| خلاصه مقاله | Background and Aims: Following the reperfusion after cerebral ischemia, the release of cellular stress-related particles known as DamageAssociated Molecular Patterns (DAMPs) activates an inflamatory cascade and causes ischemic-reperfusion injury (IRI). Recent studies investigated the key role of Toll-like Receptors (TLRs), particularly TLR4, in the activation of IRI. Various in vivo studies show the impact of various anti-TLR4 agents on minimizing IRI. We aimed to give a comprehensive review of the efficacy and safety of TLR4 inhibitor agents in the animal model studies.
Methods: PubMed, Scopus, Web of Sciences, Embase, and the Cochrane Library were systematically searched. The results were screened by two authors independently. In vivo studies that examined direct TLR4 antagonists or agents with the main inhibitory effect on TLR4 expression in the Middle Cerebral Artery Occlusion (MCAO) or Common Carotid Artery Occlusion models were our inclusion criteria. The risk of bias assessment of the included studies was performed using the CAMARADES criteria by two authors independently.
Results: After removing duplicate results and screening according to our inclusion criteria, a total of 6 studies were included. Administration of MTS510 as an anti-TLR4 antibody, miR-542-3p as a TLR4 expression inhibitor, ApTLR#4F and ApTLR#4FT as TLR4-blocking DNA aptamers, TAK-242 and Eritoran (E5564) as TLR4 antagonists, and intracerebroventricular injection of Resatorvid as a TLR4-NOX4 signal inhibitor on the MCAO mice model showed a significant reduction in infarction volume and improvement in neurological function.
Conclusions: These findings indicate to potential strategies for employing anti-TLR4 agents in various inhibitory categories to cure cerebral ischemic injury along with reperfusion therapy. |