Perihematoma edema: a potential translational target in intracerebral hemorrhage?
Perihematoma edema: a potential translational target in intracerebral hemorrhage?
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DOI：
10.1007/s12975-015-0389-7
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发表时间：
2015-04
影响因子：
6.9
通讯作者：
Sheth, Kevin N.
中科院分区：
文献类型：
--
作者：
Selim, Magdy;Sheth, Kevin N.
脑出血（ICH）的继发性损伤正变得越来越好的特点，是激烈的调查的主题。在由血肿的组织破坏和质量效应引起的初始损伤后，凝血、凝块收缩和血红蛋白分解的产物引发了二次级联的有害事件，包括细胞凋亡、坏死、铁介导的氧化应激、炎症、自噬和水肿形成[1 - 3]。尤其是组织肿胀可能导致神经功能恶化和残疾。血管源性（细胞外）水肿最常见于脑出血后。然而，有证据表明细胞毒性（细胞内）水肿也至少部分导致血肿周围水肿（PHE）[4]。在过去几年中，许多临床研究检查了几种靶向这些次级过程和PHE形成的药物[5]。这些药物包括甘氨酸拮抗剂加维替奈[6];自由基捕获剂NXY-059 [7];胞二磷胆碱[8];甘露醇和甘油[9，10];鞘氨醇-1-磷酸受体激动剂芬戈莫德[11];和PPAR-γ受体激动剂吡格列酮[12]。目前，铁螯合剂甲磺酸去铁胺正在II期试验中进行研究[13]，其他几种药物正在进行未来的临床研究。与针对血肿扩张的干预措施不同，在III期前概念验证研究中可以轻松评估治疗对ICH生长的靶向影响，
Secondary injury in intracerebral hemorrhage (ICH) is becoming increasingly well characterized and is the subject of intense investigations. After the initial injury caused by tissue disruption and mass effect of the hematoma, products of coagulation, clot retraction, and hemoglobin breakdown initiate a secondary cascade of deleterious events including apoptosis, necrosis, iron-mediated oxidative stress, inflammation, autophagy, and edema formation [1–3]. Tissue swelling, in particular, may contribute to neurological deterioration and disability.Vasogenic (extracellular) edema is most commonly described after ICH. However, there is evidence that cytotoxic (intracellular) edema also contributes, at least in part, to perihematomal edema (PHE)[4]. A number of clinical studies examined several drugs targeting these secondary processes and PHE formation over the past years [5]. These included the glycine antagonist, gavestinel [6]; the free radical trapping agent, NXY-059 [7]; citicoline [8]; mannitol and glycerol [9, 10]; the sphingosine-1-phosphate receptor agonist, fingolimod [11]; and the PPAR-γ receptor agonist, pioglitazone [12]. Currently, the iron chelator deferoxamine mesylate is being investigated in a phase II trial [13], and several other agents are in the pipeline for future clinical investigations. Unlike interventions targeting hematoma expansion where the targeted effects of therapy on ICH growth can be easily assessed in proof-of-concept pre-phase III studies, there are
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影响因子：
3.5
作者：
Zazulia, Allyson R.;Videen, Tom O.;Diringer, Michael N.;Powers, William J.
通讯作者：
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影响因子：
3.5
作者：
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作者：
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通讯作者：
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影响因子：
8.3
作者：
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通讯作者：
FONG, KY
芬戈莫德治疗脑出血的 2 臂概念验证研究
影响因子：
29
作者：
Fu, Ying;Hao, Junwei;Shi, Fu-Dong
通讯作者：
Shi, Fu-Dong