切换至 "中华医学电子期刊资源库"

中华针灸电子杂志 ›› 2024, Vol. 13 ›› Issue (02) : 73 -77. doi: 10.3877/cma.j.issn.2095-3240.2024.02.007

综述

小胶质细胞在缺血性卒中后脑白质损伤中的作用及针刺干预机制
高琪1, 彭拥军1,()   
  1. 1. 210029 南京中医药大学附属医院针灸康复科
  • 收稿日期:2023-10-28 出版日期:2024-05-15
  • 通信作者: 彭拥军
  • 基金资助:
    国家自然科学基金项目(82174484,81973932); 江苏省中医院高峰学术人才项目(k2021rc24); 江苏省第六期"333高层次人才培养工程"

The role of microglia in white matter injury after ischaemic stroke and the mechanism of acupuncture intervention

Qi Gao1, Yongjun Peng1,()   

  1. 1. Department of Acupuncture and Rehabilitation, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing 210029, China
  • Received:2023-10-28 Published:2024-05-15
  • Corresponding author: Yongjun Peng
引用本文:

高琪, 彭拥军. 小胶质细胞在缺血性卒中后脑白质损伤中的作用及针刺干预机制[J]. 中华针灸电子杂志, 2024, 13(02): 73-77.

Qi Gao, Yongjun Peng. The role of microglia in white matter injury after ischaemic stroke and the mechanism of acupuncture intervention[J]. Chinese Journal of Acupuncture and Moxibustion(Electronic Edition), 2024, 13(02): 73-77.

缺血性卒中后脑白质损伤是导致卒中后长期感觉运动障碍和认知障碍的重要原因,脑白质在卒中后神经恢复中的关键作用不容忽视。目前研究表明小胶质细胞可调控中枢免疫炎症反应,在缺血性卒中诱导的脑白质损伤中起着加重损伤和促进修复的双重作用,而针刺通过调节小胶质细胞达到改善缺血性卒中后脑白质损伤结局的可能干预机制近来颇受关注。其干预机制主要通过抑制Toll样受体4信号通路、抑制基质金属蛋白酶-9的表达、促进膜联蛋白1和髓细胞触发受体2的表达等途径发挥改善炎症环境、促进髓鞘修复与再生的作用。

Cerebral white matter injury is a significant contributor to enduring sensorimotor and cognitive impairments post stroke. Microglia are pivotal in modulating immune-inflammatory responses within the central nervous system and play a dual role in both exacerbating injury and facilitating repair in cases of ischaemic stroke-induced white matter injury. This highlights the potential efficacy of acupuncture as a therapeutic intervention target these mechanisms. Recently, the potential mechanism of acupuncture in improving the prognosis of white matter injury post ischemic stroke through the regulation of microglia has attracted much attention. Acupuncture mainly ameliorates the inflammatory milieu and facilitates myelin regeneration and repair by suppressing the TLR4 signaling pathway, reducing MMP-9 expression, and promoting the expression of ANXA1 and TERM2.

1
Tu WJ, Wang LD;Special Writing Group of China Stroke Surveillance Report. China stroke surveillance report 2021[J]. Mil Med Res, 2023, 10(1): 33.
2
Wang Y, Liu G, Hong DD, et al. White matter injury in ischemic stroke[J].Prog Neurobiol, 2016, 141: 45-60.
3
Marin MA, Carmichael ST. Mechanisms of demyelination and remyelination in the young and aged brain following white matter stroke[J]. Neurobiol Dis, 2019, 126: 5-12.
4
Zhang Q, Zhu W, Xu F, et al. The interleukin-4/PPARγ signaling axis promotes oligodendrocyte differentiation and remyelination after brain injury[J]. PLoS Biol, 2019, 17(6): e3000330.
5
Zhao LR, Willing A. Enhancing endogenous capacity to repair a stroke-damaged brain: An evolving field for stroke research[J]. Prog Neurobiol, 2018, 163-164: 5-26.
6
Fu Y, Liu Q, Anrather J, et al. Immune interventions in stroke[J]. Nat Rev Neurol, 2015, 11(9): 524-535.
7
Olah M, Amor S, Brouwer N, et al. Identification of a microglia phenotype supportive of remyelination[J]. Glia, 2012, 60(2): 306-321.
8
Colonna M, Butovsky O. Microglia function in the central nervous system during health and neurodegeneration[J]. Annu Rev Immunol, 2017, 35: 441-468.
9
梁兴森,王华军,郑小飞.针灸疗法对微环境影响的研究进展[J/OL].中华针灸电子杂志2020, 9(4): 149-151.
10
赵守法,王舒,Vados LM,等. 醒脑开窍针刺法结合康复疗法治疗缺血性卒中病恢复期的疗效观察[J/OL].中华针灸电子杂志2023, 12(4): 151-155.
11
Ginhoux F, Greter M, Leboeuf M, et al. Fate mapping analysis reveals that adult microglia derive from primitive macrophages[J]. Science2010, 330(6005): 841-845.
12
Mo Y, Xu W, Fu K, et al. The dual function of microglial polarization and its treatment targets in ischemic stroke[J]. Front Neurol202213:921705.
13
Yenari MA, Kauppinen TM, Swanson RA. Microglial activation in stroke: therapeutic targets[J]. Neurotherapeutics, 2010, 7(4): 378-391.
14
Ponomarev ED, Veremeyko T, Weiner HL. MicroRNAs are universal regulators of differentiation, activation, and polarization of microglia and macrophages in normal and diseased CNS[J]. Glia, 2013, 61(1): 91-103.
15
Gülke E, Gelderblom M, Magnus T. Danger signals in stroke and their role on microglia activation after ischemia[J]. Ther Adv Neurol Disord, 2018, 11: 1756286418774254.
16
An C, Shi Y, Li P, et al. Molecular dialogs between the ischemic brain and the peripheral immune system: dualistic roles in injury and repair[J]. Prog Neurobiol, 2014, 115: 6-24.
17
Li J, Ramenaden ER, Peng J, et al. Tumor necrosis factor alpha mediates lipopolysaccharide-induced microglial toxicity to developing oligodendrocytes when astrocytes are present[J]. J Neurosci, 2008, 28(20): 5321-5330.
18
Greenhalgh AD, David S, Bennett FC. Immune cell regulation of glia during CNS injury and disease[J]. Nat Rev Neurosci, 2020, 21(3): 139-152.
19
da Fonseca AC, Matias D, Garcia C,et al. The impact of microglial activation on blood-brain barrier in brain diseases[J]. Front Cell Neurosci20148:362.
20
Singh S, Houng AK, Reed GL. Matrix metalloproteinase-9 mediates the deleterious effects of α2-antiplasmin on blood-brain barrier breakdown and ischemic brain injury in experimental stroke[J]. Neuroscience, 2018376:40-47.
21
陈安琪.小胶质细胞来源的TNF-α介导缺血性卒中后内皮程序性坏死加重血脑屏障破坏[D].武汉:华中科技大学,2021.
22
Neumann H, Kotter MR, Franklin RJ. Debris clearance by microglia: an essential link between degeneration and regeneration[J]. Brain, 2009132(Pt 2):288-295.
23
Natrajan MS, de la Fuente AG, Crawford AH, et al. Retinoid X receptor activation reverses age-related deficiencies in myelin debris phagocytosis and remyelination[J]. Brain, 2015138(Pt 12):3581-3597.
24
Berghoff SA, Spieth L, Sun T, et al.Microglia facilitate repair of demyelinated lesions via post-squalene sterol synthesis[J]. Nat Neurosc202124(1):47-60.
25
许瑶,周罗绮,秦川,等.缺血性卒中后小胶质细胞的异质性活化对脑内皮细胞的作用[J].神经损伤与功能重建202217(10):591-592,616.
26
Shichita T, Sakaguchi R, Suzuki M, et al. Post-ischemic inflammation in the brain[J]. Front Immunol20123:132.
27
Nalamolu KR, Smith NJ, Chelluboina B,et al. Prevention of the severity of post-ischemic inflammation and brain damage by simultaneous knockdown of Toll-like receptors 2 and 4[J]. Neuroscience2018373:82-91.
28
张慧宇,赵一锦,章培军,等.针刺对大鼠脑缺血后小胶质细胞极化和炎性反应的影响[J].针刺研究202247(11):941-948.
29
韩冰冰,卢岩,赵海军,等.电针对MCAO大鼠脑小胶质细胞TLR4及NF-κB p65蛋白表达的调控研究[J].世界中西医结合杂志201510(6):841-843,848.
30
孔营楠,詹松华,龚志刚,等.从TLR4信号通路探讨电针减轻小鼠脑缺血再灌注损伤的炎症反应机制[J].中国中西医结合影像学杂志202018(6):568-571,581.
31
Perego C, Fumagalli S, Zanier ER, et al. Macrophages are essential for maintaining a M2 protective response early after ischemic brain injury[J]. Neurobiol Dis, 201696:284-293.
32
Li JD .醒脑开窍针刺法对脑梗死大鼠血脑屏障保护作用及基质金属蛋白酶网络调节机制的实验研究[D].南京:南京中医药大学,2022.
33
陈丽莹,蒋佩萱,徐诗婷,等.小胶质细胞活化介导的MMP-9信号通路在电针预处理对MCAO大鼠的脑保护效应中的作用[J].上海针灸杂志202039(1):90-97.
34
林咸明,陈丽萍,姚旭.不同时程电针预处理对脑缺血再灌注大鼠血脑屏障基质金属蛋白酶-9、血管内皮生长因子的影响[J].针刺研究201540(1):40-44.
35
Xu X, Gao W, Li L, et al. Annexin A1 protects against cerebral ischemia-reperfusion injury by modulating microglia/macrophage polarization via FPR2/ALX-dependent AMPK-mTOR pathway[J]. J Neuroinflammation, 202118(1):119.
36
Li X, Xia Q, Mao M, et al.Annexin-A1 SUMOylation regulates microglial polarization after cerebral ischemia by modulating IKKα stability via selective autophagy[J]. Sci Adv, 20217(4):eabc5539.
37
邹璟.ANXA1诱导小胶质细胞表型转换介导电针对脑缺血损伤的保护作用[D].武汉:华中科技大学,2021.
38
Zou J, Huang GF, Xia Q, et al.Electroacupuncture promotes microglial M2 polarization in ischemic stroke via annexin A1[J]. Acupunct Med, 202240(3):258-267.
39
Wu R, Li X, Xu P, et al. TREM2 protects against cerebral ischemia/reperfusion injury[J]. Mol Brain, 201710(1):20.
40
Li L, Chen Q, Qin Y, et al. Regulation of TREM2 on BV2 inflammation through PI3K/AKT/mTOR pathway[J]. Biotechnol Genet Eng Rev, 202326:1-22.
41
Gouna G, Klose C, Bosch-Queralt M, et al.TREM2-dependent lipid droplet biogenesis in phagocytes is required for remyelination[J]. J Exp Med, 2021218(10):e20210227.
42
Xu H, Mu S, Qin W. Microglia TREM2 is required for electroacupuncture to attenuate neuroinflammation in focal cerebral ischemia/reperfusion rats[J]. Biochem Biophys Res Commun2018503(4):3225-3234.
43
李蕾.火针"温通"效应改善脊髓损伤后免疫微环境稳态的实验研究[D].天津:天津中医药大学,2022.
[1] 黄艺承, 梁海祺, 何其焕, 韦发烨, 杨舒博, 谭舒婷, 翟高强, 程继文. 机器学习模型评估RAS亚家族基因对膀胱癌免疫治疗的作用[J]. 中华腔镜泌尿外科杂志(电子版), 2024, 18(02): 131-140.
[2] 石豆豆, 王新星, 王向阳, 刘震洋, 曾淑娟, 仝海波. 急性前循环大血管闭塞机械取栓的研究进展[J]. 中华神经创伤外科电子杂志, 2024, 10(02): 112-116.
[3] 梁明, 魏珍, 祖合热·肉孜, 李金贤. 超声评估脑卒中气管切开患者膈肌功能与肺功能的相关性研究[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 133-139.
[4] 沈康敏, 康晓宇, 刘丽旭. Theta爆发式经颅磁刺激治疗卒中后失语的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 171-176.
[5] 武继敏, 袁春雨, 王鲁佳, 陈伟霞, 李晓东, 马丽虹. 重复经颅磁刺激治疗脑卒中后中枢性疼痛的研究进展[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(03): 182-186.
[6] 徐金, 龙耀斌, 郑继青. 头针联合辣椒素治疗脑卒中后慢性期吞咽障碍的临床疗效分析[J]. 中华脑科疾病与康复杂志(电子版), 2024, 14(02): 80-85.
[7] 黄灏宇, 庄泽森, 林万庆, 石娇, 袁旭, 王单, 周晓媚, 万义文, 林源, 陈尚杰. 调神益智艾灸治疗遗忘型轻度认知障碍的弥散张量成像研究[J]. 中华针灸电子杂志, 2024, 13(02): 58-64.
[8] 王晖, 李丽, 周宝华, 杨琼, 李葆华, 罗永梅. 间歇管饲在脑卒中吞咽障碍患者康复中的应用进展[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 177-180.
[9] 邓晨阳, 侯淑肖. 中青年脑卒中患者抗逆力相关研究进展及启示[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 97-103.
[10] 华美芳, 陈莉, 张峰林, 刘忠. 出血性脑卒中术后并发肺部感染的影响因素分析[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 110-114.
[11] 王丽萍, 聂玉琴, 朱爱丽. 盆底肌电刺激联合生物反馈疗法在女性卒中后尿失禁患者中的应用价值[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 129-133.
[12] 左舜之, 张志强, 肖云燚, 江娇, 何亚玲, 刘羽. 针刺结合重复经颅磁刺激改善脑卒中患者单侧忽略的效果[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 134-139.
[13] 胡秀朝, 徐霁华, 米荷音, 郝咏刚, 秦伟, 王韵. 高分辨磁共振成像在颈部动脉夹层致脑卒中诊断及随访研究中的价值[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 140-144.
[14] 赖敏, 林碧玲, 王亚文, 林玉禧, 欧开雅. 中青年脑卒中患者重返工作的影响因素分析及预测模型构建[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 145-152.
[15] 李淑敏, 侯淑肖. 脑卒中照顾者获益感研究的范围综述[J]. 中华脑血管病杂志(电子版), 2024, 18(02): 157-163.
阅读次数
全文


摘要