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Neurological Surgery 脳神経外科35巻7号

2007年07月発行

文献概要

連載 脳神経外科における再生医療―臨床応用にむけて(4)

中枢神経回路の再生への戦略

著者: 山下俊英1 羽田克彦1 山口淳1 久保武一1

所属機関: 1千葉大学大学院医学研究院神経生物学

ページ範囲:P.733 - P.739

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Ⅰ.はじめに

 近年,中枢神経疾患による神経脱落症状を緩和するための治療法の研究が急速に進んでいる.特に脊髄損傷後の機能回復を高めるさまざまな手法が動物実験で試みられており,既に臨床応用されているものもある.しかしながら,それらの治療法がなぜ機能的回復をもたらすのかというメカニズムについては,実はよくわかっていない.脊髄の完全損傷の場合,損傷部を通過する軸索はすべて離断される.したがって運動機能を取り戻すためには,損傷した軸索が損傷部を超えて再生し,末梢の運動神経まで途切れなく回路をつくらなければならない.ところが中枢神経細胞をとりまく環境が軸索再生に適しておらず,さらに中枢神経自体の軸索再生力が弱いために,損傷した中枢神経回路は自然には再生しない.一方,不完全損傷の場合には,ある程度の運動機能の回復が長い期間のうちにもたらされることがある.これは,脳および脊髄で代償的な回路網の再形成が起こるためだと考えられる.実際に,損傷を免れた軸索からの側枝の形成による新たな回路の形成が,ほ乳類の成体でも起こっていることが明らかになってきた16).これらの知見から,損傷した軸索の再生を誘導したり,代償回路の形成を促進したりする治療法が有効ではないかと考えられる.本稿では,神経回路の再生を正と負に制御するメカニズムと,神経回路の再形成を促進する実験的治療法について概説したい.

参考文献

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掲載誌情報

出版社:株式会社医学書院

電子版ISSN:1882-1251

印刷版ISSN:0301-2603

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