Inflammatory mechanisms in ischemic .full.pdfVIP

Inflammatory mechanisms in ischemic stroke: role of inflammatory cells Rong Jin,* Guojun Yang,? and Guohong Li*,1 *Department of Neurosurgery, Louisiana State University Health Science Center, Shreveport, Louisiana, USA; and ?Department of Internal Medicine, Ningbo University School of Medicine, Ningbo City, China RECEIVED NOVEMBER 30, 2009; REVISED JANUARY 11, 2010; ACCEPTED JANUARY 17, 2010. DOI: 10.1189/jlb.1109766 ABSTRACT Inflammation plays an important role in the pathogene- sis of ischemic stroke and other forms of ischemic brain injury. Experimentally and clinically, the brain re- sponds to ischemic injury with an acute and prolonged inflammatory process, characterized by rapid activation of resident cells (mainly microglia), production of proin- flammatory mediators, and infiltration of various types of inflammatory cells (including neutrophils, different subtypes of T cells, monocyte/macrophages, and other cells) into the ischemic brain tissue. These cellular events collaboratively contribute to ischemic brain in- jury. Despite intense investigation, there are still numer- ous controversies concerning the time course of the recruitment of inflammatory cells in the brain and their pathogenic roles in ischemic brain injury. In this review, we provide an overview of the time-dependent recruit- ment of different inflammatory cells following focal ce- rebral I/R. We discuss how these cells contribute to ischemic brain injury and highlight certain recent find- ings and currently unanswered questions about inflam- matory cells in the pathophysiology of ischemic stroke. J. Leukoc. Biol. 87: 779–789; 2010. Introduction Stroke is the third leading cause of death and the most fre- quent cause of permanent disability worldwide [1], and inflam- mation appears to play an important role in the pathogenesis of ischemic stroke and other forms of ischemic brain injury. Clinically, the susceptibility of the patients to stroke and the subsequent prognosis are influenced by sy