文献检索文档翻译深度研究
Suppr Zotero 插件Zotero 插件
邀请有礼套餐&价格历史记录

新学期,新优惠

限时优惠:9月1日-9月22日

30天高级会员仅需29元

1天体验卡首发特惠仅需5.99元

了解详情
不再提醒
插件&应用
Suppr Zotero 插件Zotero 插件浏览器插件Mac 客户端Windows 客户端微信小程序
高级版
套餐订阅购买积分包
AI 工具
文献检索文档翻译深度研究
关于我们
关于 Suppr公司介绍联系我们用户协议隐私条款
关注我们

Suppr 超能文献

核心技术专利:CN118964589B侵权必究
粤ICP备2023148730 号-1Suppr @ 2025

脑水肿的机制和治疗靶点的新见解。

New Insights on Mechanisms and Therapeutic Targets of Cerebral Edema.

机构信息

Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Department of Neurology, Mayo Clinic College of Medicine and Science, Rochester, MN, USA.

出版信息

Curr Neuropharmacol. 2024;22(14):2330-2352. doi: 10.2174/1570159X22666240528160237.


DOI:10.2174/1570159X22666240528160237
PMID:38808718
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11451312/
Abstract

Cerebral Edema (CE) is the final common pathway of brain death. In severe neurological disease, neuronal cell damage first contributes to tissue edema, and then Increased Intracranial Pressure (ICP) occurs, which results in diminishing cerebral perfusion pressure. In turn, anoxic brain injury brought on by decreased cerebral perfusion pressure eventually results in neuronal cell impairment, creating a vicious cycle. Traditionally, CE is understood to be tightly linked to elevated ICP, which ultimately generates cerebral hernia and is therefore regarded as a risk factor for mortality. Intracranial hypertension and brain edema are two serious neurological disorders that are commonly treated with mannitol. However, mannitol usage should be monitored since inappropriate utilization of the substance could conversely have negative effects on CE patients. CE is thought to be related to bloodbrain barrier dysfunction. Nonetheless, a fluid clearance mechanism called the glial-lymphatic or glymphatic system was updated. This pathway facilitates the transport of cerebrospinal fluid (CSF) into the brain along arterial perivascular spaces and later into the brain interstitium. After removing solutes from the neuropil into meningeal and cervical lymphatic drainage arteries, the route then directs flows into the venous perivascular and perineuronal regions. Remarkably, the dual function of the glymphatic system was observed to protect the brain from further exacerbated damage. From our point of view, future studies ought to concentrate on the management of CE based on numerous targets of the updated glymphatic system. Further clinical trials are encouraged to apply these agents to the clinic as soon as possible.

摘要

脑水肿(CE)是脑死亡的最终共同途径。在严重的神经疾病中,神经元细胞损伤首先导致组织水肿,然后颅内压(ICP)升高,导致脑灌注压降低。反过来,脑灌注压降低引起的缺氧性脑损伤最终导致神经元细胞损伤,形成恶性循环。传统上,CE 被认为与升高的 ICP 密切相关,而升高的 ICP 最终会导致脑疝,因此被认为是死亡率的一个危险因素。颅内压增高和脑水肿是两种常见的神经科疾病,通常用甘露醇治疗。然而,应该监测甘露醇的使用,因为不恰当地使用这种物质可能会对 CE 患者产生负面影响。CE 被认为与血脑屏障功能障碍有关。然而,一种被称为胶质淋巴或糖质系统的液体清除机制得到了更新。该途径促进了脑脊液(CSF)沿着动脉周围间隙进入大脑,并随后进入脑间质。将溶质从神经胶中清除后,该途径将流向脑膜和颈淋巴引流动脉,然后再流入静脉周围和神经周间隙。值得注意的是,糖质系统的双重功能被观察到可以保护大脑免受进一步恶化的损伤。从我们的角度来看,未来的研究应该集中在基于更新的糖质系统的多个靶点来管理 CE。鼓励进一步的临床试验尽快将这些药物应用于临床。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f509/11451312/ff79130b73f2/CN-22-2330_F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f509/11451312/409e8c81b8b9/CN-22-2330_F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f509/11451312/ff79130b73f2/CN-22-2330_F2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f509/11451312/409e8c81b8b9/CN-22-2330_F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f509/11451312/ff79130b73f2/CN-22-2330_F2.jpg

相似文献

[1]
New Insights on Mechanisms and Therapeutic Targets of Cerebral Edema.

Curr Neuropharmacol. 2024

[2]
The glymphatic pathway in neurological disorders.

Lancet Neurol. 2018-11

[3]
Effects of increased intracranial pressure on cerebrospinal fluid influx, cerebral vascular hemodynamic indexes, and cerebrospinal fluid lymphatic efflux.

J Cereb Blood Flow Metab. 2022-12

[4]
The impact of neurovascular, blood-brain barrier, and glymphatic dysfunction in neurodegenerative and metabolic diseases.

Int Rev Neurobiol. 2020

[5]
Clearance dysfunction of trans-barrier transport and lymphatic drainage in cerebral small vessel disease: Review and prospect.

Neurobiol Dis. 2023-12

[6]
The Underlying Role of the Glymphatic System and Meningeal Lymphatic Vessels in Cerebral Small Vessel Disease.

Biomolecules. 2022-5-25

[7]
Glymphatic System: Emerging Therapeutic Target for Neurological Diseases.

Oxid Med Cell Longev. 2022

[8]
Use of hypertonic saline solutions in treatment of cerebral edema and intracranial hypertension.

Crit Care Med. 2000-9

[9]
Attenuation of cerebral edema facilitates recovery of glymphatic system function after status epilepticus.

JCI Insight. 2021-9-8

[10]
Dystrophin 71 deficiency causes impaired aquaporin-4 polarization contributing to glymphatic dysfunction and brain edema in cerebral ischemia.

Neurobiol Dis. 2024-9

引用本文的文献

[1]
The Collapse of Brain Clearance: Glymphatic-Venous Failure, Aquaporin-4 Breakdown, and AI-Empowered Precision Neurotherapeutics in Intracranial Hypertension.

Int J Mol Sci. 2025-7-25

[2]
Meningeal lymphatic drainage: novel insights into central nervous system disease.

Signal Transduct Target Ther. 2025-5-5

本文引用的文献

[1]
Glymphatic influx and clearance are accelerated by neurovascular coupling.

Nat Neurosci. 2023-6

[2]
Single-Cell RNA Sequencing and Spatial Transcriptomics Reveal Pathogenesis of Meningeal Lymphatic Dysfunction after Experimental Subarachnoid Hemorrhage.

Adv Sci (Weinh). 2023-7

[3]
Mechanically manipulating glymphatic transport by ultrasound combined with microbubbles.

Proc Natl Acad Sci U S A. 2023-5-23

[4]
Open pathways for cerebrospinal fluid outflow at the cribriform plate along the olfactory nerves.

EBioMedicine. 2023-5

[5]
The Expression of FOXO3a as a Forensic Diagnostic Tool in Cases of Traumatic Brain Injury: An Immunohistochemical Study.

Int J Mol Sci. 2023-1-30

[6]
Photodynamic Opening of the Blood-Brain Barrier and the Meningeal Lymphatic System: The New Niche in Immunotherapy for Brain Tumors.

Pharmaceutics. 2022-11-26

[7]
Ischemic Preconditioning Alleviates Cerebral Ischemia-Reperfusion Injury by Interfering With Glycocalyx.

Transl Stroke Res. 2023-12

[8]
Glymphatic System a Window on TBI Pathophysiology: A Systematic Review.

Int J Mol Sci. 2022-8-15

[9]
Endothelial Glycocalyx.

Compr Physiol. 2022-8-23

[10]
A functional role of meningeal lymphatics in sex difference of stress susceptibility in mice.

Nat Commun. 2022-8-16

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

推荐工具

医学文档翻译智能文献检索