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缺血性脑损伤的高血糖代谢并发症:当前的治疗策略、抗糖尿病药物和干细胞治疗。

Hyperglycaemic Metabolic Complications of Ischemic Brain: Current Therapeutics, Anti-Diabetics and Stem Cell Therapy.

机构信息

Pharmacology Research Lab, Department of Pharmacology, Nirma University, Ahmedabad, Gujarat 382481, India.

出版信息

CNS Neurol Disord Drug Targets. 2023;22(6):832-856. doi: 10.2174/1871527321666220609200852.

Abstract

Stroke is the leading cause of morbidity and mortality in diabetic patients. Diabetes alters the endothelial function and disrupts brain pathways, resulting in a variety of systemic metabolic complications. Diabetics not only have impaired neurotransmission, but also have progressive neurodegeneration, which leads to long-term neurological complications. Diabetes risk factors and physiology alter the frequency and severity of cardiovascular and cerebrovascular events, necessitating more hospitalizations. Stroke and diabetes have a mutually reinforcing relationship that worsens their outcomes. Diabetes has far-reaching systemic consequences for human physiology as a metabolic syndrome. As a result, diabetic stroke patients require dual-therapeutics with dual protection. Scientific researchers have made tremendous progress in diabetes-related stroke and its therapeutics over the last few decades. We have summarised diabetic brain and associated risk factors, co-morbidities, biomarkers, and hyperglycemia-associated neurovascular insult and cognitive demur. In addition to providing an overview of the effects of hyperglycaemia on brain physiology, this article aims to summarise the evidence from current glucose-lowering treatment, recent advances in stroke therapeutics as well as exploring stem cell therapy in the management of diabetes-associated stroke.

摘要

中风是糖尿病患者发病率和死亡率的主要原因。糖尿病会改变血管内皮功能并破坏大脑通路,导致各种全身性代谢并发症。糖尿病患者不仅神经传递受损,而且还会进行性神经退行性变,从而导致长期神经并发症。糖尿病的风险因素和生理学改变了心血管和脑血管事件的频率和严重程度,这需要更多的住院治疗。中风和糖尿病之间存在相互加强的关系,会使它们的预后恶化。糖尿病作为一种代谢综合征,对人体生理有深远的全身性影响。因此,糖尿病中风患者需要双重治疗和双重保护。在过去几十年中,科学研究人员在糖尿病相关中风及其治疗方面取得了巨大进展。我们总结了糖尿病大脑及其相关风险因素、合并症、生物标志物以及与高血糖相关的神经血管损伤和认知障碍。除了概述高血糖对大脑生理学的影响外,本文还旨在总结目前降低血糖治疗的证据、中风治疗的最新进展以及探索干细胞疗法在糖尿病相关中风管理中的应用。

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