表观遗传学调控神经元分化治疗脊髓损伤的研究进展

Research progress on epigenetics regulated neuronal differentiation in the treatment of spinal cord injury

中文关键词:  生物力学研究  尸体标本  颈椎融合术

英文关键词:Biomechanics  Cadaveric specimens  Fusion  Cervical spine

中文摘要:

  脊髓损伤（spinal cord injury，SCI）是脊柱骨折的严重并发症之一。SCI不仅导致肢体活动和功能的障碍、社会和职业角色的受损，还可以导致患者心理状态的改变，从而增加患抑郁症的几率，严重影响患者与家属的日常生活。严重的SCI几乎可以导致损伤部位的神经细胞完全丧失活性，造成神经回路的不可逆破坏。神经干细胞或前体细胞（neural stem or precursor cells，NS/PCs）可分化为神经元和胶质细胞（星形胶质细胞和少突胶质细胞），从而替补损伤部位失活的神经细胞，因此NS/PCs移植被认为是治疗SCI的潜在有效方法。了解NS/PCs及其子代增殖与分化的分子机制，有助于制定更好的SCI后再生治疗策略。近年来，一些研究表明，特定的表观遗传学调控有助于促进损伤部位的NS/PCs向神经元分化或幸存的神经元轴突伸长，其中研究较多的是组蛋白修饰和非编码RNA（non-coding RNAs，NcRNAs）。笔者就近年来通过表观遗传学调控神经元分化治疗SCI的研究进展综述如下。

英文摘要:

  【Abstract】 Objectives: To evaluate the immediate stability of a new miniature memory compression alloy plate (GYZ memory alloy plate) for anterior cervical discectomy and fusion through biomechanical test in fresh cadaver specimens. Methods: Thin layer CT scan and bone density examination were on the cervical spine of 6 fresh cadaveric specimens(male, average age: 55.2±7.1 years old, average height: 175.4±3.8cm, average weight: 72.3±6.0kg) to exclude fractures, deformities and osteoporosis. All specimens were removed from peripheral blood vessels, muscles and other soft tissues, while ligaments and joint capsules were retained. Then, the specimens were divided into intact group, injury group, new alloy plate group and traditional titanium plate group. In the intact group no treatment was given. In the injury group, only the C3/4 intervertebral disc was damaged. In the new prosthesis group, C3/4 intervertebral fusion and fixation with GYZ memory alloy plate was given. In the traditional titanium plate group, C3/4 intervertebral fusion and fixation with traditional titanium platewas given. Each group was loaded under 1.5N·m in the direction of flexion, extension, left and right lateral bending and left and right torsion. The results of the third experiment were recorded and the range of motion (ROM) of C3/4 intervertebral disc in flexion, extension, left and right lateral bending and left and right torsion direction of the four groups were collected and analyzed. Results: Postoperative imaging showed that the position of the prostheses was normal. In the intact group, the ROMs of C3/4 disc in flexion, extension, left lateral bending, right lateral bending, left rotation and right rotation were 4.8°±0.5°, 2.5°±0.1°, 2.4°±0.3°, 2.6°±0.3°, 2.0°±0.2° and 3.9°±0.1°, respectively. The ROMs of C3/4 disc in the injury group were respectively 6.0°±0.7°, 3.4°±0.3°, 3.4°±0.5°, 3.8°±0.6°, 2.4°±0.9° and 5.7°±1.3°. Compared with the intact group, the C3/4 ROMs in the injury group in flexion, extension, lateral bending and rotation direction increased significantly(P<0.05). The C3/4 ROMs in the new alloy plate group in the above six directions were 0.6°±0.1°, 0.4°±0.1°, 0.5°±0.1°, 0.7°±0.1°, 0.6°±0.1° and 1.0°±0.1°, respectively, while those in the traditional titanium plate group were 0.6°±0.1°, 0.5°±0.1°, 0.5°±0.1°, 0.7°±0.1°, 0.5°±0.1° and 1.0°±0.1°. The ROMs of the new alloy plate group and the traditional titanium plate group decreased significantly in the above directions(P<0.05). There was no significant difference in ROMs between the new alloy plate group and the traditional titanium plate group in the above directions(P>0.05). Conclusions: The miniature memory alloy plate can obtain the fixation strength and the immediate stability of the operation site similar to the traditional titanium plate.