蓝斑核在帕金森病发病中的病理改变及其作用

Pathology and impact of the locus ceruleus in Parkinson's disease

目的帕金森病是一种常见的神经变性性疾病,其病理特征为中脑黑质多巴胺能神经元的选择性和进行性变性。而近来的临床资料提示,在帕金森病早期,脑桥蓝斑核的去甲肾上腺素能神经元先于黑质发生病变。实验室研究也发现,蓝斑变性后,黑质多巴胺能神经元的电生理状态、神经递质代谢活动会发生改变,对损伤因素的易感性增高,促进了帕金森病的发病。其原因可能为蓝斑通过调节递质释放、摄取毒物、分泌营养物质等方式影响黑质多巴胺能神经元以及该区域的神经胶质细胞,对多巴胺系统起到保护作用。本文综述了帕金森病临床资料中蓝斑的病理表现、以及基础研究中蓝斑与黑质的关系以及蓝斑对黑质起保护作用的可能机制。本综述应能为深入研究帕金森病的发病机制提供参考。

Objective Parkinson＇ s disease （PD） is a degenerative disorder of the brain characterized by the degeneration of dopaminergic neurons in the suhstantia nigra pars compacta （SNc）. Recently, however, it has been shown that noradrenergic cells from the locus coeruleus （LC） also degenerate prior to the SNc. Animal studies have disclosed that the eleetrophysiology and transmitter metabolism of DA neurons as well as its sensitivity to injury factors were abnormal due to LC lesion. The mechanism maybe lies in the function of LC which can accommodate of transmitter in DA neurons, absorb toxic substance and excrete nutrition factors to the SNc area influencing neurons and/or glial ceils, leading to promotion of onset of PD. In this article, we reviewed the pathology of the LC in PD patients, the relation between the LC and SNc in laboratory researches on PD animal models, and the protective mechanism of LC to the SNc, intending to help further studies on PD pathogenesis.