The outcome of ischemic stroke varies across socioeconomic strata, even among countries with universal health care. Emerging evidence suggests that psychosocial aspects of low socioeconomic status such as social isolation and social defeat stress interact with, and contribute to, stroke pathophysiology. However, experimental investigations of stroke rarely account for such socioeconomic influences. Social isolation in stroke survivors is associated with increased infarction volume, increased risk of post-stroke depression, and worse long-term functional outcome. Social defeat is thought to contribute significantly to chronic stress in low socioeconomic status groups and is associated with poor health outcomes. Chronic stress is also associated with worse post-stroke functional outcome and greater disability even after accounting for stroke severity, vascular risk factors, and access to acute stroke care. Experimental stroke studies which incorporate social isolation or social defeat stress have shown that both tissue and functional stroke outcome is affected by the increased expression of TNF-α and IL-6, increased glucocorticoid production, and suppression of the protooncogene bcl-2. This review explores the consequences of social isolation and social defeat stress on stroke, preclinical stroke models that have been used to investigate these factors, and possible molecular mechanisms underlying the influence of socioeconomic disparities on stroke outcome.

中文翻译：

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改善实验性卒中模型的社会相关性：动物和人类的社会隔离，社会失败压力和卒中结果。

缺血性中风的结果因社会经济阶层而异，即使在具有全民医疗保健的国家之间也是如此。越来越多的证据表明，社会经济地位低下的社会心理方面（如社会孤立和社会挫败压力）与中风病理生理学相互作用并对其做出贡献。但是，对中风的实验研究很少能说明这种社会经济影响。中风幸存者的社会隔离与梗死面积增加，中风后抑郁的风险增加以及长期功能恶化有关。在社会经济地位低下的人群中，社交失败被认为是造成慢性压力的重要原因，并与健康状况不佳相关。即使考虑了中风的严重程度，血管危险因素和获得急性中风的护理，慢性应激也与中风后的功能恶化和更大的残疾有关。结合社交隔离或社交失败压力的实验性卒中研究表明，组织和功能性卒中结局均受TNF-α和IL-6表达增加，糖皮质激素生成增加以及原癌基因bcl-2抑制的影响。这篇综述探讨了社会隔离和社会失败压力对中风的后果，用于研究这些因素的临床前中风模型以及社会经济差异对中风结果影响的潜在分子机制。结合社交孤立或社交失败压力的实验性卒中研究表明，组织和功能性卒中结局均受TNF-α和IL-6表达增加，糖皮质激素生成增加以及原癌基因bcl-2抑制的影响。这篇综述探讨了社会隔离和社会失败压力对中风的后果，用于研究这些因素的临床前中风模型以及社会经济差异对中风结果影响的潜在分子机制。结合社交孤立或社交失败压力的实验性卒中研究表明，组织和功能性卒中结局均受TNF-α和IL-6表达增加，糖皮质激素生成增加以及原癌基因bcl-2抑制的影响。这篇综述探讨了社会隔离和社会失败压力对中风的后果，用于研究这些因素的临床前中风模型以及社会经济差异对中风结果影响的潜在分子机制。