HMGB1: 缺血性中风和出血性转变的新目标
Jiamin Li1, Zixin Wang1, Jiameng Li1
1Department of Neurology and Cerebrovascular Diseases Research Institute, Xuanwu Hospital, Capital Medical University, 45 Changchun Street, Beijing, China.
Translational stroke research
|May 13, 2024
概括
高流动性组盒1 (HMGB1) 在中风中驱动神经炎症和血脑屏障损伤,增加出血转化风险. 向HMGB1为急性缺血性中风和恢复提供了新的治疗策略.
科学领域:
- 神经科学是一个神经科学.
- 免疫学 免疫学 免疫学
- 血管生物学 血管生物学
背景情况:
- 中国中风的发病率和死亡率很高,急性缺血性中风的治疗因出血转化风险而复杂化.
- 高流动性组盒1 (HMGB1),一种与损伤相关的分子模式 (DAMP),在缺血性中风的发病和恢复中起着双重作用.
研究的目的:
- 审查HMGB1在缺血性中风及其并发症中的结构,分泌和调节作用.
- 阐明HMGB1对神经炎症的贡献,血脑屏障的完整性以及中风后的功能结果.
- 突出显示HMGB1作为神经保护和扩大血栓溶解窗口的治疗点.
主要方法:
- 文献综述总结了有关HMGB1在缺血性中风中的作用的现有研究.
- 对HMGB1在动脉样硬化,血栓栓塞,神经炎症和神经血管改造中的参与进行分析.
- 检查HMGB1调解出血转化及其对免疫和质细胞两极分化的影响.
主要成果:
- HMGB1由死细胞释放,并由各种细胞分泌,作为早期中风炎症和晚期恢复的关键调解剂.
- HMGB1通过促进神经炎症,破坏血脑屏障的完整性和增强MMP9分泌来加剧出血转化.
- HMGB1通过兴奋毒性,自,MMP9释放,NET形成,影响中风后抑郁和肺炎风险来影响中风的发病.
结论:
- HMGB1是缺血性中风和出血性转变的关键治疗标和预后标记.
- 了解HMGB1通路对于开发新型神经保护药物和减少中风后的神经炎症至关重要.
- 向HMGB1可能允许在急性缺血性中风治疗中扩大血栓溶解时间窗口.
相关概念视频
01:29Stroke: Introduction and Types
A stroke is an acute neurological event caused by the sudden disruption of cerebral blood flow, leading to rapid loss of neuronal function. Neurons depend on continuous oxygen and glucose supply, so even brief interruptions can cause irreversible injury within minutes. Strokes are classified into ischemic and hemorrhagic types.Ischemic StrokeIschemic strokes are most common and occur due to arterial occlusion, depriving brain tissue of oxygen and nutrients. This leads to energy failure, ionic...
01:15Ischemic Stroke l: Introduction
Ischemic stroke is an acute cerebrovascular condition in which blood flow to a brain region is suddenly interrupted, leading to tissue infarction. Neurons depend on continuous oxygen and glucose supply, so even brief reductions in perfusion cause energy failure, ionic imbalance, and irreversible injury. Ischemic strokes are classified into thrombotic and embolic types based on their underlying mechanisms.Thrombotic MechanismsThrombotic stroke develops when a clot forms within a cerebral artery.
01:15Ischemic Stroke ll: Pathophysiology
An ischemic stroke occurs when a cerebral blood vessel becomes obstructed, most often by a thrombus or embolus, interrupting the delivery of oxygen and glucose to brain tissue. Because neurons rely on continuous aerobic metabolism, energy failure begins within minutes of reduced perfusion. The region receiving the least blood flow becomes the infarct core, an area of irreversible cellular death. Surrounding this core lies the penumbra, a zone of hypoperfused but still viable tissue that is...
01:17Hemorrhagic Stroke l: Introduction
A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
01:29Hemorrhagic Stroke ll: Pathophysiology
A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
01:26Transient Ischemic Attack l: Introduction
A transient ischemic attack (TIA) is a brief episode of neurological dysfunction caused by a temporary, focal reduction in cerebral blood flow. Although symptoms resemble those of an ischemic stroke, the interruption in perfusion is short-lived and does not cause permanent infarction. TIAs are clinically important because they often serve as early warning events for future stroke.Mechanisms of Transient Cerebral IschemiaTransient cerebral ischemia may arise through several mechanisms. One...