蛛网膜下腔出血中星形胶质细胞与小胶质细胞的相互作用:机制与治疗
Astrocyte-microglia crosstalk in subarachnoid hemorrhage: mechanisms and treatments.
作者信息
Yu Kaibo, Wang Ding, Yu Wenhua
机构信息
Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, School Of Medicine, Westlake University, Hangzhou, China.
出版信息
Front Immunol. 2025 Jun 30;16:1547858. doi: 10.3389/fimmu.2025.1547858. eCollection 2025.
Subarachnoid hemorrhage (SAH) is a frequently encountered critical emergency characterized by the rupturing of an unhealthy blood vessel, resulting in high mortality and disability rates. Alterations in the neurovascular unit (NVU) are closely related to the pathogenesis of SAH. Microglia, the primary innate immune cells in the brain, and astrocytes, the most abundant cells in the brain, both play crucial roles in the response to SAH-associated cerebral injuries. Recently, the crosstalk between these two cells in the pathology and treatment of central nervous system (CNS) diseases, including SAH, has been revealed. Following acute brain insult, activated microglia and astrocytes can further activate each other, contributing to amplified neuroinflammatory reactions and thus inducing secondary brain injury. This review addresses the pathophysiological mechanisms of microglia and astrocytes in SAH, including neuroinflammation, neuronal damage, blood-brain barrier (BBB) disruption, vasospasm, and hematoma clearance. In addition, the newly identified therapeutic strategies against SAH by regulating astrocytes-microglia crosstalk through targeting damage-associated molecular patterns (DAMPs), immune mediators, and their receptors are also discussed. A thorough comprehension of microglia-astrocyte communication could provide novel ideas for future research and treatment of SAH.
蛛网膜下腔出血(SAH)是一种常见的危急重症,其特征是不健康的血管破裂,导致高死亡率和致残率。神经血管单元(NVU)的改变与SAH的发病机制密切相关。小胶质细胞是大脑中的主要固有免疫细胞,星形胶质细胞是大脑中数量最多的细胞,它们在对SAH相关脑损伤的反应中都起着关键作用。最近,已经揭示了这两种细胞在包括SAH在内的中枢神经系统(CNS)疾病的病理和治疗中的相互作用。急性脑损伤后,活化的小胶质细胞和星形胶质细胞可进一步相互激活,导致神经炎症反应放大,从而引发继发性脑损伤。本文综述了小胶质细胞和星形胶质细胞在SAH中的病理生理机制,包括神经炎症、神经元损伤、血脑屏障(BBB)破坏、血管痉挛和血肿清除。此外,还讨论了通过靶向损伤相关分子模式(DAMPs)、免疫介质及其受体来调节星形胶质细胞-小胶质细胞相互作用从而针对SAH的新确定的治疗策略。对小胶质细胞-星形胶质细胞通讯的深入理解可为未来SAH的研究和治疗提供新思路。