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免疫干预在脑出血中的作用机制及应用。

Mechanism and application of immune interventions in intracerebral haemorrhage.

机构信息

Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.

出版信息

Expert Rev Mol Med. 2024 Oct 8;26:e22. doi: 10.1017/erm.2024.22.

Abstract

Despite stroke being one of the major and increasing burdens to global health, therapeutic interventions in intracerebral haemorrhage (ICH) continue to be a challenge. Existing treatment methods, such as surgery and conservative treatment have shown limited efficacy in improving the prognosis of ICH. However, more and more studies show that exploring the specific process of immune response after ICH and taking corresponding immunotherapy may have a definite significance to improve the prognosis of cerebral haemorrhage. Therefore, immune interventions are currently under consideration as therapeutic interventions in the ICH. In this review, we aim to clarify unique immunological features of stroke, and consider the evidence for immune interventions. In acute ICH, activation of glial cells and cell death products trigger an inflammatory cascade that damages vessels and the parenchyma within minutes to hours of the haemorrhage. Immune interventions that ameliorate brain inflammation, vascular permeability and tissue oedema should be administered promptly to reduce acute immune destruction and avoid subsequent immunosuppression. A deeper understanding of the immune mechanisms involved in ICH is likely to lead to successful immune interventions.

摘要

尽管中风是全球健康的主要且日益加重的负担之一,但在治疗脑出血(ICH)方面仍然面临挑战。现有的治疗方法,如手术和保守治疗,在改善 ICH 预后方面的效果有限。然而,越来越多的研究表明,探索 ICH 后免疫反应的具体过程并采取相应的免疫疗法可能对改善脑出血的预后具有重要意义。因此,免疫干预目前被认为是 ICH 的治疗干预措施。在这篇综述中,我们旨在阐明中风的独特免疫学特征,并考虑免疫干预的证据。在急性 ICH 中,胶质细胞的激活和细胞死亡产物触发炎症级联反应,在出血后数分钟到数小时内损害血管和实质。应迅速进行改善脑炎症、血管通透性和组织水肿的免疫干预,以减少急性免疫破坏并避免随后的免疫抑制。更深入地了解 ICH 中涉及的免疫机制可能会导致成功的免疫干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffbd/11488334/7558f43b0fdb/S146239942400022X_fig1.jpg

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