title: The Polarization States of Microglia in TBI: A New Paradigm for Pharmacological Intervention.
abstract: Traumatic brain injury (TBI) is a serious medical and social problem worldwide. Because of the complex pathophysiological mechanisms of TBI, effective pharmacotherapy is still lacking. The microglial cells are resident tissue macrophages located in the brain and have two major polarization states, M1 phenotype and M2 phenotype, when activated. The M1 phenotype is related to the release of proinflammatory cytokines and secondary brain injury, while the M2 phenotype has been proved to be responsible for the release of anti-inflammation cytokines and for central nervous system (CNS) repair. In animal models, pharmacological strategies inhibiting the M1 phenotype and promoting the M2 phenotype of microglial cells could alleviate cerebral damage and improve neurological function recovery after TBI. In this review, we aimed to summarize the current knowledge about the pathological significance of microglial M1/M2 polarization in the pathophysiology of TBI. In addition, we reviewed several drugs that have provided neuroprotective effects against brain injury following TBI by altering the polarization states of the microglia. We emphasized that future investigation of the regulation mechanisms of microglial M1/M2 polarization in TBI is anticipated, which could contribute to the development of new targets of pharmacological intervention in TBI.
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Hangzhe
authors.identifier: 0000-0001-9402-6487
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Zhijiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Jianru
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Neurosurgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Qingchun East Road 3rd, Hangzhou 310016, China.
authors.forename: Haijian
authors.identifier: 0000-0003-1219-719X
authors.initials: H
authors.lastname: Wu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Yucong
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Linfeng
authors.initials: L
authors.lastname: Fan
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Jingyin
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Chi
authors.initials: C
authors.lastname: Gu
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Feng
authors.initials: F
authors.lastname: Yan
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Jiefang Road 88th, Hangzhou 310016, China.
authors.forename: Gao
authors.identifier: 0000-0003-1085-0028
authors.initials: G
authors.lastname: Chen
mesh_terms: D000818:Animals; D001921:Brain / Q000187:drug effects* / Q000378:metabolism*; D000070642:Brain Injuries, Traumatic / Q000150:complications / Q000188:drug therapy / Q000378:metabolism*; D064987:Cell- and Tissue-Based Therapy / Q000379:methods; D016207:Cytokines / Q000378:metabolism; D004660:Encephalitis / Q000150:complications / Q000378:metabolism*; D006801:Humans; D018836:Inflammation Mediators; D017628:Microglia / Q000187:drug effects* / Q000378:metabolism*; D018696:Neuroprotective Agents / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D016207:Cytokines; D018836:Inflammation Mediators; D018696:Neuroprotective Agents