Pías-Peleteiro Juan, Campos Francisco, Perez-Mato María, Lopez-Arias Esteban, Rodriguez-Yanez Manuel, Castillo Jose, Sobrino Tomas
Clinical Neurosciences Research Laboratory, Department of Neurology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitário, Travesa da Choupana S/N, 15706 - Santiago de Compostela, Spain.
Curr Pharm Des. 2017;23(15):2238-2251. doi: 10.2174/1381612822666161221153937.
Intracerebral hemorrhage (ICH) is the most lethal subtype of stroke, a leading cause of death and disability in developed countries. Therapeutic options are notably limited. There is no specific pharmacological treatment, and early surgery has few indications that represent only a small clinically relevant survival advantage. It is therefore mandatory to investigate repairing processes after ICH in order to develop related therapeutic strategies.
The goal of this review is to discuss the current status of knowledge about the potential therapeutic role of endothelial progenitor cells (EPCs) in ICH, as well as the possible molecular mechanisms and future perspectives.
ICH is characterized by a primary vascular rupture, followed by a secondary vascular tearing due to the peripheral pressure exerted by the hematoma. Hypoperfusion may also play a role, although not as markedly as in ischemic stroke. In this context, the repairing of damaged vessels and the development of new ones seem logical therapeutic targets. Circulating EPCs have been suggested to play a major role in re-endothelization, angiogenesis and vasculogenesis. Congruently, EPC levels have been associated with good neurological and functional outcome as well as with reduced residual volume in patients with acute ICH.
An EPC-based therapy, acting primarily through angiogenic mechanisms, may be a valid therapeutic option in ICH.
脑出血（ICH）是中风最致命的亚型，是发达国家死亡和残疾的主要原因。治疗选择明显有限。没有特异性药物治疗，早期手术的适应证很少，仅具有很小的临床相关生存优势。因此，研究脑出血后的修复过程以制定相关治疗策略是必要的。
本综述的目的是讨论内皮祖细胞（EPCs）在脑出血中潜在治疗作用的当前知识状况，以及可能的分子机制和未来前景。
脑出血的特征是原发性血管破裂，随后由于血肿施加的外周压力导致继发性血管撕裂。尽管不如缺血性中风明显，但低灌注也可能起作用。在这种情况下，修复受损血管和生成新血管似乎是合理的治疗靶点。循环内皮祖细胞已被认为在再内皮化、血管生成和血管发生中起主要作用。相应地，急性脑出血患者的内皮祖细胞水平与良好的神经和功能预后以及残余体积减少有关。
主要通过血管生成机制起作用的基于内皮祖细胞的治疗可能是脑出血的一种有效治疗选择。
