外泌体减轻出血性脑血管病后继发性损伤的研究进展

Research Progress of Exosomes in Alleviating Secondary Injury of Hemorrhagic Cerebrovascular Disease

对于出血性脑血管病,目前临床上采用外科手术干预较多,但是患者在治疗后仍不可避免地出现不同程度的神经功能损伤。因此,寻求一种能够有效减轻患者继发性损伤的治疗手段至关重要。随着再生医学的发展,外泌体概念的引入为出血性脑血管病的诊疗提供了新的理念与方向。外泌体作为一种细胞外囊泡,能够携带细胞内物质,在细胞间发挥信息传递功能,更重要的是外泌体能自由穿过血脑屏障,在神经系统相关疾病中发挥调控作用。本综述主要介绍外泌体减轻出血性脑血管病后继发性损伤的4种病理生理机制——抑制炎症反应、减少细胞程序性死亡、保护血脑屏障以及减轻氧化应激损伤,并总结了其在临床诊断和治疗中的应用前景。

At present,there are many surgical interventions in the clinical practice for hemorrhagic cerebrovascular diseases,but patients still have different degrees of neurological damage after treatment.Therefore,it is very important to find a way to reduce the secondary injury of patients effectively.With the development of regenerative medicine,the introduction of the concept of exosomes provided new ideas and directions for the diagnosis and treatment of hemorrhagic cerebrovascular diseases.As a kind of extracellular vesicle,exosomes can carry intracellular substances and play a role in information transmission among cells.More importantly,exosomes can freely cross the blood-brain barrier,thus playing a regulatory role in nervous system-related diseases.Therefore,this paper mainly reviewed four pathophysiological mechanisms of exosomes in alleviating secondary injury of hemorrhagic cerebrovascular diseases,including inhibiting inflammatory reaction,reducing programmed cell death,protecting the blood-brain barrier,and alleviating oxidative stress damage,and summarized their application prospects in clinical diagnosis and treatment.