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急性缺血性和出血性卒中性神经炎症。

Neuroinflammation in Acute Ischemic and Hemorrhagic Stroke.

机构信息

Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.

Neurological Service, SS Annunziata Hospital, Sulmona, L'Aquila, Italy.

出版信息

Curr Neurol Neurosci Rep. 2023 Aug;23(8):407-431. doi: 10.1007/s11910-023-01282-2. Epub 2023 Jul 3.

Abstract

PURPOSE OF REVIEW

This review aims to provide an overview of neuroinflammation in ischemic and hemorrhagic stroke, including recent findings on the mechanisms and cellular players involved in the inflammatory response to brain injury.

RECENT FINDINGS

Neuroinflammation is a crucial process following acute ischemic stroke (AIS) and hemorrhagic stroke (HS). In AIS, neuroinflammation is initiated within minutes of the ischemia onset and continues for several days. In HS, neuroinflammation is initiated by blood byproducts in the subarachnoid space and/or brain parenchyma. In both cases, neuroinflammation is characterized by the activation of resident immune cells, such as microglia and astrocytes, and infiltration of peripheral immune cells, leading to the release of pro-inflammatory cytokines, chemokines, and reactive oxygen species. These inflammatory mediators contribute to blood-brain barrier disruption, neuronal damage, and cerebral edema, promoting neuronal apoptosis and impairing neuroplasticity, ultimately exacerbating the neurologic deficit. However, neuroinflammation can also have beneficial effects by clearing cellular debris and promoting tissue repair. The role of neuroinflammation in AIS and ICH is complex and multifaceted, and further research is necessary to develop effective therapies that target this process. Intracerebral hemorrhage (ICH) will be the HS subtype addressed in this review. Neuroinflammation is a significant contributor to brain tissue damage following AIS and HS. Understanding the mechanisms and cellular players involved in neuroinflammation is essential for developing effective therapies to reduce secondary injury and improve stroke outcomes. Recent findings have provided new insights into the pathophysiology of neuroinflammation, highlighting the potential for targeting specific cytokines, chemokines, and glial cells as therapeutic strategies.

摘要

综述目的

本篇综述旨在概述缺血性和出血性脑卒中的神经炎症,包括最近关于脑损伤炎症反应中涉及的机制和细胞参与者的发现。

最近的发现

神经炎症是急性缺血性脑卒中(AIS)和出血性脑卒中(HS)后的一个关键过程。在 AIS 中,神经炎症在缺血发作后几分钟内开始,并持续数天。在 HS 中,神经炎症由蛛网膜下腔和/或脑实质中的血液副产物引发。在这两种情况下,神经炎症的特征是驻留免疫细胞(如小胶质细胞和星形胶质细胞)的激活以及外周免疫细胞的浸润,导致促炎细胞因子、趋化因子和活性氧物质的释放。这些炎症介质导致血脑屏障破坏、神经元损伤和脑水肿,促进神经元凋亡和损害神经可塑性,最终加重神经功能缺损。然而,神经炎症也可以通过清除细胞碎片和促进组织修复产生有益的效果。神经炎症在 AIS 和 ICH 中的作用是复杂和多方面的,需要进一步的研究来开发针对这一过程的有效治疗方法。本综述将针对 ICH 这一 HS 亚型进行讨论。神经炎症是 AIS 和 HS 后脑组织损伤的重要原因。了解神经炎症中涉及的机制和细胞参与者对于开发有效治疗方法以减少二次损伤和改善脑卒中结局至关重要。最近的发现为神经炎症的病理生理学提供了新的见解,强调了靶向特定细胞因子、趋化因子和神经胶质细胞作为治疗策略的潜力。

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