中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (6): 2107-2123.doi: 10.4103/NRR.NRR-D-24-01424

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

脑卒中炎症中的调节性 T 细胞:治疗前景

  

  • 出版日期:2026-06-15 发布日期:2025-09-16
  • 基金资助:
    脑血管疾病质量监测平台(2022YFC2504900);“智能诊断与治疗关键技术及系统开发以提升治疗效果”项目(2022YFC2504902)

Regulatory T cells in stroke inflammation: Therapeutic perspectives

Ziyi Sun1, 2, Hongyu Zhou1, 2, Yongjun Wang1, 2, 3, 4, *, Zixiao Li1, 2, 3, 5, 6, *   

  1. 1 Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China;  2 China National Clinical Research Center for Neurological Diseases, Beijing, China;  3 National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China;  4 Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China;  5 Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China;  6 Chinese Institute for Brain Research, Beijing, China
  • Online:2026-06-15 Published:2025-09-16
  • Contact: Zixiao Li, PhD, lizixiao2008@hotmail.com; Yongjun Wang, MD, yongjunwang@ncrcnd.org.cn.
  • Supported by:
    This work was supported by National Key R&D Program: Key Special Project on Research for the Prevention and Treatment of Common Diseases - 2022 Annual Project, Nos. 2022YFC2504900, 2022YFC2504902 (both to ZL).

摘要:

调节性 T 细胞(Tregs)是关键的免疫调节细胞,在缺血性脑卒中和脑内出血中发挥着重要作用。Tregs 通过抑制免疫反应和促进组织修复对脑卒中后炎症过程起着至关重要的调节作用。此综述的目的是全面探讨脑卒中后 Treg 数量和功能的动态变化,并强调它们在脑卒中进展的不同阶段所发挥的独特作用。在急性期(发病5-7 d内),Tregs 主要通过减轻炎症发挥神经保护作用,而在慢性期(发病7 d后),Tregs 则促进神经再生和功能恢复。脑-肠轴是脑卒中后全身免疫反应的关键介质,文章讨论了 Tregs 在脑-肠轴中新出现的作用,文章还强调了Tregs在调节脑卒中后炎症和修复中的相关性。增强 Treg 反应的各种策略包括 Treg 接种、药理制剂和粘膜耐受诱导,这些策略都具有增强 Treg 介导的免疫调节和修复的潜力。尽管临床前研究结果令人鼓舞,但将基于 Treg 的疗法转化为临床实践仍面临着最佳时机、剂量和长期疗效方面的不确定性。总之,以 Treg 为靶点的干预措施是一种新颖而有前景的免疫调节方法,可减轻脑卒中诱发的损伤并促进神经修复。

https://orcid.org/0000-0002-4713-5418 (Zixiao Li); https://orcid.org/0000-0002-9976-2341 (Yongjun Wang)

关键词:

Abstract: Regulatory T cells are crucial immunomodulatory cells that play essential roles in both ischemic stroke and intracerebral hemorrhage. These cells are vital in post-stroke inflammation since they suppress immune responses and promote tissue repair. This review thoroughly examines the dynamic changes in the number and function of regulatory T cells and highlights their distinct roles at various stages of stroke progression. In the acute phase (within 5–7 days), regulatory T cells exert neuroprotective effects primarily by reducing inflammation. In the chronic phase (7 days post-onset), these cells support neuroregeneration and functional recovery. The review also explores the emerging role of regulatory T cells in the brain–gut axis, a key mediator of the systemic immune responses following stroke, and discusses its relevance in modulating post-stroke inflammation and repair. Various strategies aimed at enhancing regulatory T cell responses include adoptive transfer of regulatory T cells, administration of pharmacological agents, and induction of mucosal tolerance. All these approaches can potentially enhance the immunomodulatory and repair functions of regulatory T cells. Nevertheless, despite the promising preclinical results, the translation of regulatory T cell–based therapies into clinical practice is associated with challenges related to optimal timing, dosage, and long-term efficacy. Overall, targeting regulatory T cells is a novel and promising immunoregulatory approach for mitigating stroke-induced injury and promoting neural repair.

Key words: blood–brain barrier, cerebral infarction, immunotherapy, inflammation, interleukin-10, intracerebral hemorrhage, ischemic stroke, regulatory T lymphocytes, stroke rehabilitation, white matter