101
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Neuroprotection via AT2 receptor agonists in ischemic stroke. Clin Sci (Lond) 2018; 132:1055-1067. [DOI: 10.1042/cs20171549] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 04/30/2018] [Accepted: 05/01/2018] [Indexed: 12/12/2022]
Abstract
Stroke is a devastating disease that afflicts millions of people each year worldwide. Ischemic stroke, which accounts for ~88% of cases, occurs when blood supply to the brain is decreased, often because of thromboembolism or atherosclerotic occlusion. This deprives the brain of oxygen and nutrients, causing immediate, irreversible necrosis within the core of the ischemic area, but more delayed and potentially reversible neuronal damage in the surrounding brain tissue, the penumbra. The only currently approved therapies for ischemic stroke, the thrombolytic agent recombinant tissue plasminogen activator (rtPA) and the endovascular clot retrieval/destruction processes, are aimed at restoring blood flow to the infarcted area, but are only available for a minority of patients and are not able in most cases to completely restore neurological deficits. Consequently, there remains a need for agents that will protect neurones against death following ischemic stroke. Here, we evaluate angiotensin II (Ang II) type 2 (AT2) receptor agonists as a possible therapeutic target for this disease. We first provide an overview of stroke epidemiology, pathophysiology, and currently approved therapies. We next review the large amount of preclinical evidence, accumulated over the past decade and a half, which indicates that AT2 receptor agonists exert significant neuroprotective effects in various animal models, and discuss the potential mechanisms involved. Finally, after discussing the challenges of delivering blood–brain barrier (BBB) impermeable AT2 receptor agonists to the infarcted areas of the brain, we summarize the evidence for and against the development of these agents as a promising therapeutic strategy for ischemic stroke.
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102
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Sargento-Freitas J, Pereira A, Gomes A, Amorim P, Matos T, Cardoso CMP, Silva F, Santo GC, Nunes C, Galego O, Carda J, Branco J, Lourenço V, Cunha L, Ferreira L. STROKE34 Study Protocol: A Randomized Controlled Phase IIa Trial of Intra-Arterial CD34+ Cells in Acute Ischemic Stroke. Front Neurol 2018; 9:302. [PMID: 29867719 PMCID: PMC5949561 DOI: 10.3389/fneur.2018.00302] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 04/18/2018] [Indexed: 12/21/2022] Open
Abstract
Rationale/aim Despite the increasing efficacy of recanalization therapies for acute ischemic stroke, a large number of patients are left with long-term functional impairment, devoid of efficacious treatments. CD34+ cells comprise a subset of bone marrow-derived mononuclear cells with the capacity to promote angiogenesis in ischemic lesions and have shown promising results in observational and in vitro studies. In this study, we aim to assess the efficacy of an autotransplant of CD34+ cells in acute ischemic stroke. Sample size estimates 30 patients will be randomized for a power of 90% and alpha of 0.05 to detect a difference in 3 months infarct volume. Methods and design We will screen 18–80 years old patients with acute ischemic stroke due to occlusion of a middle cerebral artery (MCA) for randomization. Persistent arterial occlusions, contra-indications to magnetic resonance imaging (MRI), premorbid dependency, or other severe diseases will be excluded. Treatment will involve bone marrow aspiration, selection of CD34+ cells, and their administration intra-arterially in the symptomatic MCA by angiography. Patients will be randomized for treatment at 7 (±2) days, 20 (±5 days) or sham procedure, 10 in each group. Study outcomes The primary outcome will be infarct volume in MRI performed at 3 months. Secondary outcomes will include adverse events and multidimensional functional and neurological measures. Discussion/conclusion STROKE34 is a PROBE design phase IIa clinical trial to assess the efficacy of intra-arterial administration of CD34+ cells 7 and 20 days after acute ischemic stroke. Trial registration (EU Clinical Trials Register) 2017-002456-88.
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Affiliation(s)
- João Sargento-Freitas
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - Anabela Pereira
- Centro de Medicina de Reabilitação do Centro - Rovisco Pais, Tocha, Portugal
| | | | - Paula Amorim
- Centro de Medicina de Reabilitação do Centro - Rovisco Pais, Tocha, Portugal
| | | | | | - Fernando Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | | | - César Nunes
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Orlando Galego
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - José Carda
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - João Branco
- Centro de Medicina de Reabilitação do Centro - Rovisco Pais, Tocha, Portugal
| | - Víctor Lourenço
- Centro de Medicina de Reabilitação do Centro - Rovisco Pais, Tocha, Portugal
| | - Luís Cunha
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal
| | - Lino Ferreira
- Faculdade de Medicina da Universidade de Coimbra, Coimbra, Portugal.,Centro de Neurociências e Biologia Celular, Coimbra, Portugal
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103
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Quarles CC, Bell LC, Stokes AM. Imaging vascular and hemodynamic features of the brain using dynamic susceptibility contrast and dynamic contrast enhanced MRI. Neuroimage 2018; 187:32-55. [PMID: 29729392 DOI: 10.1016/j.neuroimage.2018.04.069] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 04/27/2018] [Accepted: 04/29/2018] [Indexed: 12/22/2022] Open
Abstract
In the context of neurologic disorders, dynamic susceptibility contrast (DSC) and dynamic contrast enhanced (DCE) MRI provide valuable insights into cerebral vascular function, integrity, and architecture. Even after two decades of use, these modalities continue to evolve as their biophysical and kinetic basis is better understood, with improvements in pulse sequences and accelerated imaging techniques and through application of more robust and automated data analysis strategies. Here, we systematically review each of these elements, with a focus on how their integration improves kinetic parameter accuracy and the development of new hemodynamic biomarkers that provide sub-voxel sensitivity (e.g., capillary transit time and flow heterogeneity). Regarding contrast mechanisms, we discuss the dipole-dipole interactions and susceptibility effects that give rise to simultaneous T1, T2 and T2∗ relaxation effects, including their quantification, influence on pulse sequence parameter optimization, and use in methods such as vessel size and vessel architectural imaging. The application of technologic advancements, such as parallel imaging, simultaneous multi-slice, undersampled k-space acquisitions, and sliding window strategies, enables improved spatial and/or temporal resolution of DSC and DCE acquisitions. Such acceleration techniques have also enabled the implementation of, clinically feasible, simultaneous multi-echo spin- and gradient echo acquisitions, providing more comprehensive and quantitative interrogation of T1, T2 and T2∗ changes. Characterizing these relaxation rate changes through different post-processing options allows for the quantification of hemodynamics and vascular permeability. The application of different biophysical models provides insight into traditional hemodynamic parameters (e.g., cerebral blood volume) and more advanced parameters (e.g., capillary transit time heterogeneity). We provide insight into the appropriate selection of biophysical models and the necessary post-processing steps to ensure reliable measurements while minimizing potential sources of error. We show representative examples of advanced DSC- and DCE-MRI methods applied to pathologic conditions affecting the cerebral microcirculation, including brain tumors, stroke, aging, and multiple sclerosis. The maturation and standardization of conventional DSC- and DCE-MRI techniques has enabled their increased integration into clinical practice and use in clinical trials, which has, in turn, spurred renewed interest in their technological and biophysical development, paving the way towards a more comprehensive assessment of cerebral hemodynamics.
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Affiliation(s)
- C Chad Quarles
- Division of Neuro imaging Research, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ, USA.
| | - Laura C Bell
- Division of Neuro imaging Research, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ, USA
| | - Ashley M Stokes
- Division of Neuro imaging Research, Barrow Neurological Institute, 350 W. Thomas Rd, Phoenix, AZ, USA
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104
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Makris K, Haliassos A, Chondrogianni M, Tsivgoulis G. Blood biomarkers in ischemic stroke: potential role and challenges in clinical practice and research. Crit Rev Clin Lab Sci 2018; 55:294-328. [DOI: 10.1080/10408363.2018.1461190] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Konstantinos Makris
- Clinical Biochemistry Department, KAT General Hospital, Kifissia, Athens, Greece
| | | | - Maria Chondrogianni
- Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgios Tsivgoulis
- Second Department of Neurology, Attikon Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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105
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Colás L, Domercq M, Ramos-Cabrer P, Palma A, Gómez-Vallejo V, Padro D, Plaza-García S, Pulagam KR, Higuchi M, Matute C, Llop J, Martín A. In vivo imaging of Α7 nicotinic receptors as a novel method to monitor neuroinflammation after cerebral ischemia. Glia 2018. [PMID: 29528142 DOI: 10.1002/glia.23326] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
In vivo positron emission tomography (PET) imaging of nicotinic acetylcholine receptors (nAChRs) is a promising tool for the imaging evaluation of neurologic and neurodegenerative diseases. However, the role of α7 nAChRs after brain diseases such as cerebral ischemia and its involvement in inflammatory reaction is still largely unknown. In vivo and ex vivo evaluation of α7 nAChRs expression after transient middle cerebral artery occlusion (MCAO) was carried out using PET imaging with [11 C]NS14492 and immunohistochemistry (IHC). Pharmacological activation of α7 receptors was evaluated with magnetic resonance imaging (MRI), [18 F]DPA-714 PET, IHC, real time polymerase chain reaction (qPCR) and neurofunctional studies. In the ischemic territory, [11 C]NS14492 signal and IHC showed an expression increase of α7 receptors in microglia and astrocytes after cerebral ischemia. The role played by α7 receptors on neuroinflammation was supported by the decrease of [18 F]DPA-714 binding in ischemic rats treated with the α7 agonist PHA 568487 at day 7 after MCAO. Moreover, compared with non-treated MCAO rats, PHA-treated ischemic rats showed a significant reduction of the cerebral infarct volumes and an improvement of the neurologic outcome. PHA treatment significantly reduced the expression of leukocyte infiltration molecules in MCAO rats and in endothelial cells after in vitro ischemia. Despite that, the activation of α7 nAChR had no influence to the blood brain barrier (BBB) permeability measured by MRI. Taken together, these results suggest that the nicotinic α7 nAChRs play a key role in the inflammatory reaction and the leukocyte recruitment following cerebral ischemia in rats.
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Affiliation(s)
- Lorena Colás
- Experimental Molecular Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
| | - Maria Domercq
- Department of Neurosciences, University of the Basque Country, Barrio Sarriena s/n, 48940 Leioa, Spain, Achucarro Basque Center for Neuroscience-UPV/EHU, 48170 Zamudio, Spain and Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Leioa, 48940, Spain
| | - Pedro Ramos-Cabrer
- Magnetic Resonance Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain
| | - Ana Palma
- Department of Neurosciences, University of the Basque Country, Barrio Sarriena s/n, 48940 Leioa, Spain, Achucarro Basque Center for Neuroscience-UPV/EHU, 48170 Zamudio, Spain and Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Leioa, 48940, Spain
| | - Vanessa Gómez-Vallejo
- Radiochemistry and Nuclear Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
| | - Daniel Padro
- Magnetic Resonance Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
| | - Sandra Plaza-García
- Magnetic Resonance Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
| | - Krishna R Pulagam
- Radiochemistry and Nuclear Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
| | - Makoto Higuchi
- National Institute of Radiological Sciences, National Institutes for Quantum and Radiological Science and Technology, Chiba, Japan
| | - Carlos Matute
- Department of Neurosciences, University of the Basque Country, Barrio Sarriena s/n, 48940 Leioa, Spain, Achucarro Basque Center for Neuroscience-UPV/EHU, 48170 Zamudio, Spain and Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Leioa, 48940, Spain
| | - Jordi Llop
- Radiochemistry and Nuclear Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
| | - Abraham Martín
- Experimental Molecular Imaging, Molecular Imaging Unit, CIC biomaGUNE, P° Miramon 182, San Sebastian, Spain
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106
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Liebner S, Dijkhuizen RM, Reiss Y, Plate KH, Agalliu D, Constantin G. Functional morphology of the blood-brain barrier in health and disease. Acta Neuropathol 2018; 135:311-336. [PMID: 29411111 PMCID: PMC6781630 DOI: 10.1007/s00401-018-1815-1] [Citation(s) in RCA: 491] [Impact Index Per Article: 81.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 01/24/2018] [Accepted: 01/30/2018] [Indexed: 02/07/2023]
Abstract
The adult quiescent blood-brain barrier (BBB), a structure organised by endothelial cells through interactions with pericytes, astrocytes, neurons and microglia in the neurovascular unit, is highly regulated but fragile at the same time. In the past decade, there has been considerable progress in understanding not only the molecular pathways involved in BBB development, but also BBB breakdown in neurological diseases. Specifically, the Wnt/β-catenin, retinoic acid and sonic hedgehog pathways moved into the focus of BBB research. Moreover, angiopoietin/Tie2 signalling that is linked to angiogenic processes has gained attention in the BBB field. Blood vessels play an essential role in initiation and progression of many diseases, including inflammation outside the central nervous system (CNS). Therefore, the potential influence of CNS blood vessels in neurological diseases associated with BBB alterations or neuroinflammation has become a major focus of current research to understand their contribution to pathogenesis. Moreover, the BBB remains a major obstacle to pharmaceutical intervention in the CNS. The complications may either be expressed by inadequate therapeutic delivery like in brain tumours, or by poor delivery of the drug across the BBB and ineffective bioavailability. In this review, we initially describe the cellular and molecular components that contribute to the steady state of the healthy BBB. We then discuss BBB alterations in ischaemic stroke, primary and metastatic brain tumour, chronic inflammation and Alzheimer's disease. Throughout the review, we highlight common mechanisms of BBB abnormalities among these diseases, in particular the contribution of neuroinflammation to BBB dysfunction and disease progression, and emphasise unique aspects of BBB alteration in certain diseases such as brain tumours. Moreover, this review highlights novel strategies to monitor BBB function by non-invasive imaging techniques focussing on ischaemic stroke, as well as novel ways to modulate BBB permeability and function to promote treatment of brain tumours, inflammation and Alzheimer's disease. In conclusion, a deep understanding of signals that maintain the healthy BBB and promote fluctuations in BBB permeability in disease states will be key to elucidate disease mechanisms and to identify potential targets for diagnostics and therapeutic modulation of the BBB.
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Affiliation(s)
- Stefan Liebner
- Institute of Neurology, Goethe University Clinic, Frankfurt am Main, Germany.
- Excellence Cluster Cardio-Pulmonary Systems (ECCPS), Partner site Frankfurt, Frankfurt am Main, Germany.
- German Center for Cardiovascular Research (DZHK), Partner site Frankfurt/Mainz, Frankfurt am Main, Germany.
| | - Rick M Dijkhuizen
- Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Yvonne Reiss
- Institute of Neurology, Goethe University Clinic, Frankfurt am Main, Germany
- Excellence Cluster Cardio-Pulmonary Systems (ECCPS), Partner site Frankfurt, Frankfurt am Main, Germany
- German Center for Cardiovascular Research (DZHK), Partner site Frankfurt/Mainz, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Karl H Plate
- Institute of Neurology, Goethe University Clinic, Frankfurt am Main, Germany
- Excellence Cluster Cardio-Pulmonary Systems (ECCPS), Partner site Frankfurt, Frankfurt am Main, Germany
- German Center for Cardiovascular Research (DZHK), Partner site Frankfurt/Mainz, Frankfurt am Main, Germany
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany
- German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Dritan Agalliu
- Departments of Neurology, Columbia University Medical Center, New York, NY, 10032, USA
- Departments of Pathology and Cell Biology, Columbia University Medical Center, New York, NY, 10032, USA
- Departments of Pharmacology, Columbia University Medical Center, New York, NY, 10032, USA
- Departments of Columbia Translational Neuroscience Initiative, Columbia University Medical Center, New York, NY, 10032, USA
| | - Gabriela Constantin
- Department of Medicine, Section of General Pathology, University of Verona, Verona, Italy
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107
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Dong X. Current Strategies for Brain Drug Delivery. Am J Cancer Res 2018; 8:1481-1493. [PMID: 29556336 PMCID: PMC5858162 DOI: 10.7150/thno.21254] [Citation(s) in RCA: 498] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 11/30/2017] [Indexed: 02/06/2023] Open
Abstract
The blood-brain barrier (BBB) has been a great hurdle for brain drug delivery. The BBB in healthy brain is a diffusion barrier essential for protecting normal brain function by impeding most compounds from transiting from the blood to the brain; only small molecules can cross the BBB. Under certain pathological conditions of diseases such as stroke, diabetes, seizures, multiple sclerosis, Parkinson's disease and Alzheimer disease, the BBB is disrupted. The objective of this review is to provide a broad overview on current strategies for brain drug delivery and related subjects from the past five years. It is hoped that this review could inspire readers to discover possible approaches to deliver drugs into the brain. After an initial overview of the BBB structure and function in both healthy and pathological conditions, this review re-visits, according to recent publications, some questions that are controversial, such as whether nanoparticles by themselves could cross the BBB and whether drugs are specifically transferred to the brain by actively targeted nanoparticles. Current non-nanoparticle strategies are also reviewed, such as delivery of drugs through the permeable BBB under pathological conditions and using non-invasive techniques to enhance brain drug uptake. Finally, one particular area that is often neglected in brain drug delivery is the influence of aging on the BBB, which is captured in this review based on the limited studies in the literature.
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108
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El Amki M, Wegener S. Improving Cerebral Blood Flow after Arterial Recanalization: A Novel Therapeutic Strategy in Stroke. Int J Mol Sci 2017; 18:ijms18122669. [PMID: 29232823 PMCID: PMC5751271 DOI: 10.3390/ijms18122669] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 11/30/2017] [Accepted: 12/06/2017] [Indexed: 12/14/2022] Open
Abstract
Ischemic stroke is caused by a disruption in blood supply to a region of the brain. It induces dysfunction of brain cells and networks, resulting in sudden neurological deficits. The cause of stroke is vascular, but the consequences are neurological. Decades of research have focused on finding new strategies to reduce the neural damage after cerebral ischemia. However, despite the incredibly huge investment, all strategies targeting neuroprotection have failed to demonstrate clinical efficacy. Today, treatment for stroke consists of dealing with the cause, attempting to remove the occluding blood clot and recanalize the vessel. However, clinical evidence suggests that the beneficial effect of post-stroke recanalization may be hampered by the occurrence of microvascular reperfusion failure. In short: recanalization is not synonymous with reperfusion. Today, clinicians are confronted with several challenges in acute stroke therapy, even after successful recanalization: (1) induce reperfusion, (2) avoid hemorrhagic transformation (HT), and (3) avoid early or late vascular reocclusion. All these parameters impact the restoration of cerebral blood flow after stroke. Recent advances in understanding the molecular consequences of recanalization and reperfusion may lead to innovative therapeutic strategies for improving reperfusion after stroke. In this review, we will highlight the importance of restoring normal cerebral blood flow after stroke and outline molecular mechanisms involved in blood flow regulation.
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Affiliation(s)
- Mohamad El Amki
- Department of Neurology, University Hospital Zurich and University of Zurich, 8091 Zürich, Switzerland.
| | - Susanne Wegener
- Department of Neurology, University Hospital Zurich and University of Zurich, 8091 Zürich, Switzerland.
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109
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Bai W, Zhou YG. Homeostasis of the Intraparenchymal-Blood Glutamate Concentration Gradient: Maintenance, Imbalance, and Regulation. Front Mol Neurosci 2017; 10:400. [PMID: 29259540 PMCID: PMC5723322 DOI: 10.3389/fnmol.2017.00400] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 11/20/2017] [Indexed: 12/25/2022] Open
Abstract
It is widely accepted that glutamate is the most important excitatory neurotransmitter in the central nervous system (CNS). However, there is also a large amount of glutamate in the blood. Generally, the concentration gradient of glutamate between intraparenchymal and blood environments is stable. However, this gradient is dramatically disrupted under a variety of pathological conditions, resulting in an amplifying cascade that causes a series of pathological reactions in the CNS and peripheral organs. This eventually seriously worsens a patient’s prognosis. These two “isolated” systems are rarely considered as a whole even though they mutually influence each other. In this review, we summarize what is currently known regarding the maintenance, imbalance and regulatory mechanisms that control the intraparenchymal-blood glutamate concentration gradient, discuss the interrelationships between these systems and further explore their significance in clinical practice.
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Affiliation(s)
- Wei Bai
- Molecular Biology Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Research Institute of Surgery and Daping Hospital, Third Military Medical University, Chongqing, China
| | - Yuan-Guo Zhou
- Molecular Biology Center, State Key Laboratory of Trauma, Burn, and Combined Injury, Research Institute of Surgery and Daping Hospital, Third Military Medical University, Chongqing, China
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110
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Venkatraman A, Hardas S, Patel N, Singh Bajaj N, Arora G, Arora P. Galectin-3: an emerging biomarker in stroke and cerebrovascular diseases. Eur J Neurol 2017; 25:238-246. [PMID: 29053903 DOI: 10.1111/ene.13496] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 10/16/2017] [Indexed: 01/16/2023]
Abstract
The carbohydrate-binding molecule galectin-3 has garnered significant attention recently as a biomarker for various conditions ranging from cardiac disease to obesity. Although there have been several recent studies investigating its role in stroke and other cerebrovascular diseases, awareness of this emerging biomarker in the wider neurology community is limited. We performed a systematic search in PubMed, Embase, Scopus, CINAHL, Clinicaltrials.gov and the Cochrane library in November and December 2016 for articles related to galectin-3 and cerebrovascular disease. We included both human and pre-clinical studies in order to provide a comprehensive view of the state of the literature on this topic. The majority of the relevant literature focuses on stroke, cerebral ischemia and atherosclerosis, but some recent attention has also been devoted to intracranial and subarachnoid hemorrhage. Higher blood levels of galectin-3 correlate with worse outcomes in atherosclerotic disease as well as in intracranial and subarachnoid hemorrhage in human studies. However, experimental evidence supporting the role of galectin-3 in these phenotypes is not as robust. It is likely that the role of galectin-3 in the inflammatory cascade within the central nervous system following injury is responsible for many of its effects, but its varied physiological functions and multiple sites of expression mean that it may have different effects depending on the nature of the disease condition and the time since injury. In summary, experimental and human research raises the possibility that galectin-3, which is closely linked to the inflammatory cascade, could be of value as a prognostic marker and therapeutic target in cerebrovascular disease.
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Affiliation(s)
- A Venkatraman
- Department of Neurology, Massachusetts General Hospital/Brigham and Women's Hospital/Harvard Medical School, Boston, MA
| | - S Hardas
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - N Patel
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - N Singh Bajaj
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - G Arora
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - P Arora
- Division of Cardiology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL.,Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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111
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Da Silva-Candal A, Argibay B, Iglesias-Rey R, Vargas Z, Vieites-Prado A, López-Arias E, Rodríguez-Castro E, López-Dequidt I, Rodríguez-Yáñez M, Piñeiro Y, Sobrino T, Campos F, Rivas J, Castillo J. Vectorized nanodelivery systems for ischemic stroke: a concept and a need. J Nanobiotechnology 2017; 15:30. [PMID: 28399863 PMCID: PMC5387212 DOI: 10.1186/s12951-017-0264-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Accepted: 04/03/2017] [Indexed: 02/07/2023] Open
Abstract
Neurological diseases of diverse aetiologies have significant effects on the quality of life of patients. The limited self-repairing capacity of the brain is considered to be the origin of the irreversible and progressive nature of many neurological diseases. Therefore, neuroprotection is an important goal shared by many clinical neurologists and neuroscientists. In this review, we discuss the main obstacles that have prevented the implementation of experimental neuroprotective strategies in humans and propose alternative avenues for the use of neuroprotection as a feasible therapeutic approach. Special attention is devoted to nanotechnology, which is a new approach for developing highly specific and localized biomedical solutions for the study of the multiple mechanisms involved in stroke. Nanotechnology is contributing to personalized neuroprotection by allowing us to identify mechanisms, determine optimal therapeutic windows, and protect patients from brain damage. In summary, multiple aspects of these new players in biomedicine should be considered in future in vivo and in vitro studies with the aim of improving their applicability to clinical studies.
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Affiliation(s)
- Andrés Da Silva-Candal
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Bárbara Argibay
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Ramón Iglesias-Rey
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Zulema Vargas
- Nanomag Laboratory, Department of Applied Physics, Technological Research Institute, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Campus Vida, 15782, Santiago de Compostela, Spain
| | - Alba Vieites-Prado
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Esteban López-Arias
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Emilio Rodríguez-Castro
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Iria López-Dequidt
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Manuel Rodríguez-Yáñez
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Yolanda Piñeiro
- Nanomag Laboratory, Department of Applied Physics, Technological Research Institute, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Campus Vida, 15782, Santiago de Compostela, Spain
| | - Tomás Sobrino
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - Francisco Campos
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain
| | - José Rivas
- Nanomag Laboratory, Department of Applied Physics, Technological Research Institute, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), Campus Vida, 15782, Santiago de Compostela, Spain.
| | - José Castillo
- Department of Neurology, Clinical Neurosciences Research Laboratory, Hospital Clínico Universitario, Universidade de Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), c/Travesa da Choupana, s/n, 15706, Santiago de Compostela, Spain.
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