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补体在脑出血后脑损伤中的作用:综述

The role of complement in brain injury following intracerebral hemorrhage: A review.

作者信息

Holste Katherine, Xia Fan, Garton Hugh J L, Wan Shu, Hua Ya, Keep Richard F, Xi Guohua

机构信息

Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA.

Department of Neurosurgery, University of Michigan, Ann Arbor, MI, USA; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Exp Neurol. 2021 Jun;340:113654. doi: 10.1016/j.expneurol.2021.113654. Epub 2021 Feb 20.

Abstract

Intracerebral hemorrhage (ICH) is a significant cause of death and disability and current treatment is limited to supportive measures to reduce brain edema and secondary hematoma expansion. Current evidence suggests that the complement cascade is activated early after hemorrhage and contributes to brain edema/injury in multiple ways. The aim of this review is to summarize the most recent literature about the role of the complement cascade after ICH. Primary literature demonstrating complement mediated brain edema and neurologic injury through the membrane attack complex (MAC) as well as C3a and C5a are reviewed. Further, attenuation of brain edema and improved functional outcomes are demonstrated after inhibition of specific components of the complement cascade. Conversely, complement also plays a significant role in neurologic recovery after ICH and in other neurologic disorders. We conclude that the role of complement after ICH is complex. Understanding the role of complement after ICH is essential and may elucidate possible interventions to reduce brain edema and injury.

摘要

脑出血(ICH)是导致死亡和残疾的重要原因,目前的治疗仅限于采取支持措施以减轻脑水肿和继发性血肿扩大。目前的证据表明,补体级联反应在出血后早期被激活,并以多种方式导致脑水肿/损伤。本综述的目的是总结关于脑出血后补体级联反应作用的最新文献。对通过膜攻击复合物(MAC)以及C3a和C5a介导补体导致脑水肿和神经损伤的原始文献进行了综述。此外,在抑制补体级联反应的特定成分后,脑水肿得到减轻,功能结局得到改善。相反,补体在脑出血后的神经恢复以及其他神经系统疾病中也起着重要作用。我们得出结论,脑出血后补体的作用是复杂的。了解脑出血后补体的作用至关重要,可能会阐明减少脑水肿和损伤的潜在干预措施。

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