Department of Neurology, Xinqiao Hospital & the Second Affiliated Hospital, the Third Military Medical University, Xinqiao Zhengjie No,183; Shapingba District, Chongqing, 400037, China.
Transl Stroke Res. 2014 Aug;5(4):429-41. doi: 10.1007/s12975-013-0317-7. Epub 2013 Dec 21.
Intracerebral hemorrhage (ICH) is a leading cause of morbidity and mortality around the world. Currently, there is no effective medical treatment available to improve functional outcomes in patients with ICH due to its unknown mechanisms of damage. Increasing evidence has shown that the metabolic products of erythrocytes are the key contributor of ICH-induced secondary brain injury. Iron, an important metabolic product that accumulates in the brain parenchyma, has a detrimental effect on secondary injury following ICH. Because the damage mechanism of iron during ICH-induced secondary injury is clear, iron removal therapy research on animal models is effective. Although many animal and clinical studies have been conducted, the exact metabolic pathways of iron and the mechanisms of iron removal treatments are still not clear. This review summarizes recent progress concerning the iron metabolism mechanisms underlying ICH-induced injury. We focus on iron, brain iron metabolism, the role of iron in oxidative injury, and iron removal therapy following ICH, and we suggest that further studies focus on brain iron metabolism after ICH and the mechanism for iron removal therapy.
脑出血(ICH)是全世界发病率和死亡率的主要原因。目前,由于其损伤机制未知,尚无有效的医学治疗方法可改善 ICH 患者的功能预后。越来越多的证据表明,红细胞的代谢产物是导致 ICH 继发性脑损伤的关键因素。铁是一种在脑实质中积累的重要代谢产物,对 ICH 后继发性损伤有不利影响。由于 ICH 继发性损伤中铁的损伤机制很明确,因此针对动物模型的铁去除治疗研究是有效的。尽管已经进行了许多动物和临床研究,但铁的代谢途径和铁去除治疗的机制仍不清楚。这篇综述总结了最近关于 ICH 损伤中铁代谢机制的研究进展。我们重点介绍铁、脑铁代谢、铁在氧化损伤中的作用以及 ICH 后的铁去除治疗,并建议进一步研究 ICH 后脑铁代谢和铁去除治疗的机制。