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BDNF: New Views of an Old Player in Traumatic Brain Injury. BDNF:创伤性脑损伤中老角色的新观点。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-04-17 DOI: 10.1177/10738584231164918
Lauren P Giesler, Richelle Mychasiuk, Sandy R Shultz, Stuart J McDonald

Traumatic brain injury is a common health problem affecting millions of people each year. BDNF has been investigated in the context of traumatic brain injury due to its crucial role in maintaining brain homeostasis. Val66Met is a functional single-nucleotide polymorphism that results in a valine-to-methionine amino acid substitution at codon 66 in the BDNF prodomain, which ultimately reduces secretion of BDNF. Here, we review experimental animal models as well as clinical studies investigating the role of the Val66Met single-nucleotide polymorphism in traumatic brain injury outcomes, including cognitive function, motor function, neuropsychiatric symptoms, and nociception. We also review studies investigating the role of BDNF on traumatic brain injury pathophysiology as well as circulating BDNF as a biomarker of traumatic brain injury.

脑外伤是一种常见的健康问题,每年影响数百万人。由于 BDNF 在维持脑平衡中的关键作用,人们一直在研究脑外伤中的 BDNF。Val66Met 是一种功能性单核苷酸多态性,会导致 BDNF 原域中第 66 个密码子上的氨基酸发生缬氨酸到蛋氨酸的置换,最终减少 BDNF 的分泌。在此,我们回顾了有关 Val66Met 单核苷酸多态性在创伤性脑损伤结果(包括认知功能、运动功能、神经精神症状和痛觉)中作用的实验动物模型和临床研究。我们还回顾了有关 BDNF 对创伤性脑损伤病理生理学作用的研究,以及作为创伤性脑损伤生物标志物的循环 BDNF。
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引用次数: 0
Autonomic Dysreflexia in Spinal Cord Injury: Mechanisms and Prospective Therapeutic Targets. 脊髓损伤的自主神经反射障碍:机制与前瞻性治疗目标。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-12-12 DOI: 10.1177/10738584231217455
Cameron T Trueblood, Anurag Singh, Marissa A Cusimano, Shaoping Hou

High-level spinal cord injury (SCI) often results in cardiovascular dysfunction, especially the development of autonomic dysreflexia. This disorder, characterized as an episode of hypertension accompanied by bradycardia in response to visceral or somatic stimuli, causes substantial discomfort and potentially life-threatening symptoms. The neural mechanisms underlying this dysautonomia include a loss of supraspinal control to spinal sympathetic neurons, maladaptive plasticity of sensory inputs and propriospinal interneurons, and excessive discharge of sympathetic preganglionic neurons. While neural control of cardiovascular function is largely disrupted after SCI, the renin-angiotensin system (RAS), which mediates blood pressure through hormonal mechanisms, is up-regulated after injury. Whether the RAS engages in autonomic dysreflexia, however, is still controversial. Regarding therapeutics, transplantation of embryonic presympathetic neurons, collected from the brainstem or more specific raphe regions, into the injured spinal cord may reestablish supraspinal regulation of sympathetic activity for cardiovascular improvement. This treatment reduces the occurrence of spontaneous autonomic dysreflexia and the severity of artificially triggered dysreflexic responses in rodent SCI models. Though transplanting early-stage neurons improves neural regulation of blood pressure, hormonal regulation remains high and baroreflex dysfunction persists. Therefore, cell transplantation combined with selected RAS inhibition may enhance neuroendocrine homeostasis for cardiovascular recovery after SCI.

高度脊髓损伤(SCI)通常会导致心血管功能障碍,尤其是出现自主神经反射障碍。这种障碍的特征是在内脏或躯体刺激下出现高血压并伴有心动过缓,会造成严重不适,并可能出现危及生命的症状。这种自律神经失调症的神经机制包括脊髓上交感神经元失去控制、感觉输入和本体脊髓中间神经元的适应性可塑性不良以及交感神经节前神经元过度放电。虽然损伤后对心血管功能的神经控制在很大程度上被破坏,但通过激素机制调节血压的肾素-血管紧张素系统(RAS)在损伤后会上调。然而,RAS 是否参与自律神经反射障碍仍存在争议。在治疗方面,将从脑干或更特殊的剑突区域收集的胚胎交感神经前区神经元移植到损伤的脊髓中,可重建脊髓上交感神经活动的调节,从而改善心血管状况。在啮齿类 SCI 模型中,这种治疗方法可减少自发性自主神经反射障碍的发生,并减轻人为触发的反射障碍反应的严重程度。虽然移植早期神经元能改善神经对血压的调节,但激素调节仍然很高,而且气压反射功能障碍依然存在。因此,细胞移植与选择性 RAS 抑制相结合可增强神经内分泌平衡,促进 SCI 后心血管的恢复。
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引用次数: 0
The Endoplasmic Reticulum and Its Contacts: Emerging Roles in Axon Development, Neurotransmission, and Degeneration. 内质网及其联系:轴突发育、神经传递和退化中的新作用
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-03-24 DOI: 10.1177/10738584231162810
Marijn Kuijpers, Phuong T Nguyen, Volker Haucke

The neuronal endoplasmic reticulum (ER) consists of a dynamic, tubular network that extends all the way from the soma into dendrites, axons, and synapses. This morphology gives rise to an enormous membrane surface area that, through the presence of tethering proteins, lipid transfer proteins, and ion channels, plays critical roles in local calcium regulation, membrane dynamics, and the supply of ions and lipids to other organelles. Here, we summarize recent advances that highlight the various roles of the neuronal ER in axonal growth, repair, and presynaptic function. We review the variety of contact sites between the ER and other axonal organelles and describe their influence on neurodevelopment and neurotransmission.

神经元内质网(ER)由一个动态的管状网络组成,从体细胞一直延伸到树突、轴突和突触。这种形态产生了巨大的膜表面积,通过系链蛋白、脂质转移蛋白和离子通道的存在,ER 在局部钙调节、膜动力学以及向其他细胞器供应离子和脂质方面发挥着关键作用。在此,我们总结了最近的研究进展,强调了神经元ER在轴突生长、修复和突触前功能中的各种作用。我们回顾了ER与其他轴突细胞器之间的各种接触点,并描述了它们对神经发育和神经传递的影响。
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引用次数: 0
α-Synuclein: Multiple pathogenic roles in trafficking and proteostasis pathways in Parkinson's disease. α-突触核蛋白:在帕金森病的转运和蛋白稳态途径中的多重致病作用
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2024-02-29 DOI: 10.1177/10738584241232963
Annie J Zalon, Drew J Quiriconi, Caleb Pitcairn, Joseph R Mazzulli

Parkinson's disease (PD) is a common age-related neurodegenerative disorder characterized by the loss of dopaminergic neurons in the midbrain. A hallmark of both familial and sporadic PD is the presence of Lewy body inclusions composed mainly of aggregated α-synuclein (α-syn), a presynaptic protein encoded by the SNCA gene. The mechanisms driving the relationship between α-syn accumulation and neurodegeneration are not completely understood, although recent evidence indicates that multiple branches of the proteostasis pathway are simultaneously perturbed when α-syn aberrantly accumulates within neurons. Studies from patient-derived midbrain cultures that develop α-syn pathology through the endogenous expression of PD-causing mutations show that proteostasis disruption occurs at the level of synthesis/folding in the endoplasmic reticulum (ER), downstream ER-Golgi trafficking, and autophagic-lysosomal clearance. Here, we review the fundamentals of protein transport, highlighting the specific steps where α-syn accumulation may intervene and the downstream effects on proteostasis. Current therapeutic efforts are focused on targeting single pathways or proteins, but the multifaceted pathogenic role of α-syn throughout the proteostasis pathway suggests that manipulating several targets simultaneously will provide more effective disease-modifying therapies for PD and other synucleinopathies.

帕金森病(PD)是一种常见的与年龄相关的神经退行性疾病,其特征是中脑多巴胺能神经元的丧失。家族性和散发性帕金森病的特征之一是出现路易体包涵体,主要由SNCA基因编码的突触前蛋白α-突触核蛋白(α-syn)聚集而成。尽管最近的证据表明,当α-syn在神经元内异常聚集时,蛋白稳态通路的多个分支会同时受到干扰,但驱动α-syn聚集与神经变性之间关系的机制尚未完全明了。来自患者中脑培养物的研究表明,蛋白稳态的破坏发生在内质网(ER)的合成/折叠、ER-高尔基体的下游运输以及自噬-溶酶体的清除等层面。在此,我们回顾了蛋白质转运的基本原理,强调了α-syn累积可能干预的具体步骤以及对蛋白稳态的下游影响。目前的治疗工作主要集中在针对单一途径或蛋白,但α-syn在整个蛋白稳态途径中的多方面致病作用表明,同时操纵多个靶点将为帕金森病和其他突触核蛋白病提供更有效的疾病调节疗法。
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引用次数: 0
The Azalea Hypothesis of Alzheimer Disease: A Functional Iron Deficiency Promotes Neurodegeneration. 阿尔茨海默病的杜鹃花假说:功能性缺铁促进神经退行性变
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-10-01 Epub Date: 2023-08-20 DOI: 10.1177/10738584231191743
Steven M LeVine

Chlorosis in azaleas is characterized by an interveinal yellowing of leaves that is typically caused by a deficiency of iron. This condition is usually due to the inability of cells to properly acquire iron as a consequence of unfavorable conditions, such as an elevated pH, rather than insufficient iron levels. The causes and effects of chlorosis were found to have similarities with those pertaining to a recently presented hypothesis that describes a pathogenic process in Alzheimer disease. This hypothesis states that iron becomes sequestered (e.g., by amyloid β and tau), causing a functional deficiency of iron that disrupts biochemical processes leading to neurodegeneration. Additional mechanisms that contribute to iron becoming unavailable include iron-containing structures not undergoing proper recycling (e.g., disrupted mitophagy and altered ferritinophagy) and failure to successfully translocate iron from one compartment to another (e.g., due to impaired lysosomal acidification). Other contributors to a functional deficiency of iron in patients with Alzheimer disease include altered metabolism of heme or altered production of iron-containing proteins and their partners (e.g., subunits, upstream proteins). A review of the evidence supporting this hypothesis is presented. Also, parallels between the mechanisms underlying a functional iron-deficient state in Alzheimer disease and those occurring for chlorosis in plants are discussed. Finally, a model describing the generation of a functional iron deficiency in Alzheimer disease is put forward.

杜鹃花的黄化病的特征是叶片脉间发黄,通常是由于缺铁引起的。这种情况通常是由于细胞在 pH 值升高等不利条件下无法正常获得铁元素,而不是铁元素含量不足。研究发现,萎黄病的原因和影响与最近提出的描述阿尔茨海默病致病过程的假说有相似之处。该假说认为,铁被淀粉样蛋白 β 和 tau 等螯合,造成功能性缺铁,从而破坏生化过程,导致神经变性。导致铁缺乏的其他机制包括含铁结构未进行适当的再循环(例如,有丝分裂吞噬功能紊乱和铁蛋白吞噬功能改变),以及未能成功地将铁从一个区室转运到另一个区室(例如,由于溶酶体酸化功能受损)。导致阿尔茨海默病患者功能性缺铁的其他因素还包括血红素代谢的改变或含铁蛋白及其伙伴(如亚基、上游蛋白)的生成发生改变。本文回顾了支持这一假设的证据。此外,还讨论了阿尔茨海默病功能性缺铁状态的基本机制与植物叶绿素缺乏症的基本机制之间的相似之处。最后,提出了一个描述阿尔茨海默病功能性缺铁的模型。
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引用次数: 0
Neuronal Death: Now You See It, Now You Don't. 神经元死亡现在你看到了,现在你看不到了。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-24 DOI: 10.1177/10738584241282632
Trevor Balena, Kevin Staley

Fatally injured neurons may necrose and rupture immediately, or they may initiate a programmed cell death pathway and then wait for microglial phagocytosis. Biochemical and histopathologic assays of neuronal death assess the numbers of neurons awaiting phagocytosis at a particular time point after injury. This number varies with the fraction of neurons that have necrosed vs initiated programmed cell death, the time elapsed since injury, the rate of phagocytosis, and the assay's ability to detect neurons at different stages of programmed cell death. Many of these variables can be altered by putatively neurotoxic and neuroprotective interventions independent of the effects on neuronal death. This complicates analyses of neurotoxicity and neuroprotection and has likely contributed to difficulties with clinical translation of neuroprotective strategies after brain injury. Time-resolved assays of neuronal health, such as ongoing expression of transgenic fluorescent proteins, are a useful means of avoiding these problems.

致命损伤的神经元可能会立即坏死和破裂,也可能会启动程序性细胞死亡途径,然后等待小胶质细胞的吞噬。神经元死亡的生化和组织病理学检测可评估受伤后特定时间点等待吞噬的神经元数量。这一数量随神经元坏死与启动程序性细胞死亡的比例、受伤后的时间、吞噬率以及检测处于程序性细胞死亡不同阶段的神经元的能力而变化。这些变量中的许多变量都可能因假定的神经毒性和神经保护干预措施而改变,而与对神经元死亡的影响无关。这使得神经毒性和神经保护的分析变得复杂,很可能导致脑损伤后神经保护策略难以临床转化。对神经元健康进行时间分辨检测,如持续表达转基因荧光蛋白,是避免这些问题的有效方法。
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引用次数: 0
Neuronal oscillations in cognition: Down syndrome as a model of mouse to human translation. 认知中的神经元振荡:唐氏综合征作为小鼠到人类的转化模型。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-24 DOI: 10.1177/10738584241271414
Pishan Chang, Marta Pérez-González, Jessica Constable, Daniel Bush, Karen Cleverley, Victor L J Tybulewicz, Elizabeth M C Fisher, Matthew C Walker

Down syndrome (DS), a prevalent cognitive disorder resulting from trisomy of human chromosome 21 (Hsa21), poses a significant global health concern. Affecting approximately 1 in 800 live births worldwide, DS is the leading genetic cause of intellectual disability and a major predisposing factor for early-onset Alzheimer's dementia. The estimated global population of individuals with DS is 6 million, with increasing prevalence due to advances in DS health care. Global efforts are dedicated to unraveling the mechanisms behind the varied clinical outcomes in DS. Recent studies on DS mouse models reveal disrupted neuronal circuits, providing insights into DS pathologies. Yet, translating these findings to humans faces challenges due to limited systematic electrophysiological analyses directly comparing human and mouse. Additionally, disparities in experimental procedures between the two species pose hurdles to successful translation. This review provides a concise overview of neuronal oscillations in human and rodent cognition. Focusing on recent DS mouse model studies, we highlight disruptions in associated brain function. We discuss various electrophysiological paradigms and suggest avenues for exploring molecular dysfunctions contributing to DS-related cognitive impairments. Deciphering neuronal oscillation intricacies holds promise for targeted therapies to alleviate cognitive disabilities in DS individuals.

唐氏综合征(DS)是由人类 21 号染色体三体综合征(Hsa21)引起的一种普遍认知障碍,是一个重大的全球健康问题。全球每 800 名活产婴儿中约有 1 人患有唐氏综合征,它是导致智力残疾的主要遗传原因,也是早发性阿尔茨海默氏症痴呆症的主要诱发因素。据估计,全球有 600 万 DS 患者,由于 DS 医疗保健的进步,患病率正在不断上升。全球都在努力揭示 DS 不同临床结果背后的机制。最近对 DS 小鼠模型的研究揭示了神经元回路的紊乱,为了解 DS 的病理提供了线索。然而,由于直接比较人类和小鼠的系统电生理分析有限,将这些发现转化到人类面临挑战。此外,两个物种在实验程序上的差异也给成功转化带来了障碍。本综述简要概述了人类和啮齿类动物认知中的神经元振荡。我们以最近的 DS 小鼠模型研究为重点,强调了相关大脑功能的紊乱。我们讨论了各种电生理学范式,并提出了探索导致 DS 相关认知障碍的分子功能障碍的途径。破译神经元振荡的复杂性有望为缓解 DS 患者认知障碍的靶向疗法带来希望。
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引用次数: 0
The effect of traumatic brain injury on learning and memory: A synaptic focus. 创伤性脑损伤对学习和记忆的影响:突触聚焦
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-09-24 DOI: 10.1177/10738584241275583
Eric Eyolfson, Kirsten R B Suesser, Holly Henry, Itziar Bonilla-Del Río, Pedro Grandes, Richelle Mychasiuk, Brian R Christie

Deficits in learning and memory are some of the most commonly reported symptoms following a traumatic brain injury (TBI). We will examine whether the neural basis of these deficits stems from alterations to bidirectional synaptic plasticity within the hippocampus. Although the CA1 subregion of the hippocampus has been a focus of TBI research, the dentate gyrus should also be given attention as it exhibits a unique ability for adult neurogenesis, a process highly susceptible to TBI-induced damage. This review examines our current understanding of how TBI results in deficits in synaptic plasticity, as well as how TBI-induced changes in endocannabinoid (eCB) systems may drive these changes. Through the synthesis and amalgamation of existing data, we propose a possible mechanism for eCB-mediated recovery in synaptic plasticity deficits. This hypothesis is based on the plausible roles of CB1 receptors in regulating inhibitory tone, influencing astrocytes and microglia, and modulating glutamate release. Dysregulation of the eCBs may be responsible for deficits in synaptic plasticity and learning following TBI. Taken together, the existing evidence indicates eCBs may contribute to TBI manifestation, pathogenesis, and recovery, but it also suggests there may be a therapeutic role for the eCB system in TBI.

学习和记忆障碍是创伤性脑损伤(TBI)后最常见的症状之一。我们将研究这些缺陷的神经基础是否源于海马内双向突触可塑性的改变。虽然海马的 CA1 亚区一直是 TBI 研究的重点,但齿状回也应受到关注,因为它具有独特的成体神经发生能力,而这一过程极易受到 TBI 引起的损伤。本综述探讨了我们目前对创伤性脑损伤如何导致突触可塑性缺陷以及创伤性脑损伤诱导的内源性大麻素(eCB)系统变化如何驱动这些变化的理解。通过综合和合并现有数据,我们提出了 eCB 介导的突触可塑性缺陷恢复的可能机制。这一假说基于 CB1 受体在调节抑制张力、影响星形胶质细胞和小胶质细胞以及调节谷氨酸释放方面的合理作用。eCB 的失调可能是造成创伤性脑损伤后突触可塑性和学习障碍的原因。综上所述,现有证据表明 eCBs 可能会对创伤性脑损伤的表现、发病机制和恢复做出贡献,同时也表明 eCB 系统可能会在创伤性脑损伤中发挥治疗作用。
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引用次数: 0
Navigating Central Oxytocin Transport: Known Realms and Uncharted Territories. 中枢催产素运输导航:已知领域和未知领域。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-08-07 DOI: 10.1177/10738584241268754
Deniz Parmaksiz, Yongsoo Kim

Complex mechanisms govern the transport and action of oxytocin (Oxt), a neuropeptide and hormone that mediates diverse physiologic processes. While Oxt exerts site-specific and rapid effects in the brain via axonal and somatodendritic release, volume transmission via CSF and the neurovascular interface can act as an additional mechanism to distribute Oxt signals across distant brain regions on a slower timescale. This review focuses on modes of Oxt transport and action in the CNS, with particular emphasis on the roles of perivascular spaces, the blood-brain barrier (BBB), and circumventricular organs in coordinating the triadic interaction among circulating blood, CSF, and parenchyma. Perivascular spaces, critical conduits for CSF flow, play a pivotal role in Oxt diffusion and distribution within the CNS and reciprocally undergo Oxt-mediated structural and functional reconstruction. While the BBB modulates the movement of Oxt between systemic and cerebral circulation in a majority of brain regions, circumventricular organs without a functional BBB can allow for diffusion, monitoring, and feedback regulation of bloodborne peripheral signals such as Oxt. Recognition of these additional transport mechanisms provides enhanced insight into the systemic propagation and regulation of Oxt activity.

催产素(Oxt)是一种介导多种生理过程的神经肽和激素,其运输和作用机制十分复杂。催产素在大脑中通过轴突和体支释放产生特定部位的快速效应,而通过脑脊液和神经血管界面的体积传输则是一种额外的机制,可以在较慢的时间尺度上将催产素信号分布到远处的脑区。这篇综述将重点讨论 Oxt 在中枢神经系统中的传输和作用模式,特别强调血管周围空间、血脑屏障 (BBB) 和环周器官在协调循环血液、CSF 和实质之间的三重相互作用中的作用。血管周围间隙是脑脊液流动的重要通道,在中枢神经系统内的奥克斯扩散和分布中起着关键作用,并在奥克斯介导下进行结构和功能重建。虽然在大多数脑区,BBB 可调节 Oxt 在全身循环和脑循环之间的移动,但没有功能性 BBB 的环周器官也可实现对 Oxt 等血载外周信号的扩散、监测和反馈调节。认识到这些额外的运输机制,就能更深入地了解 Oxt 活动的全身传播和调节。
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引用次数: 0
SARM1-Dependent Axon Degeneration: Nucleotide Signaling, Neurodegenerative Disorders, Toxicity, and Therapeutic Opportunities. SARM1 依赖性轴突退化:核苷酸信号、神经退行性疾病、毒性和治疗机会。
IF 3.5 3区 医学 Q1 CLINICAL NEUROLOGY Pub Date : 2024-08-01 Epub Date: 2023-03-31 DOI: 10.1177/10738584231162508
Helen Y McGuinness, Weixi Gu, Yun Shi, Bostjan Kobe, Thomas Ve

Axons are an essential component of the nervous system, and axon degeneration is an early feature of many neurodegenerative disorders. The NAD+ metabolome plays an essential role in regulating axonal integrity. Axonal levels of NAD+ and its precursor NMN are controlled in large part by the NAD+ synthesizing survival factor NMNAT2 and the pro-neurodegenerative NADase SARM1, whose activation triggers axon destruction. SARM1 has emerged as a promising axon-specific target for therapeutic intervention, and its function, regulation, structure, and role in neurodegenerative diseases have been extensively characterized in recent years. In this review, we first introduce the key molecular players involved in the SARM1-dependent axon degeneration program. Next, we summarize recent major advances in our understanding of how SARM1 is kept inactive in healthy neurons and how it becomes activated in injured or diseased neurons, which has involved important insights from structural biology. Finally, we discuss the role of SARM1 in neurodegenerative disorders and environmental neurotoxicity and its potential as a therapeutic target.

轴突是神经系统的重要组成部分,轴突退化是许多神经退行性疾病的早期特征。NAD+ 代谢组在调节轴突完整性方面发挥着重要作用。轴突中 NAD+ 及其前体 NMN 的水平在很大程度上受 NAD+ 合成存活因子 NMNAT2 和促神经退行性变的 NAD 酶 SARM1 的控制,后者的激活会引发轴突破坏。近年来,SARM1 的功能、调节、结构以及在神经退行性疾病中的作用已被广泛描述。在这篇综述中,我们首先介绍了参与 SARM1 依赖性轴突变性过程的关键分子角色。接下来,我们总结了最近在理解 SARM1 如何在健康神经元中保持非活性以及如何在受伤或患病神经元中被激活方面取得的重大进展,其中涉及结构生物学的重要见解。最后,我们讨论了 SARM1 在神经退行性疾病和环境神经毒性中的作用及其作为治疗靶点的潜力。
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