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髓系细胞表达的触发受体1/2在脑出血后继发性损伤中的作用

Role of triggering receptor expressed on myeloid cells 1/2 in secondary injury after cerebral hemorrhage.

作者信息

Yi Fan, Wu Hao, Zhao Hai-Kang

机构信息

Xi'an Medical University, Xi'an 710021, Shaanxi Province, China.

Department of Neurosurgery, The Second Affiliated Hospital of Xi'an Medical University, Xi'an 710038, Shaanxi Province, China.

出版信息

World J Clin Cases. 2025 Mar 26;13(9):100312. doi: 10.12998/wjcc.v13.i9.100312.

Abstract

Intracerebral hemorrhage (ICH) is a common severe emergency in neurosurgery, causing tremendous economic pressure on families and society and devastating effects on patients both physically and psychologically, especially among patients with poor functional outcomes. ICH is often accompanied by decreased consciousness and limb dysfunction. This seriously affects patients' ability to live independently. Although rapid advances in neurosurgery have greatly improved patient survival, there remains insufficient evidence that surgical treatment significantly improves long-term outcomes. With in-depth pathophysiological studies after ICH, increasing evidence has shown that secondary injury after ICH is related to long-term prognosis and that the key to secondary injury is various immune-mediated neuroinflammatory reactions after ICH. In basic and clinical studies of various systemic inflammatory diseases, triggering receptor expressed on myeloid cells 1/2 (TREM-1/2), and the TREM receptor family is closely related to the inflammatory response. Various inflammatory diseases can be upregulated and downregulated through receptor intervention. How the TREM receptor functions after ICH, the types of results from intervention, and whether the outcomes can improve secondary brain injury and the long-term prognosis of patients are unknown. An analysis of relevant research results from basic and clinical trials revealed that the inhibition of TREM-1 and the activation of TREM-2 can alleviate the neuroinflammatory immune response, significantly improve the long-term prognosis of neurological function in patients with cerebral hemorrhage, and thus improve the ability of patients to live independently.

摘要

脑出血(ICH)是神经外科常见的严重急症,给家庭和社会带来巨大经济压力,对患者的身体和心理造成毁灭性影响,尤其是功能预后较差的患者。脑出血常伴有意识障碍和肢体功能障碍。这严重影响患者的独立生活能力。尽管神经外科的快速发展极大地提高了患者的生存率,但仍缺乏足够证据表明手术治疗能显著改善长期预后。随着对脑出血后病理生理学研究的深入,越来越多的证据表明,脑出血后的继发性损伤与长期预后相关,且继发性损伤的关键是脑出血后各种免疫介导的神经炎症反应。在各种全身性炎症疾病的基础和临床研究中,髓系细胞表达的触发受体1/2(TREM-1/2)以及TREM受体家族与炎症反应密切相关。通过受体干预可上调和下调各种炎症性疾病。脑出血后TREM受体如何发挥作用、干预产生的结果类型以及这些结果是否能改善继发性脑损伤和患者的长期预后尚不清楚。对基础和临床试验相关研究结果的分析表明,抑制TREM-1和激活TREM-2可减轻神经炎症免疫反应,显著改善脑出血患者神经功能的长期预后,从而提高患者的独立生活能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d48e/11670023/2f96ccc78f7a/100312-g001.jpg

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