Rethinking the Roles of Inflammation in the Intracerebral Hemorrhage
Rethinking the Roles of Inflammation in the Intracerebral Hemorrhage
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DOI：
10.1007/s12975-015-0402-1
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发表时间：
2015-05
影响因子：
6.9
通讯作者：
Xiao-Yi Xiong;Qing-Wu Yang
中科院分区：
文献类型：
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作者：
Xiao-Yi Xiong;Qing-Wu Yang
结论过度的中枢和外周炎症反应参与了脑出血后的脑损伤，而适度的炎症反应则促进了神经发生。因此，找出启动炎症级联反应的关键靶点，并更多地关注外周炎症的调节，将提供更清晰的炎症特征，以实现更好的ICH治疗效果。此外，SsnB作为一种中药单体，不仅可以抑制中枢和外周的TLRs信号传导，减少导致脑损伤的上游炎症事件，同时不会改变血液中免疫细胞的数量，避免增加感染风险。因此，它在脑出血的治疗中具有较好的应用前景。然而，SsnB在脑出血患者中的临床作用有待进一步研究，尤其是在早期靶向炎症级联反应以减少继发性脑损伤，并在晚期保持适度的炎症环境以促进神经发生和恢复。因此，为ICH治疗寻求合适的治疗时间窗可能会提供更好的治疗策略。
ConclusionsExcessive inflammatory responses, both central and peripheral inflammation, contribute to brain injury following ICH, while modest inflammation promotes the neurogenesis. Therefore, finding out the critical targets that initiate the inflammatory cascade and giving more attention to regulating the peripheral inflammation will provide a more clear inflammatory profile to achieve better therapeutic effects for ICH. In addition, we have demonstrated that SsnB, as a Chinese herb monomer, can not only inhibit the central but also the peripheral TLRs signaling to reduce the upstream inflammatory events that caused brain injury; meanwhile, it would not change the blood immune cell quantities which avoid increasing infection risk. So, it may have a better application prospect for the ICH treatment. However, further study should perform to investigate the clinical effects of SsnB in the ICH patients, in particular, targeting the inflammatory cascade in the early stage to reduce secondary brain injury and keeping a modest inflammation milieu in the late stage to promote neurogenesis and recovery. Therefore, seeking an appropriate treatment time window for the ICH treatment may provide a better therapeutic strategy.