Abstract:
Brain edema is a critical complication arising from stroke and traumatic brain injury (TBI) with an important impact on patient recovery and can lead to long-term consequences. Therapeutic options to reduce edema progression are limited with variable patient outcomes. Aquaporin 4 (AQP4) is a water channel that allows bidirectional water diffusion across the astrocyte membrane and participates in the distinct phases of cerebral edema. The absence or inhibition of this channel has been demonstrated to ameliorate edema and brain damage. The endocannabinoid system (ECS) is a neuromodulator system with a wide expression in the brain and its activation has shown neuroprotective properties in diverse models of neuronal damage. This review describes and discusses the major features of ECS and AQP4 and their role during brain damage, observing that ECS stimulation reduces edema and injury size in diverse models of brain damage, however, the relationship between AQP4 expression and dynamics and ECS activation remains unclear. The research on these topics holds promising therapeutic implications for the treatment of brain edema following stroke and TBI.
摘要:
脑水肿是由中风和创伤性脑损伤(TBI)引起的严重并发症,对患者的康复有重要影响,并可能导致长期后果。减少水肿进展的治疗选择因患者预后可变而受到限制。水通道蛋白4(AQP4)是一种水通道,允许水双向扩散穿过星形细胞膜,并参与脑水肿的不同阶段。已证明该通道的缺乏或抑制可改善水肿和脑损伤。内源性大麻素系统(ECS)是一种在大脑中广泛表达的神经调质系统,其激活已在各种神经元损伤模型中显示出神经保护特性。这篇综述描述并讨论了ECS和AQP4的主要特征及其在脑损伤中的作用,观察到ECS刺激减少不同脑损伤模型中的水肿和损伤大小,然而,AQP4表达和动力学与ECS激活之间的关系尚不清楚。关于这些主题的研究对于中风和TBI后的脑水肿的治疗具有有希望的治疗意义。