Cao Bing-Qian, Tan Feng, Zhan Jie, Lai Peng-Hui
Department of Neurology, Foshan Hospital of Traditional Chinese Medicine, Guangzhou University of Chinese Medicine, Foshan, Guangdong Province, China.
Department of Rehabilitation, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, Guangdong Province, China.
Neural Regen Res. 2021 May;16(5):944-954. doi: 10.4103/1673-5374.297061.
The inflammatory response after cerebral ischemia/reperfusion is an important cause of neurological damage and repair. After cerebral ischemia/reperfusion, microglia are activated, and a large number of circulating inflammatory cells infiltrate the affected area. This leads to the secretion of inflammatory mediators and an inflammatory cascade that eventually causes secondary brain damage, including neuron necrosis, blood-brain barrier destruction, cerebral edema, and an oxidative stress response. Activation of inflammatory signaling pathways plays a key role in the pathological process of ischemic stroke. Increasing evidence suggests that acupuncture can reduce the inflammatory response after cerebral ischemia/reperfusion and promote repair of the injured nervous system. Acupuncture can not only inhibit the activation and infiltration of inflammatory cells, but can also regulate the expression of inflammation-related cytokines, balance the effects of pro-inflammatory and anti-inflammatory factors, and interfere with inflammatory signaling pathways. Therefore, it is important to study the transmission and regulatory mechanism of inflammatory signaling pathways after acupuncture treatment for cerebral ischemia/reperfusion injury to provide a theoretical basis for clinical treatment of this type of injury using acupuncture. Our review summarizes the overall conditions of inflammatory cells, mediators, and pathways after cerebral ischemia/reperfusion, and discusses the possible synergistic intervention of acupuncture in the inflammatory signaling pathway network to provide a foundation to explore the multiple molecular mechanisms by which acupuncture promotes nerve function restoration.
脑缺血/再灌注后的炎症反应是神经损伤和修复的重要原因。脑缺血/再灌注后，小胶质细胞被激活，大量循环炎症细胞浸润到受影响区域。这导致炎症介质的分泌和炎症级联反应，最终引起继发性脑损伤，包括神经元坏死、血脑屏障破坏、脑水肿和氧化应激反应。炎症信号通路的激活在缺血性中风的病理过程中起关键作用。越来越多的证据表明，针刺可以减轻脑缺血/再灌注后的炎症反应，促进受损神经系统的修复。针刺不仅可以抑制炎症细胞的激活和浸润，还可以调节炎症相关细胞因子的表达，平衡促炎和抗炎因子的作用，并干扰炎症信号通路。因此，研究针刺治疗脑缺血/再灌注损伤后炎症信号通路的传导和调控机制，为针刺临床治疗此类损伤提供理论依据具有重要意义。我们的综述总结了脑缺血/再灌注后炎症细胞、介质和通路的总体情况，并探讨了针刺在炎症信号通路网络中可能的协同干预作用，为探索针刺促进神经功能恢复的多种分子机制提供基础。
