The role of immune inflammation in aneurysmal subarachnoid hemorrhage
The role of immune inflammation in aneurysmal subarachnoid hemorrhage
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DOI：
10.1016/j.expneurol.2020.113535
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发表时间：
2021-02-01
影响因子：
5.3
通讯作者：
Chen, Sheng
中科院分区：
文献类型：
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作者：
Zhang, Zeyu;Fang, Yuanjian;Chen, Sheng
动脉瘤性蛛网膜下腔出血（aSAH）是一种破坏性疾病，主要由颅内动脉瘤破裂引起。临床试验表明，脑血管痉挛（CVS）不是aSAH患者延迟性脑缺血（DCI）和不良预后的唯一因素。目前，越来越多的证据表明，aSAH发病后72h内发生的早期脑损伤（EBI）是患者后续病理生理变化和预后不良的基础。EBI的病理机制主要包括颅内压升高、氧化应激、神经炎症、血脑屏障（BBB）破坏、脑水肿和细胞死亡。其中，脑免疫炎症反应涉及多种免疫细胞和活性物质，在aSAH后EBI中发挥重要作用，可能与DCI和远期预后有关。因此，应重视针对脑免疫炎症反应的策略。在这篇综述中，我们讨论了免疫炎症反应在aSAH发生和发展中的作用，以及与CVS、DCI和aSAH结局相关的一些炎症生物标志物。此外，我们还总结了目前研究中针对aSAH患者脑免疫炎症反应的潜在治疗药物。
Aneurysmal subarachnoid hemorrhage (aSAH) is a devastating disease, which mainly caused by the rupture of an intracranial aneurysm. Clinical trials have demonstrated that cerebral vasospasm (CVS) is not the sole contributor to delayed cerebral ischemia (DCI) and poor outcomes in patients with aSAH. Currently, accumulating evidence suggests that early brain injury (EBI), which occurs within 72 h after the onset of aSAH, lays the foundation for subsequent pathophysiological changes and poor outcomes of patients. The pathological mechanisms of EBI mainly include increased intracranial pressure, oxidative stress, neuroinflammation, blood-brain barrier (BBB) disruption, cerebral edema and cell death. Among them, the brain immune inflammatory responses involve a variety of immune cells and active substances, which play an important role in EBI after aSAH and may be related to DCI and long-term outcomes. Thus, attention should be paid to strategies targeting cerebral immune inflammatory responses. In this review, we discuss the role of immune inflammatory responses in the occurrence and development of aSAH, as well as some inflammatory biomarkers related to CVS, DCI, and aSAH outcomes. In addition, we also summarize the potential therapeutic drugs that target cerebral immune inflammatory responses for patients with aSAH in current research.