Neurological Surgery 脳神経外科49巻4号

2021年07月発行

総説

実験的脳動脈瘤モデルを用いた基礎研究の歴史と最新知見

著者： 小関宏和¹ 村山雄一¹

所属機関： ¹東京慈恵会医科大学医学部脳神経外科

ページ範囲：P.888 - P.897

Ⅰ はじめに
　脳動脈瘤は，発生から増大，破裂に至るまでの経過を予測することが極めて困難な疾患であることから，その病態機序の解明には臨床像を模倣した疾患モデルが不可欠である．臨床での動脈瘤壁の病理学的・遺伝学的所見，および血管画像を用いた流体解析などから，脳動脈瘤が血流ストレス依存的な疾患であり，血管壁に炎症を伴う病変であることが示唆されてきたが^1-4），それらの因果関係や，炎症に至るまでの機序については未だ不明な点も多い．この課題を解決すべく，70年ほどの間に実験的な脳動脈瘤モデルの開発が進み，それと相まって疾患に対する理解が深まり，そこから生まれてくる新たな課題に対してそれらのモデルが進化を遂げてきた，あるいは新たなモデルが生み出されてきた．
　本稿では，実験的脳動脈瘤モデルの歴史を紐解きながら，それらのバリエーションや特徴について概説する．詳細な病態機序の解説については他稿に譲るが，これらの実験的脳動脈瘤モデルによって得られた最新の知見について紹介する．

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