Title:Molecular, Cellular and Clinical Aspects of Intracerebral Hemorrhage: Are the Enemies Within?
Volume: 14
Issue: 4
Author(s): Cássia Righy, Marcelo T. Bozza, Marcus F. Oliveira and Fernando A. Bozza
Affiliation:
Keywords:
Heme, hemorrhagic stroke, inflammatory response, intracranial bleeding, iron, reactive oxygen species, subarachnoid
hemorrhage.
Abstract: Hemorrhagic stroke is a disease with high incidence and mortality rates. In addition to the
mass lesions that result from hemorrhagic stroke, substances such as the blood-derived products (BDP) (hemoglobin (Hb),
heme and iron) induce a potent inflammatory response and exert direct toxic effects on neurons, astrocytes, and microglia.
In the present review, we discuss the mechanisms of brain injury secondary to hemorrhagic stroke, focusing on the
involvement of BDP as major players of cellular redox imbalance, inflammation, and glutamate excitotoxicity. Potential
natural mechanisms of protection against free Hb and heme such as haptoglobin and hemopexin, respectively, are
highlighted. We finally discuss the experimental and clinical trials targeting free iron and heme scavenging as well as
inflammation, as potential new therapies to minimize the devastating effects of hemorrhagic stroke on brain structure and
function.
