Li Xinglan, Yuan Yongjin, Jing Weiyao, Liu Cui, Wei Mai, Liu Qianru, Li Xing, Wei Long, Du Xiaozheng, Wang Jinhai
Department of Acupuncture-Moxibustion and Tuina, Gansu University of Chinese Medicine, Lanzhou, 730000, China.
Lanzhou Hospital of Traditional Chinese Medicine, Lanzhou, 730000, China.
J Thromb Thrombolysis. 2025 Sep 16. doi: 10.1007/s11239-025-03179-y.
Stroke is the second-leading cause of mortality and the principal contributor to long-term disability worldwide. Despite the widespread clinical implementation of secondary prevention protocols, the 90-day stroke recurrence rate remains a significant concern, particularly among patients with atherosclerosis. Mounting evidence implicates inflammatory pathways as central mediators in both atherogenesis and plaque destabilization. It is known that ischemic stroke triggers a substantial release of cell-free DNA (cfDNA) into the systemic circulation. These nucleic acid fragments can subsequently activate endothelial cells, thereby promoting atherosclerosis, and can also activate nucleotide-sensing inflammasomes within vulnerable plaques, thus triggering thrombotic cascades and early recurrent cerebrovascular events. In this review, we comprehensively examine the pathophysiological origins of cfDNA, delineate its mechanistic involvement in stroke recidivism, and evaluate current therapeutic strategies targeting cfDNA catabolism in the management of ischemic stroke, aiming to provide insights for future research in this field.
中风是全球第二大致死原因，也是导致长期残疾的主要因素。尽管二级预防方案已在临床上广泛实施，但90天中风复发率仍是一个重大问题，尤其是在动脉粥样硬化患者中。越来越多的证据表明，炎症途径是动脉粥样硬化形成和斑块不稳定的核心介质。已知缺血性中风会促使大量游离细胞DNA（cfDNA）释放到体循环中。这些核酸片段随后可激活内皮细胞，从而促进动脉粥样硬化，还可激活易损斑块内的核苷酸感应炎性小体，进而引发血栓形成级联反应和早期复发性脑血管事件。在本综述中，我们全面研究了cfDNA的病理生理起源，阐述其在中风复发中的机制，评估目前针对cfDNA分解代谢的治疗策略在缺血性中风管理中的应用，旨在为该领域的未来研究提供见解。
