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【文獻(xiàn)速遞561】甲氨蝶呤化療誘導(dǎo)持續(xù)性三神經(jīng)膠質(zhì)細(xì)胞失調(diào)是化療相關(guān)認(rèn)知障礙的基礎(chǔ)

 生物_醫(yī)藥_科研 2019-02-20

小 貓 說

隨著醫(yī)療技術(shù)和條件的進(jìn)步,癌癥生存率相較于之前有較高的提升,但癌癥治療過程中經(jīng)化療手段治療的患者有超過一半存在化療導(dǎo)致的認(rèn)知障礙,這種癥狀可能存在一定時(shí)間,給患者生活帶來不便。發(fā)表于《Cell》的本研究中,科學(xué)家致力于尋找能夠提高癌癥幸存者生活質(zhì)量的治療方法,以治療癌癥患者的“化療腦”。本研究通過研究化療藥物甲氨蝶呤對神經(jīng)系統(tǒng)的影響,發(fā)現(xiàn)了化療導(dǎo)致認(rèn)知障礙的治療靶點(diǎn)。

Methotrexate Chemotherapy Induces Persistent Tri-glial Dysregulation that Underlies Chemotherapy-Related Cognitive Impairment

圖片來源:文獻(xiàn)原文


Chemotherapy results in a frequent yet poorly understood syndrome of long-term neurological deficits. Neural precursor cell dysfunction and white matter dysfunction are thought to contribute to this debilitating syndrome. Here, we demonstrate persistent depletion of oligodendrocyte lineage cells in humans who received chemotherapy. Developing a mouse model of methotrexate chemotherapy-induced neurological dysfunction, we find a similar depletion of white matter OPCs, increased but incomplete OPC differentiation, and a persistent deficit in myelination. OPCs from chemotherapy-naive mice similarly exhibit increased differentiation when transplanted into the microenvironment of previously methotrexate-exposed brains, indicating an underlying microenvironmental perturbation. Methotrexate results in persistent activation of microglia and subsequent astrocyte activation that is dependent on inflammatory microglia. Microglial depletion normalizes oligodendroglial lineage dynamics, myelin microstructure, and cognitive behavior after methotrexate chemotherapy. These findings indicate that methotrexate chemotherapy exposure is associated with persistent tri-glial dysregulation and identify inflammatory microglia as a therapeutic target to abrogate chemotherapy-related cognitive impairment.


甲氨蝶呤化療誘導(dǎo)持續(xù)性三神經(jīng)膠質(zhì)細(xì)胞失調(diào)是化療相關(guān)認(rèn)知障礙的基礎(chǔ)

化療會(huì)導(dǎo)致一種常見的長期神經(jīng)功能缺損綜合癥,但人們對此知之甚少。神經(jīng)前體細(xì)胞功能障礙和白質(zhì)功能障礙被認(rèn)為是造成這種衰弱綜合征的原因。我們證明了接受化療的人體中少突膠質(zhì)細(xì)胞的持續(xù)消耗。通過建立甲氨蝶呤化療誘導(dǎo)的神經(jīng)功能障礙的小鼠模型,我們發(fā)現(xiàn)相似的白質(zhì)OPCs消耗:OPC分化增加但不完全,髓鞘形成持續(xù)缺乏。初次接受化療的小鼠OPCs在移植到先前暴露于甲氨蝶呤的大腦微環(huán)境后,表現(xiàn)出更高的分化,表明潛在的微環(huán)境干擾。甲氨蝶呤導(dǎo)致小膠質(zhì)細(xì)胞的持續(xù)活化及隨后星形細(xì)胞的活化——其依賴于炎性小膠質(zhì)細(xì)胞。小膠質(zhì)細(xì)胞的消耗使甲氨蝶呤化療后的少突膠質(zhì)細(xì)胞譜系動(dòng)力學(xué)、髓鞘微觀結(jié)構(gòu)和認(rèn)知行為正?;?。這些研究結(jié)果表明,暴露于甲氨蝶呤化療與三神經(jīng)膠質(zhì)的持續(xù)失調(diào)有關(guān),并確定了炎性小膠質(zhì)細(xì)胞可作為消除化療相關(guān)認(rèn)知障礙的治療靶點(diǎn)。


文獻(xiàn)來源

Gibson, E. M., et al. (2018). Methotrexate chemotherapy induces persistent tri-glial dysregulation that underlies chemotherapy-related cognitive impairment. Cell, 176(1):p43-55.E13. Doi:10.1016/j.cell.2018.10.049.


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