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Qin R, Huang L, Xu W, Qin Q, Liang X, Lai X, Huang X, Xie M, Chen L. Unveiling the role of HIST2H2AC in stroke through single-cell and transcriptome analysis. Funct Integr Genomics 2024; 24:76. [PMID: 38656411 DOI: 10.1007/s10142-024-01355-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 03/29/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
Stroke is a leading cause of death and disability, and genetic risk factors play a significant role in its development. Unfortunately, effective therapies for stroke are currently limited. Early detection and diagnosis are critical for improving outcomes and developing new treatment strategies. In this study, we aimed to identify potential biomarkers and effective prevention and treatment strategies for stroke by conducting transcriptome and single-cell analyses. Our analysis included screening for biomarkers, functional enrichment analysis, immune infiltration, cell-cell communication, and single-cell metabolism. Through differential expression analysis, enrichment analysis, and protein-protein interaction (PPI) network construction, we identified HIST2H2AC as a potential biomarker for stroke. Our study also highlighted the diagnostic role of HIST2H2AC in stroke, its relationship with immune cells in the stroke environment, and our improved understanding of metabolic pathways after stroke. Overall, our research provided important insights into the pathogenesis of stroke, including potential biomarkers and treatment strategies that can be explored further to improve outcomes for stroke patients.
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Affiliation(s)
- Rongxing Qin
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Lijuan Huang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
- National Center for International Research of Biological Targeting Diagnosis and Therapy (Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research), Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Wei Xu
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
- National Center for International Research of Biological Targeting Diagnosis and Therapy (Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research), Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Qingchun Qin
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
- National Center for International Research of Biological Targeting Diagnosis and Therapy (Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research), Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Xiaojun Liang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Xinyu Lai
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Xiaoying Huang
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Minshan Xie
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China
| | - Li Chen
- Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China.
- National Center for International Research of Biological Targeting Diagnosis and Therapy (Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research), Guangxi Medical University, Guangxi Zhuang Autonomous Region, Nanning, 530021, China.
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Tao C, Wang Y, Xiao S. Clinical significance of CT angiographic assessment of collateral circulation combined with serum NLRP1 levels in ischemic stroke patients. Medicine (Baltimore) 2023; 102:e33433. [PMID: 37000063 PMCID: PMC10063313 DOI: 10.1097/md.0000000000033433] [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: 11/01/2022] [Revised: 03/11/2023] [Accepted: 03/13/2023] [Indexed: 04/01/2023] Open
Abstract
This research aimed to combine serum NLR-pyrin domain containing 1 (NLRP1) levels and collateral circulation to assess ischemic stroke patients and predict the prognoses of the patients. This present prospective observational study enrolled 196 ischemic stroke patients. All patients underwent CTA as well as digital subtraction angiography (DSA) to assess collateral circulation by American Society of Interventional and Therapeutic Neuroradiology/Society of Interventional Radiology (ASITN/SIR). In addition, we collected serum samples from 100 patients with carotid atherosclerosis as controls. The serum NLRP1, tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-1β and C-reactive protein (CRP) levels were measured by enzyme-linked immunosorbent assay (ELISA). The age, BMI, sex, smoke condition, diastolic blood pressure, systolic blood pressure, National Institutes of Health Stroke Scores (NIHSS), modified Rankin Scale (mRS) scores, imaging indicators and the levels of triglyceride, total cholesterol (TC), low-density leptin cholesterol (LDLC), high-density leptin cholesterol of all subjects were recorded. All data used SPSS 18.0 to statistical analyses. The serum levels of NLRP1 were remarkably enhanced in the ischemic stroke patients compared with the carotid atherosclerosis patients. The NIHSS score, the mRS score after 90 days and the levels of NLRP1, CRP, TNF-α IL-6 and IL-1β of ischemic stroke patients in the ASITN/SIR grade 0 to 2 group were remarkably elevated than the ischemic stroke patients in ASITN/SIR grade 3 to 4 group. Spearman analysis supported that a positive correlation existed among the NLRP1, CRP, IL-6, TNF-α, and IL-1β levels. The NIHSS score, infarct volume and the levels of NLRP1, IL-6, TNF-α, and IL-1β of ischemic stroke patients in the mRS score ≥ 3 group were remarkably elevated than the ischemic stroke patients in the mRS score ≤ 2 group. ASITN/SIR grade and NLRP1 could be potential diagnostic biomarkers of poor prognosis of ischemic stroke patients. It was found that NLRP1, ASITN/SIR grade, infarct volume, NIHSS, IL-6, and IL-1β were the risk factors for bad prognosis of ischemic stroke patients. This study showed that the serum NLRP1 levels were remarkably decreased in ischemic stroke patients. In addition, the serum NLRP1 levels and ASITN/SIR grade could predict the prognosis of ischemic stroke patients.
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Affiliation(s)
- Chong Tao
- Department of Radiology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, Hubei, P. R. China
| | - Yu Wang
- Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, Hubei, P. R. China
| | - Shiyin Xiao
- Department of Radiology, Wuhan Hospital of Traditional Chinese Medicine, Wuhan, Hubei, P. R. China
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Leng X, Leung TW. Collateral Flow in Intracranial Atherosclerotic Disease. Transl Stroke Res 2023; 14:38-52. [PMID: 35672561 DOI: 10.1007/s12975-022-01042-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 04/27/2022] [Accepted: 05/26/2022] [Indexed: 01/31/2023]
Abstract
Intracranial atherosclerotic disease (ICAD) is a major cause of ischemic stroke and transient ischemic attack (TIA) worldwide. The culprit of ICAD is frequently a high-grade intracranial atherosclerotic stenosis (ICAS) pertaining to the infarct territory, and by then, the ICAS is described as symptomatic. A high-grade ICAS may progressively limit cerebral perfusion downstream, demanding collateral compensation. Collateral circulation refers to the pre-existing and dynamic emergence of vascular channels that maintain and compensate for a failing principal vascular route. Collaterals through the Circle of Willis and leptomeningeal circulation are of utmost importance in this regard. In this article, we first discussed the epidemiology, stroke mechanisms, contemporary therapeutics, and prognosis of symptomatic ICAD. Then, we reviewed the collateral routes in ICAS, factors associated with recruitment and development of the collaterals and diagnostic imaging modalities in assessing the origin and function of collateral circulation. We discussed the associations between collateral circulation and clinical outcomes after acute reperfusion treatment in ICAD-related ischemic strokes with or without large vessel occlusion (LVO). We also conducted a systematic review and meta-analysis on the associations of collateral circulation with the risk of recurrent stroke and the functional outcome in symptomatic ICAS patients on medical treatment as secondary stroke prevention. Finally, we summarized current evidence in these aspects and proposed the future directions.
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Affiliation(s)
- Xinyi Leng
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR, China
| | - Thomas W Leung
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, Hong Kong SAR, China.
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Wang Y, Wang J, Qiu J, Li W, Sun X, Zhao Y, Liu X, Zhao Z, Liu L, Nguyen TN, Chen H. Association between collaterals, cerebral circulation time and outcome after thrombectomy of stroke. Ann Clin Transl Neurol 2022; 10:266-275. [PMID: 36527245 PMCID: PMC9930428 DOI: 10.1002/acn3.51718] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/22/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE Cerebral circulation time (CCT) and collateral score (CS) are associated with functional outcomes in acute ischemic stroke (AIS) patients after endovascular treatment (EVT), and may be related to each other. We aim to determine the relationship between CS and CCT on functional outcomes. METHODS We retrospectively enrolled consecutive patients with anterior circulation large vessel occlusion (LVO) AIS who received EVT. CS and CCT were measured based on digital subtraction angiography (DSA). We defined CS 0-2 and 3-4 as poor and good collateral status, respectively, and used change of CCT (cCCT), which was defined as the change of stroke side CCT (sCCT) versus healthy side CCT (hCCT). Mediating analysis was used to evaluate the influence of cCCT on the association between CS and functional outcomes, and ROC curves were further used to explore the predictive ability of the interaction between cCCT and CS for functional outcomes. RESULTS A total of 100 patients were enrolled in the final analysis. A higher cCCT (r = -0.239; p = 0.017) was associated with lower CS, and cCCT mediated the association of CS with functional outcome. Logistic regression analysis found that CS, cCCT and cCCT-CS interactions were independently associated with functional outcome, and cCCT-CS interaction has better predictive performance, with a higher area under curve value than CS or cCCT alone (0.79 vs. 0.75 or 0.75). INTERPRETATION To our knowledge, this study provides the first report of the association of collateral status with cCCT, and their interaction effect on functional outcome in AIS-LVO patients receiving EVT.
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Affiliation(s)
- Ying‐Jia Wang
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Jia‐Qi Wang
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Jin Qiu
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Wei Li
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Xian‐Hui Sun
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Yong‐Gang Zhao
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Xin Liu
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Zi‐Ai Zhao
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Liang Liu
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
| | - Thanh N. Nguyen
- Neurology, RadiologyBoston Medical CenterBostonMassachusettsUSA
| | - Hui‐Sheng Chen
- Department of NeurologyGeneral Hospital of Northern Theater CommandShenyangChina
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Li Q, Wang B, Sun Y, Qiao J, Tong X. Association between Cerebrovascular Risk Factors and Collateral Compensation in Chronic Symptomatic Intracranial Vertebrobasilar Stenosis. Eur Neurol 2022; 85:478-485. [PMID: 35764062 PMCID: PMC9808775 DOI: 10.1159/000525372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 01/30/2022] [Indexed: 01/07/2023]
Abstract
INTRODUCTION The level of collateral compensation plays a pivotal role in chronic symptomatic intracranial vertebrobasilar stenosis (IVBS). This study aimed to evaluate the association between cerebrovascular risk factors and collateral compensation in chronic symptomatic IVBS. METHODS This single-center cross-sectional study retrospectively reviewed 238 patients with angiographically demonstrated IVBS and divided them into good collateral compensation (GCC) group (collateral grade: 3-4, n = 110) and poor collateral compensation (PCC) group (collateral grade: 0-2, n = 128). The demographic information, laboratory tests, and clinical data of the two groups were compared and assessed using univariate logistic regression. Multivariate logistic regression was employed to analyze the independent related factors of collateral compensation. RESULTS Hyperlipidemia, high-density lipoprotein (HDL), and fasting blood glucose (FBG) were significantly different between the two groups. Multivariate logistic regression analysis revealed that HDL (odds ratio [OR]: 1.134, 95% confidence interval [CI]: 1.081-1.190), FBG (OR: 0.945, 95% CI: 0.925-0.964), and hyperlipidemia (OR: 0.261, 95% CI: 0.129-0.527) were statistically independent related factors of collateral compensation. The receiver-operating characteristic (ROC) analysis provided cutoff values of 34 mg/dL and 135 mg/dL for HDL and FBG associated with GCC and PCC. CONCLUSION Higher HDL levels are associated with higher incidence of GCC, whereas higher FBG levels and hyperlipidemia are associated with higher incidence of PCC.
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Affiliation(s)
- Qi Li
- School of Medicine, Nankai University, Tianjin, China
| | - Benlin Wang
- School of Medicine, Nankai University, Tianjin, China
| | - Yang Sun
- Graduate School of Tianjin Medical University, Clinical College of Neurology, Neurosurgery and Neurorehabilitation, Tianjin Medical University, Tianjin, China
| | - Jie Qiao
- Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin Neurosurgical Institute, Tianjin, China
| | - Xiaoguang Tong
- School of Medicine, Nankai University, Tianjin, China,Department of Neurosurgery, Tianjin Huanhu Hospital, Tianjin Neurosurgical Institute, Tianjin, China,*Xiaoguang Tong,
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Ban M, Han X, Bao W, Zhang H, Zhang P. Evaluation of collateral status and outcome in patients with middle cerebral artery stenosis in late time window by CT perfusion imaging. Front Neurol 2022; 13:991023. [PMID: 36176551 PMCID: PMC9513124 DOI: 10.3389/fneur.2022.991023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 08/23/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesCollateral status (CS) is a crucial determinant of outcome in patients with ischemic stroke. We aimed to test whether the cerebral blood volume (CBV) and cerebral blood flow (CBF) based on computed tomography perfusion (CTP) measurements can quantitatively evaluate CS and explore the predictive ability of CTP parameters in determining clinical outcomes in patients with MCA severe stenosis or occlusion presenting beyond 24 h.Materials and methodsIn this retrospective study, data obtained from September 2018 to March 2022 in consecutive stroke patients caused by isolated middle cerebral artery severe stenosis or occlusion were reviewed within 24–72 h after onset. Correlation between the collateral score systems assessed with CT angiography (CTA) and CTP parameters was calculated using the Spearman correlation. The optimal threshold of the CBV ratio for predicting a good outcome was determined using receiver operating characteristic curve (ROC) analysis.ResultsA total of 69 patients met inclusion criteria. Both the CBV ratio and the CBF ratio had significant correlation with collateral score systems assessed with CTA [CBV ratio and Tan score: rs = 0.702, P < 0.0001; CBV ratio and regional leptomeningeal collateral (rLMC) score: rs = 0.705, P < 0.0001; CBV ratio and Miteff score: rs = 0.625, P < 0.0001. CBF ratio and Tan score: rs= 0.671, P < 0.0001; CBF ratio and rLMC score: rs = 0.715, P < 0.0001; CBF ratio and Miteff score: rs = 0.535, P < 0.0001]. ROC analysis revealed the CBV ratio performed better than the qualitative collateral assessments and the CBF ratio in the prediction of a favorable 90-day modified Rankin scale score. The CBV ratio was a useful parameter that predicted a good functional outcome [area under the curve (AUC), 0.922; 95% CI, 0.862 ± 0.982].ConclusionsIn late time window stroke patients, the CBV and CBF ratio on CTP may be valuable parameters for quantitatively revealing the collateral status after stroke. In addition, the CBV ratio was the predictor of clinical outcomes in patients with MCA severe stenosis or occlusion.
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Zhou X, Yang J, Liu L, Zhu Y. Clinical Effect of Butylphthalide Combined with Rt-PA Intravenous Thrombolysis in the Treatment of Acute Cerebral Infarction. Appl Bionics Biomech 2022; 2022:9215685. [PMID: 35756870 PMCID: PMC9232321 DOI: 10.1155/2022/9215685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/27/2022] [Accepted: 05/31/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To assess the clinical effect of butylphthalide combined with rt-PA intravenous thrombolysis in the treatment of acute cerebral infarction (ACI). Methods Totally, 312 acute cerebral infarction patients were included in this research. Those in the group for experiment received butylphthalide (25 mg QD) combined with rt-PA intravenous thrombolysis (0.9 mg/kg QD), while the control group received rt-PA intravenous (P < 0.05). Moreover, NIHSS (NIH Stroke Scale/Score) and Barthel index scores in the two groups improved, NIHSS score had ameliorated, and Barthel index score was higher than that in the reference group (P < 0.05). Conclusion The combination of butylphthalide and recombination plasminogen activator alteplase (rt-PA) intravenous thrombolysis has a significant clinical effect in the treatment of acute cerebral infarction. It can alleviate the inflammatory symptoms, accelerate the recovery of neurological function, and improve the ability of daily living.
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Affiliation(s)
- Xiangchen Zhou
- Department of Neurointerventional, Laizhou People's Hospital, Shandong 261400, China
| | - Jundong Yang
- Department of Neurointerventional, Laizhou People's Hospital, Shandong 261400, China
| | - Lihua Liu
- Department of Neurointerventional, Laizhou People's Hospital, Shandong 261400, China
| | - Yingying Zhu
- Department of Neurointerventional, Laizhou People's Hospital, Shandong 261400, China
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Gene Differential Expression and Interaction Networks Illustrate the Biomarkers and Molecular Mechanisms of Atherosclerotic Cerebral Infarction. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:3912697. [PMID: 35070236 PMCID: PMC8769835 DOI: 10.1155/2022/3912697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/18/2022]
Abstract
Atherosclerotic cerebral infarction (ACI) seriously threatens the health of the senile patients, and the strategies are urgent for the diagnosis and treatment of ACI. This study investigated the mRNA profiling of the patients with ischemic stroke and atherosclerosis via excavating the datasets in the GEO database and attempted to reveal the biomarkers and molecular mechanism of ACI. In this study, GES16561 and GES100927 were obtained from Gene Expression Omnibus (GEO) database, and the related differentially expressed genes (DEGs) were analyzed with R language. Furthermore, the DEGs were analyzed with Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Besides, the protein-protein interaction (PPI) network of DEGs was analyzed by STRING database and Cytoscape. The results showed that 133 downregulated DEGs and 234 upregulated DEGs were found in GES16561, 25 downregulated DEGs and 104 upregulated DEGs were found in GSE100927, and 6 common genes were found in GES16561 and GES100927. GO enrichment analysis showed that the functional models of the common genes were involved in neutrophil activation, neutrophil degranulation, neutrophil activation, and immune response. KEGG enrichment analysis showed that the DEGs in both GSE100927 and GSE16561 were connected with the pathways including Cell adhesion molecules (CAMs), Cytokine-cytokine receptor interaction, Phagosome, Antigen processing and presentation, and Staphylococcus aureus infection. The PPI network analysis showed that 9 common DEGs were found in GSE100927 and GSE16561, and a cluster with 6 nodes and 12 edges was also identified by PPI network analysis. In conclusion, this study suggested that FCGR3A and MAPK pathways were connected with ACI.
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