1)三峡大学健康医学院,宜昌 443002;2)三峡大学国家中医药管理局中药药理科研三级实验室,宜昌 443002;3)三峡大学现代药物制剂宜昌市重点实验室,宜昌 443002
湖北省自然科学基金(2024AFD99)资助项目。
1)College of Medicine and Health Sciences, China Three Gorges University, Yichang 443002, China;2)Third-grade Pharmacological Laboratory on Traditional Chinese Medicine, State Administration of Traditional Chinese Medicine, China Three Gorges University, Yichang 443002, China;3)Key Laboratory of Advanced Pharmaceutics, China Three Gorges University, Yichang 443002, China
This work was supported by a grant from Natural Science Foundation of Hubei Province (2024AFD99).
缺血性脑卒中(ischemic stroke,IS)约占所有卒中病例的80%,是全球范围内导致死亡和长期残疾的主要神经系统疾病,其核心病理机制为脑血流中断导致的神经细胞坏死和脑组织缺血性损伤,涉及细胞凋亡、炎症反应及氧化应激等多重分子过程。组蛋白去乙酰化酶(histone deacetylase,HDAC)通过去除组蛋白上的乙酰基团(acetyl group,Ac)调控染色质构象与基因表达,在神经细胞存活、炎症反应调控及血脑屏障稳态调节中发挥重要的作用。组蛋白去乙酰化酶抑制剂(HDAC inhibitor,HDACi)可抑制HDAC的活性,HDACi不仅作用于组蛋白,还可作用于热休克转录因子1(HSF1)、分子伴侣热休克蛋白90(HSP90)及细胞骨架蛋白α微管蛋白(α-tubulin)在内的多种非组蛋白,进而调控下游基因转录及相关信号通路,在IS模型中表现出显著神经保护作用。本文系统综述HDACs的分类、HDACi的作用机制,及其在IS后细胞凋亡抑制、神经炎症调控、血脑屏障修复及认知功能改善中的多重效应,同时探讨HDACi的靶向策略与临床应用前景,为HDACi治疗IS提供了新的理论依据与科学的研究方向。
Ischemic stroke (IS) accounts for approximately 80% of all stroke cases and is a leading cause of death and long-term disability worldwide. Its core pathological mechanism involves the interruption of cerebral blood flow, leading to neuronal cell death and ischemic tissue necrosis in the brain, which is associated with multiple molecular processes including apoptosis, inflammation, and oxidative stress. This review systematically discusses the classification of HDACs, the mechanisms of action of HDAC inhibitors, and their multiple effects in inhibiting cell apoptosis, regulating neuroinflammation, repairing the blood-brain barrier, and improving cognitive function following IS. HDACs function by removing acetyl groups from histone lysine residues, leading to chromatin condensation and gene silencing. The HDAC family is classified into four classes: class I (HDAC1, 2, 3, 8), class IIa (HDAC4, 5, 7, 9), class IIb (HDAC6, 10), and class IV (HDAC11), with class III being the NAD+-dependent sirtuins. Histone deacetylase inhibitors (HDACi) exert significant neuroprotective effects following ischemic stroke through a multi-target, multi-pathway synergistic mechanism. The core mechanisms include inhibition of neuronal apoptosis, regulation of neuroinflammation, protection of the blood-brain barrier (BBB), and improvement of cognitive impairments (PSCI). HDACi regulate gene expression epigenetically by upregulating genes such as p21/CIP1, leading to cell cycle arrest, while also modulating apoptosis-related proteins by inhibiting pro-apoptotic signaling pathways, thereby reducing neuronal cell death. In terms of neuroinflammation, HDACi suppress NF-κB and activate Nrf2 pathways, decreasing the release of pro-inflammatory cytokines and preventing the pro-inflammatory polarization of microglia and macrophages, thus modulating the inflammatory response. Regarding BBB protection, HDACi regulate the expression and restoration of tight junction proteins such as occludin and claudin-5, while inhibiting the release of destructive factors like MMP-9, alleviating vasogenic edema, and maintaining BBB integrity. Furthermore, HDACi promote the transcription of neurotrophic factors and synaptic-associated genes, enhancing neuroplasticity and repairing neuronal networks, ultimately improving cognitive functions. Therefore, HDACi demonstrate great potential as a multifaceted therapeutic strategy for ischemic stroke. HDACis represent a powerful multi-target therapeutic approach that transcends the limitations of traditional thrombolytic therapies. HDACis represent a powerful multi-target therapeutic approach that transcends the limitations of traditional thrombolytic therapies, which are hampered by a narrow time window and risks of reperfusion injury. Histone acetylation is increased by HDACis, which relaxes chromatin and reactivates protective gene transcription. Their selectivity and chemical structure are used to classify them. Trichostatin A (TSA) and sodium butyrate (SB), a short-chain fatty acid, are examples of broad-spectrum inhibitors that are effective in lowering infarct volume and reducing neuroinflammation. More selective inhibitors, including Tubastatin A (HDAC6-selective) and Entinostat (class I-selective), may have fewer adverse effects while increasing efficacy. By suppressing apoptosis by modifying the p53, Bcl-2, and JNK pathways, reducing neuroinflammation by blocking NF-κB and NLRP3 activation, preserving the integrity of the blood-brain barrier by strengthening tight junction proteins, and promoting synaptic plasticity, neurogenesis, and the expression of neurotrophic factors like BDNF, these inhibitors provide neuroprotection through a variety of interrelated mechanisms.Despite their great potential, HDACis’ clinical translation is fraught with difficulties, mostly because of non-selective inhibition-related adverse effects such as hepatotoxicity and gastrointestinal problems with valproic acid (VPA). In order to accomplish targeted delivery to the brain, future research is consequently shifting toward the development of highly selective inhibitors, refining dosing regimes, and utilizing cutting-edge drug delivery technologies like nanoparticles. In summary, the development of effective neuroprotective and neurorestorative treatments for IS may be greatly aided by a nuanced, spatiotemporally accurate understanding of HDAC activities and the judicious use of subtype-selective HDACis.
潘冯缘,徐怡薇,邹歆妤,陈静.组蛋白去乙酰化酶抑制剂调控缺血性脑卒中的分子机制[J].生物化学与生物物理进展,2026,53(1):66-76
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