Rotaru-Zăvăleanu Alexandra-Daniela, Dinescu Venera Cristina, Aldea Madalina, Gresita Andrei
Department of Epidemiology, University of Medicine and Pharmacy of Craiova, 2-4 Petru Rares Str., 200349 Craiova, Romania.
Experimental Research Centre for Normal and Pathological Aging, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Gels. 2024 Jul 18;10(7):476. doi: 10.3390/gels10070476.
Stroke remains the second leading cause of death and a major cause of disability worldwide, significantly impacting individuals, families, and healthcare systems. This neurological emergency can be triggered by ischemic events, including small vessel arteriolosclerosis, cardioembolism, and large artery atherothromboembolism, as well as hemorrhagic incidents resulting from macrovascular lesions, venous sinus thrombosis, or vascular malformations, leading to significant neuronal damage. The resultant motor impairment, cognitive dysfunction, and emotional disturbances underscore the urgent need for effective therapeutic interventions. Recent advancements in biomaterials, particularly hydrogels, offer promising new avenues for stroke management. Hydrogels, composed of three-dimensional networks of hydrophilic polymers, are notable for their ability to absorb and retain substantial amounts of water. Commonly used polymers in hydrogel formulations include natural polymers like alginate, chitosan, and collagen, as well as synthetic polymers such as polyethylene glycol (PEG), polyvinyl alcohol (PVA), and polyacrylamide. Their customizable characteristics-such as their porosity, swelling behavior, mechanical strength, and degradation rates-make hydrogels ideal for biomedical applications, including drug delivery, cell delivery, tissue engineering, and the controlled release of therapeutic agents. This review comprehensively explores hydrogel-based approaches to both ischemic and hemorrhagic stroke therapy, elucidating the mechanisms by which hydrogels provide neuroprotection. It covers their application in drug delivery systems, their role in reducing inflammation and secondary injury, and their potential to support neurogenesis and angiogenesis. It also discusses current advancements in hydrogel technology and the significant challenges in translating these innovations from research into clinical practice. Additionally, it emphasizes the limited number of clinical trials utilizing hydrogel therapies for stroke and addresses the associated limitations and constraints, underscoring the need for further research in this field.
中风仍然是全球第二大死因和致残的主要原因，对个人、家庭和医疗保健系统产生重大影响。这种神经急症可由缺血性事件引发，包括小血管动脉硬化、心源性栓塞和大动脉粥样血栓栓塞，以及由大血管病变、静脉窦血栓形成或血管畸形导致的出血事件，从而导致严重的神经元损伤。由此产生的运动障碍、认知功能障碍和情绪紊乱凸显了有效治疗干预措施的迫切需求。生物材料，特别是水凝胶的最新进展为中风治疗提供了有前景的新途径。水凝胶由亲水性聚合物的三维网络组成，以其吸收和保留大量水分的能力而著称。水凝胶配方中常用的聚合物包括天然聚合物，如藻酸盐、壳聚糖和胶原蛋白，以及合成聚合物，如聚乙二醇（PEG）、聚乙烯醇（PVA）和聚丙烯酰胺。它们的可定制特性，如孔隙率、溶胀行为、机械强度和降解速率，使水凝胶非常适合生物医学应用，包括药物递送、细胞递送、组织工程和治疗剂的控释。本综述全面探讨了基于水凝胶的缺血性和出血性中风治疗方法，阐明了水凝胶提供神经保护的机制。它涵盖了水凝胶在药物递送系统中的应用、其在减轻炎症和继发性损伤中的作用，以及其支持神经发生和血管生成的潜力。它还讨论了水凝胶技术的当前进展以及将这些创新从研究转化为临床实践的重大挑战。此外，它强调了利用水凝胶疗法治疗中风的临床试验数量有限，并解决了相关的局限性和限制，强调了该领域进一步研究的必要性。
