Neural Regeneration Research ›› 2026, Vol. 21 ›› Issue (7): 2787-2809.doi: 10.4103/NRR.NRR-D-24-01523

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Lipid metabolism, microglia, and stroke

Lei Chen1, #, Minmin Zhang1, #, Wei Wei2, #, Qiang Li1 , Lijun Wang1 , Ming Zhao2 , He Li3 , Hongye Xu1 , Pengfei Yang1, *, Ping Zhang1, 2, *   

  1. 1 Department of Neurovascular Center, Changhai Hospital, Naval Medical University, Shanghai, China;  2 Department of Neurology, Naval Medical Center of PLA, Naval Medical University, Shanghai, China;  3 Department of Emergency, Naval Medical Center of PLA, Naval Medical University, Shanghai, China
  • Online:2026-07-15 Published:2025-10-17
  • Contact: Ping Zhang, MD, pingzhang1121@163.com; Pengfei Yang, MD, 15921196312@163.com.
  • Supported by:
    This work was supported by the Shanghai Municipal Health Commission, No. 20224Z0008 (to PY); the National Natural Science Foundation of China, No. 82101412 (to MZ); the Science Foundation of Naval Medical Center of PLA, No. 23M2702 (to MZ); and National Key Research and Development Program of China, No. 2023YFC2506506 (QL).

Abstract: Microglia, lipids, and their interaction are found to play important roles in post-stroke immunity. Microglia are sensitive to detect environment change in injured brain. Activated microglia undergo phenotypical remodeling and trigger complex signal cascades to regulate immune responses after stroke. Lipids including peripheral lipid metabolism and lipid droplet biogenesis are involved in the control of microglia functions, such as activation, phagocytosis, proliferation, and pro-inflammation. In this review, we explore new scope of microglia and lipids in immune regulation of stroke. Implication of peripheral lipid metabolism after stroke is mentioned and advances in microglia-lipid interaction are discussed. We give a special focus on how diet and gut microbiome influence neuroinflammation system via gut–brain axis, and how these processes associate with the risk and outcome of stroke. Moreover, we reviewed the therapeutic targets related to lipid metabolism and microglial modulation after stroke. These can provide a prospective strategy for more efficient and safer treatment for ischemic and hemorrhagic stroke.

Key words: cerebral hemorrhage, diet, gut microbiome, inflammation, ischemic stroke, lipid, metabolism, microglia, regeneration, therapeutic targets