Zhang Jiatong, Zhu Qi, Wang Jie, Peng Zheng, Zhuang Zong, Hang Chunhua, Li Wei
Department of Neurosurgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu Province, China.
Department of Neurosurgery, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu Province, China.
Neural Regen Res. 2024 Apr;19(4):825-832. doi: 10.4103/1673-5374.381493.
The dramatic increase in intracranial pressure after subarachnoid hemorrhage leads to a decrease in cerebral perfusion pressure and a reduction in cerebral blood flow. Mitochondria are directly affected by direct factors such as ischemia, hypoxia, excitotoxicity, and toxicity of free hemoglobin and its degradation products, which trigger mitochondrial dysfunction. Dysfunctional mitochondria release large amounts of reactive oxygen species, inflammatory mediators, and apoptotic proteins that activate apoptotic pathways, further damaging cells. In response to this array of damage, cells have adopted multiple mitochondrial quality control mechanisms through evolution, including mitochondrial protein quality control, mitochondrial dynamics, mitophagy, mitochondrial biogenesis, and intercellular mitochondrial transfer, to maintain mitochondrial homeostasis under pathological conditions. Specific interventions targeting mitochondrial quality control mechanisms have emerged as promising therapeutic strategies for subarachnoid hemorrhage. This review provides an overview of recent research advances in mitochondrial pathophysiological processes after subarachnoid hemorrhage, particularly mitochondrial quality control mechanisms. It also presents potential therapeutic strategies to target mitochondrial quality control in subarachnoid hemorrhage.
蛛网膜下腔出血后颅内压急剧升高,导致脑灌注压降低和脑血流量减少。线粒体直接受到缺血、缺氧、兴奋性毒性以及游离血红蛋白及其降解产物的毒性等直接因素的影响,这些因素会引发线粒体功能障碍。功能失调的线粒体释放大量活性氧、炎症介质和凋亡蛋白,激活凋亡途径,进一步损害细胞。为应对这一系列损伤,细胞在进化过程中采用了多种线粒体质量控制机制,包括线粒体蛋白质质量控制、线粒体动力学、线粒体自噬、线粒体生物发生和细胞间线粒体转移,以在病理条件下维持线粒体稳态。针对线粒体质量控制机制的特异性干预措施已成为蛛网膜下腔出血颇具前景的治疗策略。本文综述了蛛网膜下腔出血后线粒体病理生理过程,特别是线粒体质量控制机制的最新研究进展。还介绍了针对蛛网膜下腔出血中线粒体质量控制的潜在治疗策略。
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