Neuroinflammation und Schlaganfall

S. Jander

doi:10.1055/s-0038-1629944

Nervenheilkunde, Table of Contents

Nervenheilkunde 2005; 24(02): 82-88
DOI: 10.1055/s-0038-1629944

Original Article

Schattauer GmbH

Neuroinflammation und Schlaganfall

Neuroinflammation in stroke

S. Jander

¹Neurologische Klinik, Universitätsklinikum Düsseldorf, Heinrich-Heine-Universität, Düsseldorf

› Author Affiliations

Abstract

Zusammenfassung

Der ischämische Schlaganfall ist die häufigste Ursache bleibender neurologischer Behinderung und mit hoher sekundärer Mortalität behaftet. Mit der Thrombolyse steht nur in einem engen Zeitfenster von 3 bis 6 Stunden ein partiell wirksames Theerapieverfahren zur Verfügung. Demgegenüber ist die Infarktentwicklung ein dynamischer Prozess, der über mehrere Tage noch zu einer Zunahme der Läsionsgröße führt und in einer Defektheilung mit variablem neurologischen Defizit resultiert. Lokale Entzündungsprozesse sind ein integraler Bestandteil der Läsionspathogenese. Innerhalb weniger Stunden werden residente Hirnmakrophagen (Mikroglia) aktiviert, während die Rekrutierung hämatogener Makrophagen verzögert erfolgt. Entzündungsmediatoren können zur Ausdehnung des Infarktschadens beitragen und die zelluläre Regeneration inhibieren, vermitteln aber auch Neuroprotektion und sind an der Läsionsreparatur beteiligt. Neue zellspezifische Kontrastmittel für die Kernspintomographie ermöglichen die nichtinvasive Detektion von Neuroinflammation beim Hirninfarkt. Hiervon erhoffen wir uns Ansatzpunkte für die gezielte immunologische Therapie des ischämischen Schlaganfalls.

Summary

Stroke due to focal brain ischemia is the leading cause of persistent neurological disability in modern western societies. Current thrombolysis therapy is only effective within a narrow time window of 3 to 6 hours. Substantial evidence however indicates that the evolution of ischemic brain damage is a dynamic process extending well into subacute stages of days to weeks after the insult. Lesion-associated inflammation is an integral part of the cellular pathobiology of brain infarction. Within hours after ischemia resident brain macrophages/microglia are activated and produce a wide range of potentially harmful mediators. During later stages, activated monocytes and macrophages migrate from the blood stream into infarcted brain tissue. Brain inflammation may cause secondary infarct growth and inhibit the regenerative capacity of injured brain tissue, but can also mediate neuroprotection and lesion repair. Inflammatory cell recruitment can now be monitored using iron oxide nanoparticles as cell-specific contrast agents for magnetic resonance imaging. These new imaging techniques will contribute to the development of therapies targeting neuroinflammation in ischemic stroke.

Schlüsselwörter

Schlaganfall - zerebrale Ischämie - Entzündung - Kernspintomographie

Keywords

Stroke - cerebral ischemia - inflammation - magnetic resonance imaging

Full Text

References

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