3讨论 Müller细胞是视网膜特有的主要的神经胶质细胞,它和神经节细胞有密切的关系,能识别多种神经信号,并能敏感地感受和调控细胞外K+,H+,Na+和神经递质浓度的改变,它在视网膜损伤后早期就具有明显的病理改变[6]。已有研究证实Müller细胞参与神经元损伤、变性和再生[68]。Nestin属第六类中间丝蛋白,以往的研究认为它只出现在CNS发育过程的神经干细胞中,干细胞分化成成熟的神经元或伸进胶质细胞后即不再表达nestin,因此,它被用来作为神经干细胞的标记物[13]。最近的研究对这种观点提出的质疑,Frisen等[9]提出大脑和脊髓外伤后,反应性星形胶质细胞表达nestin。中枢神经系统肿瘤中也发现了nestin阳性细胞,并且随着恶性程度的升高,其表达也要更强烈一些[10]。在成年纹状体和体外培养的纹状体细胞中也发现了nestin阳性细胞[11]。在眼科方面的研究中,视网膜毒性损伤、激光损伤和眼压升高后Müller细胞出现nestin的诱导表达[5,12,13]。人胎儿视网膜分化成熟和未分化的Müller细胞表达nestin[14]。对于视网膜中出现的这些nestin阳性细胞人们提出了不同的解释,大部分人认为在特定情况下表达nestin的Müller细胞可能代表一种神经前体细胞,或具有神经干细胞特点的一类细胞,在特定情况下可以出现去分化或转分化[7,12,13],另外也有人提出它仅仅是一种胶质化反应[3]。我们的前期研究发现,正常大鼠视网膜Müller细胞几乎不表达nestin,在青光眼模型中可以检测到nestin和GFAP在Müller细胞上的诱导表达。本实验中,我们发现视神经横断后Müller细胞上出现了nestin,随病程进展RGC数量仍然急剧减少。因此我们认为病理情况下,Nestin在Müller细胞上的诱导表达是Müller细胞针对损伤发生的一种反应性改变,而不是说明Müller细胞具有了干细胞的特性。视神经横断后,Nestin在Müller细胞上的诱导表达的原因和意义尚不是很明确,实验中我们发现nestin在Müller细胞上的诱导表达在足板处尤其强烈,Müller细胞足板包绕RGC与其功能的完整性有着密切的关系,当RGC的轴浆流突然中断后,Müller敏感的感受到外环境的改变,胞浆中的细胞骨架蛋白nestin发生改变,这种改变可能通过活化Müller细胞释放一系列生长因子如神经生长因子(NGF),碱性成纤维细胞生长因子(bFGF),胰岛素样生长因子(IGF)和睫状生长因子(CNTF)等对神经节细胞有保护作用。
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