Remote ischemic Conditioning Promotes Cerebrovascular Recovery after Intracerebral Hemorrhage

项目总结 脑出血(ICH)是出血性中风最常见的形式，占所有中风的15% 中风。每年影响6.7万美国人的ICH，导致最高的急性死亡率和最严重的长期- 所有类型中风的长期神经学结局。原发性脑出血是由损伤的小血管破裂引起的 由慢性高血压或脑淀粉样血管病引起。由此产生的血肿扰乱了神经网络， 破坏血管结构，最终导致大脑功能丧失，需要终身医疗 援助。重建由小动脉和小动脉组成的功能性脑血管网络是一种 移除受损组织和恢复脑血流以提供营养的先决条件， 营养因子和受损脑组织中的干细胞。因此，迫切需要神经恢复性疗法。 为脑出血后脑血管的恢复提供帮助。远程缺血适应(RIC)，重复传递 远端肢体的亚致死性缺血，在早期临床试验中证明了安全性、多功能性和有效性； 然而，ICH后RIC的应用仍未得到充分的研究。这项提案的目标是测试 RIC诱导血管重塑和改善长期神经功能的重要假说 通过脑出血后抗炎髓系细胞的激活。特殊目标1将检验髓系细胞 AMPKα1介导RIC诱导的脑出血后血管修复具体目标2将检验大米的假设 脑出血后通过释放Del-1促进血管生成。《特定目标3》将检验这一假设 RIC的实施以性别和年龄无关的方式改善慢性脑出血的预后。预期 拟议研究的结果包括确定RIC是一种临床安全、非侵入性的 促进脑出血后脑血管恢复的干预措施。由于脑出血患者表现出高度永久性残疾 降低生活质量的比率，我们提议的研究将确定一种简单的治疗方法来驾驭内源性 神经修复途径，为慢性脑出血的康复提供了一种创新和经济有效的方法 病人。 。

PROJECT SUMMARY Intracerebral hemorrhage (ICH), the most common form of hemorrhagic stroke, accounts for up to 15% of all strokes. ICH, which affects 67,000 Americans annually, induces the highest acute mortality and the worst long- term neurological outcomes of all types of stroke. Primary ICH is caused by the rupture of small vessels damaged by chronic hypertension or cerebral amyloid angiopathy. The resultant hematoma disrupts neural networks and damages the vascular architecture, culminating in a loss of brain function and the need for lifelong medical assistance. Re-establishment of a functional cerebrovascular network of small arteries and arterioles is a prerequisite for the removal of damaged tissue and for restoration of cerebral blood flow to deliver nutrients, trophic factors, and stem cells within the injured brain. Thus, there is a dire need for neurorestorative therapies that provide cerebrovascular recovery after ICH. Remote ischemic conditioning (RIC), the repetitive delivery of sub-lethal ischemia to a remote limb, demonstrated safety, versatility, and efficacy in early stage clinical trials; however, the utility of RIC after ICH remains understudied. The objective of this proposal is to test the overarching hypothesis that RIC induces vascular remodeling and improves long-term neurological function via anti-inflammatory myeloid cell activation after ICH. Specific Aim 1 will test the hypothesis that myeloid AMPKα1 mediates RIC-induced vascular repair after ICH. Specific Aim 2 will test the hypothesis that RIC increases angiogenesis via Del-1 release after ICH. Specific Aim 3 will test the hypothesis that delayed implementation of RIC improves chronic ICH outcomes in a sex- and age-independent manner. Expected outcomes of the proposed research include the identification of RIC as a clinically-safe, non-invasive intervention to promote cerebrovascular recovery after ICH. As ICH patients exhibit high permanent disability rates that diminish quality of life, our proposed research will identify a simple therapy to harness an endogenous pathway of neurological repair, providing an innovative and cost-effective approach to rehabilitate chronic ICH patients. .