Department of Physiology, Anatomy, and Microbiology, and Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, Victoria, Australia.
Clinical Trials, Imaging, and Informatics (CTI) Division, Stroke and Ageing Research (STARC), Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Trends Pharmacol Sci. 2021 Feb;42(2):96-105. doi: 10.1016/j.tips.2020.11.010. Epub 2020 Dec 16.
Stroke is responsible for almost 6 million deaths and more than 10% of all mortalities each year, and two-thirds of stroke survivors remain disabled. With treatments for ischemic stroke still limited to clot lysis and/or mechanical removal, new therapeutic targets are desperately needed. In this review, we provide an overview of the complex mechanisms of innate and adaptive immune cell-mediated inflammatory injury, that exacerbates infarct development for several days after stroke. We also highlight the features of poststroke systemic immunodepression that commonly leads to infections and some mortalities, and argue that safe and effective therapies will need to balance pro- and anti-inflammatory mechanisms in a time-sensitive manner, to maximize the likelihood of an improved long-term outcome.
中风每年导致近 600 万人死亡，占所有死亡人数的 10%以上，三分之二的中风幸存者仍留有残疾。由于对缺血性中风的治疗仍然仅限于溶解血栓和/或机械清除，因此迫切需要新的治疗靶点。在这篇综述中，我们概述了固有和适应性免疫细胞介导的炎症损伤的复杂机制，这些机制加剧了中风后数天的梗死发展。我们还强调了中风后全身免疫抑制的特征，这通常导致感染和一些死亡，并认为安全有效的治疗方法需要以时间敏感的方式平衡促炎和抗炎机制，以最大限度地提高改善长期预后的可能性。
