Traumatic brain injury (TBI) is one of the leading causes of fatality and disability worldwide. Despite its high prevalence, effective treatment strategies for TBI are limited. Traumatic brain injury induces structural and functional alterations of astrocytes, the most abundant cell type in the brain. As a way of coping with the trauma, astrocytes respond in diverse mechanisms that result in reactive astrogliosis. Astrocytes are involved in the physiopathologic mechanisms of TBI in an extensive and sophisticated manner. Notably, astrocytes have dual roles in TBI, and some astrocyte-derived factors have double and opposite properties. Thus, the suppression or promotion of reactive astrogliosis does not have a substantial curative effect. In contrast, selective stimulation of the beneficial astrocyte-derived molecules and simultaneous attenuation of the deleterious factors based on the spatiotemporal-environment can provide a promising astrocyte-targeting therapeutic strategy. In the current review, we describe for the first time the specific dual roles of astrocytes in neuronal plasticity and reconstruction, including neurogenesis, synaptogenesis, angiogenesis, repair of the blood-brain barrier, and glial scar formation after TBI. We have also classified astrocyte-derived factors depending on their neuroprotective and neurotoxic roles to design more appropriate targeted therapies. Video Abstract.

中文翻译：

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脑外伤后星形胶质细胞在可塑性和重建中的双重作用。

颅脑外伤（TBI）是世界范围内致死和致残的主要原因之一。尽管TBI的患病率很高，但有效的TBI治疗策略仍然有限。颅脑外伤导致星形细胞的结构和功能改变，星形细胞是大脑中最丰富的细胞类型。作为应对创伤的一种方式，星形胶质细胞以多种机制做出反应，从而导致反应性星形胶质增生。星形胶质细胞以广泛而复杂的方式参与了TBI的生理病理机制。值得注意的是，星形胶质细胞在TBI中具有双重作用，某些星形胶质细胞衍生的因子具有双重和相反的特性。因此，抑制或促进反应性星形胶质细胞增生没有实质性的疗效。相反，基于时空环境对星形胶质细胞有益分子的选择性刺激和有害因子的同时衰减可以提供一种有希望的针对星形胶质细胞的治疗策略。在当前的审查，我们第一次描述星形胶质细胞在神经元可塑性和重建，包括神经发生，突触发生，血管生成，血脑屏障的修复和TBI后胶质瘢痕形成中的特定双重作用。我们还根据星形胶质细胞衍生的因子的神经保护作用和神经毒性作用对其进行分类，以设计更合适的靶向疗法。录像摘要。我们首次描述了星形胶质细胞在神经元可塑性和重建中的特定双重作用，包括神经发生，突触发生，血管生成，血脑屏障的修复以及TBI后胶质瘢痕的形成。我们还根据星形胶质细胞衍生的因子的神经保护作用和神经毒性作用对其进行分类，以设计更合适的靶向疗法。录像摘要。我们首次描述了星形胶质细胞在神经元可塑性和重建中的特定双重作用，包括神经发生，突触发生，血管生成，血脑屏障修复和TBI后胶质瘢痕形成。我们还根据星形胶质细胞衍生的因子的神经保护作用和神经毒性作用对其进行分类，以设计更合适的靶向疗法。录像摘要。