中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (4): 1512-1527.doi: 10.4103/NRR.NRR-D-24-01405

• 综述:脊髓损伤修复保护与再生 • 上一篇    下一篇

脊髓损伤后髓鞘碎片的生成和清除

  

  • 出版日期:2026-04-15 发布日期:2025-07-26
  • 基金资助:
    国家自然科学基金（82271411，51803072）；吉林大学中日联谊医院人才培养国际合作项目 “星海计划”（XHLH202404）；吉林省科技发展计划（YYH202404）；吉林大学科技进步二等奖（YYH202404）。吉林省科技发展计划（YDZJ202201ZYTS038）；吉林省财政计划（2022SCZ10）。

Generation and clearance of myelin debris after spinal cord injury

Chaoyuan Li1 , Wenqi Luo1 , Irshad Hussain2 , Renrui Niu1 , Xiaodong He1 , Chunyu Xiang1 , Fengshuo Guo1 , Wanguo Liu1, *, Rui Gu1, *   

  1. 1 Department of Orthopedic Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China;  2 Department of Chemistry and Chemical Engineering, SBA School of Science & Engineering, Lahore University of Management Sciences, DHA, Lahore, Pakistan
  • Online:2026-04-15 Published:2025-07-26
  • Contact: Wanguo Liu, MD, PhD, liuwanguo6016@jlu.edu.cn; Rui Gu, MD, PhD, gurui@jlu.edu.cn.
  • Supported by:

    1 Department of Orthopedic Surgery, China-Japan Union Hospital, Jilin University, Changchun, Jilin Province, China; 

    2 Department of Chemistry and Chemical Engineering, SBA School of Science & Engineering, Lahore University of Management Sciences, DHA, Lahore, Pakistan

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摘要：

外伤性脊髓损伤通常会导致神经细胞和轴突解体，造成大量髓鞘碎片堆积，多年来一直无法清除。损伤部位髓鞘碎片的异常堆积严重阻碍了神经再生，因此清除微环境中的碎片对脊髓损伤后的有效修复至关重要。为此，文章全面概述促进髓鞘碎片清除和新陈代谢的相关机制，并总结其在脊髓损伤中的作用。此综述首先全面总结了髓鞘碎片的组成和特征，并解释了髓鞘碎片对损伤部位的影响。然后，文章介绍了髓鞘碎片的吞噬细胞，包括专业吞噬细胞(巨噬细胞和小胶质细胞)、非专业细胞(星形胶质细胞和微血管内皮细胞)以及可能参与吞噬的细胞，这些细胞值得进一步研究。最后，文章重点研究了促进吞噬细胞吞噬髓鞘碎片和促进脊髓损伤脂质代谢的靶点和途径。通过总结和分析发现，不仅单核细胞源性巨噬细胞，小胶质细胞、星形胶质细胞和微血管内皮细胞也具有吞噬髓鞘碎片的能力。通过调节与吞噬和脂质代谢相关的基因表达，可以调节脂质代谢紊乱并影响炎症表型，进而影响脊髓损伤后运动功能的恢复。此外，靶向线粒体移植疗法中的吞噬细胞、外泌体疗法和重复经脊髓磁刺激等疗法可有效提高髓鞘碎片的清除率，具有广阔的应用前景。

https://orcid.org/0009-0004-8053-9934 (Wanguo Liu); https://orcid.org/0009-0001-4652-5561 (Rui Gu)

关键词: 泡沫细胞, 脂滴, 脂质代谢, 巨噬细胞, 髓鞘碎片, 小胶质细胞, 髓鞘蛋白, 髓鞘, 神经再生, 吞噬, 脊髓损伤

Abstract: Traumatic spinal cord injury often leads to the disintegration of nerve cells and axons, resulting in a substantial accumulation of myelin debris that can persist for years. The abnormal buildup of myelin debris at sites of injury greatly impedes nerve regeneration, making the clearance of debris within these microenvironments crucial for effective post-spinal cord injury repair. In this review, we comprehensively outline the mechanisms that promote the clearance of myelin debris and myelin metabolism and summarize their roles in spinal cord injury. First, we describe the composition and characteristics of myelin debris and explain its effects on the injury site. Next, we introduce the phagocytic cells involved in myelin debris clearance, including professional phagocytes (macrophages and microglia) and non-professional phagocytes (astrocytes and microvascular endothelial cells), as well as other cells that are also proposed to participate in phagocytosis. Finally, we focus on the pathways and associated targets that enhance myelin debris clearance by phagocytes and promote lipid metabolism following spinal cord injury. Our analysis indicates that myelin debris phagocytosis is not limited to monocyte-derived macrophages, but also involves microglia, astrocytes, and microvascular endothelial cells. By modulating the expression of genes related to phagocytosis and lipid metabolism, it is possible to modulate lipid metabolism disorders and influence inflammatory phenotypes, ultimately affecting the recovery of motor function following spinal cord injury. Additionally, therapies such as targeted mitochondrial transplantation in phagocytic cells, exosome therapy, and repeated trans-spinal magnetic stimulation can effectively enhance the removal of myelin debris, presenting promising potential for future applications.

Key words: foam cells, lipid droplets, lipid metabolism, macrophages, microglia, myelin debris, myelin proteins, myelin sheath, nerve regeneration, phagocytosis, spinal cord injury