Suppression of inflammation in ischemic and hemorrhagic stroke: therapeutic options
Suppression of inflammation in ischemic and hemorrhagic stroke: therapeutic options
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DOI：
10.1097/wco.0b013e32832b4db3
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发表时间：
2009-06-01
影响因子：
4.8
通讯作者：
Vink, Robert
中科院分区：
文献类型：
--
作者：
Kleinig, Timothy J.;Vink, Robert
综述目的炎症现在被认为是中枢神经系统急性损伤后预后的一个极其重要的决定因素，可能导致继发性损伤的发生。本综述总结了对缺血性和出血性中风后炎症机制的最新进展，并强调了治疗前景的领域。最新发现缺血性和出血性中风后会发生显着的炎症反应，从而加剧继发性损伤。最近的努力致力于了解中风后炎症的直接触发因素介导其影响的机制。中风前急性炎症刺激是有害的，但亚急性刺激可能是有害的，也可能是保护性的。 Toll 样受体信号传导被认为是一种调节因素。越来越多的证据表明，全身炎症，无论是中风前还是中风引起的，都会影响中风的结果，并且治疗可能还需要减轻全身炎症才能有效。干细胞治疗的有益作用可能至少部分是由其全身抗炎作用介导的。总结抑制缺血性和出血性中风后的炎症仍然是一种有前途的方法。具有多效性有益效果的更复杂的疗法以及针对潜在接受者的更复杂的靶向治疗将增加成功临床转化的可能性。
Purpose of reviewInflammation is now considered to be a critically important determinant of outcome following acute injury to the CNS, potentially contributing to the development of secondary injury. The current review summarizes the most recent advances in the understanding of inflammatory mechanisms following both ischemic and hemorrhagic stroke, and highlights areas of therapeutic promise.Recent findingsA prominent inflammatory response occurs following both ischemic and hemorrhagic stroke, thereby exacerbating secondary injury. Recent efforts have been directed toward understanding the mechanisms by which immediate triggers of poststroke inflammation mediate their effects. Inflammatory stimuli administered acutely prestroke are deleterious, but subacute stimuli can be either deleterious or protective; toll-like receptor signaling has been implicated as a regulatory factor. There is growing evidence that systemic inflammation, whether prestroke or stroke-induced, influences stroke outcome and that therapies may need to also attenuate systemic inflammation to be effective. The beneficial effects of stem cell therapy may be mediated, at least in part, by its systemic anti-inflammatory effects.SummaryInhibiting inflammation following both ischemic and hemorrhagic stroke remains a promising approach. More sophisticated therapies, with pleiotropic beneficial effects, and more sophisticated targeting of potential recipients, will increase the likelihood of successful clinical translation.