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血栓炎症在缺血性卒中中的作用:聚焦于调控与临床应用

The Role of Thrombo-inflammation in Ischemic Stroke: Focus on the Manipulation and Clinical Application.

作者信息

Luo Yuanfei, Dong Weichen, Yuan Linying, Zhu Yunqing Amelia, Zhang Dachuan Dustin, Ni Heyu, Zhu Wusheng

机构信息

Department of Neurology, Nanjing Jinling Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.

Department of Laboratory Medicine, LKSKI-Keenan Research Centre for Biomedical Science, St. Michael's Hospital, and Toronto Platelet Immunobiology Group, Toronto, ON, M5B 1W8, Canada.

出版信息

Mol Neurobiol. 2025 Feb;62(2):2362-2375. doi: 10.1007/s12035-024-04397-w. Epub 2024 Aug 6.

Abstract

Stroke leaves a great economic burden due to its high morbidity and mortality. Rapid revascularization of targeted vessel(s) is the effective treatment for ischemic stroke, but subsequent ischemia-reperfusion (I/R) injury is a common complication following revascularization, leading to microcirculation dysfunction and infarct volume increase. Thrombo-inflammation, the interaction between thrombosis and inflammation, plays a critical role in the pathophysiology of ischemic stroke. In the context of I/R injury, thrombo-inflammation consists of platelet activation, endothelial injury, and inflammatory cell infiltration. Numerous studies are devoted to exploring methods of regulating thrombo-inflammation to mitigate I/R injury post-stroke, including blocking activations of platelets and neutrophils. Drugs such as antiplatelet medications, anticoagulants, and glucocorticoids have been confirmed to have the potential to regulate thrombo-inflammation. Furthermore, several recently developed drugs have also shown promises in relieving I/R injury by manipulating thrombo-inflammation. However, the majority of these studies are still in the preclinical stage. Herein, in this review, we will address the mechanisms of thrombo-inflammation in ischemic stroke, related research advances, and particularly the clinical feasibility of thrombo-inflammation as a therapeutic strategy against I/R injury.

摘要

由于其高发病率和高死亡率,中风带来了巨大的经济负担。对目标血管进行快速血管再通是缺血性中风的有效治疗方法,但随后的缺血再灌注(I/R)损伤是血管再通后的常见并发症,会导致微循环功能障碍和梗死体积增加。血栓炎症,即血栓形成与炎症之间的相互作用,在缺血性中风的病理生理学中起关键作用。在I/R损伤的情况下,血栓炎症包括血小板活化、内皮损伤和炎症细胞浸润。众多研究致力于探索调节血栓炎症以减轻中风后I/R损伤的方法,包括阻断血小板和中性粒细胞的活化。抗血小板药物、抗凝剂和糖皮质激素等药物已被证实具有调节血栓炎症的潜力。此外,一些最近开发的药物也显示出通过控制血栓炎症来减轻I/R损伤的前景。然而,这些研究大多仍处于临床前阶段。在此综述中,我们将阐述缺血性中风中血栓炎症的机制、相关研究进展,特别是血栓炎症作为对抗I/R损伤的治疗策略的临床可行性。

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