The prognosis of intracerebral haemorrhage continues to be devastating despite much research into this condition. A prominent feature of intracerebral haemorrhage is neuroinflammation, particularly the excessive representation of pro-inflammatory CNS-intrinsic microglia and monocyte-derived macrophages that infiltrate from the circulation. The pro-inflammatory microglia/macrophages produce injury-enhancing factors, including inflammatory cytokines, matrix metalloproteinases and reactive oxygen species. Conversely, the regulatory microglia/macrophages with potential reparative and anti-inflammatory roles are outcompeted in the early stages after intracerebral haemorrhage, and their beneficial roles appear to be overwhelmed by pro-inflammatory microglia/macrophages. In this review, we describe the activation of microglia/macrophages following intracerebral haemorrhage in animal models and clinical subjects, and consider their multiple mechanisms of cellular injury after haemorrhage. We review strategies and medications aimed at suppressing the pro-inflammatory activities of microglia/macrophages, and those directed at elevating the regulatory properties of these myeloid cells after intracerebral haemorrhage. We consider the translational potential of these medications from preclinical models to clinical use after intracerebral haemorrhage injury, and suggest that several approaches still lack the experimental support necessary for use in humans. Nonetheless, the preclinical data support the use of deactivator or inhibitor of pro-inflammatory microglia/macrophages, whilst enhancing the regulatory phenotype, as part of the therapeutic approach to improve the prognosis of intracerebral haemorrhage.

中文翻译：

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脑出血中的小胶质细胞和巨噬细胞表型：治疗机会。

尽管对此病进行了大量研究，但脑出血的预后仍然令人吃惊。脑出血的一个显着特征是神经炎症，尤其是过度炎症的中枢神经系统内在小胶质细胞和单核细胞衍生的巨噬细胞从循环中渗入。促炎性小胶质细胞/巨噬细胞产生损伤增强因子，包括炎性细胞因子，基质金属蛋白酶和活性氧。相反，具有潜在的修复和抗炎作用的调节性小胶质细胞/巨噬细胞在脑出血后的早期就没有竞争了，而促炎性小胶质细胞/巨噬细胞似乎无法发挥其有益作用。在这篇评论中 我们描述了在动物模型和临床受试者中脑出血后小胶质细胞/巨噬细胞的活化，并考虑了出血后细胞损伤的多种机制。我们回顾了旨在抑制小胶质细胞/巨噬细胞促炎活性的策略和药物，以及旨在提高脑出血后这些髓样细胞的调节特性的策略和药物。我们考虑了这些药物从脑出血后的临床前模型到临床应用的转化潜力，并建议几种方法仍缺乏人体必需的实验支持。尽管如此，临床前数据支持使用促炎性小胶质细胞/巨噬细胞的减活剂或抑制剂，同时增强了调节表型，