G. Gaslini Institute and University of Genoa, Genoa, Italy.
Thromb Haemost. 2011 Mar;105(3):409-20. doi: 10.1160/TH10-10-0662. Epub 2010 Dec 21.
The definition of ischaemic stroke has been recently updated as an acute episode of neurological dysfunction caused by focal brain, spinal cord, or retinal ischaemia in the presence of a cerebral infarction. This "tissular" definition has highlighted the importance of pathophysiological processes underlying cerebral damage. In particular, post- ischaemic inflammation in the brain and in the blood stream could influence crucial steps of the tissue injury/repair cascade. CC and CXC chemokines orchestrate the inflammatory response in atherosclerotic plaque vulnerability and cerebral infarction. These molecules exert their activities through the binding to selective transmembrane receptors. CC and CXC chemokines modulate crucial processes (such as inflammatory cell recruitment and activation, neuronal survival, neoangiogenesis). On the other hand, CXC chemokines could also modulate stem cell homing, thus favouring tissue repair. Given this evidence, both CC and CXC chemokines could represent promising therapeutic targets in primary and secondary prevention of ischaemic stroke. Only preliminary studies have been performed investigating treatments with selective chemokine agonists/antagonists. In this review, we will update evidence on the role and the potential therapeutic strategies targeting CC and CXC chemokines in the pathophysiology of ischaemic stroke.
缺血性脑卒中的定义最近已经更新,将其定义为由于脑、脊髓或视网膜局部缺血导致的急性神经功能障碍,同时伴有脑梗死。这种“组织学”定义强调了脑损伤背后病理生理过程的重要性。特别是,缺血后在脑和血液中的炎症反应可能会影响组织损伤/修复级联的关键步骤。CC 和 CXC 趋化因子在动脉粥样硬化斑块易损性和脑梗死中协调炎症反应。这些分子通过与选择性跨膜受体结合发挥作用。CC 和 CXC 趋化因子调节关键过程(如炎症细胞募集和激活、神经元存活、新生血管形成)。另一方面,CXC 趋化因子也可以调节干细胞归巢,从而有利于组织修复。鉴于这一证据,CC 和 CXC 趋化因子都可能成为缺血性脑卒中一级和二级预防的有前途的治疗靶点。目前仅进行了一些初步研究,以调查使用选择性趋化因子激动剂/拮抗剂的治疗方法。在这篇综述中,我们将更新 CC 和 CXC 趋化因子在缺血性脑卒中病理生理学中的作用和潜在治疗策略的证据。