Hu Wenlong, Huang Weiyi, Ji Wei, Sun Jun
Department of Neurosurgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Jiangsu, China.
Curr Mol Med. 2024 Jun 6. doi: 10.2174/0115665240306767240603091329.
Subarachnoid hemorrhage is a serious subtype of stroke with high mortality and disability. The rupture of intracranial aneurysms is the main cause. However, in recent years, with the popularization of CT, MRI, and cerebral angiography, the detection rate of unruptured aneurysms has increased, and the incidence of aneurysm rupture and hemorrhage has gradually decreased. However, there are still some patients who fail to detect aneurysms in time and receive treatment, resulting in the occurrence of aneurysm rupture and bleeding, and these patients usually have a poor prognosis and leave a lasting disability. Therefore, exploring the causes of aneurysm formation and the mechanism of brain injury caused by aneurysm rupture is of great significance for preventing aneurysm formation and improving the prognosis of patients. MicroRNAs (miRNAs) are highly conserved non-coding RNAs that can bind to the 3'UTR of target mRNAs to regulate gene expression. Studies have shown that miRNAs can affect the formation and rupture of intracranial aneurysms by participating in apoptosis, inflammation, phagocyte migration, and vascular smooth muscle cells (VSMCs) regulation, and regulate the damage of brain tissue after aneurysm rupture. They play a role in multiple pathophysiological processes of aneurysmal subarachnoid hemorrhage. This article reviews the role of miRNAs in different pathophysiological stages of aneurysmal subarachnoid hemorrhage (aSAH). We further described the research progress of miRNAs as biomarkers for the diagnosis and prognosis of aSAH and discussed their application prospects in the prevention and treatment of aSAH.
蛛网膜下腔出血是一种严重的中风亚型,具有高死亡率和致残率。颅内动脉瘤破裂是主要原因。然而,近年来,随着CT、MRI和脑血管造影的普及,未破裂动脉瘤的检出率有所提高,动脉瘤破裂和出血的发生率逐渐降低。然而,仍有一些患者未能及时发现动脉瘤并接受治疗,导致动脉瘤破裂出血的发生,这些患者通常预后较差,会留下永久性残疾。因此,探究动脉瘤形成的原因以及动脉瘤破裂所致脑损伤的机制,对于预防动脉瘤形成和改善患者预后具有重要意义。微小RNA(miRNA)是高度保守的非编码RNA,可与靶mRNA的3'UTR结合以调节基因表达。研究表明,miRNA可通过参与细胞凋亡、炎症、吞噬细胞迁移和血管平滑肌细胞(VSMC)调节来影响颅内动脉瘤的形成和破裂,并调节动脉瘤破裂后脑组织的损伤。它们在动脉瘤性蛛网膜下腔出血的多个病理生理过程中发挥作用。本文综述了miRNA在动脉瘤性蛛网膜下腔出血(aSAH)不同病理生理阶段中的作用。我们进一步阐述了miRNA作为aSAH诊断和预后生物标志物的研究进展,并讨论了它们在aSAH预防和治疗中的应用前景。