中国神经再生研究(英文版) ›› 2016, Vol. 11 ›› Issue (1): 71-72.doi: 10.4103/1673-5374.169614

• 观点:神经损伤修复保护与再生 • 上一篇    下一篇

多重药理学在中枢神经系统疾病神经再生中的地位?

  

  • 收稿日期:2015-08-19 出版日期:2016-01-15 发布日期:2016-01-15

Exploiting kinase polypharmacology for nerve regeneration

Hassan Al-Ali*, John L. Bixby, Vance P. Lemmon   

  1. Miami Project to Cure Paralysis, University of Miami, Miami, FL, USA(Al-Ali H, Bixby JL, Lemmon VP)
    Center for Computational Science, University of Miami, Miami, FL, USA (Bixby JL, Lemmon VP)
    Department of Neurological Surgery, University of Miami, Miami, FL, USA (Bixby JL, Lemmon VP)
    Department of Molecular & Cellular Pharmacology, University of Miami, Miami, FL, USA (Bixby JL)
  • Received:2015-08-19 Online:2016-01-15 Published:2016-01-15
  • Contact: Hassan Al-Ali, Ph.D., HAIALI@miami.edu.

摘要:

人类的中枢神经系统在轴突损伤后的再生能力极差。这可能有以下两个主要原因:(1)成熟中枢神经系统神经元内的发育调节再生能力下降;(2)存在构成轴突再生障碍的生物成分(例如,生长抑制分子)。除了这些神经元固有因子外,一些分子簇也是中枢神经系统微环境固有的(例如髓鞘相关蛋白)和其他由损伤激活的星形细胞分泌物(如硫酸软骨素蛋白聚糖),均会对轴突生长产生抑制作用。鉴于抑制成人中枢神经系统轴突再生的因素较多,要实现创伤性脑损伤后功能恢复是很困难的。实验性改变一些抑制因子或它们的介体从而促进神经再生/发芽已取得一定进展。同时也发表在以内源性抑制因子为靶点进行干预时,若能阻抑外源性抑制因子的作用,则会取得更为显著地促进神经再生效果。因此,开发促进中枢神经系统损伤的治疗药物,需要关注到多个神经再生靶标,这就涉及到了多重药理学。文章认为采用多靶点药物来治疗复杂的中枢神经系统疾病并不是一个新概念;然而,由于缺乏适当的方法而阻碍了多重药理学的系统性研究。但有趣的是,多重药理学在许多已批准的药物的研究过程起到了十分重要的作用。

Abstract:

The humancentral nervous system (CNS) has a markedly poor capacity for regenerating its axons following injury. This appears to be due to two main causes: 1) a developmentally regulated decline in regenerative capacity within mature CNS neurons, and 2) the presence of biological components that constitute barriers to axon regeneration (e.g., growth-inhibitory molecules). Intrinsic alterations have been elucidated by studies that show causative links between developmental changes in gene expression programs and growth-signaling states on one hand, and changes in regenerative capacity on the other. In addition to these neuron-intrinsic factors, several molecular species that are native to the CNS microenvironment, such as myelin associated proteins, and others that are secreted by injury-activated astrocytes, such as chondroitin sulfate proteoglycans (CSPGs), exert extrinsic inhibitory influences on growing axons.

Given the various factors that negatively influence axon regrowth in the adult CNS, achieving clinically relevant regeneration to promote recovery from traumatic injury has been difficult. Experimental manipulation of individual inhibitory factors, or their mediators, has resulted in some improvement of regeneration/sprouting. However, manipulations that simultaneously target intrinsic growth capacity while also blocking inhibition from extrinsic factors appear to produce the most pronounced effects in vivo. Development of effective therapies thus requires agents that simultaneously modulate multiple sources of regeneration failure. This could be achieved with drugs that engage multiple targets (polypharmacology) within various relevant signaling networks. The use of multi-target drugs to treat complex polygenic disorders is not a new concept; however,the lack of appropriate methodologies have hindered systematic exploitation of polypharmacology. Interestingly though, it appears that polypharmacologyis important for the therapeutic efficacy of many approved drugs.