中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (3): 1074-1088.doi: 10.4103/NRR.NRR-D-24-01062

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

星形胶质细胞：脑卒中的干预靶点

  

  • 出版日期:2026-03-15 发布日期:2025-07-02

Astrocytes: Therapeutic targets for stroke

Jingxiu Li1, #, Keyuan Gao1, #, Lili Wang2, #, Jiayue Wang3, 4, Mian Qin3, 4, Xinrui Wang1 , Kai Lian1 , Chao Li5 , Shan’e Gao3, *, Chenxi Sun1, *   

  1. 1 School of Life Science and Technology, Shandong Second Medical University, Weifang, Shandong Province, China;  2 Department of Operating Room, Affiliated Hospital of Shandong Second Medical University, Shandong Second Medical University, Weifang, Shandong Province, China;  3 Department of Neurosurgery, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, China;  4 NeuroRe Medical Technology Limited Company, Shanghai, China;  5 Hepatobiliary and Pancreatic Medicine Center, Weifang People’s Hospital, Shandong Second Medical University, Weifang, Shandong Province, China
  • Online:2026-03-15 Published:2025-07-02
  • Contact: Shan’e Gao, PhD, gaoshan2009@tongji.edu.cn; Chenxi Sun, PhD, sunchenxi@sdsmu.edu.cn.
  • Supported by:
    This project was supported by the National Natural Science Foundation of China, No. 82001325; Visiting Scholar Foundation of Shandong Province, No. 20236-01 (both to CS).

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摘要：

脑卒中是导致全球死亡的主要原因，最终会造成严重的终生神经损伤。患者会遭受神经炎症、细胞毒性、氧化应激和线粒体功能障碍等一系列继发性损害。遗憾的是，临床上可供选择的治疗方法很少。越来越多的证据表明，在缺血性脑卒中的各个阶段，大脑中最丰富的胶质细胞--星形胶质细胞起着至关重要的作用。这篇综述首先全面概述了星形胶质细胞在大脑中的基本生理功能，强调了它们在调节神经元稳态、突触活动和血脑屏障完整性方面的关键作用。然后，强调星形胶质细胞在缺血性脑卒中中的功能多样性和异质性。文章不仅深入探讨了星形胶质细胞在能量供应、代谢调节和神经递质平衡方面的公认贡献，还讨论了它们在缺血性损伤后参与线粒体恢复、神经炎症调节和氧化应激调节的新情况。并探讨了这些功能的细胞和分子机制，特别关注了最近在星形胶质细胞内发现的靶点，这些靶点为治疗干预提供了光明的前景。文章最后详细概述了目前针对星形胶质细胞治疗脑卒中的治疗策略。这些针对星形胶质细胞的治疗策略分为传统的小分子药物、微小核糖核酸（miRNA）、干细胞疗法、细胞重编程、水凝胶和细胞外囊泡。通过总结当前有关星形胶质细胞功能和靶向治疗方法的知识，文章旨在强调星形胶质细胞在脑卒中，尤其是缺血性脑卒中期间和之后的关键作用，并进一步强调新型星形胶质细胞靶向治疗方法的前景，这些方法为临床改善脑卒中患者的预后开拓视野。

https://orcid.org/0000-0002-7871-1537 (Shan’e Gao); http://orcid.org/0000-0002-1170-3006 (Chenxi Sun)

关键词: 星形胶质细胞, 缺血, 缺血性脑卒中, 神经炎症, 反应性星形胶质细胞, 脑卒中

Abstract: Stroke is the leading cause of mortality globally, ultimately leading to severe, lifelong neurological impairments. Patients often suffer from a secondary cascade of damage, including neuroinflammation, cytotoxicity, oxidative stress, and mitochondrial dysfunction. Regrettably, there is a paucity of clinically available therapeutics to address these issues. Emerging evidence underscores the pivotal roles of astrocytes, the most abundant glial cells in the brain, throughout the various stages of ischemic stroke. In this comprehensive review, we initially provide an overview of the fundamental physiological functions of astrocytes in the brain, emphasizing their critical role in modulating neuronal homeostasis, synaptic activity, and blood–brain barrier integrity. We then delve into the growing body of evidence that highlights the functional diversity and heterogeneity of astrocytes in the context of ischemic stroke. Their well-established contributions to energy provision, metabolic regulation, and neurotransmitter homeostasis, as well as their emerging roles in mitochondrial recovery, neuroinflammation regulation, and oxidative stress modulation following ischemic injury, are discussed in detail. We also explore the cellular and molecular mechanisms underpinning these functions, with particular emphasis on recently identified targets within astrocytes that offer promising prospects for therapeutic intervention. In the final section of this review, we offer a detailed overview of the current therapeutic strategies targeting astrocytes in the treatment of ischemic stroke. These astrocyte-targeting strategies are categorized into traditional small-molecule drugs, microRNAs (miRNAs), stem cell-based therapies, cellular reprogramming, hydrogels, and extracellular vesicles. By summarizing the current understanding of astrocyte functions and therapeutic targeting approaches, we aim to highlight the critical roles of astrocytes during and after stroke, particularly in the pathophysiological development in ischemic stroke. We also emphasize promising avenues for novel, astrocyte-targeted therapeutics that could become clinically available options, ultimately improving outcomes for patients with stroke.

Key words: astrocyte, ischemia, ischemic stroke, neuroinflammation, reactive astrocyte, stroke