Hypoxic conditioning and the central nervous system: A new therapeutic opportunity for brain and spinal cord injuries?
Hypoxic conditioning and the central nervous system: A new therapeutic opportunity for brain and spinal cord injuries?
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DOI：
10.1177/1535370217712691
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发表时间：
2017-06-01
影响因子：
3.2
通讯作者：
Verges, S.
中科院分区：
文献类型：
--
作者：
Baillieul, S.;Chacaroun, S.;Verges, S.
中枢神经系统疾病是世界上最致残的疾病之一。急性或慢性神经变性的神经保护和脑恢复仍然是神经病学和神经康复的挑战，因为药理学治疗通常不够有效。调节中枢神经系统已被提出作为一种潜在的非药理学神经治疗。条件反射是指在接近但低于损伤阈值的情况下对生物体施加潜在有害刺激以增加对高于损伤阈值的相同或甚至不同有害刺激的抗性的过程。在几种细胞和临床前模型中已经研究了低氧条件反射，并且现在被认为是诱导神经保护的内源性机制。缺血性、创伤性或慢性神经退行性疾病可受益于旨在预防有害后果或降低病理状况的严重性（预处理）或旨在诱导中枢神经系统损伤后的神经可塑性和恢复（后处理）的低氧调节策略。低氧条件反射可以是单一的（持续的）或周期性的（间歇性的，穿插着短时间的常氧）低氧刺激，其持续时间从几分钟到几小时不等，并且可以重复几天或几周。这篇简短的评论讨论了现有的证据，关于使用低氧条件反射作为一种潜在的创新神经治疗方式，以诱导神经保护，神经可塑性和脑恢复。这篇简短的评论也强调了仍有待澄清的问题和该领域未来的研究。
Central nervous system diseases are among the most disabling in the world. Neuroprotection and brain recovery from either acute or chronic neurodegeneration still represent a challenge in neurology and neurorehabilitation as pharmacology treatments are often insufficiently effective. Conditioning the central nervous system has been proposed as a potential non-pharmacological neuro-therapeutic. Conditioning refers to a procedure by which a potentially deleterious stimulus is applied near to but below the threshold of damage to the organism to increase resistance to the same or even different noxious stimuli given above the threshold of damage. Hypoxic conditioning has been investigated in several cellular and preclinical models and is now recognized as inducing endogenous mechanisms of neuroprotection. Ischemic, traumatic, or chronic neurodegenerative diseases can benefit from hypoxic conditioning strategies aiming at preventing the deleterious consequences or reducing the severity of the pathological condition (preconditioning) or aiming at inducing neuroplasticity and recovery (postconditioning) following central nervous system injury. Hypoxic conditioning can consist in single (sustained) or cyclical (intermittent, interspersed by short period of normoxia) hypoxia stimuli which duration range from few minutes to several hours and that can be repeated over several days or weeks. This mini-review addresses the existing evidence regarding the use of hypoxic conditioning as a potential innovating neuro-therapeutic modality to induce neuroprotection, neuroplasticity and brain recovery. This mini-review also emphasizes issues which remain to be clarified and future researches to be performed in the field.