Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Department of Neurosurgery, The University Hospital Brno and Faculty of Medicine, Masaryk University, Brno, Czech Republic.
Curr Neuropharmacol. 2018;16(9):1365-1374. doi: 10.2174/1570159X16666180222155833.
Stroke represents devastating pathology which is associated with a high morbidity and mortality. Initial damage caused directly by the onset of stroke, primary injury, may be eclipsed by secondary injury which may have a much more devastating effect on the brain. Primary injury is predominantly associated with necrotic cell death due to fatal insufficiency of oxygen and glucose. Secondary injury may on the contrary, lead apoptotic cell death due to structural damage which is not compatible with cellular functions or which may even represent the danger of malign transformation. The immune system is responsible for surveillance, defense and healing processes and the immune system plays a major role in triggering programmed cell death. Severe pathologies, such as stroke, are often associated with deregulation of the immune system, resulting in aggravation of secondary brain injury. The goal of this article is to overview the current knowledge about the role of immune system in the pathophysiology of stroke with respect to programmed neuronal cell death as well as to discuss current therapeutic strategies targeting inflammation after stroke.
中风是一种破坏性极大的疾病,其发病率和死亡率都很高。中风发作直接导致的初始损伤(原发性损伤),可能会被对大脑有更严重影响的继发性损伤所掩盖。原发性损伤主要与由于缺氧和葡萄糖严重不足而导致的致命性细胞坏死有关。相反,继发性损伤可能会导致由于结构损伤而发生的细胞凋亡,这种损伤与细胞功能不兼容,甚至可能代表恶性转化的危险。免疫系统负责监视、防御和修复过程,免疫系统在触发程序性细胞死亡方面起着重要作用。严重的疾病,如中风,通常与免疫系统失调有关,导致继发性脑损伤加重。本文的目的是概述免疫系统在中风病理生理学中的作用,特别是程序性神经元细胞死亡方面的作用,并讨论针对中风后炎症的当前治疗策略。