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多酚类化合物治疗缺血性脑卒中:新的应用与见解。

Polyphenols for the Treatment of Ischemic Stroke: New Applications and Insights.

机构信息

Department of Neurosurgery, The First Hospital of Jilin University, Changchun 130021, China.

Department of Orthopaedic Surgery, China-Japan Union Hospital of Jilin University, Changchun 130033, China.

出版信息

Molecules. 2022 Jun 29;27(13):4181. doi: 10.3390/molecules27134181.

Abstract

Ischemic stroke (IS) is a leading cause of death and disability worldwide. Currently, the main therapeutic strategy involves the use of intravenous thrombolysis to restore cerebral blood flow to prevent the transition of the penumbra to the infarct core. However, due to various limitations and complications, including the narrow time window in which this approach is effective, less than 10% of patients benefit from such therapy. Thus, there is an urgent need for alternative therapeutic strategies, with neuroprotection against the ischemic cascade response after IS being one of the most promising options. In the past few decades, polyphenolic compounds have shown great potential in animal models of IS because of their high biocompatibility and ability to target multiple ischemic cascade signaling pathways, although low bioavailability is an issue that limits the applications of several polyphenols. Here, we review the pathophysiological changes following cerebral ischemia and summarize the research progress regarding the applications of polyphenolic compounds in the treatment of IS over the past 5 years. Furthermore, we discuss several potential strategies for improving the bioavailability of polyphenolic compounds as well as some essential issues that remain to be addressed for the translation of the related therapies to the clinic.

摘要

缺血性脑卒中(IS)是全球范围内主要的致死和致残原因。目前,主要的治疗策略包括使用静脉溶栓来恢复脑血流,以防止半影向梗死核心的转变。然而,由于存在多种限制和并发症,包括该方法有效的时间窗口较窄,只有不到 10%的患者从中受益。因此,迫切需要替代的治疗策略,其中针对 IS 后缺血级联反应的神经保护是最有前途的选择之一。在过去的几十年中,由于具有高生物相容性和靶向多个缺血级联信号通路的能力,多酚化合物在 IS 的动物模型中显示出巨大的潜力,尽管生物利用度低是限制几种多酚应用的问题。在这里,我们综述了脑缺血后的病理生理变化,并总结了过去 5 年中多酚化合物在治疗 IS 中的应用研究进展。此外,我们讨论了几种提高多酚化合物生物利用度的潜在策略,以及将相关治疗方法转化为临床应用仍需要解决的一些重要问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3090/9268254/2bfb0371a057/molecules-27-04181-g001.jpg

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