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缺血性脑卒中后的全身免疫反应:从中心到外周。

Systemic immune responses after ischemic stroke: From the center to the periphery.

机构信息

Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.

Department of Clinical Laboratory, Renmin Hospital, Faculty of Medical Sciences, Wuhan University, Wuhan, China.

出版信息

Front Immunol. 2022 Sep 20;13:911661. doi: 10.3389/fimmu.2022.911661. eCollection 2022.

Abstract

Ischemic stroke is a leading cause of disability and death. It imposes a heavy economic burden on individuals, families and society. The mortality rate of ischemic stroke has decreased with the help of thrombolytic drug therapy and intravascular intervention. However, the nerve damage caused by ischemia-reperfusion is long-lasting and followed by multiple organ dysfunction. In this process, the immune responses manifested by systemic inflammatory responses play an important role. It begins with neuroinflammation following ischemic stroke. The large number of inflammatory cells released after activation of immune cells in the lesion area, along with the deactivated neuroendocrine and autonomic nervous systems, link the center with the periphery. With the activation of systemic immunity and the emergence of immunosuppression, peripheral organs become the second "battlefield" of the immune response after ischemic stroke and gradually become dysfunctional and lead to an adverse prognosis. The purpose of this review was to describe the systemic immune responses after ischemic stroke. We hope to provide new ideas for future research and clinical treatments to improve patient outcomes and quality of life.

摘要

缺血性脑卒中是导致残疾和死亡的主要原因。它给个人、家庭和社会带来了沉重的经济负担。溶栓药物治疗和血管内介入治疗帮助降低了缺血性脑卒中的死亡率。然而,缺血再灌注引起的神经损伤是持久的,并伴有多器官功能障碍。在这个过程中,全身性炎症反应表现出的免疫反应起着重要作用。它始于缺血性脑卒中后的神经炎症。大量的炎症细胞在病变部位的免疫细胞被激活后释放出来,同时神经内分泌和自主神经系统失活,将中枢与外周联系起来。随着全身免疫的激活和免疫抑制的出现,外周器官成为缺血性脑卒中后的免疫反应的第二个“战场”,逐渐出现功能障碍,并导致不良预后。本综述旨在描述缺血性脑卒中后的全身免疫反应。我们希望为未来的研究和临床治疗提供新的思路,以改善患者的预后和生活质量。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a1f6/9533176/500e7750d1c8/fimmu-13-911661-g001.jpg

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