胶质细胞和中枢神经系统疾病

本文述及了中枢神经系统胶质细胞的种类、生物学特点及其在常见中枢神经系统疾病中的形态、功能变化。胶质细胞在中枢神经系统疾病的发生发展中发挥重要作用。     

单细胞测序技术解析动脉粥样硬化巨噬细胞异质性的研究进展

动脉粥样硬化是冠状动脉、脑血管和外周动脉疾病的重要病理基础,动脉血管壁多种类型的细胞（如皮细胞、血管平滑肌细胞、巨噬细胞、淋巴细胞等）共同参与脂质驱动的血管炎症和动脉粥样硬化斑块形成的病理过程。动脉粥样硬化斑块内巨噬细胞具有高度异质性和复杂性,不同巨噬细胞亚群执行不同的功能,调控血管炎症反应的方向。单细胞技术是全面无偏倚分析细胞异质性的理想工具。最新单细胞研究解析了动脉粥样硬化斑块复杂的细胞和分子组成,证实斑块微环境中细胞的高度适应性和可塑性。通过高通量、高分辨率单细胞测序技术分析斑块内巨噬细胞的状态、来源、动态转化轨迹、细胞间通讯及分子调控机制,有助于全面、深入理解动脉粥样硬化的发生、发展机制,最终实现临床精准靶向治疗。本文综述单细胞测序技术在揭示人和小鼠动脉粥样硬化斑块内巨噬细胞表型、分布与功能异质性方面的最新研究进展,并讨论其局限性及未来应用前景。     

诱导多能干细胞与中枢神经系统疾病模型

重编程患者体细胞建立相关患者特异性诱导多能干细胞(iPS细胞)模型,对研究中枢神经系统疾病的发病机理、药物筛选及进一步自体移植治疗意义深刻.本文重点讨论了利用重编程技术建立脊髓性肌萎缩症、帕金森病、阿尔茨海默病、肌萎缩性脊髓侧索硬化症、雷特综合征、精神分裂症等6种常见中枢神经系统疾病iPS细胞模型的最新进展,同时概述了该领域目前面临的问题.我们相信疾病特异性iPS细胞模型的建立,必将有助于中枢神经系统疾病的早期诊断及治疗.     

影响神经干细胞定向分化因素的研究进展

神经干细胞(NSC)具有自我更新和多分化潜能属性,可分化产生神经元、星形胶质细胞和少突胶质细胞,这使得NSC移植替代神经系统疾病中丢失的细胞成为可能.NSC在胚胎和成体中枢神经系统均存在.NSC移植在体内环境下(尤其是非神经发生区域)绝大多数分化成胶质细胞(星形胶质细胞),有可能会加重胶质瘢痕形成.在中枢神经系统疾病的NSC细胞替代治疗策略中,NSC分化成合适的细胞类型显得格外重要.现就影响NSC定向分化的因素作一综述.     

Fas/FasL系统和中枢神经系统疾病

Fas/ FasL抗原系统是重要的细胞凋亡信号传导系统,目前认为它也是重要的细胞凋亡和免疫调节系统,涉及到中枢神经系统(CNS)细胞的发生、再生、增殖、病理性退化.近年来,对Fas/ FasL抗原系统及其在中枢神经系统疾病过程中的作用有了进一步的认识,现综述如下.……     

嗅鞘细胞移植治疗中枢神经系统疾病的基础研究

中枢神经系统疾病可以导致人们的神经功能缺损。同时，损伤区出现轴突受损，形成胶质瘢痕、空腔和裂隙。嗅鞘细胞作为自体移植最佳的候选细胞，它可以分泌神经营养因子等起到不同程度地神经保护作用，刺激血管再生，促进未受损和受损害轴突的生长。嗅鞘细胞还可以改变损伤后内源性神经胶质的应答情况，并且在受到一定程度的脱髓鞘损害时能够将轴突再髓鞘化。近几年来，嗅鞘细胞移植逐渐成为了一种临床治疗手段应用于人类的中枢神经系统疾病。因此，嗅鞘细胞移植可以成为由细胞介导的神经修复策略，治疗许多中枢神经系统疾病。文章通过该研究领域大量的实验结果来阐述嗅鞘细胞移植治疗中枢神经系统疾病基础研究目前的情况。     

骨髓基质细胞在中枢神经系统疾病中的应用

骨髓基质细胞具有多潜能性,可作为多种疾病细胞替代治疗和基因治疗的载体。最近研究发现,通过多种途径包括静脉注射、脑内不同部位行大鼠骨髓基质细胞移植,骨髓基质细胞均可在中枢神经系统内成活并可分化成为神经样细胞,提示骨髓基质细胞有可能取代神经干细胞用于中枢神经系统疾病的细胞治疗和损伤的修复。由于骨髓基质细胞取材容易,且能迅速培养扩增,通过自体移植又可避免免疫排斥反应,具有更广阔的应用前景。     

激光扫描共聚焦显微镜技术应用于脑脊液淋巴细胞的系列研究

脑脊液（CSF）细胞学经过长期发展至今，已广泛用于多种神经系统疾病，特别是中枢神经系统感染、肿瘤、白血病、寄生虫病、血管病以及免疫性疾病等的诊断和鉴别诊断。近10年来，随着各种检测技术的发展。为脑脊液细胞检测研究提供了新的技术和方法。使脑脊液细胞检测具有更大的发展前景和良好的临床应用价值。激光扫描共聚焦显微镜（confocal laser scaning microscope，CLSM）是20世纪80年代发展起来的先进的分子细胞生物学分析仪器，它在荧光显微镜成像等基础上增设了激光扫描装置，利用计算机进行图像处理，将光学成像的分辨力提高了30％～40％。这是光学显微镜发展史上的重大突破。通过其独特的成像原理和检测技术,[第一段]     

白细胞介素-6-滤泡辅助性T细胞介导视神经脊髓炎谱系病的研究进展

视神经脊髓炎谱系病(NMOSD)是一类视神经、脊髓和大脑同时或相继受累、以体液免疫为主要介导的中枢神经系统炎性脱髓鞘疾病.白细胞介素-6(IL-6)-滤泡辅助性T(Tfh)细胞与NMOSD的发生、发展密切相关.抗IL-6受 体的重组人源化单克隆抗体作为治疗NMOSD的新型药物疗效较好.文中对IL-6-Tfh细胞介导NM...     

髓鞘少突胶质细胞糖蛋白抗体相关疾病

髓鞘少突胶质细胞糖蛋白抗体相关疾病(MOGAD)为近年来确立的一类自身免疫性中枢神经系统脱髓鞘疾病, 以血清可检测出抗全长髓鞘少突胶质细胞糖蛋白IgG1为关键诊断标准。该疾病尽管与多发性硬化、水通道蛋白4抗体相关视神经脊髓炎谱系疾病在临床表现上有些类似, 但其具有相对特殊的病程、病理学以及影像学特征, 应作为独立的病种去探讨和研究。文中拟对MOGAD的致病机制、诊断与治疗进展作一概述, 为临床实践提供指导。     

肠道微生物在神经系统自身免疫性疾病中的研究进展

肠道微生物是人体最直接的外环境,对维持健康具有重要作用.肠道微生物可维持人体免疫系统稳态,与宿主共生可影响人体营养、代谢和免疫功能.肠道微生物通过免疫系统和内分泌系统与神经系统产生双向联系,即微生物-肠-脑轴.肠道微生物失调引起神经系统及外周异常免疫反应,参与自身免疫性疾病的发病机制.本文综述肠道微生物在多发性硬化、视...     

Changing trends in nervous system diseases among hospitalized children in the Chongqing region★

OBJECTIVE: To investigate the changing trends of nervous system diseases among hospitalized children and the risk factors of death. METHOD: The disease was statistically classified according to the International Statistical Classification of Disease and Health Problem (ICD10). The retrospective investigation includes demographic characteristics, as well as categories and fatality rates for nervous system diseases. All data was statistically analyzed. RESULTS: The percentage of nervous system diseases among inpatients in all wards was 2.4% (2 537/ 107 250) between January 1993 and December 1999, and 3.6% (6 082/170 619) between January 2000 and December 2006. The first ten patterns of various etiologic forms of nervous system diseases were identical-epilepsies and seizures, infections of the central nervous system, autoimmune and demyelination disorders, cerebral palsy, motor unit disorders, hypoxic-ischemic encephalopathy, hydrocephalus, extra-pyramidal disorders, congenital abnormalities of nervous system, and headache. Epilepsies and seizures took first place in both year groups, with 29.4% and 35%, respectively. Bacterial infections were responsible for the majority of cranial infections in both year groups, with 78.9% and 63.6% respectively. The death rate in the year group January 2000 to December 2006 was significantly less than in the year group January 1993 to December 1999 (χ2 = 27.832, P < 0.01). CONCLUSION: Among all nervous system diseases, epilepsies and seizures were among the most common, with the lowest fatality rate. Key Words: children; nervous system diseases; epidemiology     

Disturbances in the expression Of neuronal cell adhesion proteins NCAM. Clinical aspects

The NCAM neuronal cell adhesion protein, with adhesion and signal functions, helps to perform two-way communication with the environment and plays an important role in the formation and development of the nervous system. Changes in the expression of this protein during antenatal and postnatal development result in the appearance of a number of psychological, neurological, and oncological diseases. We reviewed studies that showed disturbances in NCAM expression in neuropsychic (multiple sclerosis and Alzheimer’s disease), psychological (schizophrenia and bipolar disorders), and oncological diseases.     

Magnetic resonance imaging of the brain and spine

Summary The efficacy of magnetic resonance imaging (MRI) in the diagnosis of diseases of the central nervous system is reviewed. MRI, computed tomography (CT) and certain radionuclide studies are compared in the evaluation of intracranial tumours, cerebral vascular disease, multiple sclerosis and other white matter diseases, dementia, head injury, infection, epilepsy, spinal lesions and in paediatric central nervous system disorders. The measurement of cerebrospinal fluid volumes and dynamics by MRI is discussed. MRI most clearly has advantages where CT is degraded by bone hardening and streak artefacts (spine, skull base, posterior and temporal fossa, sella and parasellar regions) and in diseases in which the X-ray attenuation of the suspected lesion differs little from normal parenchyma (paediatric brain disorders, demyelination and dysmyelination, early oedema associated with infarction, infection or low-grade infiltrating neoplasm, subacute and chronic haemorrhage and lesions in the spinal subarachnoid space and cord). Elsewhere MRI and CT should be seen as complementary rather than competitive methods of imaging. In spite of an absence of information about the contribution of MRI to management decisions and a lack of rigorous, prospective controlled trials, MRI will play an increasing role in the diagnosis of diseases of the central nervous system.     

Differential diagnosis of white matter diseases in the tropics: An overview

In hospitals in the tropics, the availability of magnetic resonance imaging (MRI) facilities in urban areas and especially in teaching institutions have resulted in white matter diseases being frequently reported in a variety of clinical settings. Unlike the west where multiple sclerosis (MS) is the commonest white matter disease encountered, in the tropics, there are myriad causes for the same. Infectious and post infectious disorders probably account for the vast majority of these diseases. Human immunodeficiency virus (HIV) infection tops the list of infective conditions. Central nervous system (CNS) tuberculosis occasionally presents with patchy parenchymal lesions unaccompanied by meningeal involvement. Human T cell leukemia virus (HTLV) infection and cystic inflammatory lesions such as neurocysticercosis are important causes to be considered in the differential diagnosis. Diagnosing post infectious demyelinating disorders is equally challenging since more than a third of cases seen in the tropics do not present with history of past infection or vaccinations. Metabolic and deficiency disorders such as Wernicke''s encephalopathy, osmotic demyelinating syndrome associated with extra pontine lesions and Vitamin B12 deficiency states can occassionaly cause confusion in diagnosis. This review considers a few important disorders which manifest with white matter changes on MRI and create diagnostic difficulties in a population in the tropics.     

Neuromyelitis optica spectrum disorders and systemic lupus erythematosus: A case series from a university center

Neuromyelitis optica spectrum disorders (NMOSD) are immune-mediated inflammatory diseases of the central nervous system (CNS), which preferentially affect the optic nerves and the spinal cord. Anti-aquaporin 4 antibody is a specific serological marker. Systemic lupus erythematosus (SLE) is a rheumatologic disease that may affect the CNS. There are several reports about the coexistence of NMOSD and autoimmune diseases, mainly those of rheumatologic origin. We describe three different cases in which SLE and NMOSD subsequently occurred, drawing attention to the clinical heterogeneity, the challenge and the importance of recognizing this possible association.     

累及中枢神经系统的小血管病

脑小血管病是缺血性和出血性卒中的常见原因,累及小血管的疾病包括血管内容异常或血管壁异常。血管内容异常包括血细胞疾病(如红细胞增多症、血小板增多症、嗜酸细胞过多综合征)、凝血障碍性疾病(如抗磷脂抗体综合征、血栓性血小板减少性紫癜);血管壁异常包括动脉硬化、炎性血管炎、非炎性小血管病以及血管内皮细胞病。     

Nervous system manifestations in Sjögren''s syndrome

Central and peripheral manifestations of the nervous system were evaluated in 48 Sjögren's syndrome patients. Fifty-six percent of the patients had neurological disturbances. The most common manifestations were entrapment neuropathies (19%) and polyneuropathy (15%). Electrophysiological tests gave further evidence of subclinical nervous system involvement in Sjögren's syndrome: electroencephalography (EEG) was abnormal in 48%, and visual evoked potentials (VEP) in 12% of patients tested. To find possible neuropsychiatric abnormalities, the Minnesota Multiphasic Personality Inventory was applied, and 33/43 patients were found to have psychiatric symptoms. The most frequent were depressive symptoms. In 44% of the patients there was additional evidence of extraglandular involvement or autoimmune disorders. No correlation could be found between the groups of patients with or without neurological disturbances in relation to simultaneous occurrence of associated disorders. It is suggested that nervous system involvement in Sjögren's syndrome reflects the pathogenetic consequences of Sjögren's syndrome alone, and not those of associated autoimmune diseases or extraglandular disorders.     

Contributions of triggering-receptor-expressed-on-myeloid-cells-2 to neurological diseases

Recent laboratory and gene sequencing data suggest that variations in receptors called the “triggering-receptors-expressed-on-myeloid-cells” (TREMs) are implicated in Alzheimer's disease, Parkinson's disease, multiple sclerosis, and frontotemporal lobar degeneration. TREM receptors are thought to play a critical role in regulating the immune system, inflammation, and certain cellular functions. One TREM, in particular, TREM2, is highly expressed on cells of the myeloid lineage. The binding of TREM2 to the adapter protein, DNAX activating protein of 12 kD (DAP12), in microglial cells has been shown to modulate phagocytosis within the nervous system. This review highlights the role of TREM2 in neurological diseases. Moreover, here we consider potential contributions of TREM2 and mechanisms underlying TREM2 activity as contributing to neurodegeneration. These findings may provide novel insights and opportunities to consider, especially for clinicians, as they diagnose and treat certain neurological diseases.