M2小胶质细胞在缺血性脑卒中的作用及干预的研究进展  

Progress in role and intervention of M2 microglia in ischemic stroke

作　　者：王斯柔 张谦[1] 赵国建 张梦杰 黄志华 WANG Si-rou;ZHANG Qian;ZHAO Guo-jian;ZHANG Meng-jie;HUANG Zhi-hua(The Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases,Ministry of Education,Gannan Medical University,Ganzhou Jiangxi 341000,China;Dept of Physiology,School of Basic Medical Sciences,Gannan Medical University,Ganzhou Jiangxi 341000,China)

机构地区：[1]赣南医科大学心脑血管疾病防治教育部重点实验室,江西赣州341000 [2]赣南医科大学基础医学院生理教研室,江西赣州341000

出　　处：《中国药理学通报》2025年第3期411-416,共6页Chinese Pharmacological Bulletin

基　　金：国家自然科学基金资助项目(No 31960190);江西省自然科学基金资助项目(No 20192BAB205117);赣南医学院研究生创新项目校级课题(No YC2022-X016,YC2024-X013)。

摘　　要：脑卒中是危害人类健康的主要疾病之一,包括缺血性脑卒中(ischemic stroke,IS)和出血性脑卒中,以前者为主。缺血性脑卒中重要的发病机制有神经炎症、氧化应激和兴奋性毒性损伤,而神经炎症在缺血性脑卒中的发病及康复过程中发挥重要作用。小胶质细胞是中枢神经系统的固有免疫细胞,在脑卒中发生时第一时间监测到损伤部位并做出免疫应答。激活的小胶质细胞主要极化为促炎性M1型和抗炎性M2型。前者通过分泌促炎介质加重神经损伤,而后者可通过抑制神经炎症,促进神经元的再生与髓鞘的修复及维持血脑屏障的完整性,在对抗急性期损伤和促进慢性期康复中改善神经功能障碍。这提示M2型小胶质细胞可能是治疗缺血性脑卒中的潜在靶点,精准调控M1/M2型的活化对缺血性脑卒中具有重要的脑保护的治疗价值。该文重点以M2小胶质细胞在缺血性脑卒中的作用以及各类药物或针灸疗法调节小胶质细胞向M2型转化的机制进行论述,以期为脑卒中的临床治疗和新药物研发提供理论依据。Stroke is one of the main diseases that threaten human health,including ischemic stroke and hemorrhagic stroke,with the former being the main cause.The important pathogenesis of ischemic stroke includes neuroinflammation,oxidative stress,and excitatory toxic damage,and neuroinflammation plays an important role in the pathogenesis and rehabilitation process of ischemic stroke.Microglia are inherent immune cells in the central nervous system,which monitor the site of injury and respond to the immune response as soon as a stroke occurs.The activated microglia are mainly polarized into pro-inflammatory M1 type and anti-inflammatory M2 type.The latter improves neurological dysfunction by inhibiting neuroinflammation,promoting neuronal regeneration and myelin repair,and maintaining the integrity of the blood-brain barrier.It suggests that it may be a potential target for treating ischemic stroke by combating acute phase injury and promoting chronic phase rehabilitation.Precise regulation of M1/M2 activation has important therapeutic value in cerebral protection in ischemic stroke.This article focuses on the role of M2 microglia in ischemic stroke and the mechanism of various drugs or acupuncture and moxibustion therapy regulating the transformation of microglia into M2 type,in order to provide theoretical basis for clinical treatment of stroke and new drug development.

关 键 词：缺血性脑卒中 M2小胶质细胞 神经炎症 神经元再生 药物 干预 

分 类 号：R322.8[医药卫生—人体解剖和组织胚胎学] R338.2[医药卫生—基础医学] R392.1R743.3R743.31