Update on Strategies to Reduce Early Brain Injury after Subarachnoid Hemorrhage.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Current Neurology and Neuroscience Reports Pub Date : 2024-12-26 DOI:10.1007/s11910-024-01396-1

Bosco Seong Kyu Yang, Aaron M Gusdon, Xuefang Sophie Ren, Han-Gil Jeong, Chang-Hun Lee, Spiros Blackburn, Huimahn Alex Choi

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引用次数: 0

Abstract

Purpose of review: Early brain injury (EBI) after aneurysmal subarachnoid hemorrhage (SAH) is the most influential clinical determinant of outcomes. Despite significant advances in understanding of the pathophysiology of EBI, currently no treatments to target EBI have been developed. This review summarizes recent advances in EBI research over the past five years with a focus on potential therapeutic targets.

Recent findings: Mechanism-specific translational studies are converging on several pathophysiologic pathways: improved antioxidant delivery and the Sirt1/Nrf2 pathway for reactive oxygen species; NLRP3 inflammasome and microglial polarization for inflammation; and the PI3K/Akt pathway for apoptosis. Recently identified mechanistic components, such as microcirculatory failure and ferroptosis, need particular attention. Clinical studies developing radiographic markers and mechanism-specific, biofluid markers are attempting to bridge the translational therapeutic gap. There has been an exponential growth in EBI research. Further clinical studies which address specific pathophysiology mechanisms need to be performed to identify novel therapeutic approaches.

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减少蛛网膜下腔出血后早期脑损伤策略的最新进展。

回顾目的：动脉瘤性蛛网膜下腔出血（SAH）后早期脑损伤（EBI）是影响预后的最重要的临床决定因素。尽管对EBI病理生理的理解取得了重大进展，但目前还没有针对EBI的治疗方法。本文综述了近五年来EBI研究的最新进展，重点关注潜在的治疗靶点。最近的发现：机制特异性的转化研究集中在几个病理生理途径上：改善抗氧化传递和Sirt1/Nrf2途径的活性氧；NLRP3炎性体和小胶质细胞极化与炎症；以及凋亡的PI3K/Akt通路。最近发现的机械成分，如微循环衰竭和铁下垂，需要特别注意。临床研究开发放射学标志物和机制特异性，生物流体标志物正试图弥合转化治疗的差距。EBI研究呈指数级增长。进一步的临床研究需要解决具体的病理生理机制，以确定新的治疗方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.