Rajkovic Olivera, Potjewyd Geoffrey, Pinteaux Emmanuel
Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, United Kingdom.
Front Neurol. 2018 Sep 3;9:734. doi: 10.3389/fneur.2018.00734. eCollection 2018.
Inflammation is a major pathological event following ischemic stroke that contributes to secondary brain tissue damage leading to poor functional recovery. Following the initial ischemic insult, post-stroke inflammatory damage is driven by initiation of a central and peripheral innate immune response and disruption of the blood-brain barrier (BBB), both of which are triggered by the release of pro-inflammatory cytokines and infiltration of circulating immune cells. Stroke therapies are limited to early cerebral blood flow reperfusion, and whilst current strategies aim at targeting neurodegeneration and/or neuroinflammation, innovative research in the field of regenerative medicine aims at developing effective treatments that target both the acute and chronic phase of inflammation. Anti-inflammatory regenerative strategies include the use of nanoparticles and hydrogels, proposed as therapeutic agents and as a delivery vehicle for encapsulated therapeutic biological factors, anti-inflammatory drugs, stem cells, and gene therapies. Biomaterial strategies-through nanoparticles and hydrogels-enable the administration of treatments that can more effectively cross the BBB when injected systemically, can be injected directly into the brain, and can be 3D-bioprinted to create bespoke implants within the site of ischemic injury. In this review, these emerging regenerative and anti-inflammatory approaches will be discussed in relation to ischemic stroke, with a perspective on the future of stroke therapies.
炎症是缺血性中风后的主要病理事件,会导致继发性脑组织损伤,进而导致功能恢复不佳。在最初的缺血性损伤之后,中风后的炎症损伤是由中枢和外周先天性免疫反应的启动以及血脑屏障(BBB)的破坏所驱动的,这两者都是由促炎细胞因子的释放和循环免疫细胞的浸润所触发的。中风治疗仅限于早期脑血流再灌注,虽然目前的策略旨在针对神经退行性变和/或神经炎症,但再生医学领域的创新研究旨在开发针对炎症急性期和慢性期的有效治疗方法。抗炎再生策略包括使用纳米颗粒和水凝胶,它们被提议作为治疗剂以及用于封装治疗性生物因子、抗炎药物、干细胞和基因疗法的递送载体。生物材料策略——通过纳米颗粒和水凝胶——能够在全身注射时更有效地穿过血脑屏障、可以直接注射到大脑中,并且可以进行3D生物打印以在缺血性损伤部位创建定制植入物。在这篇综述中,将讨论这些新兴的再生和抗炎方法与缺血性中风的关系,并展望中风治疗的未来。