鱼藤酮诱导细胞内泛素化α-synuclein聚集选择性损伤多巴胺神经元

目的探讨鱼藤酮对多巴胺能神经元内泛素化-αsynuclein聚集的影响及其细胞损伤作用。方法应用鱼藤酮处理经NGF诱导的神经元样分化的PC12细胞株(多巴胺能神经元)与N2a细胞株(非多巴胺能神经元)4、8、16、24 h以及用利血平预处理PC12细胞4 h再加入鱼藤酮处理16 h;采用免疫荧光双标记方法在共聚焦显微镜下观察细胞内泛素化-αsynuclein聚集,以MTT法和流式细胞术分别检测PC12细胞活力及凋亡率。结果单用鱼藤酮处理16 h后,PC12细胞株与N2a细胞株相比较,免疫荧光双标记显示PC12细胞内泛素化-αsynu-clein发生明显聚集,并且鱼藤酮对PC12细胞株的作用具有时间依赖性,而N2a细胞内泛素化-αsynuclein聚集不明显。利血平耗竭PC12细胞内多巴胺后再经鱼藤酮处理,PC12细胞内泛素化-αsynuclein聚集不明显;经不同浓度鱼藤酮处理后,细胞活力呈剂量依赖性下降;与对照组相比,经20 nmol/L鱼藤酮处理4、16、24 h后细胞存活率分别为(81.6±12.3)%、(59.8±6.7)%和(52.2±7.4)%(P<0.01)。鱼藤酮处理后出现早期凋亡细胞,随着处理时间的延长细胞凋亡率逐渐上升(P<0.01)。结论鱼藤酮选择性作用于多巴胺能神经元,使细胞内泛素化-αsynuclein发生聚集,而且这种变化具有时间依赖性,最终导致细胞发生凋亡,然而鱼藤酮对非多巴胺能神经元作用不明显。同时,鱼藤酮诱导泛素化-αsynuclein发生聚集的作用与神经元的特性存在密切关系。     

线粒体KATP通道开放剂对多巴胺能神经细胞的保护作用研究

目的研究线粒体KATP通道的开放对于鱼藤酮诱导的细胞凋亡的保护作用并初步探讨其机制。方法用神经生长因子(NGF)将PC12细胞诱导分化成多巴胺能神经元模型,经鱼藤酮和线粒体KATP通道的开放剂二氮嗪及选择性线粒体KATP通道拮抗剂5-羟葵酸(5-HD)处理,用台盼蓝染色和四甲基偶氮唑盐(MTT)法检测细胞活力,磷脂酰丝氨酸外翻法(Annexin V)检测细胞的凋亡,JC-1检测线粒体膜电位的变化。结果经鱼藤酮处理24h后PC12细胞突起结构消失,细胞体积变小,形态变圆,台盼蓝染色阳性细胞增多,细胞活力下降,可见An-nexin V阳性的早期凋亡细胞,凋亡率为31.1%±2.65%(P<0.01);同时加入二氮嗪能减少PC12细胞的凋亡,凋亡率为17.9%±0.71%(P<0.05);JC-1染色法证实二氮嗪可稳定线粒体膜电位。而同时加入5-HD的PC12细胞活力及线粒体膜电位与鱼藤酮处理组相比无变化。结论鱼藤酮可引起多巴胺神经元的凋亡,线粒体KATP通道的开放剂二氮嗪能够拮抗鱼藤酮的毒性作用,其机制可能是通过在线粒体膜电位降低时稳定线粒体膜电位而起到对多巴胺能细胞的保护作用。     

α-synuclein片段NAC对多巴胺能神经元的神经变性作用

目的 :探讨α 突触核蛋白的非淀粉样成分 (NAC)对多巴胺能细胞的毒性作用。方法 :PC12细胞经不同浓度的NAC处理 48h后 ,观察细胞形态改变 ,MTT法测定细胞活力 ;TUNEL和Annexin V法流式细胞仪检测调亡 ;硫磺素S染色研究蛋白聚集。结果 :NAC处理 48h后 ,PC12细胞突起样结构消失 ;与对照组比较 ,NAC >2 5 μmol·L使细胞活力明显下降 (P <0 0 5 ) ,并诱导出现凋亡及蛋白聚集。结论 :ANC对多巴胺能细胞有毒性作用 ,并引起蛋白聚集。     

溶酶体自噬途径降解α—synuclein蛋白作用研究

目的探讨α—synuclein蛋白细胞内溶酶体途径降解机制。方法用神经生长因子NGF诱导分化PCI2细胞作为研究多巴胺能神经元的细胞载体,应用鱼藤酮处理PCI2细胞建立α-synuclein蛋白细胞模型。使用溶酶体途径降解抑制剂E64处理神经元样分化的PCI2细胞,应用免疫荧光双标方法观察PCI2细胞内硫黄素S、α—synuclein蛋白阳性聚集包涵体形成情况,比较各组的差异。结果用E64处理鱼藤酮预处理过的PCI2细胞后α—synuclein蛋白聚集且较多包涵体形成（15．36±0．85）％,与对照组相比差异有统计学意义（P〈0．05）。结论溶酶体自噬途径可能在α—synuclein蛋白降解、聚集和多巴胺神经元死亡过程中发挥重要作用。     

99mTc-Annexin V检测早期凋亡多巴胺能神经元的实验研究

目的 研究放射性核素标记的膜联蛋白V(Annexin V)与凋亡的多巴胺能神经元的结合特性,探讨使用凋亡显像剂99mTc-Annexin V早期活体显像诊断帕金森病的可行性.方法 采用不同浓度的1-甲基-4-苯基吡啶离子(1-methyl-4-phenylpyridinium, MPP+)处理大鼠肾上腺嗜铬细胞瘤细胞(PC12)和人神经母细胞瘤细胞(SH-SY5Y)以诱导其凋亡(PC12 0～200 μm/L, SH-SY5Y 0～500 μm/L),FITC -Annexin V及碘化吡啶(propidiumiodide, PI)双染进行流式细胞仪凋亡检测.以99mTc-Annexin V与凋亡的细胞进行饱和结合实验及细胞摄取实验,研究凋亡细胞与Annexin V的亲和力及其摄取99mTc-Annexin V的动力学.结果 MPP+可诱导PC12细胞及SH-SY5Y细胞发生凋亡,并有明显的量效关系.凋亡细胞可特异性与99mTc-Annexin V结合,亲和力可达(7.16±1.78)nmol/L,每个凋亡的多巴胺能神经元表面的结合位点可达到(179±33)fmol/106cells (PC12)及(220±26)fmol/106cells (SH-SY5Y),且神经元的凋亡水平与其膜结合的99mTc-Annexin V放射性强度有相关性(P＜0.001).结论 凋亡的多巴胺能神经元与99mTc-Annexin V有高度亲和力,其所结合的99mTc-Annexin V放射性强度与细胞的凋亡水平相关,99mTc-Annexin V可用于检测多巴胺能神经元的早期凋亡.     

α-触核蛋白在帕金森病发病机制中作用的研究

目的　探讨α 触核蛋白的异常聚集在帕金森病发病机制中的作用。方法　以PC12细胞为多巴胺能神经元的细胞模型 ,应用Hoechst 332 5 8核染色法、流式细胞术 (FCM)、TdT末端转移酶介导的缺口末端标记法(TUNEL)等方法 ,检测α 触核蛋白片段 (NAC ,thenon β amyloidcomponent)聚合物对PC12细胞凋亡的影响。 结果　NAC聚合物 10、15、2 0 μmol/L浓度组 ,Hoechst332 5 8核染色法可见染色质浓聚、核固缩和凋亡小体 ;FCM显示凋亡峰出现 ,3个组的凋亡率分别为 (19 75± 1 87) % ,(30 37± 2 35 ) % ,(4 3 1± 5 4 1) % ,较对照组 (3 5 2± 0 4 6 ) %显著增高 (P均小于 0 0 5 ) ,3个组两两之间也存在差异 (F =6 4 2 9,P <0 0 1) ;TUNEL可检测到凋亡细胞DNA发生双链断裂。对照组和 2 5 μmol/L浓度组未发现凋亡。 结论　一定浓度的NAC聚集物可以诱导PC12细胞发生凋亡 ,提示体内发现的α 触核蛋白异常聚集可能通过诱导多巴胺能神经元发生凋亡这一机制参与该病的发病。     

丙炔苯丙胺对鱼藤酮致多巴胺能神经细胞损伤的保护机制研究

目的:探讨丙炔苯丙胺对多巴胺能神经细胞保护机制的研究。方法:用神经生长因子(NGF)将PC12细胞诱导分化成多巴胺能神经元的细胞模型,经鱼藤酮处理后给予不同浓度的丙炔苯丙胺,观察细胞形态改变,四甲基偶氮唑盐(MTT)法检测细胞活性及代谢状态,磷脂酰丝氨酸外翻法(Annexin-V)检测细胞凋亡,JC-1检测线粒体膜功能及DCFH-DA检测细胞内ROS。结果:经鱼藤酮处理24h后PC12细胞突起样结构消失,应用丙炔苯丙胺后细胞形态逐渐变大,突起也有恢复,细胞贴壁能力增强,与鱼藤酮组比较,在丙炔苯丙胺50μmol·L-1作用24h时即出现细胞活力恢复,A570值为0.39±0.01(P<0.01);Annexin-V检测凋亡细胞明显减少;JC-1检测丙炔苯丙胺处理组的线粒体膜电位较鱼藤酮处理组有明显恢复,DCFH-DA检测鱼藤酮组ROS水平升高,丙炔苯丙胺组ROS降低。结论:鱼藤酮在体外对多巴胺能神经元有毒性作用,丙炔苯丙胺能够明显减少鱼藤酮诱导的PC12细胞的死亡。其机制可能是抑制氧化应激及拮抗细胞凋亡。     

丁基苯酞对帕金森病细胞模型保护作用的初步研究

目的探讨丁基苯酞(dl-3-n-Butylphthalide,NBP)对鱼藤酮诱导的帕金森病细胞模型的保护作用及其机制。方法分别使用终浓度为0.1、1、10、100μM NBP和溶剂二甲基亚砜(DMSO)预处理SH-SY5Y细胞24h后,加入终浓度为200nM的鱼藤酮处理24h建立多巴胺能细胞损伤模型,观察各组细胞形态,采用四甲基偶氮唑盐(MTT)比色法检测细胞活性,流式细胞术检测细胞凋亡率(Annexin V-FITC/PI)、线粒体膜电位(JC-1)、细胞内活性氧水平(DCFH-DA)。结果200nmol/L鱼藤酮处理SH-SY5Y细胞24h能够诱导细胞活性下降和细胞凋亡,NBP预处理后SH-SY5Y细胞存活率明显升高,细胞凋亡率降低,线粒体膜电位显著升高(P0.05),细胞内活性氧水平显著降低(P0.05),且随NBP浓度的增加对SH-SY5Y细胞的保护作用增强。结论NBP对鱼藤酮诱导的SH-SY5Y细胞损伤具有良好的保护作用,线粒体保护可能是其作用机制之一。     

溶酶体自噬途径降解α-synuclein蛋白作用研究

目的 探讨α-synuclein蛋白细胞内溶酶体途径降解机制.方法 用神经生长因子NGF诱导分化PC12细胞作为研究多巴胺能神经元的细胞载体,应用鱼藤酮处理PC12细胞建立α-synuclein蛋白细胞模型.使用溶酶体途径降解抑制剂E64处理神经元样分化的PC12细胞,应用免疫荧光双标方法观察PC12细胞内硫黄素S、α-synuclein蛋白阳性聚集包涵体形成情况,比较各组的差异.结果 用E64处理鱼藤酮预处理过的PC12细胞后α-synuclein蛋白聚集且较多包涵体形成(15.36±0.85)%,与对照组相比差异有统计学意义(P＜0.05).结论 溶酶体自噬途径可能在α-synuclein蛋白降解、聚集和多巴胺神经元死亡过程中发挥重要作用.     

MPP+重新启动多巴胺能神经元细胞周期的作用及机制

目的研究1-甲基-4-苯基吡啶离子(MPP )重新启动多巴胺能神经元细胞周期的作用及机制。方法使用MPP 处理神经元样分化的PC12细胞,采用四甲基偶氮唑盐(MTT)法检测细胞活力,流式细胞仪检测早期凋亡细胞和细胞周期分布,免疫细胞化学检测ERK/MAPK通路活化水平。结果经MPP 处理后,细胞活力呈浓度依赖性下降,经25、50、75、100、150 mmol/L MPP 处理24 h后细胞存活率分别下降至对照组的(97.32±2.41)%(、67.69±3.03)%、(56.00±3.12)%、(47.23±2.55)%、(40.00±2.46)%,与对照组相比差异均有统计学意义(P<0.01)。经75 mmol/L MPP 处理后出现早期凋亡细胞,随处理时间延长,细胞凋亡率逐渐增加,其处理4、8、16和24 h后细胞凋亡率分别为(7.26±3.43)%、(8.34±3.55)%(、20.04±2.64)%和(28.46±2.35)%(P<0.01)。同时细胞周期中G0/G1期细胞减少,S期和G2/M期细胞增多(P<0.01),细胞内ERK1/2通路活化。结论MPP 可通过活化ERK1/2通路重新启动多巴胺神经元的细胞周期,并诱导多巴胺能神经元凋亡。     

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.     

Special Pharmacokinetic Considerations in Children

Summary: Pediatric patients have greater degrees of pharmacokinetic variability and unpredictability than adults. This variability results from the effects of pharmacogenetics, age and growth, prior and current comedication, and disease. Newborns with seizures have the least predictable dosage requirements, and their needs change as drug-eliminating mechanisms mature in the neonatal period. Infants have the highest relative capacities to eliminate antiepileptics of any age group and require the largest relative doses. In addition to age-related trends, children demonstrate the same drug-specific, pharmacokinetic phenomena that adults do, including nonlinear phenytoin elimination, nonlinear valproate binding, and autoinduction of carbamazepine. Intercurrent illness and drug interactions further modify the age-related pharmacokinetic patterns in children and make dosage requirements even more unpredictable. Recent studies have shown that febrile illness can affect drug elimination, sometimes decreasing drug levels by 50% or more. Intermittent treatment with benzodiazepines administered either orally or rectally can be an important adjunct and help minimize this type of problem for children with marginally controlled epilepsy. Intermittent benzodiazepines are also helpful for children who have febrile seizures and who need only occasional antiepileptic protection.