Tianjin Medical University General Hospital, Tianjin, China; Department of Neurology, and Department of Neurosurgery, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, Phoenix, AZ, USA.
China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Tianjin Medical University General Hospital, Tianjin, China.
Lancet Neurol. 2019 Nov;18(11):1058-1066. doi: 10.1016/S1474-4422(19)30078-X. Epub 2019 Jul 8.
Stroke, including acute ischaemic stroke and intracerebral haemorrhage, results in neuronal cell death and the release of factors such as damage-associated molecular patterns (DAMPs) that elicit localised inflammation in the injured brain region. Such focal brain inflammation aggravates secondary brain injury by exacerbating blood-brain barrier damage, microvascular failure, brain oedema, oxidative stress, and by directly inducing neuronal cell death. In addition to inflammation localised to the injured brain region, a growing body of evidence suggests that inflammatory responses after a stroke occur and persist throughout the entire brain. Global brain inflammation might continuously shape the evolving pathology after a stroke and affect the patients' long-term neurological outcome. Future efforts towards understanding the mechanisms governing the emergence of so-called global brain inflammation would facilitate modulation of this inflammation as a potential therapeutic strategy for stroke.
中风(包括急性缺血性中风和脑出血)可导致神经元细胞死亡,并释放损伤相关分子模式(DAMPs)等因子,从而在受损的脑区引发局部炎症。这种局灶性脑炎症通过加重血脑屏障损伤、微血管衰竭、脑水肿、氧化应激以及直接诱导神经元细胞死亡,加重继发性脑损伤。除了局限于损伤脑区的炎症外,越来越多的证据表明,中风后炎症反应发生并持续存在于整个大脑。全脑炎症可能持续影响中风后的病理演变,并影响患者的长期神经预后。未来努力理解控制所谓全脑炎症出现的机制,将有助于调节这种炎症,作为中风的一种潜在治疗策略。