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Li Z, Gao T, Wang J, Zhang X, Zhang Y, Zhang L, Yang P, Liu J. Ferroptosis mediated by TNFSF9 interferes in acute ischaemic stroke reperfusion injury with the progression of acute ischaemic stroke. J Neurochem 2024; 168:1030-1044. [PMID: 38344886 DOI: 10.1111/jnc.16058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 05/31/2024]
Abstract
In this study, we investigated the potential involvement of TNFSF9 in reperfusion injury associated with ferroptosis in acute ischaemic stroke patients, mouse models and BV2 microglia. We first examined TNFSF9 changes in peripheral blood from stroke patients with successful reperfusion, and constructed oxygen-glucose deprivation-reperfusion (OGD-R) on BV2 microglia, oxygen-glucose deprivation for 6 h followed by reoxygenation and re-glucose for 24 h, and appropriate over-expression or knockdown of TNFSF9 manipulation on BV2 cells and found that in the case of BV2 cells encountering OGD-R over-expression of TNFSF9 resulted in increased BV2 apoptosis. Still, the knockdown of TNFSF9 ameliorated apoptosis and ferroptosis. In an in vivo experiment, we constructed TNFSF9 over-expression or knockout mice by intracerebral injection of TNFSF9-OE or sh-TNFSF9 adenovirus. We performed the middle cerebral artery occlusion (MCAO) model on day four, 24 h after ligation of the proximal artery, for half an hour to recanalize. As luck would have it, over-expression of TNFSF9 resulted in increased brain infarct volumes, neurological function scores and abnormalities in TNFSF9-related TRAF1 and ferroptosis-related pathways, but knockdown of TNFSF9 improved brain infarcts in mice as well as reversing TNFSF9-related signalling pathways. In conclusion, our data provide the first evidence that TNFSF9 triggers microglia activation by activating the ferroptosis signalling pathway following ischaemic stroke, leading to brain injury and neurological deficits.
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Affiliation(s)
- Zifu Li
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
| | - Tianxiang Gao
- University of Shanghai for Science and Technology, Shanghai, P. R. China
| | - Jing Wang
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
| | - Xiaoxi Zhang
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
| | - Yongxin Zhang
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
| | - Lei Zhang
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
| | - Pengfei Yang
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
| | - Jianmin Liu
- Neurovascular center, Changhai Hospital, Shanghai, P. R. China
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Non-genomic Effect of Estradiol on the Neurovascular Unit and Possible Involvement in the Cerebral Vascular Accident. Mol Neurobiol 2023; 60:1964-1985. [PMID: 36596967 DOI: 10.1007/s12035-022-03178-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 12/16/2022] [Indexed: 01/05/2023]
Abstract
Cerebrovascular diseases, such as ischemic cerebral vascular accident (CVA), are responsible for causing high rates of morbidity, mortality, and disability in the population. The neurovascular unit (NVU) during and after ischemic CVA plays crucial roles in cell regulation and preservation, the immune and inflammatory response, and cell and/or tissue survival and repair. Cellular responses to 17β-estradiol (E2) can be triggered by two mechanisms: one called classical or genomic, which is due to the activation of the "classical" nuclear estrogen receptors α (ERα) and β (ERβ), and the non-genomic or rapid mechanism, which is due to the activation of the G protein-coupled estrogen receptor 1 (GPER) that is located in the plasma membrane and some in intracellular membranes, such as in the Golgi apparatus and endoplasmic reticulum. Nuclear receptors can regulate gene expression and cellular functions. On the contrary, activating the GPER by E2 and/or its G-1 agonist triggers several rapid cell signaling pathways. Therefore, E2 or its G-1 agonist, by mediating GPER activation and/or expression, can influence several NVU cell types. Most studies argue that the activation of the GPER may be used as a potential therapeutic target in various pathologies, such as CVA. Thus, with this review, we aimed to summarize the existing literature on the role of GPER mediated by E2 and/or its agonist G-1 in the physiology and pathophysiology of NVU.
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Li B, Wang W, Li Y, Wang S, Liu H, Xia Z, Gao W, Zhao B. cGAS-STING pathway aggravates early cerebral ischemia-reperfusion injury in mice by activating NCOA4-mediated ferritinophagy. Exp Neurol 2023; 359:114269. [PMID: 36343680 DOI: 10.1016/j.expneurol.2022.114269] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022]
Abstract
Stroke patients are often complicated by cerebral ischemia-reperfusion injury (CIRI) after the restoration of cerebral perfusion, and how to prevent CIRI at an early stage has received close attention. The imbalance of iron metabolism is one of the essential factors in the aggravation of CIRI, and NCOA4-mediated ferritinophagy, as a critical pathway to regulate iron metabolism, is expected to be an effective intervention target. We established a mouse model of cerebral ischemia-reperfusion (CIR) with NCOA4 silencing. We found that activation of NCOA4-mediated ferritinophagy atthe early stage of CIR mediated the onset of oxidative stress and contributed to autophagy and apoptosis, and eventually resulted in increased brain injury. This suggests that NCOA4-mediated ferritinophagy plays a vital role in early CIR and can be an effective target to prevent and treat CIRI. We next explored the upstream regulatory targets of NCOA4-mediated ferritinophagy. The previous evidence for the cGAS-STING pathway's importance during CIR and its strong relationship with autophagy attracted our attention. To investigate whether the cGAS-STING pathway regulates NCOA4-mediated ferritinophagy, we further administered a cGAS inhibitor to mice with CIR and overexpressed NCOA4. Along with the inhibition of the cGAS-STING pathway, ferritinophagy, oxidative stress, autophagy, and apoptosis were inhibited, and CIRI was ameliorated, which was attenuated by NCOA4 overexpression. In conclusion, our results suggest that activation of the cGAS-STING pathway exacerbates CIRI at the early stage of CIR, which may be achieved by mediating NCOA4-mediated ferritinophagy.
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Affiliation(s)
- Bingyu Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Wei Wang
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yanan Li
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Su Wang
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Hengjuan Liu
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Zhongyuan Xia
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Wenwei Gao
- Critical Care Medicine, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Bo Zhao
- Department of Anesthesiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.
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He M, Wang H, Tang Y, Cui B, Xu B, Niu X, Sun Y, Zhang G, He X, Wang B, Xu B, Li Z, Zhang Y, Wang Y. Red blood cell distribution width in different time-points of peripheral thrombolysis period in acute ischemic stroke is associated with prognosis. Aging (Albany NY) 2022; 14:5749-5767. [PMID: 35832033 PMCID: PMC9365566 DOI: 10.18632/aging.204174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 07/05/2022] [Indexed: 12/30/2022]
Abstract
The relationship between red blood cell distribution width (RDW) in peripheral thrombolysis period and prognosis is not fully clarified in those who underwent intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). Our study aimed to clarify this issue. A retrospective analysis of about 510 consecutive thrombolysis cases for AIS from January 2015 to March 2019 in a single-center database was done and followed-up for 3 months. We used univariate and multivariable models to evaluate the relationship between RDW levels at various time-points after IVT and the occurrence risk of hemorrhagic transformation (HT) and recurrent stroke, and used COX regression to assess the hazard ratios of outcomes with RDW levels. Elevated risk of HT was found in higher tertiles of RDW (OR = 10.282, 95% confidence interval (CI) 2.841–39.209, P < 0.001 in Tp tertile G3; OR = 5.650, 95% CI 1.992–16.025, P = 0.001 in T24 tertile G3; OR = 4.308, 95% CI 1.480–12.542, P = 0.007 in T48 tertile G3 and OR = 6.384, 95% CI 2.201–18.515, P = 0.001 in T72 tertile G3, respectively). Occurrence of recurrent stroke was highest in the RDW tertile G3 (HR = 4.580, 95% CI 2.123–9.883, P < 0.001 in Tp tertile G3; HR = 5.731, 95% CI 2.498–13.151, P = 0.001 in T24 tertile G3; HR = 3.019, 95% CI 1.969–4.059, P = 0.031 in T48 tertile G3; HR = 3.318, 95% CI 1.598–6.890, P = 0.001 in T72 tertile G3, respectively). Mean RDW levels ≥13.60 among AIS patients undergoing thrombolysis was associated with higher risk of HT and recurrent stroke.
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Affiliation(s)
- Mingli He
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Hongrui Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yi Tang
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Bing Cui
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Bingchao Xu
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xiaoqin Niu
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Yongan Sun
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Guanghui Zhang
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Xiaobing He
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Bei Wang
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Bei Xu
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Zaipo Li
- Department of Neurology, The Affiliated Lianyungang Hospital of Xuzhou Medical University, Jiangsu, China
| | - Yu Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yibo Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Liu S, Xu J, Liu Y, You Y, Xie L, Tong S, Chen Y, Liang K, Zhou S, Li F, Tang Z, Mei N, Lu H, Wang X, Gao X, Chen J. Neutrophil-Biomimetic "Nanobuffer" for Remodeling the Microenvironment in the Infarct Core and Protecting Neurons in the Penumbra via Neutralization of Detrimental Factors to Treat Ischemic Stroke. ACS APPLIED MATERIALS & INTERFACES 2022; 14:27743-27761. [PMID: 35695238 DOI: 10.1021/acsami.2c09020] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
High level of detrimental factors including reactive oxygen species (ROS) and inflammatory cytokines accumulated in the infarct core and their erosion to salvageable penumbra are key pathological cascades of ischemia-reperfusion injury in stroke. Few neuroprotectants can remodel the hostile microenvironment of the infarct core for the failure to interfere with dead or biofunctionally inactive dying cells. Even ischemia-reperfusion injury is temporarily attenuated in the penumbra by medications; insults of detrimental factors from the core still erode the penumbra continuously along with drug metabolism and clearance. Herein, a strategy named "nanobuffer" is proposed to neutralize detrimental factors and buffer destructive erosion to the penumbra. Inspired by neutrophils' tropism to the infarct core and affinity to inflammatory cytokines, poly(lactic-co-glycolic acid) (PLGA) nanoparticles are coated with neutrophil membrane to target the infarct core and absorb inflammatory cytokines; α-lipoic acid is decorated on the surface and cannabidiol is loaded for ROS scavenging and neuroprotection, respectively, to construct the basic unit of the nanobuffer. Such a nanobuffer exerts a comprehensive effect on the infarct area via detrimental factor neutralization and cannabidiol-induced neuroprotection. Besides, the nanobuffer can possibly be enhanced by dynamic ROP (ring-opening-polymerization)-induced membrane cross-fusion among closely adjacent units in vivo. Systematic evaluations show significant decrease of detrimental factors in the core and the penumbra, reduced infarct volume, and improved neurological recovery compared to the untreated group of stroke rats.
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Affiliation(s)
- Shanshan Liu
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Jianpei Xu
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Yipu Liu
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Yang You
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Laozhi Xie
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Shiqiang Tong
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Yu Chen
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Kaifan Liang
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Songlei Zhou
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Fengan Li
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
| | - Zhuang Tang
- School of Pharmacy and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macao 999078, China
| | - Ni Mei
- Shanghai Center for Drug Evaluation and Inspection, Lane 781, Cailun Road, Shanghai 201203, China
| | - Huiping Lu
- Department of Pharmacy, Shanghai Pudong Hospital, Fudan University, 2800 Gongwei Road, Shanghai 201399, China
| | - Xiaolin Wang
- School of Pharmacy and State Key Laboratory of Quality Research in Chinese Medicine, Macau University of Science and Technology, Avenida Wai Long, Taipa, Macao 999078, China
| | - Xiaoling Gao
- Department of Pharmacology and Chemical Biology, State Key Laboratory of Oncogenes and Related Genes, Shanghai Universities Collaborative Innovation Center for Translational Medicine, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai 200025, China
| | - Jun Chen
- School of Pharmacy, Shanghai Pudong Hospital & Department of Pharmaceutics, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
- Key Laboratory of Smart Drug Delivery, Ministry of Education, School of Pharmacy, Fudan University, Lane 826, Zhangheng Road, Shanghai 201203, China
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Chen W, Yu J, Li S. Effect of Pei Yuan Tong Nao capsules on cerebral infarction: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e29050. [PMID: 35356918 PMCID: PMC10684159 DOI: 10.1097/md.0000000000029050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Pei Yuan Tong Nao (PYTN) capsules has been widely used for the treatment of cerebrovascular disease, including cerebral infarction. However, the mechanisms of action of PYTN capsule on cerebral infarction are ambiguous and unclear. We conducted a protocol for systematic review and meta-analysis to evaluate the efficacy and safety of PYTN capsules for the treatment of cerebral infarction. METHODS A comprehensive search of several databases from 1966 to February 2022 will be conducted. The databases includes Ovid Medline In-Process & Other NonIndexed Citations, Ovid MEDLINE, Ovid EMBASE, Ovid PsycINFO, Ovid Cochrane Central Register of Controlled Trials, Ovid Cochrane Database of Systematic Reviews, and Scopus. Two authors independently performed the literature searching, data extraction, and quality evaluation. The risk of bias in each included study will be assessed utilizing the Cochrane Collaboration's risk of bias tool. The Review Manager 5.3 (Cochrane Collaboration, Oxford, UK) will be used to analyze the data. RESULT A synthesis of current evidence of PYTN capsules for cerebral infarction will be provided in this protocol. CONCLUSION This review will provide more reliable references to help clinicians make decisions when dealing with cerebral infarction.
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Affiliation(s)
| | | | - Suting Li
- Correspondence: Suting Li, Department of Internal Medicine, BinZhou Polytechnic, 919 Huanghe 12th Road, Binzhou City 256600, Shandong Province, China (e-mail: ).
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Liu X, Li Y, Bai N, Yu C, Xiao Y, Li C, Liu Z. Updated evidence of Dengzhan Shengmai capsule against ischemic stroke: A systematic review and meta-analysis. JOURNAL OF ETHNOPHARMACOLOGY 2022; 283:114675. [PMID: 34571078 DOI: 10.1016/j.jep.2021.114675] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/15/2021] [Accepted: 09/21/2021] [Indexed: 06/13/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ischemic stroke is the most common type of stroke, with high mortality, disability and recurrence rate, which brings a heavy burden to individuals, families and the medical system. Therefore, the intervention and treatment of ischemic stroke are of great significance. Chinese herbal medicine is widely used in treating stroke, for example, Dengzhan shengmai (DZSM) capsule. The current systematic review aims to comprehensively evaluate the efficacy and safety of the DZSM capsule in treating ischemic stroke. MATERIALS AND METHODS Eligible randomized controlled trials (RCTs) were included to evaluate the efficacy and safety of Chinese herbal medicine DZSM capsule in treating ischemic stroke. Eight electronic databases were searched up to January 27, 2021. The risk ratio (RR), standardized mean difference (SMD), or weighted mean difference (WMD) with 95% confidence interval (CI) were used to assess DZSM capsule treatment outcomes. RESULTS A total of 28 RCTs involving 6683 participants were included in the systematic review and meta-analysis. Compared with conventional therapy group, DZSM capsule plus conventional therapy improved Barthel Index scores (WMD: 8.97, 95%CI: 5.88-12.05) and reduced modified Rankin Scale (WMD: -0.75, 95%CI: -1.02∼ -0.48), reduced neurological functional deficit scores (WMD: -2.81, 95%CI: -4.17∼ -1.44), recurrence rate (RR: 0.57, 95%CI: 0.44-0.73) and mortality (RR: 0.54, 95%CI: 0.31-0.95), improved clinical effect (RR: 1.18, 95%CI: 1.12-1.24) and quality of life (WMD: 21.67, 95%CI: 6.74-36.61), exhibited a beneficial effect on hemorheology such as elevated levels of APTT (SMD: 1.17, 95%CI: 0.87-1.47) and INR (SMD: 1.12, 95%CI: 0.82-1.42), and on lipid metabolism such as levels of TC (SMD: -0.62, 95%CI: -1.04 ∼ -0.20), TG (SMD: -0.72, 95%CI: -1.18∼ -0.26), LDL (SMD: -1.14, 95%CI: -1.57∼ -0.71) and HDL (SMD: 0.93, 95%CI: 0.36-1.50). No trials reported severe adverse events. CONCLUSION DZSM capsule appears to be safe and effective in clinical applications for ischemic stroke. Based on conventional therapy, adding the DZSM capsule could reduce the mortality, recurrence rate, and neurological functional deficit scores, improve clinical effect and quality of life. In addition, compared with conventional therapy, the addition of the DZSM capsule played a beneficial role in hemorheology and lipid metabolism, which may attribute to the potential mechanism.
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Affiliation(s)
- Xueyan Liu
- Fujian Medical University, Fuzhou, Fujian, 350122, China
| | - Yiqi Li
- Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350108, China
| | - Ningning Bai
- Guangzhou Chinese Medicinal Materials Magazine Co., Ltd, Guangzhou, Guangdong, 510000, China
| | - Chuanyu Yu
- Fujian Medical University, Fuzhou, Fujian, 350122, China
| | - Yun Xiao
- Fujian Medical University, Fuzhou, Fujian, 350122, China
| | - Chi Li
- World Federation of Chinese Medicine Societies, Beijing, 100101, China.
| | - Zhiqiang Liu
- Fujian Medical University, Fuzhou, Fujian, 350122, China.
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8
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Gulyaeva NV, Onufriev MV, Moiseeva YV. Ischemic Stroke, Glucocorticoids, and Remote Hippocampal Damage: A Translational Outlook and Implications for Modeling. Front Neurosci 2021; 15:781964. [PMID: 34955730 PMCID: PMC8695719 DOI: 10.3389/fnins.2021.781964] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 11/22/2021] [Indexed: 01/16/2023] Open
Abstract
Progress in treating ischemic stroke (IS) and its delayed consequences has been frustratingly slow due to the insufficient knowledge on the mechanism. One important factor, the hypothalamic-pituitary-adrenocortical (HPA) axis is mostly neglected despite the fact that both clinical data and the results from rodent models of IS show that glucocorticoids, the hormones of this stress axis, are involved in IS-induced brain dysfunction. Though increased cortisol in IS is regarded as a biomarker of higher mortality and worse recovery prognosis, the detailed mechanisms of HPA axis dysfunction involvement in delayed post-stroke cognitive and emotional disorders remain obscure. In this review, we analyze IS-induced HPA axis alterations and supposed association of corticoid-dependent distant hippocampal damage to post-stroke brain disorders. A translationally important growing point in bridging the gap between IS pathogenesis and clinic is to investigate the involvement of the HPA axis disturbances and related hippocampal dysfunction at different stages of SI. Valid models that reproduce the state of the HPA axis in clinical cases of IS are needed, and this should be considered when planning pre-clinical research. In clinical studies of IS, it is useful to reinforce diagnostic and prognostic potential of cortisol and other HPA axis hormones. Finally, it is important to reveal IS patients with permanently disturbed HPA axis. Patients-at-risk with high cortisol prone to delayed remote hippocampal damage should be monitored since hippocampal dysfunction may be the basis for development of post-stroke cognitive and emotional disturbances, as well as epilepsy.
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Affiliation(s)
- Natalia V Gulyaeva
- Laboratory of Functional Biochemistry of Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia.,Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, Moscow, Russia
| | - Mikhail V Onufriev
- Laboratory of Functional Biochemistry of Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia.,Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, Moscow, Russia
| | - Yulia V Moiseeva
- Laboratory of Functional Biochemistry of Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
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Onufriev MV, Moiseeva YV, Zhanina MY, Lazareva NA, Gulyaeva NV. A Comparative Study of Koizumi and Longa Methods of Intraluminal Filament Middle Cerebral Artery Occlusion in Rats: Early Corticosterone and Inflammatory Response in the Hippocampus and Frontal Cortex. Int J Mol Sci 2021; 22:13544. [PMID: 34948340 PMCID: PMC8703333 DOI: 10.3390/ijms222413544] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 12/11/2021] [Accepted: 12/14/2021] [Indexed: 02/08/2023] Open
Abstract
Two classical surgical approaches for intraluminal filament middle cerebral artery occlusion (MCAO), the Longa et al. (LM) and Koizumi et al. methods (KM), are used as alternatives in preclinical studies to induce stroke in rodents. Comparisons of these MCAO models in mice showed critical differences between them along with similarities (Smith et al. 2015; Morris et al. 2016). In this study, a direct comparison of MCAO-KM and MCAO-LM in rats was performed. Three days after MCAO, infarct volume, mortality rate, neurological deficit, and weight loss were similar in these models. MCAO-LM rats showed an increase in ACTH levels, while MCAO-KM rats demonstrated elevated corticosterone and interleukin-1β in blood serum. Corticosterone accumulation was detected in the frontal cortex (FC) and the hippocampus of the MCAO-KM group. IL1β beta increased in the ipsilateral hippocampus in the MCAO-KM group and decreased in the contralateral FC of MCAO-LM rats. Differences revealed between MCAO-KM and MCAO-LM suggest that corticosterone and interleukin-1β release as well as hippocampal accumulation is more expressed in MCAO-KM rats, predisposing them to corticosterone-dependent distant neuroinflammatory hippocampal damage. The differences between two models, particularly, malfunction of the hypothalamic-pituitary-adrenal axis, should be considered in the interpretation, comparison, and translation of pre-clinical experimental results.
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Affiliation(s)
- Mikhail V. Onufriev
- Laboratory of Functional Biochemistry of the Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerov Str., 117485 Moscow, Russia; (M.V.O.); (Y.V.M.); (M.Y.Z.); (N.A.L.)
- Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, 43 Donskaya Str., 115419 Moscow, Russia
| | - Yulia V. Moiseeva
- Laboratory of Functional Biochemistry of the Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerov Str., 117485 Moscow, Russia; (M.V.O.); (Y.V.M.); (M.Y.Z.); (N.A.L.)
| | - Marina Y. Zhanina
- Laboratory of Functional Biochemistry of the Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerov Str., 117485 Moscow, Russia; (M.V.O.); (Y.V.M.); (M.Y.Z.); (N.A.L.)
- Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, 43 Donskaya Str., 115419 Moscow, Russia
| | - Natalia A. Lazareva
- Laboratory of Functional Biochemistry of the Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerov Str., 117485 Moscow, Russia; (M.V.O.); (Y.V.M.); (M.Y.Z.); (N.A.L.)
| | - Natalia V. Gulyaeva
- Laboratory of Functional Biochemistry of the Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 5A Butlerov Str., 117485 Moscow, Russia; (M.V.O.); (Y.V.M.); (M.Y.Z.); (N.A.L.)
- Research and Clinical Center for Neuropsychiatry of Moscow Healthcare Department, 43 Donskaya Str., 115419 Moscow, Russia
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Yao Y, Cao X, Zou R, Wen H, Zhang S, Xu H, Guo X, Guo Y. Study on the Baseline Factors and Platelet Indices That Predict Outcome of Acute Ischemic Stroke Patients after Thrombolytic Therapy. Cerebrovasc Dis 2021; 51:357-364. [PMID: 34788754 DOI: 10.1159/000519705] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 08/01/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The aim of the study was to investigate the baseline characters that influence 3-month clinical outcomes in patients with acute ischemic stroke (AIS) after thrombolytic therapy. METHODS We consecutively enrolled 241 AIS patients who are treated with thrombolytic therapy with recombinant tissue plasminogen activator. Baseline characters were measured on admission including the National Institutes of Health Stroke Scale (NIHSS), Trial of Org 10172 in Acute Stroke Treatment (TOAST), risk factors, platelet indices, and lipid parameters. The subjects were divided into good or poor functional outcomes based on modified Rankin Scale at 3 months. The multivariate logistic regression was performed to explore the association between baseline factors and outcomes. Pearson correlation was used to investigate whether linear associations existed between platelet indices in different outcomes. RESULTS Multivariate logistic regression analysis showed that the NIHSS, TOAST classification, diabetes, mean platelet volume (MPV) are important factors for predicting clinical outcomes after 3 months in AIS patients. We found a correlation between elevated MPV and worse outcome at 3 months, particularly in large-artery atherosclerosis stroke patients. MPV and platelet count are negative correlated (r = -0.375, p = 0.000). MPV and platelet-to-lymphocyte ratio (PLR) (r = 0.83, p = 0.000), MPV and platelet distribution width (PDW) (r = 0.820, p = 0.000) both have highly positive linear correlations in patients with good outcome. CONCLUSIONS Overall, lower NIHSS and MPV levels on admission were predictors of good functional outcomes in patients with AIS after undergoing thrombolytic therapy. The correlations between MPV, PDW, and PLR may be helpful to evaluate prognosis in stroke patients and deserve further exploration.
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Affiliation(s)
- Yiqin Yao
- Department of Neurology, Nanjing Lishui People's Hospital, ZhongDa Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Xuejin Cao
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Rongcheng Zou
- Department of Neurology, Nanjing Lishui People's Hospital, ZhongDa Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Hongbo Wen
- Department of Neurology, Nanjing Lishui People's Hospital, ZhongDa Hospital Lishui Branch, Southeast University, Nanjing, China
| | - Shiyao Zhang
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Hui Xu
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Xiaoying Guo
- Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
| | - Yijing Guo
- Department of Neurology, Nanjing Lishui People's Hospital, ZhongDa Hospital Lishui Branch, Southeast University, Nanjing, China.,Department of Neurology, Affiliated ZhongDa Hospital of Southeast University, Medical School of Southeast University, Nanjing, China
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Qin Z, Tang L, Huang Q, Chen Y, Zhong W, Tang X. A systematic review of the correlation between serum asymmetric dimethylarginine, carotid atherosclerosis and ischaemic stroke. Eur J Clin Invest 2021; 51:e13558. [PMID: 33756002 DOI: 10.1111/eci.13558] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 03/19/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To investigate the correlation between serum asymmetric dimethylarginine (ADMA) and the risk of ischaemic stroke and carotid atherosclerosis in adults. METHODS We systematically searched PubMed, EMBASE, Web of Science and other databases for relevant studies on serum ADMA and ischaemic stroke or carotid atherosclerosis, which were published from December 1980 to December 2019. The quality of the included studies was evaluated according to the Cochrane system evaluation standard. The difference in serum ADMA level between ischaemic stroke and control group was selected as the effect size (standardized mean difference, SMD). The pooled analysis was performed using Review Manager (V.5.3). RESULTS According to the selection criteria, thirteen studies were included in the meta-analysis after screening. Nine studies compared ADMA levels between the ischaemic stroke group and healthy control group, involving a total of 1315 and 880 subjects in the two groups, respectively. Pooled effect sizes were calculated using the random-effects model due to the high heterogeneity (I2 = 93%, P < .00001). The level of serum ADMA in patients with ischaemic stroke was significantly higher than that in healthy people (SDM = 0.69, 95% CI [0.32, 1.06], P = .0002). Seven of the thirteen articles compared ADMA levels between the carotid arteriosclerosis group and the healthy control group, with 559 and 330 subjects in the two groups, respectively. The random-effects model was applied due to the high heterogeneity (I2 = 91%, P < .00001). The level of serum ADMA in patients with carotid arteriosclerosis was significantly higher than that in healthy people (SDM = 1.03, 95% CI [0.49, 1.57], P = .0002). CONCLUSION The serum ADMA may be related to ischaemic stroke, and it is a risk factor for carotid atherosclerosis.
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Affiliation(s)
- Zhen Qin
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Lisha Tang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Qianyi Huang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yan Chen
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Wei Zhong
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiangqi Tang
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
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Role of Citicoline in the Management of Traumatic Brain Injury. Pharmaceuticals (Basel) 2021; 14:ph14050410. [PMID: 33926011 PMCID: PMC8146347 DOI: 10.3390/ph14050410] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/20/2021] [Accepted: 04/24/2021] [Indexed: 01/07/2023] Open
Abstract
Head injury is among the most devastating types of injury, specifically called Traumatic Brain Injury (TBI). There is a need to diminish the morbidity related with TBI and to improve the outcome of patients suffering TBI. Among the improvements in the treatment of TBI, neuroprotection is one of the upcoming improvements. Citicoline has been used in the management of brain ischemia related disorders, such as TBI. Citicoline has biochemical, pharmacological, and pharmacokinetic characteristics that make it a potentially useful neuroprotective drug for the management of TBI. A short review of these characteristics is included in this paper. Moreover, a narrative review of almost all the published or communicated studies performed with this drug in the management of patients with head injury is included. Based on the results obtained in these clinical studies, it is possible to conclude that citicoline is able to accelerate the recovery of consciousness and to improve the outcome of this kind of patient, with an excellent safety profile. Thus, citicoline could have a potential role in the management of TBI.
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Paul S, Candelario-Jalil E. Special Issue: Comorbidities in stroke outcomes: Novel therapeutic targets. Exp Neurol 2021; 340:113641. [PMID: 33689986 DOI: 10.1016/j.expneurol.2021.113641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Surojit Paul
- Department of Neurology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA.
| | - Eduardo Candelario-Jalil
- Department of Neuroscience, McKnight Brain Institute, 1149 Newell Drive, University of Florida, Gainesville, FL 32610, USA.
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