缺血性脑卒中后血脑屏障内皮跨细胞转运的调控机制及靶向治疗  

Regulation mechanism and targeted therapy of transcytosis in blood-brain barrier after cerebral ischemia

作　　者：周敏 陈智利 张丽丽 张伯礼[4] Zhou Min;Chen Zhili;Zhang Lili;Zhang Boli(Department of Traditional Chinese Medicine,General Hospital of Tianjin Medical University,Tianjin 300052,China;Department of Neurology,General Hospital of Tianjin Medical University,Tianjin 300052,China;National Clinical Research Center of Chinese Acupuncture and Moxibustion,First Affiliated Hospital of Tianjin University of Chinese Medicine,Tianjin 300193,China;Tianjin State Key Laboratory of Modern Chinese Medicine,Tianjin University of Traditional Chinese Medicine,Tianjin 301617,China)

机构地区：[1]天津医科大学总医院中医科,天津300052 [2]天津医科大学总医院神经内科,天津300052 [3]国家中医针灸临床医学研究中心,天津中医药大学第一附属医院针灸科,天津300193 [4]天津市现代中药国家重点实验室,天津中医药大学中医药研究院,天津301617

出　　处：《中华神经医学杂志》2022年第2期189-194,共6页Chinese Journal of Neuromedicine

基　　金：国家自然科学基金青年项目(81704019)。

摘　　要：缺血性脑卒中(IS)后的血脑屏障(BBB)通透性改变对缺血急性期脑水肿、脑免疫炎症、出血转化及恢复期血管新生和再通均具有重要影响。研究表明IS后的BBB高通透性由IS数小时后显著增加的脑血管内皮跨细胞转运(跨细胞通路)和缺血数日后的紧密连接(TJs)解体(细胞旁通路)逐步导致,且跨细胞转运上调早于并独立于TJs解体。维持较低的血管内皮跨细胞转运率和保持完整的TJs对BBB的生理功能和脑稳态起关键作用,因此跨细胞转运的发生和调控机制成为IS后BBB靶向治疗研究的新方向。本文围绕BBB内皮跨细胞转运的生物学分类、细胞结构及其调控机制、靶向该途径的治疗策略等方面进行综述。The changes of blood-brain barrier(BBB)permeability after ischemic stroke(IS)have important effects on brain edema,brain immune inflammation,hemorrhage transformation and angiogenesis and recanalization in convalescence.Recent studies have shown that the high permeability of BBB is gradually caused by significant up-regulation of endothelial transcytosis(transcellular pathway)several hours after IS and the disintegration of tight junctions(paracellular pathway)several days after IS;the up-regulation of transcytosis is earlier than tight junction destruction and independent of tight junction destruction.Therefore,maintaining a low endothelial transcytosis rate and maintaining a complete tight junction play key roles in the physiological function and brain homeostasis of BBB.The transcellular transport occurrence and regulation have become new topics in targeted therapy of BBB after IS.This review briefly summarizes the biological classification and cellular structure of endothelial transcytosis in BBB,reviews the molecular mechanisms that have been found in recent years to regulate this pathway,and summarizes the post-stroke therapeutic drugs and methods that target this pathway,besides,the relevant treatment strategies and research entry points are prospected.

关 键 词：缺血性脑卒中 血脑屏障 跨细胞转运 小窝 

分 类 号：R743.3[医药卫生—神经病学与精神病学]