Title:Programmed Cell Death after Intracerebral Hemorrhage
Volume: 16
Issue: 9
Author(s): Tobias Bobinger, Petra Burkardt, Hagen B. Huttner and Anatol Manaenko*
Affiliation:
- Department of Neurology, University of Erlangen-Nuremberg, Schwabachanlage 6, Erlangen 91054,Germany
Keywords:
Cell death, intracerebral hemorrhage, apoptosis, necrosis, pyroptosis, ICH.
Abstract: Background: Intracerebral hemorrhage (ICH) accounts for up to 15% of all strokes and
is characterized by high rates of mortality and morbidity. The post-ICH brain injury can be distinguished
in 1) primary, which are caused by disruption and mechanical deformation of brain tissue
due to hematoma growth and 2) secondary, which are induced by microglia activation, mitochondrial
dysfunction, neurotransmitter and inflammatory mediator release. Although these events typically
lead to necrosis, the occurrence of programmed cell death has also been reported after ICH.
Methods: We reviewed recent publications describing advance in pre- and clinic ICH research.
Results: At present, treatment of ICH patients is based on oral anticoagulant reversal, management
of blood pressure and other medical complications. Several pre-clinical studies showed promising
results and demonstrated that anti-oxidative and anti-inflammatory treatments reduced neuronal cell
death, however, to date, all of these attempts have failed in randomized controlled clinical trials.
Yet, the time frame of administration may be crucial in translation from animal to clinical studies.
Furthermore, the latest pre-clinical research points toward the existence of other, apoptosisunrelated
forms kinds of programmed cell death.
Conclusion: Our review summarizes current knowledge of pathways leading to programmed cell
death after ICH in addition to data from clinical trials. Some of the pre-clinical results have not yet
demonstrated clinical confirmation, however they significantly contribute to our understanding of
post-ICH pathology and can contribute to development of new therapeutic approaches, decreasing
mortality and improving ICH patients’ quality of life.
