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The Critical Role of Erythrolysis and Microglia/Macrophages in Clot Resolution After Intracerebral Hemorrhage: A Review of the Mechanisms and Potential Therapeutic Targets

Abstract

Intracerebral hemorrhage (ICH) is a common cerebrovascular disorder with high morbidity and mortality. Secondary brain injury after ICH, which is initiated by multiple hemolytic products during erythrolysis, has been identified as a critical factor accounting for the poor prognosis of ICH patients. Clot resolution and hematoma clearance occur immediately after ICH via erythrolysis and erythrophagocytosis. During this process, erythrolysis after ICH results in the release of hemoglobin and products of degradation along with rapid morphological changes in red blood cells (RBCs). Phagocytosis of deformed erythrocytes and products of degradation by microglia/macrophages accelerates hematoma clearance, which turns out to be neuroprotective. Thus, a better understanding of the mechanism of erythrolysis and the role of microglia/macrophages after ICH is urgently needed. In this review, the current research progresses on the underlying mechanism of erythrolysis and erythrophagocytosis, as well as several useful tools for the quantification of erythrolysis-induced brain injury, are summarized, providing potential intervention targets and possible treatment strategies for ICH patients.

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Acknowledgements

This work was supported by the National Natural Science Foundation for Young Scientists of China (Grant No. 81801144).

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YHZ came up with the idea for the review and drafted the manuscript. XXT and SLC critically revised the work. All authors reviewed and approved the manuscript for publication.

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Correspondence to Shenglong Cao.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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Zheng, Y., Tan, X. & Cao, S. The Critical Role of Erythrolysis and Microglia/Macrophages in Clot Resolution After Intracerebral Hemorrhage: A Review of the Mechanisms and Potential Therapeutic Targets. Cell Mol Neurobiol (2022). https://doi.org/10.1007/s10571-021-01175-3

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  • DOI: https://doi.org/10.1007/s10571-021-01175-3

Keywords

  • Intracerebral hemorrhage
  • Hematoma clearance
  • Erythrolysis
  • Phagocytosis
  • Microglia/macrophages