亚低温通过影响ACSL4调节铁死亡改善脑缺血再灌注损伤的研究进展  

Progress in the study of mild hypothermia improving brain ischemia-reperfusion injury by regulating iron death via ACSL4

作　　者：谭璐璐[1] 方鑫富 陈兴华[1] TAN Lu-lu;FANG Xin-fu;CHEN Xing-hua(Department of Neurology,the First Affiliated Hospital of Guangxi University of Traditional Chinese Medicine,Nanning 530023,Guangxi,China;不详)

机构地区：[1]广西中医药大学第一附属医院神经内科,广西南宁530023 [2]广西中医药大学研究生院,广西南宁530023

出　　处：《广东医学》2024年第5期656-660,共5页Guangdong Medical Journal

基　　金：广西中医脑病临床研究中心项目(桂科AD20238028);广西高等学校高水平创新团队及卓越学者计划(桂教人才[2020]6号);广西中医药大学第一附属医院学术团队建设项目(院字[2018]146号);广西中医药重点学科建设项目(GZXK-Z-20-13)。

摘　　要：脑缺血再灌注损伤是发生在脑缺血后的更加严重阶段,目前临床治疗仍以药物及手术溶栓为主。铁死亡作为一种独特的细胞死亡方式,已被证实其在脑缺血及其再灌注损伤中扮演的特殊机制,这与酰基辅酶A合成酶长链家族(ACSL4)介导脂质过氧化物的积累导致铁死亡发生有关。最近研究发现,亚低温作为临床接受的物理治疗方法,对脑缺血再灌注损伤的疗效作用可能是阻止发生脂质氧化、改善脑缺血缺氧,调节凝血酶功能及铁代谢、抑制兴奋毒性、减轻炎症及水肿、降低血脑屏障的通透性等手段,最终使得铁死亡发生沉默。本文旨在分析亚低温如何通过影响ACSL4调节铁死亡的发生,进而为脑缺血再灌注损伤的机制学研究及临床治疗提供新的途径与方法。Brain ischemia-reperfusion injury represents a more severe phase occurring after cerebral ischemia.Currently,clinical treatments mainly focus on pharmacotherapy and surgical thrombolysis.Iron death,as a unique form of cell death,has been demonstrated to play a distinct role in cerebral ischemia and reperfusion injury,which is related to the accumulation of lipid peroxides mediated by acyl-CoA synthetase long-chain family member 4(ACSL4).Recent studies have found that mild hypothermia,as a clinically accepted physical therapy,may exert therapeutic effects on brain ischemia-reperfusion injury by preventing lipid oxidation,improving cerebral ischemia hypoxia,regulating coagulation enzyme function and iron metabolism,inhibiting excitotoxicity,reducing inflammation and edema,and decreasing blood-brain barrier permeability,ultimately silencing iron death.This review aims to analyze how mild hypothermia regulates iron death by affecting ACSL4,thereby providing new pathways and methods for mechanistic research and clinical treatment of brain ischemia-reperfusion injury.

关 键 词：亚低温 ACSL4 脑缺血再灌注损伤 铁死亡 

分 类 号：R741[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学]