胞血管内皮细胞生长因子、神经生长因子和血小板衍生生长因子基因表达（P < 0.01）。 结论：黄芩苷作用于脑微血管内皮细胞可诱导神经干细胞向神经元分化,黄芩苷同时作用于脑微血管内皮细胞和星形胶质细胞可诱导神经干细胞向神经元定向分化并促进其成熟,可能与黄芩苷调控脑微血管内皮细胞和星形胶质细胞生长因子分泌,改善微环境有关。     

海马神经元条件培养液体外诱导大鼠骨髓间质干细胞向神经元样细胞和神经胶质样 细胞的分化：与含b-FGF培养基和无血清培养基的比较*☆

背景：目前关于骨髓间质干细胞能否向神经元方向分化的报道不多,且争论多集中在分化后的神经元是否仅具有神经元形态而不具有神经元功能。 目的：探讨海马神经元条件培养液诱导大鼠骨髓间质干细胞向神经元样细胞和神经胶质样细胞分化的可能性。 方法：将第5代大鼠骨髓间质干细胞分为4组：条件培养基组加入海马神经元和胶质细胞的培养液;b-FGF组加入含b-FGF的DMEM培养基;无血清培养组加入含Neurobasal和B27的无血清培养基;阴性对照组加入含胎牛血清的DMEM。各组诱导12,24 h后,应用免疫细胞化学染色行神经元特异性烯醇化酶、微管相关蛋白2、胶质纤维酸性蛋白的鉴定,Western-blot法检测细胞神经元特异性烯醇化酶、微管相关蛋白2和胶质纤维酸性蛋白的表达。 结果与结论：诱导12,24 h后,条件培养基组、b-FGF组、无血清培养组骨髓间质充干细胞微管相关蛋白2、胶质纤维酸性蛋白、神经元特异性烯醇化酶均呈阳性表达,阴性对照组未见表达。与阴性对照组比较,诱导后24 h,条件培养基组、b-FGF组、无血清培养组微管相关蛋白2表达均明显增强(P < 0.05),且条件培养基组增强幅度显著高于另两组(P < 0.05);条件培养基组、b-FGF组、无血清培养组神经元特异性烯醇化酶及胶质纤维酸性蛋白表达无明显差异。结果证实海马神经元条件培养液可体外诱导大鼠骨髓间质干细胞分化为神经元样细胞和神经胶质样细胞,与含b-FGF的培养基和无血清培养基相比,海马神经元条件培养基诱导的神经元和神经胶质细胞阳性率最高。     

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。     

STAT3信号通路影响人胶质瘤细胞株存活和凋亡的研究

目的 了解STAT3在星形细胞瘤中的表达情况并研究STAT3通路在胶质瘤细胞株生长、凋亡过程中的作用和相关机制。方法 通过免疫组化的方法显示星形细胞瘤手术标本中STAT3的表达情况。用AG490作用于体外培养的人胶质瘤细胞株U251、U87，通过Western blot了解STAT3蛋白在肿瘤细胞株中的表达和AG490对STAT3通路的阻断情况。观察AG490作用后胶质瘤细胞存活率的变化，并用流式细胞分析技术检测STAT3阻断后肿瘤细胞的凋亡情况。通过RT-PCR了解STAT3通路阻断后部分相关基因mRNA表达的改变。结果 STAT3在星形细胞瘤中有广泛表达，瘤内表达明显高于瘤周组织（P〈0．01）。STAT3在不同病理分级、性别、年龄组之间，差异无统计学意义（P〉0．05）。AG490作用胶质瘤细胞株后可使细胞内p-STAT3表达下降，同时肿瘤细胞存活率明显下降，肿瘤细胞凋亡比例明显升高。AG490对U251细胞存活率和凋亡的影响与AG490的浓度和作用时间有关。在AG490阻断STAT3信号通路的过程中，Mcl-1、Bcl-XL和Survivin的mRNA表达有所下降。结论 STAT3在星形细胞瘤中有广泛表达并与肿瘤细胞生长凋亡的生物学特性有着内在联系，STAT3通路有可能成为胶质瘤治疗的有用靶点。     

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.     

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.     

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.     

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.     

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.     

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.