Khattar Nicolas K, James Robert F
Department of Neurological Surgery, University of Louisville School of Medicine, Louisville, KY, United States.
Front Neurol. 2018 Mar 27;9:97. doi: 10.3389/fneur.2018.00097. eCollection 2018.
Various neurological diseases have recently been associated with neuroinflammation and worsening outcomes. Subarachnoid hemorrhage has been shown to generate a potent neuroinflammatory response. Heparin is a potential effective anti-inflammatory agent to prevent initial injury as well as delayed neurological decline. Different mechanisms of action for heparin have been proposed including, but not limited to the binding and neutralization of oxyhemoglobin, decreased transcription and signal transduction of endothelin-1, inhibition of binding to vessel wall selectins and vascular leakage into the subarachnoid space as well as direct binding and neutralization of inflammatory molecules. With a reasonably safe side-effect profile, heparin has shown significant promise in small series in human studies of aneurysmal subarachnoid hemorrhage in decreasing both initial and delayed neurological injury. Further studies are needed to validate various neuroprotective features of heparin in subarachnoid hemorrhage as well as other disease states.
最近，各种神经系统疾病都与神经炎症及预后恶化有关。蛛网膜下腔出血已被证明会引发强烈的神经炎症反应。肝素是一种潜在的有效抗炎剂，可预防初始损伤以及延迟性神经功能衰退。肝素的作用机制有多种，包括但不限于与氧合血红蛋白的结合和中和、内皮素-1转录和信号转导的减少、对血管壁选择素结合的抑制以及血管渗漏至蛛网膜下腔的抑制，还有对炎症分子的直接结合和中和。由于肝素具有相对安全的副作用，在人类动脉瘤性蛛网膜下腔出血的小型研究系列中，肝素在减少初始和延迟性神经损伤方面显示出了巨大的前景。需要进一步的研究来验证肝素在蛛网膜下腔出血以及其他疾病状态下的各种神经保护特性。
