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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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Spontaneous intracerebral hemorrhage (ICH) is a catastrophic illness causing significant morbidity and mortality. Despite advances in surgical technique addressing primary brain injury caused by ICH, little progress has been made treating the subsequent inflammatory cascade. Pre-clinical studies have made advancements identifying components of neuroinflammation, including microglia, astrocytes, and T lymphocytes. After cerebral insult, inflammation is initially driven by the M1 microglia, secreting cytokines (e.g., interleukin-1β [IL-1β] and tumor necrosis factor-α) that are involved in the breakdown of the extracellular matrix, cellular integrity, and the blood brain barrier. Additionally, inflammatory factors recruit and induce differentiation of A1 reactive astrocytes and T helper 1 (Th1) cells, which contribute to the secretion of inflammatory cytokines, augmenting M1 polarization and potentiating inflammation. Within 7 days of ICH ictus, the M1 phenotype coverts to a M2 phenotype, key for hematoma removal, tissue healing, and overall resolution of inflammation. The secretion of anti-inflammatory cytokines (e.g., IL-4, IL-10) can drive Th2 cell differentiation. M2 polarization is maintained by the secretion of additional antiinflammatory cytokines by the Th2 cells, suppressing M1 and Th1 phenotypes. Elucidating the timing and trigger of the anti-inflammatory phenotype may be integral in improving clinical outcomes. A challenge in current translational research is the absence of an equivalent disease animal model mirroring the patient population and comorbid pathophysiologic state. We review existing data and describe potential therapeutic targets around which we are creating a bench to bedside translational research model that better reflects the pathophysiology of ICH patients.
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참고문헌 (158)
참고문헌 신청
Qureshi AI / 2009 / Intracerebral haemorrhage / Lancet 373:1632~1644
van Asch CJ / 2010 / Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis / Lancet Neurol 9:167~176
Fogelholm R / 2005 / Long term survival after primary intracerebral haemorrhage : a retrospective population based study / J Neurol Neurosurg Psychiatry 76:1534~1538
Writing Group Members / 2010 / Heart disease and stroke statistics-2010 update : a report from the American Heart Association / Circulation 121:e46~e215
Qureshi AI / 2007 / Changes in cost and outcome among US patients with stroke hospitalized in 1990 to 1991 and those hospitalized in 2000 to 2001 / Stroke 38:2180~2184
van Asch CJ / 2010 / Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis / Lancet Neurol 9:167~176
Fogelholm R / 2005 / Long term survival after primary intracerebral haemorrhage : a retrospective population based study / J Neurol Neurosurg Psychiatry 76:1534~1538
Writing Group Members / 2010 / Heart disease and stroke statistics-2010 update : a report from the American Heart Association / Circulation 121:e46~e215
Qureshi AI / 2007 / Changes in cost and outcome among US patients with stroke hospitalized in 1990 to 1991 and those hospitalized in 2000 to 2001 / Stroke 38:2180~2184
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