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The Fate of Erythrocytes after Cerebral Hemorrhage

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Abstract

After a cerebral hemorrhage (intracerebral, subarachnoid, and intraventricular), extravasated blood contributes to both initial brain injury, via physical disruption and mass effect, and secondary injury, through the release of potentially neurotoxic and pro-inflammatory factors such as hemoglobin, iron, and peroxiredoxin-2. Erythrocytes are a major blood component and are a source of such damaging factors. Erythrolysis after cerebral hemorrhage releases potential neurotoxins, contributing to brain injury and edema. Alternatively, erythrocyte phagocytosis via microglia or macrophages may limit the spill of neurotoxins therefore limiting subsequent brain injury. The aim of this review is to discuss the process of phagocytosis of erythrocytes by microglia or macrophages after cerebral hemorrhage, the effect of erythrolysis on brain injury, novel mechanisms of erythrocyte and phagocyte egress from the brain, and exciting new targets in this pathway to attenuate brain injury. Understanding the fate of erythrocytes after cerebral hemorrhage may uncover additional potential interventions for clinical translational research.

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Funding

YH, RFK, and GX were supported by grants NS-096917, NS106746, NS112394, and NS116786 from the National Institutes of Health (NIH). KGH was supported by a research fellowship grant from Neurosurgery Research & Education Foundation.

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  1. Department of Neurosurgery, University of Michigan, 5018 BSRB, 109 Zina Pitcher Place, Ann Arbor, MI, 48109-2200, USA

    Fan Xia, Richard F. Keep, Fenghui Ye, Katherine G. Holste, Shu Wan, Guohua Xi & Ya Hua

  2. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China

    Fan Xia

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  1. Fan Xia
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Correspondence to Guohua Xi or Ya Hua.

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Fan Xia, Richard F. Keep, Fenghui Ye, Katherine G. Holste, Shu Wan, Guohua Xi, and Ya Hua declare that they have no conflict of interest. Guohua Xi is Deputy Editor-in-Chief of Translational Stroke Research.

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Xia, F., Keep, R.F., Ye, F. et al. The Fate of Erythrocytes after Cerebral Hemorrhage. Transl. Stroke Res. 13, 655–664 (2022). https://doi.org/10.1007/s12975-021-00980-8

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