血栓调节素-凝血酶-高迁移率族蛋白1通路在慢性硬膜下血肿发生发展中的作用研究进展

Role of thrombomodulin-thrombin-high mobility group box 1 pathway in chronic subdural hematoma

慢性硬膜下血肿(CSDH)是一种位于硬脑膜边界细胞层内,由包膜包被的血液、血凝块及其降解产物的集合体。血肿腔内的炎症反应、凝血功能障碍、新生毛细血管生成异常等病理生理过程在CSDH的发生发展中起重要作用。高迁移率族蛋白1(HMGB1)可介导炎症反应、血管生成及止血等过程,血栓调节素(TM)则可通过与HMGB1结合,以依赖凝血酶的方式降解HMGB1。目前研究已证实CSDH的血肿液中TM、HMGB1及其下游相关因子的表达异常增高,但TM-凝血酶-HMGB1通路在CSDH发生发展中的作用尚不完全明确。本文围绕TM-凝血酶-HMGB1通路在CSDH发生发展中的作用研究进展进行综述,旨在为CSDH的发病机制及治疗新靶点研究提供一些参考。

Chronic subdural hematoma(CSDH)is a collection of blood,blood clots and their degradation products,encapsulated by membrane and located within dural border cell layer.Pathophysiological processes such as inflammatory responses within hematoma cavity,coagulation abnormalities,and abnormalities in neovascularization play significant roles in CSDH development.High mobility group box 1(HMGB1)can mediate processes such as inflammation,angiogenesis,and hemostasis,while thrombomodulin(TM)can bind with HMGB1 and rely on thrombin to degrade HMGB1.Current research has confirmed that the expressions of TM,HMGB1,and their downstream related factors are abnormally increased in the hematoma fluid of CSDH;however,the role of TM-thrombin-HMGB1 pathway in CSDH development is not fully clear.This article reviews the role of TM-thrombin-HMGB1 pathway in CSDH development,aiming to provide some references for pathogenesis and new therapeutic targets of CSDH.