Haematoma scavenging in intracerebral haemorrhage: from mechanisms to the clinic

The products of erythrocyte lyses, haemoglobin (Hb) and haem, are recognized as neurotoxins and the main contributors to delayed cerebral oedema and tissue damage after intracerebral haemorrhage (ICH). Finding a means to efficiently promote absorption of the haemolytic products (Hb and haem) around...

Full description

Saved in:
Bibliographic Details
Published in:Journal of cellular and molecular medicine 2018-02, Vol.22 (2), p.768-777
Main Authors: Wang, Gaiqing, Wang, Li, Sun, Xin‐gang, Tang, Jiping
Format: Article
Language:English
Subjects:
Animals
Blood
Brain
Brain Injuries - metabolism
Brain Injuries - pathology
Brain injury
CD163 antigen
Cerebral Hemorrhage - complications
Cerebral Hemorrhage - pathology
Edema
Garbage
Haem
haematoma resolution
haematoma scavenge
Haptoglobin
Hematoma
Hematoma - complications
Hematoma - pathology
Heme
Hemoglobin
Hemopexin
Hemorrhage
Humans
intracerebral haemorrhage
Models, Biological
neural recovery
Neurotoxins
Peroxisome proliferator-activated receptors
Phagocytosis
Receptors, Scavenger - metabolism
Recovery of function
Review
Reviews
Scavenger receptors
Therapeutic applications
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:The products of erythrocyte lyses, haemoglobin (Hb) and haem, are recognized as neurotoxins and the main contributors to delayed cerebral oedema and tissue damage after intracerebral haemorrhage (ICH). Finding a means to efficiently promote absorption of the haemolytic products (Hb and haem) around the bleeding area in the brain through stimulating the function of the body's own garbage cleaning system is a novel clinical challenge and critical for functional recovery after ICH. In this review, available information of the brain injury mechanisms underlying ICH and endogenous haematoma scavenging system is provided. Meanwhile, potential intervention strategies are discussed. Intracerebral blood itself has ‘toxic’ effects beyond its volume effect after ICH. Haptoglobin–Hb–CD163 as well as haemopexin–haem–LRP1 is believed to be the most important endogenous scavenging pathway which participates in blood components resolution following ICH. PPARγ–Nrf2 activates the aforementioned clearance pathway and then accelerates haematoma clearance. Meanwhile, the scavenger receptors as novel targets for therapeutic interventions to treat ICH are also highlighted.
ISSN:1582-1838
1582-4934
DOI:10.1111/jcmm.13441