a College of Medicine , University of Cincinnati , Cincinnati , OH , USA.
b Department of Emergency Medicine , University of Cincinnati , Cincinnati , OH , USA.
Immunopharmacol Immunotoxicol. 2019 Feb;41(1):7-15. doi: 10.1080/08923973.2019.1566361. Epub 2019 Jan 31.
The secondary inflammatory injury following intracerebral hemorrhage (ICH) results in increased morbidity and mortality. White blood cells have been implicated as critical mediators of this inflammatory injury. Currently, no medications have been clinically proven to ameliorate or beneficially modulate inflammation, or to improve outcomes by any mechanism, following ICH. However, other neuroinflammatory conditions, such as multiple sclerosis, have approved pharmacologic therapies that modulate the inflammatory response and minimize the damage caused by inflammatory cells. Thus, there is substantial interest in existing therapies for neuroinflammation and their potential applicability to other acute neurological diseases such as ICH. In this review, we examined the mechanism of action of twelve currently approved medications for multiple sclerosis: alemtuzumab, daclizumab, dimethyl fumarate, fingolimod, glatiramer acetate, interferon beta-1a, interferon beta-1b, mitoxantrone, natalizumab, ocrelizumab, rituximab, teriflunomide. We analyzed the existing literature pertaining to the effects of these medications on various leukocytes and also with emphasis on mechanisms of action during the acute period following initiation of therapy. As a result, we provide a valuable summary of the current body of knowledge regarding these therapies and evidence that supports or refutes their likely promise for treating neuroinflammation following ICH.
脑出血 (ICH) 后继发的二次炎症损伤导致发病率和死亡率增加。白细胞被认为是这种炎症损伤的关键介质。目前，尚无药物被临床证明可改善或有益地调节炎症，或以任何机制改善 ICH 后的结果。然而，其他神经炎症性疾病，如多发性硬化症，已经有批准的药物治疗方法可以调节炎症反应并最大限度地减少炎症细胞造成的损害。因此，人们对现有的神经炎症治疗方法及其在其他急性神经疾病（如 ICH）中的潜在应用有很大的兴趣。在这篇综述中，我们检查了 12 种目前批准用于多发性硬化症的药物的作用机制：阿仑单抗、达利珠单抗、二甲基富马酸、芬戈莫德、醋酸格拉替雷、干扰素β-1a、干扰素β-1b、米托蒽醌、那他珠单抗、奥瑞珠单抗、利妥昔单抗、特立氟胺。我们分析了与这些药物对各种白细胞的影响有关的现有文献，并重点关注了在开始治疗后的急性期间作用机制。因此，我们提供了这些治疗方法的当前知识体系的有价值的总结，并提供了支持或反驳它们在治疗 ICH 后继发性神经炎症方面的潜在前景的证据。
