中国神经再生研究(英文版) ›› 2017, Vol. 12 ›› Issue (8): 1220-1224.doi: 10.4103/1673-5374.213534

• 综述:视神经损伤修复保护与再生 • 上一篇    下一篇

神经营养因子和角膜神经再生

  

  • 收稿日期:2017-07-20 出版日期:2017-08-15 发布日期:2017-08-15

Neurotrophic factors and corneal nerve regeneration

Marta Sacchetti, Alessandro Lambiase   

  1. Department of Sense Organs, Sapienza University of Rome, Rome, Italy
  • Received:2017-07-20 Online:2017-08-15 Published:2017-08-15
  • Contact: Alessandro Lambiase, M.D.,Ph.D.,alessandro.lambiase@uniroma1.it.

摘要:

已有研究显示,多种营养因子对角膜再生有积极作用,包括神经生长因子(NGF)、表皮生长因子、物质P和胰岛素样生长因子-1、血管内皮生长因子、信号素、神经营养因子3和4、生长相关蛋白-43。这些营养因子虽可促进角膜炎(NK)患者角膜愈合,但从体内成像证据来看,很少表现出角膜敏感性和神经形态功能恢复的效果。本次临床试验初步表明,施NGF滴眼液能够诱导鼠发生与NK患者角膜敏感性恢复相关的角膜愈合。此外,NGF在诱导神经再生中的潜在作用已经在多种人类疾病如糖尿病、创伤性和中毒性神经病变中得到了清楚的证实。最近,研究已经开发了一种新的重组人类NGF,并且对NK患者进行了II期临床试验,这为今后NGF用于诱导角膜神经再生开辟了新的前景。

orcid:0000-0002-8974-991X(Alessandro Lambiase)
0000-0001-5569-778X(Marta Sacchetti)

 

Abstract:

The cornea has unique features that make it a useful model for regenerative medicine studies. It is an avascular, transparent, densely innervated tissue and any pathological changes can be easily detected by slit lamp examination. Corneal sensitivity is provided by the ophthalmic branch of the trigeminal nerve that elicits protective reflexes such as blinking and tearing and exerts trophic support by releasing neuromediators and growth factors. Corneal nerves are easily evaluated for both function and morphology using standard instruments such as corneal esthesiometer and in vivo confocal microscope. All local and systemic conditions that are associated with damage of the trigeminal nerve cause the development of neurotrophic keratitis, a rare degenerative disease. Neurotrophic keratitis is characterized by impairment of corneal sensitivity associated with development of persistent epithelial defects that may progress to corneal ulcer, melting and perforation. Current neurotrophic keratitis treatments aim at supporting corneal healing and preventing progression of corneal damage. Novel compounds able to stimulate corneal nerve recovery are in advanced development stage. Among them, nerve growth factor eye drops showed to be safe and effective in stimulating
corneal healing and improving corneal sensitivity in patients with neurotrophic keratitis. Neurotrophic keratitis represents an useful model to evaluate in clinical practice novel neuro-regenerative drugs.

Key words: neurotrophic keratitis, corneal sensitivity, nerve regeneration, nerve growth factor