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促红细胞生成素(EPO)是一个具有强大的神经保护作用的物质,可以作为潜在的治疗脑损伤的辅助药物。众所周知,由肾脏分泌的EPO通过抑制骨髓细胞凋亡促进红细胞生成,但近年来研究发现,大脑也能产生EPO,并且大脑的神经细胞和星形胶质细胞中有EPO受体(EPOR)及其信号组件的表达。EPO激活一系列级联反应,稳定线粒体膜,限制活性氧和氮中介体的形成,抑制促炎细胞因子的产生,抑制中性粒细胞的浸润,从而增加大脑对抗缺血再灌注的能力。总的来说,EPO通过这些机制保护脑组织,改善缺血后神经认知功能恢复。该文对脑损伤后的EPO保护作用机制及其意义进行综述,并且介绍EPO的治疗途径和最佳剂量及其可能的不良反应。
Erythropoietin (EPO) is a potent neuroprotective agent that can be used as a potential adjunct to brain damage. It is well-known that EPO secreted by the kidneys promotes erythropoiesis by inhibiting the apoptosis of bone marrow cells. However, recent studies have found that the brain can also produce EPO, and there are EPO receptors (EPORs) in brain neurons and astrocytes Expression of signal components. EPO activates a series of cascade reactions that stabilize the mitochondrial membrane, limiting the formation of reactive oxygen species and nitrogen intermediates, inhibiting the production of proinflammatory cytokines, inhibiting the infiltration of neutrophils, and increasing the brain’s ability to combat ischemia-reperfusion. In general, EPO protects brain tissue through these mechanisms and improves neurocognitive function recovery after ischemia. This article reviews the mechanism and significance of EPO protection after brain injury, and introduces the treatment route and the optimal dose of EPO and its possible adverse reactions.