老龄化常伴有年龄相关性白内障的发生及大脑功能和结构的衰退。白内障术后视觉重建不仅可改善视觉功能,而且会影响大脑的功能和结构;白内障手术能增强内在光敏性视网膜神经节细胞对蓝光的有效传输,增加体内褪黑素分泌,从而调节生物节律,提高患者认知水平;褪黑素能激活其相关通路,如Reelin、Notch等,影响β淀粉样蛋白酶的聚集和沉积,减少神经细胞的凋亡,在多种神经退行性疾病中发挥重要作用。尽管临床研究证实白内障术后视觉重建能部分逆转大脑功能和结构的衰退,但其相关分子机制尚不清楚。本文将根据眼和大脑的相互关系,针对白内障术后视觉重建对大脑功能和结构的影响及潜在分子机制进行综述及讨论,为视觉重建促进大脑重塑提供新的思路和方法。
Aging is often accompanied by age-related cataract and concurrent degeneration in brain function and structure.Restoration of vision after cataract surgery not only improves visual function, but also affects brain function and structure.Cataract surgery can enhance the effective transmission of blue light by intrinsically photoreceptive ganglion cells, and increase the secretion of melatonin in vivo, thereby regulating biological rhythm and improving the cognitive level of patients.Melatonin can activate its related molecular pathways, such as Reelin, Notch signaling, etc., affecting the accumulation and deposition of β-amyloid protein, reducing neuronal apoptosis, and playing an important role in a variety of neurodegenerative diseases.Although clinical studies have confirmed that vision restoration after cataract surgery can partially reverse the decline in brain function and structure, the molecular mechanisms involved remain unclear.Based on the eye-brain relationship, this paper reviewed and discussed the effects of vision restoration after cataract surgery on brain function and structure and the potential molecular mechanism, so as to provide new ideas and methods for brain remodeling.
张立,项奕,林浩添. 白内障术后视觉重建对大脑功能和结构的影响及其潜在分子机制[J]. 中华实验眼科杂志,2023,41(06):603-606.
DOI:10.3760/cma.j.cn115989-20201214-00840版权归中华医学会所有。
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