Chen Sheng, Wu Haijian, Tang Jiping, Zhang Jianmin, Zhang John H
Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
Acta Neurochir Suppl. 2015;120:39-46. doi: 10.1007/978-3-319-04981-6_7.
Subarachnoid hemorrhage (SAH) is a devastating condition with high morbidity and mortality rates due to the lack of effective therapy. Early brain injury (EBI) and cerebral vasospasm (CVS) are the two most important pathophysiological mechanisms for brain injury and poor outcomes for patients with SAH. CVS has traditionally been considered the sole cause of delayed ischemic neurological deficits after SAH. However, the failure of antivasospastic therapy in patients with SAH supported changing the research target from CVS to other mechanisms. Currently, more attention has been focused on global brain injury within 3 days after ictus, designated as EBI. The dysfunction of subcellular organelles, such as endoplasmic reticulum stress, mitochondrial failure, and autophagy-lysosomal system activation, has developed during EBI and delayed brain injury after SAH. To our knowledge, there is a lack of review articles addressing the direction of organelle dysfunction after SAH. In this review, we discuss the roles of organelle dysfunction in the pathogenesis of SAH and present the opportunity to develop novel therapeutic strategies of SAH via modulating the functions of organelles.
蛛网膜下腔出血(SAH)是一种严重的疾病,由于缺乏有效的治疗方法,其发病率和死亡率都很高。早期脑损伤(EBI)和脑血管痉挛(CVS)是SAH患者脑损伤和预后不良的两个最重要的病理生理机制。传统上,CVS被认为是SAH后延迟性缺血性神经功能缺损的唯一原因。然而,SAH患者抗血管痉挛治疗的失败支持了将研究目标从CVS转向其他机制。目前,更多的注意力集中在发病后3天内的全脑损伤,即EBI。在EBI和SAH后的延迟性脑损伤过程中,亚细胞器功能障碍,如内质网应激、线粒体功能衰竭和自噬-溶酶体系统激活已经出现。据我们所知,缺乏关于SAH后细胞器功能障碍方向的综述文章。在这篇综述中,我们讨论了细胞器功能障碍在SAH发病机制中的作用,并提出了通过调节细胞器功能来开发SAH新治疗策略的机会。