وقایع بیوشیمیایی و سلولی در آسیب‌های نخاعی: ازپاتوفیزیولوژی تا درمان

نوع مقاله : مقاله های پژوهشی

نویسنده

دکتری تخصصی ژنتیک مولکولی، مرکز تحقیقات ژنتیک انسانی، دانشگاه علوم پزشکی بقیه‌اله، تهران، ایران

چکیده

هنوز درمان قطعی برای آسیب‌های نخاعی که در اثر عوامل ترومایی (ناشی از حادثه) و غیر ترومایی (ناشی از بیماری‌ها) ایجاد می‌شوند، یافت نشده است و این امر به دلیل پاتوفیزیولوژی پیچیده‌ای است که این آسیب‌ها دارند؛ به ویژه اگر بیماری در مراحل مزمن باشد. این مسأله هزینه‌های اقتصادی و روانی گزافی را به خانواده و اجتماع تحمیل می‌نماید. از نظر بالینی، پاتوفیزیولوژی این بیماران به دو فاز اصلی آسیب اولیه و ثانویه تقسیم‌بندی می‌گردد. آسیب اولیه با ضایعه به نخاع شروع می‌شود و طی یک سری وقایع مولکولی ثانویه که به صورت آبشاری اتفاق می‌افتد، یک حفره‌ی بزرگ در ناحیه‌ی آسیب تشکیل می‌دهد و زخم گلیایی را ایجاد می‌کند که سد فیزیکی و شیمیایی در مقابل ترمیم نخاع آسیب‌دیده می‌باشد. به طور کلی، موانعی بر سر راه ترمیم نورون‌ها و درمان قطعی آسیب‌های نخاعی وجود دارد که استراتژی‌های ترمیمی مورد استفاده در درمان این بیماری باید بر این سدها غلبه کند. بسیاری از استراتژی‌های پیشنهادی، در مراحل آزمایشگاهی و پیش‌بالینی موفق بوده و حتی به مرحله‌ی بالینی نیز رسیده‌اند. پژوهش مروری حاضر، خلاصه‌ای از آخرین یافته‌های درمانی مؤثر در این بیماری را ارایه نمود.

کلیدواژه‌ها

عنوان مقاله [English]

Biochemical and Cellular Events in Spinal Cord Injury: From Pathophysiology to Treatment

نویسنده [English]

  • Houri Edalat
PhD in Molecular Genetics, Human Genetics Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
چکیده [English]

No definite treatment has been reported thus far for spinal cord injuries (SCI) that is mainly due to its complex nature and pathophysiology, specifically in chronic stages of the disease. The disease imposes lots of financial and psychological costs to the families and society. From pathophysiological aspects, the disease can be divided into two phases of primary and secondary injuries. The primary damage begins with an initial lesion which -during a series of secondary molecular events in the form of a cascade- produces a large cavity in the initial damaged area called glial scar. The glial scar creates a physical and chemical barrier against repairing the injured spinal cord. In fact, there are many barriers against recovery of neurons that regenerative treatment strategies have to overcome. Many of methods suggested to cure SCI have been shown to be successful in vitro and pre-clinical studies, and have not reached clinical trial phases. This review study provides some of the latest strategies shown to be effective for treatment of SCI.

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مجله دانشکده پزشکی اصفهان
دوره 37، شماره 521 - شماره پیاپی 521
خرداد و تیر 1398
صفحه 316-327

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سابقه مقاله

  • تاریخ دریافت: 01 دی 1397
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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