Ma Shubei, Zhao Haiping, Ji Xunming, Luo Yumin
Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
Department of Neurosurgery, Xuanwu Hospital of Capital Medical University, Beijing 100053, China.
Exp Neurol. 2015 Oct;272:41-9. doi: 10.1016/j.expneurol.2015.05.014. Epub 2015 Jun 6.
Stroke is associated with a high risk of disability and mortality, and with the exception of recombinant tissue-type plasminogen activator for acute stroke, most treatments have proven ineffective. Clinical translation of promising experimental therapeutics is limited by inadequate stroke models and a lack of understanding of the mechanisms underlying acute stroke and how they affect outcome. Bidirectional communication between the ischemic brain and peripheral immune system modulates stroke progression and tissue repair, while epidemiological studies have provided evidence of an association between organ dysfunction and stroke risk. This crosstalk can determine the fate of stroke patients and must be taken into consideration when investigating the pathophysiological mechanisms and therapeutic options for stroke. This review summarizes the current evidence for interactions between the brain and other organs in stroke pathophysiology in basic and clinic studies, and discusses the role of these interactions in the progression and outcome of stroke and how they can direct the development of more effective treatment strategies.
中风与高致残率和高死亡率相关,除了用于急性中风的重组组织型纤溶酶原激活剂外,大多数治疗方法已被证明无效。有前景的实验性疗法的临床转化受到中风模型不完善以及对急性中风潜在机制及其如何影响预后缺乏了解的限制。缺血性脑与外周免疫系统之间的双向通讯调节中风进展和组织修复,而流行病学研究已提供器官功能障碍与中风风险之间存在关联的证据。这种相互作用可以决定中风患者的预后,在研究中风的病理生理机制和治疗选择时必须予以考虑。本综述总结了基础和临床研究中关于中风病理生理学中脑与其他器官之间相互作用的现有证据,并讨论了这些相互作用在中风进展和预后中的作用,以及它们如何指导更有效治疗策略的开发。