文献类型：期刊文献

英文题名：Dynamic mechanisms and targeted interventions in cerebral ischemia-reperfusion injury: pathological cascade from ischemia to reperfusion and promising therapeutic strategies

作者：Meng, Xufeng[1];Zheng, Zhi[1];Yang, Li[1];Yang, Chen[1];Li, Xiaoli[2,3];Hao, Yunfei[1,2]

第一作者：Meng, Xufeng

通信作者：Hao, YF[1];Hao, YF[2]

机构：[1]Gansu Univ Tradit Chinese Med, Clin Med Coll 1, Coll Integrated Tradit Chinese & Western Med, Lanzhou, Peoples R China;[2]Gansu Prov Peoples Hosp, Cerebrovasc Dis Ctr, Key Lab Cerebrovasc Dis Gansu Prov, Lanzhou, Peoples R China;[3]Lanzhou Univ, Lanzhou, Peoples R China

第一机构：甘肃中医药大学中西医结合学院

通信机构：[1]corresponding author), Gansu Univ Tradit Chinese Med, Clin Med Coll 1, Coll Integrated Tradit Chinese & Western Med, Lanzhou, Peoples R China;[2]corresponding author), Gansu Prov Peoples Hosp, Cerebrovasc Dis Ctr, Key Lab Cerebrovasc Dis Gansu Prov, Lanzhou, Peoples R China.|[10735ed249c6606940a33]甘肃中医药大学中西医结合学院;[10735]甘肃中医药大学;

年份：2025

卷号：19

外文期刊名：FRONTIERS IN NEUROSCIENCE

收录：;Scopus(收录号：2-s2.0-105014737509);WOS:【SCI-EXPANDED(收录号:WOS:001564921800001)】；

基金：The author(s) declare that financial support was received for the research and/or publication of this article. This study was supported by Gansu Provincial Joint Research Fund Project (no. 24JRRA889) and Gansu Provincial People's Hospital Intra-hospital Research Fund Project (no. 21GSSYB-13).

语种：英文

外文关键词：cerebral ischemia reperfusion injury (CI/RI); ischemic stroke (IS); pathologic process; mitochondrial dysfunction; inflammation

摘要：Cerebral ischemia-reperfusion injury (CI/RI) is a critical event causing secondary neurological deterioration following vascular recanalization in patients with ischemic stroke (IS), involving multiple interrelated pathological processes that synergistically aggravate brain injury. However, the underlying mechanisms remain incompletely elucidated, necessitating systematic investigation. This review systematically elucidates the dynamic pathological mechanisms underlying CI/RI during ischemic and reperfusion phases. Hypoxia-induced mitochondrial energy failure and TLR4/NF-kappa B-mediated inflammation predominate in the ischemic phase, while reperfusion triggers a reactive oxygen species (ROS) burst, amplifying oxidative stress (OS). These interconnected cascades form a self-perpetuating pathological loop. Targeting these pathways, therapies such as the TLR4 antagonist ApTOLL, the iron chelator deferoxamine, and the free radical scavenger Edaravone have shown promise. Nevertheless, significant challenges persist, including single-target limitations, poor delivery efficiency across the blood-brain barrier, and insufficient mechanistic insights. By integrating dynamic mechanisms and corresponding therapeutic strategies, this review summarizes recent advances in understanding the core pathological mechanisms and targeted interventions for CI/RI, discusses the current status and future prospects of these mechanisms and therapies, and aims to provide a systematic framework for mechanistic insights into CI/RI and a theoretical foundation for its precision treatment.