准炎症以减少复发性中风的发生
Annaelle Zietz1,2, Sarah Gorey3,4,5, Peter J Kelly3,4,6
1Department of Neurology and Stroke Center, University Hospital Basel and University of Basel, Basel, Switzerland.
概括
炎症在各种类型的中风和复发性血管事件中起着关键作用. 使用生物标志物识别残留炎症风险的患者可以指导未来的抗炎疗法,以预防二次中风.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 心脏病学 心脏病学
背景情况:
- 回复性血管事件影响大约25%的中风患者,需要改善二次预防.
- 炎症是冠状动脉样硬化的一个已知的因素,但其在各种中风亚型中的作用尚未完全理解.
- 根据中风亚型了解炎症的预后价值对于设计有效的抗炎疗法随机对照试验 (RCT) 至关重要.
研究的目的:
- 审查缺血性中风亚型中的炎症途径.
- 为了检查炎症标志物和中风后血管复发之间的关联.
- 评估用于血管预防的抗炎药物的RCT证据.
主要方法:
- 实验,遗传和成像研究的叙述性回顾.
- 分析证据,将炎症标志物 (例如IL-6,hsCRP) 与中风复发联系起来.
- 对研究抗炎疗法用于减轻血管风险的RCT的审查.
主要成果:
- 炎症与动脉样硬化性中风,小血管疾病 (神经炎症) 和心房动有关.
- 干白素-6 (IL-6) 和高灵敏性C反应蛋白 (hsCRP) 在识别高风险患者方面表现有前途.
- 抗炎疗法已证明可以降低冠状动脉疾病的血管风险,目前正在进行预防中风的试验.
结论:
- 在多种中风病因方面,炎症很重要,这表明抗炎策略的潜在益处.
- 生物标志物可以识别具有残留炎症风险的患者,用于有针对性的二次中风预防.
- 建议在未来评估抗炎治疗的RCT中以生物标志物为导向的患者选择.
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