针刺干预microRNA与缺血性脑卒中作用机制的研究进展

Research advances in the role of microRNA in the mechanisms of acupuncture therapy for ischemic stroke

摘要:

缺血性脑卒中（IS）是大脑局部供血不足所引发的局部神经细胞损伤及死亡的一种急性脑血管疾病。IS发生后神经元因缺血缺氧迅速死亡，随后引发一系列复杂的病理反应，包括炎症、细胞程序性死亡、血脑屏障破坏等，这些反应会相互影响，加重脑缺血后的神经损伤。MicroRNA（miRNA）在IS后的调控神经炎症和细胞程序性死亡、血管功能重塑及神经修复等方面发挥重要作用，可以通过靶向目的基因参与脑缺血后的病理反应。针刺在治疗脑缺血中具有多靶点、多途径的特点，可以通过干预miRNA治疗IS，主要涉及炎症反应、焦亡、凋亡、自噬、血管新生及神经修复。该文通过阐述针刺调控miRNA治疗IS的具体机制，旨在为后续深入研究针刺多靶点协同作用的机制、优化临床治疗方案提供理论参考。

Abstract:

Ischemic stroke (IS) is an acute cerebrovascular disease characterized by local neuronal damage and death resulting from insufficient blood supply to a specific brain region. Following the onset of IS, neurons rapidly die due to ischemia and hypoxia, triggering a cascade of complex pathological reactions. These include inflammation, programmed cell death, and blood-brain barrier disruption, which interact and exacerbate post-ischemia neurological damage. MicroRNA (miRNA) play crucial roles in regulating neuroinflammation, programmed cell death, vascular remodeling, and neural repair after IS, participating in post-ischemic pathological processes by targeting specific genes. Acupuncture exerts therapeutic effects in IS through multiple targets and pathways. It can alleviate IS by modulating microRNA, with mechanisms mainly involving the regulation of inflammation, pyroptosis, apoptosis, autophagy, angiogenesis, and neurorepair. This review elucidates the specific mechanisms by which acupuncture regulates miRNA to treat IS, aiming to provide a theoretical foundation for further research into the synergistic multi-target mechanisms of acupuncture and for optimizing clinical treatment strategies.