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Reperfusion syndrome: cellular mechanisms of microvascular dysfunction and potential therapeutic strategies.

机译:再灌注综合征:微血管功能障碍的细胞机制和潜在的治疗策略。

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摘要

Reperfusion injury is the paradoxical and complex phenomenon of exacerbation of cellular dysfunction and increase in cell death after the restoration of blood flow to previously ischemic tissues. It involves biochemical and cellular changes causing oxidant production and complement activation, which culminates in an inflammatory response, mediated by neutrophil and platelet cell interactions with the endothelium and among the cells themselves. The mounted inflammatory response has both local and systemic manifestations. Despite improvements in imaging, interventional techniques, and pharmacological agents, morbidity from reperfusion remains high. Extensive research has furthered the understanding of the various pathophysiological mechanisms involved and the development of potential therapeutic strategies. Preconditioning has emerged as a powerful method of ameliorating ischemia reperfusion injury to the myocardium and in transplant surgery. More recently, postconditioning has been shown to provide a therapeutic counter to vasoocclusive emergencies. More research and well-designed trials are needed to bridge the gap between experimental evidence and clinical implementation.
机译:再灌注损伤是在恢复到先前缺血组织的血流之后,细胞功能障碍加重和细胞死亡增加的矛盾和复杂现象。它涉及引起氧化剂产生和补体激活的生化和细胞变化,最终由中性粒细胞和血小板细胞与内皮以及细胞自身之间的相互作用介导的炎症反应达到顶点。发生的炎症反应具有局部和全身性表现。尽管在影像学,介入技术和药理学方面有所改善,但是再灌注的发病率仍然很高。广泛的研究使人们对所涉及的各种病理生理机制以及潜在治疗策略的发展有了进一步的了解。预处理已经成为缓解心肌缺血再灌注损伤和移植手术中一种有效的方法。最近,已经显示后处理可提供对血管闭塞紧急情况的治疗性抵抗。需要更多的研究和精心设计的试验来弥合实验证据与临床实施之间的差距。

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