喉返神经损伤基因治疗的研究进展

Advances in Research on Gene Therapy for Recurrent Laryngeal Nerve Injury

喉返神经损伤是甲状腺手术的严重并发症之一,会导致语言和吞咽等功能障碍,降低患者术后生活质量。目前喉返神经修复的机制仍不明确,治疗的主要方法是通过建立转基因载体,将治疗基因植入神经纤维、喉肌和声带黏膜等治疗靶点,从而实现神经及声带相关肌肉功能的恢复,其中神经生长因子在喉返神经基因治疗中发挥重要作用。目前该技术中神经纤维错向再生仍无法有效解决,即修复后的神经元可能错误地支配其他喉肌。未来,研究的重点是找出定向诱导神经纤维修复再生的方法,从而使再生的神经纤维可以精准地支配对应部位的肌肉。

Recurrent laryngeal nerve injury is one of the serious complications of thyroid surgery,resulting in voice and swallowing dysfunction,which seriously reduces the quality of life of the patients.At present,the recovery mechanisms of the recurrent laryngeal nerve repair is not clear,and the general treatment method is to establish a transgenic vector and implant therapeutic genes into nerve fibers,laryngeal muscles,vocal cord mucosa and other therapeutic targets,so as to restore the function of nerves and vocal cord-related muscles,among which nerve growth factor plays an important role.At present,the wrong direction regeneration of nerve fibers in this technology still cannot be effectively solved,that is,the repaired neurons may incorrectly innervate other laryngeal muscles.In the future,the focus of the research will be finding a method for directional induction of nerve fiber repair and regeneration,so that the regenerated nerve fiber can accurately innervate the muscles of the corresponding part.