脊髓损伤后继发性损伤的相关信号通路

Signaling pathways in secondary injuries following spinal cord injury

背景:在脊髓损伤的病理过程中,原发性损伤对脊髓神经结构的伤害难以逆转,目前国内外研究的重点主要集中在通过各种手段干预"继发性损伤"阶段,减少神经元的坏死和凋亡,减少损伤面积的进一步扩大,为轴突再生创造良好的微环境,阻断脊髓损伤后继发性损伤的进展并促进神经再生。目的:通过回顾分析国内外关于脊髓损伤后继发性损伤相关信号通路的研究报道,以明确参与脊髓损伤后继发损伤中的关键信号通路及药物作用途径,为脊髓损伤的治疗提供理论依据。方法:以"spinal cord injury,signaling pathway"为英文关键词,以"脊髓损伤,信号通路"为中文关键词,计算机检索Pub Med数据库、EMBASE数据库、Medline数据库、CNKI中国期刊全文数据库及万方数据库2006至2016年有关脊髓损伤信号转导通路的文献,就脊髓损伤后继发性损伤相关信号通路进行综述。结果与结论:(1)目前脊髓损伤后继发性损伤相关信号转导通路主要集中在丝裂原活化蛋白激酶(MAPK)信号通路、核转录因子κB信号通路、PI3K/PKB(Akt)信号通路、Janus激酶/信号转导子和转录激活子(JAK/STAT)信号通路、Wnt信号通路方面;(2)以上通路在脊髓损伤后继发损伤的发生发展及修复中扮演重要角色,值得深入研究。

BACKGROUND： Primary injuries of the spinal cord are irreversible in the pathoplhysiological process. Most of studieshave focused on prevention against secondary injuries, by reducing neuronal apoptosis and necrosis as well asdecreasing damage area, which provides favorable environment for axonal regeneration, blocks secondary injury andpromotes neural regeneration after spinal cord injury.OBJECTIVE： To review the recent advances in the signaling pathway related to secondary injuries after spinal cord injury,and to clarify the related signaling pathways, thereby providing theoretical basis for the treatment of spinal cord injury.METHODS： PubMed, EMBASE, Medline, CNKI, CJFD and Wanfang databases were retrieved for the articlesaddressing the signaling pathways in spinal cord injury published between 2006 to 2016. The keywords were “spinal cordinjury, signaling pathway” in English and Chinese, respectively. The signaling pathways in secondary injuries after spinalcord injury were summarized.RESULTS AND CONCLUSION： Mitogen activated protein kinase, nuclear factor of kappa B, PI3K/PKB （Akt）, Januskinase/signal transducer and activator of transcription, and Wnt signaling pathways are mainly involved in secondaryinjuries after spinal cord injury. All these pathways play a significant role in the development and repair of spinal cordinjury, and future investigation on them is warranted.