Intracranial Aneurysm as a Macrophage-mediated Inflammatory Disease
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- SHIMIZU Kampei
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center Department of Neurosurgery, Kyoto University Graduate School of Medicine
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- KUSHAMAE Mika
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center Department of Neurosurgery, Showa University School of Medicine
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- MIZUTANI Tohru
- Department of Neurosurgery, Showa University School of Medicine
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- AOKI Tomohiro
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center
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抄録
<p>Subarachnoid hemorrhage (SAH) is mainly attributable to the rupture of intracranial aneurysms (IAs). Although the outcome of SAH is considerably poor in spite of the recent intensive medical care, mechanisms regulating the progression of IAs or triggering rupture remain to be clarified, making the development of effective preemptive medicine to prevent SAH difficult. However, a series of recent studies have been expanding our understanding of the pathogenesis of IAs. These studies have suggested the crucial role of macrophage-mediated chronic inflammation in the pathogenesis of IAs. In histopathological analyses of IA lesions in humans and induced in animal models, the number of macrophages infiltrating in lesions is positively correlated with enlargement or rupture of IAs. In animal models, a genetic deletion or an inhibition of monocyte chemotactic protein-1, a major chemoattractant for macrophages, or a pharmacological depletion of macrophages consistently suppresses the development and progression of IAs. Furthermore, a macrophage-specific deletion of Ptger2 (gene for prostaglandin E receptor subtype 2) or a macrophage-specific expression of a mutated form of IκBα which inhibits nuclear translocation of nuclear factor κB significantly suppress the development of IAs, supporting the role of macrophages and the inflammatory signaling functioning there in the pathogenesis of IAs. The development of drug therapies suppressing macrophage-mediated inflammatory responses in situ can thus be a potential strategy in the pre-emptive medicine targeting SAH. In this manuscript, we summarize the experimental evidences about the pathogenesis of IAs focused on inflammatory responses and propose the definition of IAs as a macrophage-mediated inflammatory disease.</p>
収録刊行物
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- Neurologia medico-chirurgica
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Neurologia medico-chirurgica 59 (4), 126-132, 2019
一般社団法人 日本脳神経外科学会