ВОССТАНОВИТЕЛЬНЫЙ ПОСТИШЕМИЧЕСКИЙ НЕЙРОГЕНЕЗ: ПЕРСПЕКТИВЫ КЛИНИЧЕСКОГО ПРИМЕНЕНИЯ

В настоящее время существует два основных подхода к изучению восстановления мозга после ишемического инсульта. Один из них связан с введением стволовых клеток в повреждённый мозг. Другой подход направлен на стимуляцию эндогенных процессов восстановления, в частности, постнатального нейрогенеза. Настоящий обзор рассматривает изменения постнатального нейрогенеза, вызванные ишемией мозга, и возможные пути регуляции этого процесса. Множество исследований на моделях животных демонстрируют, что нейрогенез в основном усиливается после ишемии, однако, несмотря на усиленную пролиферацию и миграцию нейрональных предшественников к зоне инсульта, большинство новых нейронов погибает, так и не созрев. Кроме того, усиление нейрогенеза в патологическом состоянии происходит в основном за счёт рекрутинга новых стволовых клеток, а не за счёт дополнительных делений клеток-предшественниц, что приводит, в конечном итоге, к ещё большему снижению способности к регенерации. Таким образом, эндогенных репаративных механизмов недостаточно, и необходим поиск новых мишеней для активизации пролиферации, выживания и созревания новых нейронов после ишемического инсульта. В качестве потенциальных регуляторов постишемического нейрогенеза рассматриваются ростовые факторы, системы нейротрансмиттеров и противовоспалительные препараты, а также показанное в последнее время перепрограммирование астроцитов в нейроны.

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