Wang Xiaoyu, Wehbe Alexandra, Kaura Shawn, Chaudhry Naveed, Geng Xiaokun, Ding Yuchuan
Department of Luhe Institute of Neuroscience, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Luhe Hospital, Capital Medical University, Beijing, China.
Front Neurol. 2022 May 6;13:899547. doi: 10.3389/fneur.2022.899547. eCollection 2022.
Thrombectomy or thrombolysis are the current standards of care for acute ischemic stroke (AIS), however, due to time constraints regarding operations and a multitude of contraindications, AIS remains one of the leading causes of death and chronic disability worldwide. In recent years, therapeutic hypothermia has been explored as an adjuvant therapy for AIS treatment and has shown potential to improve outcomes in patients with AIS. In particular, selective therapeutic hypothermia has shown to markedly reduce infarct volumes and have neuroprotective effects, while also minimizing many systemic side effects seen with systemic therapeutic hypothermia. Both preclinical and clinical trials have demonstrated that selective therapeutic hypothermia is a safe and feasible therapy for patients who have suffered an AIS. In this review, we summarize the current update on selective hypothermia through major studies that have been conducted in rodents, large animals, and clinical trials, and briefly discuss the prospects of selective hypothermic research. We hope this review helps facilitate the exploration of other possible adjuvant treatment modalities in the neuroprotection of ischemic stroke, whether upon symptom onset or after vascular recanalization.
血栓切除术或溶栓术是目前急性缺血性卒中(AIS)的治疗标准,然而,由于手术时间限制和诸多禁忌症,AIS仍是全球主要的死亡和慢性残疾原因之一。近年来,治疗性低温已被探索作为AIS治疗的辅助疗法,并已显示出改善AIS患者预后的潜力。特别是,选择性治疗性低温已显示可显著减少梗死体积并具有神经保护作用,同时还能将全身治疗性低温所见的许多全身副作用降至最低。临床前和临床试验均表明,选择性治疗性低温对AIS患者是一种安全可行的疗法。在本综述中,我们通过在啮齿动物、大型动物和临床试验中进行的主要研究总结了选择性低温的当前进展,并简要讨论了选择性低温研究的前景。我们希望本综述有助于促进在缺血性卒中神经保护方面探索其他可能的辅助治疗方式,无论是在症状发作时还是血管再通后。