Rethinking the Roles of Inflammation in the Intracerebral Hemorrhage

• Published in: Translational stroke research 2015-10, Vol.6 (5), p.339-341
• Main Authors: Xiong, Xiao-Yi, Yang, Qing-Wu
• Format: Article
• Language: English
• Subjects: Biomedical and Life Sciences; Biomedicine; Brain damage; Brain research; Cardiology; Cerebral Hemorrhage - complications; Cerebral Hemorrhage - metabolism; Commentary; Cytokines; Encephalitis - etiology; Encephalitis - metabolism; Hematoma; Hemorrhage; Humans; Immune system; Infections; Inflammation; Inflammation - etiology; Inflammation - metabolism; Inflammation Mediators - metabolism; Nervous system; Neurogenesis; Neurology; Neurosciences; Neurosurgery; Patients; Roles; Stroke; Traumatic brain injury; Vascular Surgery
• ISSN: 1868-4483; 1868-601X
• DOI: 10.1007/s12975-015-0402-1

[...]the Surgical Trial in Intracerebral Hemorrhage (STICH) trial showed no overall benefit from early hematoma evacuation compared to initial conservative treatment [2]. [...]the secondary brain injury caused by the metabolic products or the components of hematoma attracted more researchers’ attention [3]. Subsequently, we found a novel TLR2/TLR4 heterodimer triggered by Hb that initiates the excessive inflammatory responses following ICH [4], and intervening the TLR2/TLR4 heterodimer with sparstolonin B (SsnB) [15], a Chinese herb-derived compound [16], has also achieved markedly anti-inflammatory effects and improved the neurologic deficit following ICH (data not published). [...]central excessive inflammatory responses play critical roles in the brain tissue damage after ICH, and targeting the upstream events of inflammation may provide a novel approach for the treatment of ICH. [...]targeting the immune responses by early intervention and treatment could be beneficial to the patients. [...]the late phase of recovery treatment also has a critical role for the ICH patients [31–33], and this may mainly ascribe to the neurogenesis after brain damage. [...]study should perform to investigate the clinical effects of SsnB in the ICH patients, in particular, targeting the inflammatory cascade in the early stage to reduce secondary brain injury and keeping a modest inflammation milieu in the late stage to promote neurogenesis and recovery. [...]seeking an appropriate treatment time window for the ICH treatment may provide a better therapeutic strategy.