电针治疗脊髓损伤后神经源性膀胱信号通路研究进展

Research Progress on Neurogenic Bladder Signaling Pathways after Electroacupuncture in the Treatment of Spinal Cord Injury

神经源性膀胱是脊髓损伤患者最常见的并发症之一,其所引起的泌尿系统不同程度的功能障碍,给患者及其家庭带来了巨大的痛苦。电针可通过调节体内多个信号通路来改善脊髓损伤后神经源性膀胱症状,垂体腺苷酸环化酶激活肽/环磷酸腺苷/蛋白激酶A(PACAP/cAMP/PKA)信号通路、Wnt/β-catenin信号通路、磷脂酰肌醇-3-激酶/蛋白激酶B/哺乳动物雷帕霉素靶点(PI3K/AKT/mTOR)信号通路已成为当前研究热点,但仍需关注以下几个方面:实验研究多集中在单一信号通路上,各信号通路之间的相互作用有待进一步验证;电针可激活体内信号通路,但对于相关通路上下游信号分子及其他相关转录蛋白的表达检测仍缺乏;电针不同穴位对各信号通路和信号分子的影响有待进一步研究;电针通过激活JAK-STAT信号通路改善脊髓损伤后神经源性膀胱功能的具体机制有待进一步探讨揭示。

Neurogenic bladder is one of the most common complications in patients with spinal cord injury,and the urinary system caused by it causes varying degrees of dysfunction,which brings great pain to patients and their families.Electroacupuncture can improve neurogenic bladder symptoms after spinal cord injury by regulating multiple signaling pathways in vivo,and the pituitary adenylate cyclase activates peptide/cyclic adenosine monophosphate/protein kinase A(PACAP/cAMP/PKA)signaling pathway,Wnt/β-catenin signaling pathway,phosphatidylinositol-3-kinase/protein kinase B/mammalian rapamycin target(PI3K/AKT/mTOR)signaling pathway has become a research hotspot,but the following aspects still need to be paid attention to:Experimental studies mostly focus on a single signal pathway,and the interaction between each signal pathway needs to be further verified.Electroacupuncture can activate signaling pathways in vivo,but the expression detection of signaling molecules and other related transcriptional proteins in the downstream and downstream of related pathways is still lacking.The effects of different acupuncture points on various signaling pathways and signaling molecules need to be further studied.The specific mechanism of electroacupuncture in improving neurogenic bladder function after spinal cord injury by activating the JAK-STAT signaling pathway needs to be further explored.