Wan Gui, Gu Lingui, Chen Yangyang, Wang Yiqing, Sun Ye, Li Zhenwei, Ma Wenbin, Bao Xinjie, Wang Renzhi
Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Anhui Medical College, Hefei, Anhui Province, China.
J Nanobiotechnology. 2025 Aug 14;23(1):567. doi: 10.1186/s12951-025-03661-y.
Intracerebral hemorrhage (ICH) carries a substantial global disease burden, and although it occurs less frequently than ischemic stroke, it results in a greater loss of disability-adjusted life years worldwide and is associated with one of the poorest prognoses among stroke patients. Due to the mechanisms of secondary injury following ICH, angiogenesis, inflammation, and oxidative stress (OS) levels in brain tissue are regulated by complex molecular pathways, leading to significant changes in the brain microenvironment (BME). While traditional treatments for ICH improve survival rates, they have notable drawbacks and limitations. Nanomedicines, as a promising approach, offer the potential to gradually overcome these limitations and are becoming increasingly important in ICH treatment research. This review provides an updated overview of the mechanisms behind the formation of the post-ICH BME, focusing on angiogenesis, inflammation, and OS. Conventional diagnostic and therapeutic methods are outlined, along with an analysis of their drawbacks and limitations. In addition, the current research status of nanomedicines targeting the post-ICH BME is systematically summarized from three perspectives: angiogenesis, inflammation, and OS. Finally, the progress of nanomedicines in clinical translation is analyzed, highlighting the challenges, opportunities, and future prospects for their application in the context of ICH.
脑出血（ICH）在全球范围内带来了沉重的疾病负担，尽管其发病率低于缺血性中风，但在全球范围内导致了更大的伤残调整生命年损失，并且是中风患者中预后最差的情况之一。由于脑出血后继发性损伤的机制，脑组织中的血管生成、炎症和氧化应激（OS）水平受复杂分子途径调控，导致脑微环境（BME）发生显著变化。虽然脑出血的传统治疗方法提高了生存率，但它们存在明显的缺点和局限性。纳米药物作为一种有前景的方法，有可能逐步克服这些局限性，并且在脑出血治疗研究中变得越来越重要。本综述提供了脑出血后脑微环境形成背后机制的最新概述，重点关注血管生成、炎症和氧化应激。概述了传统的诊断和治疗方法，并分析了它们的缺点和局限性。此外，从血管生成、炎症和氧化应激三个角度系统总结了针对脑出血后脑微环境的纳米药物的当前研究现状。最后，分析了纳米药物在临床转化方面的进展，突出了它们在脑出血背景下应用的挑战、机遇和未来前景。
