Modes of Brain Cell Death Following Intracerebral Hemorrhage.

Yan Zhang,Ruiyi Zhang,Zhouping Tang,Hongmin Li,Yang Liu,V Wee Yong,Suliman Khan,Mengzhou Xue,Guofeng Wu

doi:10.3389/fncel.2022.799753

Abstract

Intracerebral hemorrhage (ICH) is a devastating form of stroke with high rates of mortality and morbidity. It induces cell death that is responsible for neurological deficits postinjury. There are no therapies that effectively mitigate cell death to treat ICH. This review aims to summarize our knowledge of ICH-induced cell death with a focus on apoptosis and necrosis. We also discuss the involvement of ICH in recently described modes of cell death including necroptosis, pyroptosis, ferroptosis, autophagy, and parthanatos. We summarize treatment strategies to mitigate brain injury based on particular cell death pathways after ICH.

Highlights

Intracerebral hemorrhage (ICH) refers to non-traumatic bleeding into the parenchyma of the brain
An imbalanced oxidative stress response and overactivated inflammatory cascade trigger several cell death pathways in and around the brain hematoma following ICH. These modes of cell death comprise apoptosis, necrosis, necroptosis, pyroptosis, ferroptosis, autophagy, parthanatos, and likely others to be discovered. Strategies targeting these cell death pathways have resulted in neuroprotection in preclinical models and some of these have shown promise for patients with ICH
There remain many challenges and future directions in modulating cell death to improve the prognosis of patients with ICH

Summary

Introduction

Intracerebral hemorrhage (ICH) refers to non-traumatic bleeding into the parenchyma of the brain It accounts for approximately 15% of cerebral vascular diseases. The poor outcome in ICH is attributed to the primary brain injury caused by the hematoma and its mechanical compression of the brain (Shao et al, 2019) and to subsequent secondary brain injury The latter comprises neuroinflammation and oxidative stress-mediated through a series of events initiated by the primary injury (Zhao and Aronowski, 2013; Xi et al, 2014). Both the primary and secondary brain injuries incur significant cell death and loss of neurological functions

Objectives

Conclusion