电针治疗脊髓损伤机制研究概述
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摘要
搜集近年国内外电针治疗脊髓损伤机制研究文献,从电针促进神经修复、抑制神经细胞凋亡、改善损伤区微环境3个方面综述电针治疗机制。电针促进神经修复主要包括抑制轴突生长抑制因子表达、减少胶质瘢痕的形成、促进神经干细胞分化和神经元的生长等,改善微环境主要包括抑制细胞炎症反应、兴奋性氨基酸毒性和脂质过氧化反应、促进神经营养因子分泌、增加血流量、改善微循环、增强自噬流,最终是促进神经元再生、轴突和髓鞘重塑、抑制神经细胞死亡,各种机制相互关联、互相影响。从分子生物学角度证明电针治疗的多靶点性,为临床治疗脊髓损伤提供研究基础。
This study collected the research literature on the mechanism of electro-acupuncture treating spinal cord injury in recent years,it reviewed the mechanism from three aspects: electro-acupuncture promoting nerve repair,inhibiting neuronal apoptosis,and improving microenvironment in injured area. Electro-acupuncture promoting nerve repair mainly includes inhibiting the expression of axon growth inhibitory factor,reducing glial scar formation,promoting neural stem cell differentiation and neuronal growth. Improvement of microenvironment mainly includes inhibiting cellular inflammatory response,excitatory amino acid toxicity and lipids peroxidation,promoting the secretion of neurotrophic factors,increasing blood flow,improving microcirculation,enhancing autophagic flow,and ultimately promoting neuronal regeneration,axonal remodeling and remyelination,and inhibiting neuronal cell death; the various mechanisms are interrelated influences. The multi-targeting of electro-acupuncture treatment was demonstrated from the perspective of molecular biology.This study provided research basis for clinical treatment of spinal cord injury.
This study collected the research literature on the mechanism of electro-acupuncture treating spinal cord injury in recent years,it reviewed the mechanism from three aspects: electro-acupuncture promoting nerve repair,inhibiting neuronal apoptosis,and improving microenvironment in injured area. Electro-acupuncture promoting nerve repair mainly includes inhibiting the expression of axon growth inhibitory factor,reducing glial scar formation,promoting neural stem cell differentiation and neuronal growth. Improvement of microenvironment mainly includes inhibiting cellular inflammatory response,excitatory amino acid toxicity and lipids peroxidation,promoting the secretion of neurotrophic factors,increasing blood flow,improving microcirculation,enhancing autophagic flow,and ultimately promoting neuronal regeneration,axonal remodeling and remyelination,and inhibiting neuronal cell death; the various mechanisms are interrelated influences. The multi-targeting of electro-acupuncture treatment was demonstrated from the perspective of molecular biology.This study provided research basis for clinical treatment of spinal cord injury.
引文
[1]Holmes D.Spinal-cord injury:spurring regrowth[J].Nature,2017,552(7684):49.
[2]Wang KC,Kim JA,Sivasankaran R,et al.P75 interacts with the Nogo receptor as a co-receptor for Nogo,MAG and OMgp[J].Nature,2002,420(6911):74.
[3]闵友江,张辉,肖伟平,等.电针对脊髓损伤大鼠Nogo-A、NgRmRNA及蛋白表达影响的实验研究[J].时珍国医国药,2017,28(4):995-998.
[4]马睿杰,张柳娟,孙连珠,等.夹脊电针干预脊髓损伤大鼠OMgp表达的研究[J].中华中医药学刊,2014,32(6):1283-1286,1541.
[5]Zhang S,Kluge B,Huang F,et al.Photochemical scar ablation in chronically contused spinal cord of rat[J].Journal of Neurotrauma,2007,24(2):411-420.
[6]Zhe W,Yan W,Zhao W,et al.Electro-Acupuncture Modulates L1Adhesion Molecule Expression After Mouse Spinal Cord Injury[J].American Journal of Chinese Medicine,2017,45(1):37-52.
[7]李经辉,谢勇,刘禹,等.电针治疗对钳夹型大鼠脊髓损伤后BMP-2的表达[J].昆明医科大学学报,2014,35(3):19-22.
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[9]Lie DC,Song H,Colamarino SA,et al.Neurogenesis in the Adult Brain:New Strategies for Central Nervous System Diseases[J].Annual Review of Pharmacology&Toxicology,2004,44(1):399.
[10]Yan Q,Ruan J W,Ding Y,et al.Electro-acupuncture promotes differentiation of mesenchymal stem cells,regeneration of nerve fibers and partial functional recovery after spinal cord injury[J].Experimental&Toxicologic Pathology Official Journal of the Gesellschaft Für Toxikologische Pathologie,2011,63(1):151-156.
[11]Wang X,Ju S,Chen S,et al.Effect of Electro-Acupuncture on Neuroplasticity of Spinal Cord-Transected Rats[J].Med Sci Monit,2017,23(2):4241-4251.
[12]Kerr JF,Wyllie AH,Currie AR.Apoptosis:a basic biological phenomenon with wide-ranging implications in tissue kinetics[J].Br J Cancer,1972,26(4):239-257.
[13]Borgens RB,Liu-Snyder P.Understanding Secondary Injury[J].Quarterly Review of Biology,2012,87(2):89.
[14]李晓宁,吴磊,迟蕾,等.不同治疗周期夹脊电针对急性脊髓损伤大鼠运动功能及细胞凋亡的影响[J].针刺研究,2016,41(6):492-496.
[15]Liu J,Wu Y.Electro-acupuncture-modulated miR-214 prevents neuronal apoptosis by targeting Bax and inhibits sodium channel Nav1.3 expression in rats after spinal cord injury[J].Biomedicine&pharmacotherapy,2017,89(2):1125.
[16]尹洪娜,孙忠人,李全.电针夹脊穴对脊髓损伤大鼠内质网应激相关因子CHOP影响的实验研究[J].中医药信息,2016,33(4):35-38.
[17]尹洪娜,孙忠人,李全.电针夹脊穴对脊髓损伤大鼠内质网应激相关因子Caspase-12影响的实验研究[J].中医药学报,2016,44(3):33-36.
[18]Akhtar AM,Al STS,Eid AH.Inflammogenesis of Secondary Spinal Cord Injury[J].Frontiers in Cellular Neuroscience,2016,10(98):1-24.
[19]Chávez-Galán L,Olleros ML,Vesin D,et al.Much more than M1and M2 macrophages,there are also CD169(+)and TCR(+)macrophages[J].Front Immunol,2015,6(5):263.
[20]Italiani P,Boraschi D.From monocytes to M1/M2 macrophages:phenotypical vs.functional differentiation[J].Front Immunol,2014,5(10):514.
[21]Shechter R,Miller O,Yovel G,et al.Recruitment of beneficial M2macrophages to injured spinal cord is orchestrated by remote brain choroid plexus[J].Immunity,2013,38(2):555-569.
[22]David S,Kroner A.Repertoire of microglial and macrophage responses after spinal cord injury[J].Nat Rev Neurosci,2011,12(7):388-399.
[23]Loane DJ,Byrnes KR.Role of microglia in neurotrauma[J].Neurotherapeutics,2010,7(4):366-377.
[24]Zhao J,Wang L,Li Y.Electroacupuncture alleviates the inflammatory response via effects on M1 and M2 macrophages after spinal cord injury[J].Acupuncture in Medicine Journal of the British Medical Acupuncture Society,2017,35(3):224.
[25]Mangan MSJ,Olhava EJ.Targeting the NLRP3 inflammasome in inflammatory diseases[J].Nat Rev Drug Discov,2018,17(8):588-606.
[26]Wu J,Li M,Fan H,et al.Targeting the NLRP3 inflammasome to attenuate spinal cord injury in mice[J].Journal of Neuroinflammation,2017,14(1):207.
[27]吴磊.夹脊电针调控脊髓损伤模型大鼠微环境NLRP3炎症小体活化作用及机制研究[D].哈尔滨:黑龙江中医药大学,2018:52-54.
[28]Kim Y,Park YK,Cho HY,et al.Long-term changes in expressions of spinal glutamatetransporters after spinal cord injury[J].Brain Research,2011,1389(7):194-199.
[29]Arundine M,Tymianski M.Molecular mechanisms of calcium-dependent neurodegeneration in excitotoxicity[J].Cell Calcium,2003,34(4):325-337.
[30]Kawamata M,Omote K.Involvement of increased excitatory amino acids and intracellular Ca2+,concentration in the spinal dorsal horn in an animal model of neuropathic pain[J].Pain,1996,68(1):85-96.
[31]Tu WZ,Chen WC,Xia W,et al.The regulatory effect of electro-acupuncture on the expression of NMDA receptors in a SCI rat model[J].Life Sciences,2017,177(4):8-14.
[32]Jiang S,Tu W,Zou E,et al.Neuroprotective Effects of Different Modalities of Acupuncture on Traumatic Spinal Cord Injury in Rats[J].Evidence-Based Complementray and Alternative Medicine,2014(3):1-9.
[33]Reichardt LF.Neurotrophin-regulated signalling pathways[J].Philos Trans R Soc Lond B Biol Sci,2006,361(1473):1545-1564.
[34]Sharma HS.Selected Combination of Neurotrophins Potentiate Neuroprotection and Functional Recovery Following Spinal Cord Injury in the Rat[J].Acta Neurochirurgica Supplement,2010,106(106):295-300.
[35]黄志强,刘宇,苏昭元,等.电针“长强”穴对大鼠急性脊髓损伤后神经生长因子和脑源性神经营养因子表达的影响[J].中国针灸,2018,38(4):399-404.
[36]肖建如,赵定麟,曾华武,等.脊髓损伤组织血小板活化因子变化与脊髓水肿的关系[J].中华创伤杂志,1995(6):10-12,89.
[37]王延雷,齐英娜,董春科,等.脊髓减压联合督脉电针对急性脊髓压迫损伤大鼠疗效影响的实验研究[J].中国中医骨伤科杂志,2018,26(2):3-7.
[38]吴永刚,孙申田,贺燕,等.实验性脊髓损伤早期针刺治疗的时间窗口中度(50克-cm)脊髓损伤血流量研究[J].针灸临床杂志,1997,13(10):18-20.
[39]马培泽,孙正新,姜月华.自噬研究的新动向-自噬流[J].医学信息,2016,29(19):28-29.
[40]Goodall ML,Fitzwalter B,Zahedi S,et al.The Autophagy Machinery Controls Cell Death Switching between Apoptosis and Necroptosis[J].Developmental Cell,2016,37(4):337-349.
[41]冯德琳.夹脊电针调节细胞自噬促进脊髓损伤修复的实验研究[D].哈尔滨:黑龙江中医药大学,2018.
[42]Michael Fricker,Aviva M.Tolkovsky,Neuronal cell death[J].Physiol Rev,2018,169(2):813-888.
[43]Galluzzi L,Kroemer G.Necroptosis:a specialized pathway of programmed necrosis[J].Cell,2008,135(7):1161-1163.
[44]Galluzzi L,Kroemer G.Necroptosis turns TNF lethal[J].Immunity,2011,35(6):908-918.
[45]Dong K,Zhu ZC,Wang FH,et al.Activation of autophagy in photoreceptor necroptosisafter experimental retinal detachment[J].International Journal of Ophthalmology,2014,7(5):745.
[2]Wang KC,Kim JA,Sivasankaran R,et al.P75 interacts with the Nogo receptor as a co-receptor for Nogo,MAG and OMgp[J].Nature,2002,420(6911):74.
[3]闵友江,张辉,肖伟平,等.电针对脊髓损伤大鼠Nogo-A、NgRmRNA及蛋白表达影响的实验研究[J].时珍国医国药,2017,28(4):995-998.
[4]马睿杰,张柳娟,孙连珠,等.夹脊电针干预脊髓损伤大鼠OMgp表达的研究[J].中华中医药学刊,2014,32(6):1283-1286,1541.
[5]Zhang S,Kluge B,Huang F,et al.Photochemical scar ablation in chronically contused spinal cord of rat[J].Journal of Neurotrauma,2007,24(2):411-420.
[6]Zhe W,Yan W,Zhao W,et al.Electro-Acupuncture Modulates L1Adhesion Molecule Expression After Mouse Spinal Cord Injury[J].American Journal of Chinese Medicine,2017,45(1):37-52.
[7]李经辉,谢勇,刘禹,等.电针治疗对钳夹型大鼠脊髓损伤后BMP-2的表达[J].昆明医科大学学报,2014,35(3):19-22.
[8]马睿杰,何克林,张柳娟,等.电针干预脊髓损伤大鼠成熟少突胶质细胞增殖分化的影响[J].中华中医药杂志,2016,31(7):2771-2774.
[9]Lie DC,Song H,Colamarino SA,et al.Neurogenesis in the Adult Brain:New Strategies for Central Nervous System Diseases[J].Annual Review of Pharmacology&Toxicology,2004,44(1):399.
[10]Yan Q,Ruan J W,Ding Y,et al.Electro-acupuncture promotes differentiation of mesenchymal stem cells,regeneration of nerve fibers and partial functional recovery after spinal cord injury[J].Experimental&Toxicologic Pathology Official Journal of the Gesellschaft Für Toxikologische Pathologie,2011,63(1):151-156.
[11]Wang X,Ju S,Chen S,et al.Effect of Electro-Acupuncture on Neuroplasticity of Spinal Cord-Transected Rats[J].Med Sci Monit,2017,23(2):4241-4251.
[12]Kerr JF,Wyllie AH,Currie AR.Apoptosis:a basic biological phenomenon with wide-ranging implications in tissue kinetics[J].Br J Cancer,1972,26(4):239-257.
[13]Borgens RB,Liu-Snyder P.Understanding Secondary Injury[J].Quarterly Review of Biology,2012,87(2):89.
[14]李晓宁,吴磊,迟蕾,等.不同治疗周期夹脊电针对急性脊髓损伤大鼠运动功能及细胞凋亡的影响[J].针刺研究,2016,41(6):492-496.
[15]Liu J,Wu Y.Electro-acupuncture-modulated miR-214 prevents neuronal apoptosis by targeting Bax and inhibits sodium channel Nav1.3 expression in rats after spinal cord injury[J].Biomedicine&pharmacotherapy,2017,89(2):1125.
[16]尹洪娜,孙忠人,李全.电针夹脊穴对脊髓损伤大鼠内质网应激相关因子CHOP影响的实验研究[J].中医药信息,2016,33(4):35-38.
[17]尹洪娜,孙忠人,李全.电针夹脊穴对脊髓损伤大鼠内质网应激相关因子Caspase-12影响的实验研究[J].中医药学报,2016,44(3):33-36.
[18]Akhtar AM,Al STS,Eid AH.Inflammogenesis of Secondary Spinal Cord Injury[J].Frontiers in Cellular Neuroscience,2016,10(98):1-24.
[19]Chávez-Galán L,Olleros ML,Vesin D,et al.Much more than M1and M2 macrophages,there are also CD169(+)and TCR(+)macrophages[J].Front Immunol,2015,6(5):263.
[20]Italiani P,Boraschi D.From monocytes to M1/M2 macrophages:phenotypical vs.functional differentiation[J].Front Immunol,2014,5(10):514.
[21]Shechter R,Miller O,Yovel G,et al.Recruitment of beneficial M2macrophages to injured spinal cord is orchestrated by remote brain choroid plexus[J].Immunity,2013,38(2):555-569.
[22]David S,Kroner A.Repertoire of microglial and macrophage responses after spinal cord injury[J].Nat Rev Neurosci,2011,12(7):388-399.
[23]Loane DJ,Byrnes KR.Role of microglia in neurotrauma[J].Neurotherapeutics,2010,7(4):366-377.
[24]Zhao J,Wang L,Li Y.Electroacupuncture alleviates the inflammatory response via effects on M1 and M2 macrophages after spinal cord injury[J].Acupuncture in Medicine Journal of the British Medical Acupuncture Society,2017,35(3):224.
[25]Mangan MSJ,Olhava EJ.Targeting the NLRP3 inflammasome in inflammatory diseases[J].Nat Rev Drug Discov,2018,17(8):588-606.
[26]Wu J,Li M,Fan H,et al.Targeting the NLRP3 inflammasome to attenuate spinal cord injury in mice[J].Journal of Neuroinflammation,2017,14(1):207.
[27]吴磊.夹脊电针调控脊髓损伤模型大鼠微环境NLRP3炎症小体活化作用及机制研究[D].哈尔滨:黑龙江中医药大学,2018:52-54.
[28]Kim Y,Park YK,Cho HY,et al.Long-term changes in expressions of spinal glutamatetransporters after spinal cord injury[J].Brain Research,2011,1389(7):194-199.
[29]Arundine M,Tymianski M.Molecular mechanisms of calcium-dependent neurodegeneration in excitotoxicity[J].Cell Calcium,2003,34(4):325-337.
[30]Kawamata M,Omote K.Involvement of increased excitatory amino acids and intracellular Ca2+,concentration in the spinal dorsal horn in an animal model of neuropathic pain[J].Pain,1996,68(1):85-96.
[31]Tu WZ,Chen WC,Xia W,et al.The regulatory effect of electro-acupuncture on the expression of NMDA receptors in a SCI rat model[J].Life Sciences,2017,177(4):8-14.
[32]Jiang S,Tu W,Zou E,et al.Neuroprotective Effects of Different Modalities of Acupuncture on Traumatic Spinal Cord Injury in Rats[J].Evidence-Based Complementray and Alternative Medicine,2014(3):1-9.
[33]Reichardt LF.Neurotrophin-regulated signalling pathways[J].Philos Trans R Soc Lond B Biol Sci,2006,361(1473):1545-1564.
[34]Sharma HS.Selected Combination of Neurotrophins Potentiate Neuroprotection and Functional Recovery Following Spinal Cord Injury in the Rat[J].Acta Neurochirurgica Supplement,2010,106(106):295-300.
[35]黄志强,刘宇,苏昭元,等.电针“长强”穴对大鼠急性脊髓损伤后神经生长因子和脑源性神经营养因子表达的影响[J].中国针灸,2018,38(4):399-404.
[36]肖建如,赵定麟,曾华武,等.脊髓损伤组织血小板活化因子变化与脊髓水肿的关系[J].中华创伤杂志,1995(6):10-12,89.
[37]王延雷,齐英娜,董春科,等.脊髓减压联合督脉电针对急性脊髓压迫损伤大鼠疗效影响的实验研究[J].中国中医骨伤科杂志,2018,26(2):3-7.
[38]吴永刚,孙申田,贺燕,等.实验性脊髓损伤早期针刺治疗的时间窗口中度(50克-cm)脊髓损伤血流量研究[J].针灸临床杂志,1997,13(10):18-20.
[39]马培泽,孙正新,姜月华.自噬研究的新动向-自噬流[J].医学信息,2016,29(19):28-29.
[40]Goodall ML,Fitzwalter B,Zahedi S,et al.The Autophagy Machinery Controls Cell Death Switching between Apoptosis and Necroptosis[J].Developmental Cell,2016,37(4):337-349.
[41]冯德琳.夹脊电针调节细胞自噬促进脊髓损伤修复的实验研究[D].哈尔滨:黑龙江中医药大学,2018.
[42]Michael Fricker,Aviva M.Tolkovsky,Neuronal cell death[J].Physiol Rev,2018,169(2):813-888.
[43]Galluzzi L,Kroemer G.Necroptosis:a specialized pathway of programmed necrosis[J].Cell,2008,135(7):1161-1163.
[44]Galluzzi L,Kroemer G.Necroptosis turns TNF lethal[J].Immunity,2011,35(6):908-918.
[45]Dong K,Zhu ZC,Wang FH,et al.Activation of autophagy in photoreceptor necroptosisafter experimental retinal detachment[J].International Journal of Ophthalmology,2014,7(5):745.