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Arul S, Ghozy S, Mereuta OM, Senol YC, Orscelik A, Kobeissi H, Gupta R, Brinjikji W, Kallmes DF, Kadirvel R. Metabolite signature in acute ischemic stroke thrombi: a systematic review. J Thromb Thrombolysis 2023; 56:594-602. [PMID: 37580625 PMCID: PMC11178128 DOI: 10.1007/s11239-023-02869-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/09/2023] [Indexed: 08/16/2023]
Abstract
Metabolites are reliable biomarkers for many diseases. However, their role in acute ischemic stroke (AIS) pathogenesis is not well understood. In this systematic review we aim to evaluate the current literature on the presence of metabolites in thrombi retrieved by mechanical thrombectomy from AIS patients. Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2020 guidelines, we searched OVID Medline, PubMed, OVID Embase, Scopus, and Web of Science until July 13, 2022. Metabolites lists were extracted, and pathway analysis was performed in MetaboAnalyst database. Four articles listing metabolites were included in this systematic review. D-Glucose, diacylglycerol, phytosphingosine, galabiosylceramide, glucosylceramide and 4-hydroxynonenal were reported to be associated with clots. Metabolomics data analysis showed that glycolysis, lactose, and sphingolipid metabolism pathways were enriched. In conclusion, results of the present study show that the thrombi niche has a glycolytic phenotype. Future studies should work to better understand the metabolic properties of AIS thrombi.
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Affiliation(s)
- Santhosh Arul
- Department of Neurologic Surgery, Mayo Clinic, Stabile Building, 150 3rd St SW, Rochester, MN, 55902, USA.
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.
| | - Sherief Ghozy
- Department of Neurologic Surgery, Mayo Clinic, Stabile Building, 150 3rd St SW, Rochester, MN, 55902, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Yigit Can Senol
- Department of Neurologic Surgery, Mayo Clinic, Stabile Building, 150 3rd St SW, Rochester, MN, 55902, USA
| | | | | | - Rishabh Gupta
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Waleed Brinjikji
- Department of Neurologic Surgery, Mayo Clinic, Stabile Building, 150 3rd St SW, Rochester, MN, 55902, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | | | - Ramanathan Kadirvel
- Department of Neurologic Surgery, Mayo Clinic, Stabile Building, 150 3rd St SW, Rochester, MN, 55902, USA
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
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Rosário M, Fonseca AC. Update on Biomarkers Associated with Large-Artery Atherosclerosis Stroke. Biomolecules 2023; 13:1251. [PMID: 37627316 PMCID: PMC10452079 DOI: 10.3390/biom13081251] [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: 06/25/2023] [Revised: 08/03/2023] [Accepted: 08/15/2023] [Indexed: 08/27/2023] Open
Abstract
Intracranial and extracranial large-artery atherosclerosis (LAA) are a main cause of ischemic stroke. Biomarkers may aid in the diagnosis of LAA and help to stratify patients' risk of stroke. We performed a narrative review of the literature, mainly published in the last five years, with the aim of identifying biomarkers associated either with intracranial or extracranial LAA in humans. Several potential biomarkers of LAA, mainly related to lipidic pathways and inflammation, have been studied. Diagnostic biomarkers of LAA were evaluated by measuring biomarkers levels in patients with LAA stroke and other stroke etiologies. Some biomarkers were associated with the functional prognosis of LAA stroke patients. Increased levels of IL-6 and sLOX-1 were associated with a risk of progression of carotid atherosclerotic disease. Findings support the notion that the immune system plays a central role in the pathogenesis of LAA. Overall, in most studies, results were not externally validated. In the future, biomarkers could be useful for the selection of patients for clinical trials. To adopt these biomarkers in clinical practice, we will need robust multicentric studies proving their reproducibility and a clear practical applicability for their use.
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Affiliation(s)
- Madalena Rosário
- Stroke Unit, Neurology, Neuroscience Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
| | - Ana Catarina Fonseca
- Stroke Unit, Neurology, Neuroscience Department, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal
- Centro de Estudos Egas Moniz, Faculdade de Medicina da Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, 1649-028 Lisboa, Portugal
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Dumitriu LaGrange D, Reymond P, Brina O, Zboray R, Neels A, Wanke I, Lövblad KO. Spatial heterogeneity of occlusive thrombus in acute ischemic stroke: A systematic review. J Neuroradiol 2023; 50:352-360. [PMID: 36649796 DOI: 10.1016/j.neurad.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/12/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Following the advent of mechanical thrombectomy, occlusive clots in ischemic stroke have been amply characterized using conventional histopathology. Many studies have investigated the compositional variability of thrombi and the consequences of thrombus composition on treatment response. More recent evidence has emerged about the spatial heterogeneity of the clot or the preferential distribution of its components and compact nature. Here we review this emerging body of evidence, discuss its potential clinical implications, and propose the development of adequate characterization techniques.
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Affiliation(s)
- Daniela Dumitriu LaGrange
- Neurodiagnostic and Neurointerventional Division, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Philippe Reymond
- Neurodiagnostic and Neurointerventional Division, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Olivier Brina
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland
| | - Robert Zboray
- Center for X-Ray Analytics, Swiss Federal Laboratories for Materials Science and Technology (Empa), Dübendorf 8600, Switzerland
| | - Antonia Neels
- Center for X-Ray Analytics, Swiss Federal Laboratories for Materials Science and Technology (Empa), Dübendorf 8600, Switzerland
| | - Isabel Wanke
- Division of Neuroradiology, Klinik Hirslanden, Zurich, Switzerland; Swiss Neuroradiology Institute, Zurich, Switzerland; Division of Neuroradiology, University of Essen, Essen, Germany
| | - Karl-Olof Lövblad
- Division of Diagnostic and Interventional Neuroradiology, HUG Geneva University Hospitals, Geneva, Switzerland; Neurodiagnostic and Neurointerventional Division, Department of Radiology and Medical Informatics, Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Morihara R, Yamashita T, Osakada Y, Feng T, Hu X, Fukui Y, Tadokoro K, Takemoto M, Abe K. Efficacy and safety of spot heating and ultrasound irradiation on in vitro and in vivo thrombolysis models. J Cereb Blood Flow Metab 2022; 42:1322-1334. [PMID: 35130767 PMCID: PMC9207486 DOI: 10.1177/0271678x221079127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The feasibility of transcranial sonothrombolysis has been demonstrated, although little is known about the relationships between thermal or mechanical mechanisms and thrombolytic outcomes. Therefore, the present study aims to reveal the effect and safety of temperature and ultrasound through in vitro and in vivo thrombolysis models. Artificial clots in microtubes were heated in a water bath or sonicated by ultrasound irradiation, and then clots weight decrease with rising temperature and sonication time was confirmed. In the in vitro thrombotic occlusion model, based on spot heating, clot volume was reduced and clots moved to the distal side, followed by recanalization of the occlusion. In the in vivo study, the common carotid artery of rats was exposed to a spot heater or to sonication. No brain infarct or brain blood barrier disruption was shown, but endothelial junctional dysintegrity and an inflammatory response in the carotid artery were detected. The present spot heating and ultrasound irradiation models seem to be effective for disintegrating clots in vitro, but the safety of the in vivo model was not fully supported by the data. However, the data indicates that a shorter time exposure could be less invasive than a longer exposure.
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Affiliation(s)
- Ryuta Morihara
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Toru Yamashita
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yosuke Osakada
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Tian Feng
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Xinran Hu
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Yusuke Fukui
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koh Tadokoro
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Mami Takemoto
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
| | - Koji Abe
- Department of Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
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Vijikumar A, Saralkar P, Saylor SD, Sullivan PG, Huber JD, Geldenhuys WJ. Novel mitoNEET ligand NL-1 improves therapeutic outcomes in an aged rat model of cerebral ischemia/reperfusion injury. Exp Neurol 2022; 355:114128. [PMID: 35662609 DOI: 10.1016/j.expneurol.2022.114128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/16/2022] [Accepted: 05/27/2022] [Indexed: 11/28/2022]
Abstract
Cerebral ischemic stroke is a leading cause of mortality and disability worldwide. Currently, there are a lack of drugs capable of reducing neuronal cell loss due to ischemia/reperfusion-injury after stroke. Previously, we identified mitoNEET, a [2Fe-2S] redox mitochondrial protein, as a putative drug target for ischemic stroke. In this study, we tested NL-1, a novel mitoNEET ligand, in a preclinical model of ischemic stroke with reperfusion using aged female rats. Using a transient middle cerebral artery occlusion (tMCAO), we induced a 2 h ischemic injury and then evaluated the effects of NL-1 treatment on ischemic/reperfusion brain injury at 24 and 72 h. Test compounds were administered at time of reperfusion via intravenous dosing. Results of the study demonstrated that NL-1 (10 mg/kg) treatment markedly improved survival and reduced infarct volume and hemispheric swelling in the brain as compared aged rats treated with vehicle or a lower dose of NL-1 (0.25 mg/kg). Interestingly, the protective effect of NL-1 was significantly improved when encapsulated in PLGA nanoparticles, where a 40-fold lesser dose (0.25 mg/kg) of NL-1 produced an equivalent effect as the 10 mg/kg dose. Evaluation of changes in blood-brain barrier permeability and lipid peroxidation corroborated the protective actions of NL-1 (10 mg/kg) or NL-1 NP treatment demonstrated a reduced accumulation of parenchymal IgG, decreased levels of 4-hydroxynonenal (4-HNE) and a decreased TUNEL positive cells in the brains of aged female rats at 72 h after tMCAO with reperfusion. Our studies indicate that targeting mitoNEET following ischemia/reperfusion-injury is a novel drug target pathway that warrants further investigation.
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Affiliation(s)
- Aruvi Vijikumar
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV 26505, United States of America
| | - Pushkar Saralkar
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV 26505, United States of America
| | - Scott D Saylor
- Department of Biochemistry, School of Medicine, West Virginia University, Morgantown, WV 26505, United States of America
| | - Patrick G Sullivan
- Department of Neuroscience, Spinal and Brain Injury Research Center, School of Medicine, University of Kentucky, Lexington, KY 40536, United States of America
| | - Jason D Huber
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV 26505, United States of America; Department of Neuroscience, School of Medicine, West Virginia University, Morgantown, WV 26505, United States of America.
| | - Werner J Geldenhuys
- Department of Pharmaceutical Sciences, School of Pharmacy, West Virginia University, Morgantown, WV 26505, United States of America; Department of Neuroscience, School of Medicine, West Virginia University, Morgantown, WV 26505, United States of America; Department of Biochemistry, School of Medicine, West Virginia University, Morgantown, WV 26505, United States of America
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