The brain demands oxygen and glucose to fulfill its roles as the master regulator of body functions as diverse as bladder control and creative thinking. Chemical and electrical transmission in the nervous system is rapidly disrupted in stroke as a result of hypoxia and hypoglycemia. Despite being highly evolved in its architecture, the human brain appears to utilize phylogenetically conserved homeostatic strategies to combat hypoxia and ischemia. Specifically, several converging lines of inquiry have demonstrated that the transcription factor hypoxia-inducible factor-1 (HIF1-1) mediates the activation of a large cassette of genes involved in adaptation to hypoxia in surviving neurons after stroke. Accordingly, pharmacological or molecular approaches that engage hypoxic adaptation at the point of one of its sensors (e.g., inhibition of HIF prolyl 4 hydroxylases) leads to profound sparing of brain tissue and enhanced recovery of function. In this review, we discuss the potential mechanisms that could subserve protective and restorative effects of augmenting hypoxic adaptation in the brain. The strategy appears to involve HIF-dependent and HIF-independent pathways and more than 70 genes and proteins activated transcriptionally and post-transcriptionally that can act at cellular, local, and system levels to compensate for oxygen insufficiency. The breadth and depth of this homeostatic program offers a hopeful alternative to the current pessimism towards stroke therapeutics.

译文

大脑需要氧气和葡萄糖来发挥其作为身体功能的主要调节剂的作用,如膀胱控制和创造性思维。由于缺氧和低血糖,神经系统中的化学和电传递会迅速中断。尽管其结构高度进化,但人脑似乎利用了系统发育保守的稳态策略来对抗缺氧和缺血。具体地说,几个会聚的研究线已经证明,转录因子缺氧诱导因子-1 (HIF1-1) 介导了中风后存活神经元适应缺氧的大量基因盒的激活。因此,在其传感器之一处进行低氧适应的药理学或分子方法 (例如,抑制HIF脯氨酰4羟化酶) 导致脑组织的深度保留和功能的增强恢复。在这篇综述中,我们讨论了可能对增强大脑缺氧适应的保护和恢复作用产生亚作用的潜在机制。该策略似乎涉及HIF依赖性和HIF依赖性途径,以及超过70个基因和蛋白质在转录和转录后激活,可以在细胞,局部和系统水平上起作用以补偿氧气不足。此稳态计划的广度和深度为当前对中风疗法的悲观主义提供了希望的替代方案。

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