蛋白质组学技术进展及在老年神经病之中的应用

目的:阐述蛋白质组学研究的最新进展及其在老年神经系统疾病的应用。蛋白质组学是功能基因组时代的支柱学科,是从基因组水平对蛋白质进行综合分析。经典的蛋白质组技术基于双相电泳分离和纯化蛋白质,然后用质谱进行鉴定。蛋白质组学研究有助于阐明老年神经系统疾病的发病机制,寻找疾病相关蛋白,针对疾病靶点定向合成药物。蛋白质组学将为老年神经系统疾病的诊断、治疗和新药研发起到巨大的推动作用。     

蛋白质组学技术及脑脊液差异蛋白质组学研究进展

患者脑脊液蛋白数量升高是许多神经系统疾病的典型特征,而今蛋白质组学的飞速发展为研究这些患者脑脊液的差异蛋白质组提供了良好的技术平台.本文综述了蛋白质组学的研究方法,以及应用这些方法对脑脊液蛋白质组学研究的新进展.     

蛋白质组学在小儿神经系统疾病中的应用

蛋白质组学研究方法包括双向凝胶电泳、质谱分析、计算机软件分析等。在小儿神经系统疾病研究中通过表达蛋白质组学和相互作用蛋白质组学揭示其发病机制。为小儿神经系统疾病中遗传代谢性疾病的新生儿筛查、肿瘤、感染性疾病和中枢神经系统损伤、脱髓鞘等疾病的研究提供了有力的工具。     

脑脊液中神经系统疾病的生物标志物

蛋白质组学（proteomics）技术是采用高分辨率的蛋白质分离手段及高效率的蛋白质鉴定技术,全景式的研究各种特定环境下的人类蛋白质的表达,是后基因组时代的重要技术。蛋白质组学研究主要有两种：组成蛋白质组学,是研究一种组织或细胞基因组的表达的所有蛋白质;另一种是比较蛋白质组学,主要是鉴定不同种类和状态下各种样本之间蛋白质的表达,比较蛋白质组学在临床医学中应用价值巨大。对重大疾病的比较蛋白质组学的研究,可以有助于疾病的早期诊断,预测疾病的转归、检测病情的变化,了解疾病的病理生理过程、寻找新的药物靶点、观察疗效。脑脊液存在于脑室系统,被认为是脑和脊髓的淋巴,正常脑脊液含有极微量的蛋白质,且绝大部分为白蛋白,球蛋白仅有微量,在发生某些疾病如：颅内感染、脑出血、脑肿瘤、中毒性脑病时,脑脊液可发生不同程度的质变和量变,且多为球蛋白,近年来国外应用蛋白组学技术对神经系统疾病患者脑脊液行特异性蛋白标志物检测,探索找到这种疾病的理想的生物标志物,应能代表这种疾病的基本发病机制,其合理性应能被神经病理学所证实,生物标志物在诊断这种病时敏感性和特异性较高,具备可行性和无侵害性。     

蛋白质组学及其在神经系统重大疾病中的研究进展

随着人类基因组计划的完成,生命科学研究进入了后基因组时代,研究重心从揭示生物遗传信息转移到对生物功能的研究上。蛋白质组学技术应运而生。本文简单介绍了蛋白质组学概念及其主要研究技术,详细阐述了蛋白质组学在神经系统重大疾病包括阿尔茨海默病,多发性硬化,吉兰巴雷综合征以及缺血性脑血管病的研究进展,以期在揭示疾病分子机制,发现疾病标志蛋白,寻找新的药物靶标,早期准确诊断以及个体化治疗等方面提供依据。     

双向电泳和质谱分析在神经科学研究中的应用

人类基因组计划已经完成，这一伟大的成就标志着生命科学研究进入一个新时代——后基因组时代，其中包括蛋白质组(即蛋白质组学)的研究。双向电泳和质谱技术是蛋白质组学的核心技术，将这两种技术应用于神经科学研究，能够进一步了解神经系统复杂结构及其发育规律，揭示神经系统疾病发生机理，并为其诊断和新药研制提供有益的依据。     

神经遗传性疾病的基因学研究十年进展

神经遗传性疾病是遗传性疾病中数量最多的疾病,在目前已经发现的5000余种单基因疾病中,累及神经系统的遗传性疾病或综合征约占50%,而与多基因遗传有关的神经系统疾病的数量则更多.神经遗传性疾病研究进入基因学领域始于20世纪50年代,近10年来,神经遗传性疾病的基因学研究得到了飞速发展,随着人类基因组计划的顺利实施,目前基因学研究已进入蛋白质组学阶段[1].     

蛋白质组学技术在神经变性疾病研究中的应用

蛋白质是生命活动的载体和生理功能的执行者，对蛋白质复杂多样的结构、功能和相互作用的深入研究，将在分子、细胞和生物体等多个层次上全面揭示生命现象的本质。而蛋白质组学技术可以一次完成大量蛋白质的高通量分析．具有其他研究手段无法比拟的优势，是当今生命与生物技术中最活跃、最前沿、应用最广泛的研究领域之一。自2003年正式启动国际“人类蛋白质组计划”以来．我国政府对蛋白质的研究和发展十分重视，不断加大投入，并将“功能基因组和蛋白质组”研究纳入国家“十一五”科学技术发展规划，成为生物和医药领域4项重大研究项目之一．这必将推动我国蛋白质研究的深入发展，同时有助于了解疾病的发病机制和发现具有应用前景的生物学标志物。随着我国人口老龄化进程的加速，帕金森病和阿尔茨海默病等中枢神经系统疾病的患病率逐年上升，但目前在诊断方面尚无可靠的生物学标志物，而主要依靠医师的临床经验．其漏诊率和误诊率均较高。因此，应用先进的蛋白质组学技术，尽快开发出具有早期预警、早期诊断价值的生物学标志物将是今后中枢神经系统疾病研究的前沿课题。我们将本期专题定为“蛋白质组学研究”，旨在使临床医师更为深入地了解蛋白质组学的相关技术及其在中枢神经系统疾病研究中的应用前景，也希望使大家知道这项实验室中的前沿技术已距临床很近．在不久的将来会成为我们诊断各种神经系统疾病的先进技术。[编者按]     

蛋白质组学技术在脑缺血研究中的应用进展

通过应用双向凝胶电泳、荧光双向差异凝胶电泳、高效液相色谱分离、联合质谱及蛋白芯片等蛋白质组学技术,对缺血性脑卒中进行基因后产物一蛋白质组学研究,阐述了蛋白改变在脑缺血的发病机制、病理发展及神经修复等方面的发现,以及蛋白质组学技术在脑缺血研究中的作用。     

癫(癎)蛋白质组研究现状分析及未来展望

癫(癎)是一种常见的神经系统疾病,癫(癎)可由多种原发病诱发,寻找癫(癎)发病的分子基础,有望为癫(癎)的防治提供理论基础.蛋白质组学研究使筛选可疑致病因子成为可能.本文就癫(癎)蛋白质组学研究现状进行综述,并就目前存在的问题给予分析,同时对未来深入研究的方向做一展望.     

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.