改变基因、细胞和神经网络以在中风后重新编程大脑。
Changing genes, cells and networks to reprogram the brain after stroke.
作者信息
Li Wenlu, George Paul, Azadian Matine M, Ning MingMing, Dhand Amar, Cramer Steven C, Carmichael S Thomas, Lo Eng H
机构信息
Neuroprotection Research Laboratories, Departments of Radiology and Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Zhejiang Key Laboratory of Neuropsychopharmacology, School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, PR China.
出版信息
Nat Neurosci. 2025 Jun;28(6):1130-1145. doi: 10.1038/s41593-025-01981-8. Epub 2025 Jun 2.
Important advances have been made in reperfusion therapies for acute ischemic stroke. However, a majority of patients are either ineligible for or do not respond to treatments and continue to have considerable functional deficits. Stroke results in a pathological disruption of the neurovascular unit (NVU) that involves blood-brain barrier leakage, glial activation, neuronal damage and chronic inflammation, all of which create a microenvironment that hinders recovery. Therefore, finding ways to promote central nervous system recovery remains the holy grail of stroke research. Here we propose a conceptual framework to synthesize recent progress in the field, which is currently dispersed and disconnected in the literature. We suggest that stroke recovery requires an integrated reprogramming process throughout the brain that occurs at multiple levels, including changes in gene expression, endogenous cellular transdifferentiation within the NVU, and reorganization of larger-scale neural and social networks.
急性缺血性中风的再灌注治疗已取得重要进展。然而,大多数患者要么不符合治疗条件,要么对治疗无反应,仍然存在相当大的功能缺陷。中风导致神经血管单元(NVU)的病理破坏,包括血脑屏障渗漏、胶质细胞激活、神经元损伤和慢性炎症,所有这些都创造了一个阻碍恢复的微环境。因此,找到促进中枢神经系统恢复的方法仍然是中风研究的圣杯。在这里,我们提出一个概念框架,以综合该领域最近的进展,目前这些进展在文献中是分散且不连贯的。我们认为,中风恢复需要在整个大脑中进行一个多层次的综合重编程过程,包括基因表达的变化、NVU内源性细胞转分化以及更大规模神经和社会网络的重组。