中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (1): 39-56.doi: 10.4103/NRR.NRR-D-24-00810

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

创伤性脑损伤中活化小胶质细胞的极化途径和靶向治疗药物

  

  • 出版日期:2026-01-15 发布日期:2025-04-18
  • 基金资助:
    本研究得到云南省自然科学基金(202401AS070086)、国家重点研发计划(2018YFA0801403)、云南省科技人才与平台计划(202105AC160041)、国家自然科学基金(31960120)的资助。

Microglial polarization pathways and therapeutic drugs targeting activated microglia in traumatic brain injury

Liping Shi1, 2, Shuyi Liu1, 2, Jialing Chen1, 2, Hong Wang1, 2, *, Zhengbo Wang1, 2, *   

  1. 1 State Key Laboratory of Primate Biomedical Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming, Yunnan Province, China;   2 Yunnan Key Laboratory of Primate Biomedical Research, Kunming, Yunnan Province, China
  • Online:2026-01-15 Published:2025-04-18
  • Contact: Zhengbo Wang, PhD, wangzb@lpbr.cn; Hong Wang, PhD, wangh@lpbr.cn.
  • Supported by:
    This work was supported by the Natural Science Foundation of Yunnan Province, No. 202401AS070086 (to ZW); the National Key Research and Development Program of China, No. 2018YFA0801403 (to ZW); Yunnan Science and Technology Talent and Platform Plan, No. 202105AC160041 (to ZW); the Natural Science Foundation of China, No. 31960120 (to ZW).

摘要:

创伤性脑损伤包括原发性损伤和继发性损伤,继发性损伤是创伤性脑损伤致残的主要原因,涉及复杂的多细胞级联反应。在继发性损伤中备受关注的小胶质细胞可在创伤性脑损伤时被激活。文章回顾了小胶质细胞的起源和分类,以及小胶质细胞在创伤性脑损伤中的动态变化,阐述其其极化途径和靶向治疗药物。文章总结发现,调节促炎和抗炎小胶质细胞所涉及的信号通路(如TLR4/NFκB、MAPK、JAK/STAT、PI3K/AKT、Notch和H MGB1等),可以减轻小胶质细胞在创伤性脑损伤中引起的炎症反应,起到神经保护作用。文章还回顾了基于这些通路开发的药物和细胞替代疗法等策略。瑞舒伐他汀等炎症因子调节药物,已被证实能够促进抗炎小胶质细胞的极化,减轻TBI引起的炎症反应。间充质干细胞具有抗炎能力,已有临床研究证实间充质干细胞对创伤性脑损伤患者有显著疗效和安全性。此外,目前间充质干细胞给药方法的发展,如结合新型生物材料、基因工程编辑、间充质干细胞外泌体疗法等,显著提高了间充质干细胞在动物体内的效率和治疗效果。然而,药物和间充质干细胞治疗策略的应用仍有许多问题需要克服。未来,新技术如单细胞RNA测序和转录组分析的应用,将有助于此领域开展更多实验研究,而非人灵长类动物模型的应用也有望加速小胶质细胞的极化途径治疗策略向临床的转化。

https://orcid.org/0000-0002-4717-5137 (Zhengbo Wang)

关键词: 动物模型, 抗炎药物, 中枢神经系统, 间充质干细胞, 小胶质细胞, 神经炎症, 非人灵长类, 信号通路, 细胞替代策略, 创伤性脑损伤

Abstract: Traumatic brain injury can be categorized into primary and secondary injuries. Secondary injuries are the main cause of disability following traumatic brain injury, which involves a complex multicellular cascade. Microglia play an important role in secondary injury and can be activated in response to traumatic brain injury. In this article, we review the origin and classification of microglia as well as the dynamic changes of microglia in traumatic brain injury. We also clarify the microglial polarization pathways and the therapeutic drugs targeting activated microglia. We found that regulating the signaling pathways involved in pro-inflammatory and anti-inflammatory microglia, such as the Toll-like receptor 4 /nuclear factor-kappa B, mitogen-activated protein kinase, Janus kinase/signal transducer and activator of transcription, phosphoinositide 3-kinase/protein kinase B, Notch, and high mobility group box 1 pathways, can alleviate the inflammatory response triggered by microglia in traumatic brain injury, thereby exerting neuroprotective effects. We also reviewed the strategies developed on the basis of these pathways, such as drug and cell replacement therapies. Drugs that modulate inflammatory factors, such as rosuvastatin, have been shown to promote the polarization of antiinflammatory microglia and reduce the inflammatory response caused by traumatic brain injury. Mesenchymal stem cells possess anti-inflammatory properties, and clinical studies have confirmed their significant efficacy and safety in patients with traumatic brain injury. Additionally, advancements in mesenchymal stem cell-delivery methods—such as combinations of novel biomaterials, genetic engineering, and mesenchymal stem cell exosome therapy—have greatly enhanced the efficiency and therapeutic effects of mesenchymal stem cells in animal models. However, numerous challenges in the application of drug and mesenchymal stem cell treatment strategies remain to be addressed. In the future, new technologies, such as single-cell RNA sequencing and transcriptome analysis, can facilitate further experimental studies. Moreover, research involving non-human primates can help translate these treatment strategies to clinical practice.

Key words: animal model, anti-inflammatory drug, cell replacement strategy, central nervous system, mesenchymal stem cell, microglia, neuroinflammation, non-human primate, signaling pathway, traumatic brain injury