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Yang MF, Sun SY, Lv HG, Wang WQ, Li HX, Sun JY, Zhang ZY. Ravoxertinib Improves Long-Term Neurologic Deficits after Experimental Subarachnoid Hemorrhage through Early Inhibition of Erk1/2. ACS OMEGA 2023; 8:19692-19704. [PMID: 37305289 PMCID: PMC10249378 DOI: 10.1021/acsomega.3c01296] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023]
Abstract
Extracellular signal-regulated kinase 1 and 2 (Erk1/2) signaling has been shown to be involved in brain injury after subarachnoid hemorrhage (SAH). A first-in-human phase I study reported that ravoxertinib hydrochloride (RAH), a novel Erk1/2 inhibitor, has an acceptable safety profile and pharmacodynamic effects. Here, we showed that the level of Erk1/2 phosphorylation (p-Erk1/2) was significantly increased in the cerebrospinal fluid (CSF) of aneurysmal subarachnoid hemorrhage (aSAH) patients who developed poor outcomes. In a rat SAH model that was produced by the intracranial endovascular perforation method, western blot observed that the level of p-Erk1/2 was also increased in the CSF and basal cortex, showing a similar trend with aSAH patients. Immunofluorescence and western blot indicated that RAH treatment (i.c.v injection, 30 min post-SAH) attenuates the SAH-induced increase of p-Erk1/2 at 24 h in rats. RAH treatment can improve experimental SAH-induced long-term sensorimotor and spatial learning deficits that are evaluated by the Morris water maze, rotarod test, foot-fault test, and forelimb placing test. Moreover, RAH treatment attenuates neurobehavioral deficits, the blood-brain barrier damage, and cerebral edema at 72 h after SAH in rats. Furthermore, RAH treatment decreases the SAH-elevated apoptosis-related factor active caspase-3 and the necroptosis-related factor RIPK1 expression at 72 h in rats. Immunofluorescence analysis showed that RAH attenuated neuronal apoptosis but not neuronal necroptosis in the basal cortex at 72 h after SAH in rats. Altogether, our results suggest that RAH improves long-term neurologic deficits through early inhibition of Erk1/2 in experimental SAH.
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Affiliation(s)
- Ming-feng Yang
- Department
of Neurology, Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical
Sciences, Tai’an 271016 Shandong, People’s Republic of China
| | - Sheng-yao Sun
- Department
of Neurology, Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical
Sciences, Tai’an 271016 Shandong, People’s Republic of China
| | - Hai-guang Lv
- Department
of Neurology, Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical
Sciences, Tai’an 271016 Shandong, People’s Republic of China
| | - Wei-qi Wang
- Shandong
Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan 250021, Shandong, People’s
Republic of China
| | - Han-xia Li
- Department
of Neurology, Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical
Sciences, Tai’an 271016 Shandong, People’s Republic of China
| | - Jing-yi Sun
- Shandong
Provincial Hospital Affiliated to Shandong First Medical University, Ji’nan 250021, Shandong, People’s
Republic of China
| | - Zong-yong Zhang
- Department
of Neurology, Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical
Sciences, Tai’an 271016 Shandong, People’s Republic of China
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2
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Liu Y, Ding R, Li M, Ou W, Zhang X, Yang W, Huang X, Chai H, Wang Q. TMT proteomics analysis of cerebrospinal fluid from patients with cerebral venous sinus thrombosis. J Proteomics 2023; 275:104820. [PMID: 36646273 DOI: 10.1016/j.jprot.2023.104820] [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: 06/14/2022] [Revised: 01/05/2023] [Accepted: 01/06/2023] [Indexed: 01/15/2023]
Abstract
CVST is a type of venous stroke that mainly affects young adults with no reliable diagnostic markers and effective treatment strategies for secondary pathologies. However, the underlying pathological molecular mechanisms remain unclear. Here, we systematically analyzed the molecule profiling of the cerebrospinal fluid (CSF) in CVST patients via tandem mass tag (TMT)-based proteomics for the first time, aiming to reveal the pathogenesis and provide evidence for the diagnosis and treatment of CVST. Five CVST patients and five control patients were selected, and CSF samples were analyzed by TMT proteomics. Differentially expressed proteins (DEPs) were acquired and bioinformatics analysis was performed. Besides, parallel reaction monitoring (PRM) was utilized to validate the DEPs. 468 differentially expressed proteins were screened, 185 of which were up-regulated and 283 were down-regulated (fold change >1.2, P < 0.05). Bioinformatics analysis displayed that these proteins were significantly enriched in multiple pathways related to a variety of pathophysiological processes. PRM verification showed that apolipoprotein E, MMP-2, neuroserpin, clusterin, and several other molecules were down-regulated. These identified proteins reveal unique pathophysiological characteristics secondary to CVST. Further characterization of these proteins in future research could enable their application as potential therapeutic targets and biomarkers in CVST therapy. SIGNIFICANCE: Cerebral venous sinus thrombosis (CVST) is an underrated and potentially fatal cause of stroke with a reported mortality of 5-10% worldwide. Currently, in addition to anticoagulant and thrombolytic therapy, effective treatments targeting the injured brain parenchyma after CVST remain limited. Besides, accurate diagnostic markers are still sorely lacking. In the present study, we will detect the alterations of the CSF protein spectrum of CVST patients by TMT technique, screen differentially expressed proteins, analyze the functions of these signals through bioinformatics methods, and finally validate the key molecules through parallel reaction monitoring (PRM) technique. Collectively, the study aimed to offer a reference for the discovery of specific protein/pathway alterations in the CSF of CVST patients and further reveal the underlying pathogenesis, thereby providing evidence for the diagnosis and treatment of CVST.
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Affiliation(s)
- Yaqi Liu
- Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China. Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, 510280, Guangdong, China.; Department of cerebrovascular surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou 510630, Guangdong, China
| | - Rui Ding
- Department of cerebrovascular surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou 510630, Guangdong, China; Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Meng Li
- Department of hyperbaric oxygen, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, China
| | - Weiyang Ou
- Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China. Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, 510280, Guangdong, China
| | - Xifang Zhang
- Dongguan Kanghua Hospital, 1000# Dongguan Avenue, Dongguan 523000, Guangdong Province, China
| | - Weijie Yang
- Department of cerebrovascular surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou 510630, Guangdong, China
| | - Xiaofei Huang
- Department of cerebrovascular surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou 510630, Guangdong, China
| | - Huihui Chai
- Department of cerebrovascular surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou 510630, Guangdong, China.
| | - Qiujing Wang
- Neurosurgery Center, Department of Cerebrovascular Surgery, Engineering Technology Research Center of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, Zhujiang Hospital, Southern Medical University, Guangzhou, 510280, Guangdong, China. Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, 510280, Guangdong, China.; Department of cerebrovascular surgery, The Third Affiliated Hospital of Sun Yat-Sen University, No 600 Tianhe Road, Guangzhou 510630, Guangdong, China.
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3
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Zhou XY, Sun JY, Wang WQ, Li SX, Li HX, Yang HJ, Yang MF, Yuan H, Zhang ZY, Sun BL, Han JX. TAT-HSP27 Peptide Improves Neurologic Deficits via Reducing Apoptosis After Experimental Subarachnoid Hemorrhage. Front Cell Neurosci 2022; 16:878673. [PMID: 35573833 PMCID: PMC9096089 DOI: 10.3389/fncel.2022.878673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 03/10/2022] [Indexed: 11/16/2022] Open
Abstract
Cell apoptosis plays an important role in early brain injury (EBI) after subarachnoid hemorrhage (SAH). Heat shock protein 27 (HSP27), a member of the small heat shock protein (HSP) family, is induced by various stress factors and exerts protective role on cells. However, the role of HSP27 in brain injury after SAH needs to be further clarified. Here, we reported that HSP27 level of cerebrospinal fluid (CSF) is increased obviously at day 1 in patients with aneurysmal SAH (aSAH) and related to the grades of Hunt and Hess (HH), World Federation of Neurological Surgeons (WFNS), and Fisher score. In rat SAH model, HSP27 of CSF is first increased and then obviously declined; overexpression of HSP27, not knockdown of HSP27, attenuates SAH-induced neurological deficit and cell apoptosis in the basal cortex; and overexpression of HSP27 effectively suppresses SAH-elevated activation of mitogen-activated protein Kinase Kinase 4 (MKK4), the c-Jun N-terminal kinase (JNK), c-Jun, and caspase-3. In an in vitro hemolysate-damaged cortical neuron model, HSP2765-90 peptide effectively inhibits hemolysate-induced neuron death. Furthermore, TAT-HSP2765-90 peptide, a fusion peptide consisting of trans-activating regulatory protein (TAT) of HIV and HSP2765-90 peptide, effectively attenuates SAH-induced neurological deficit and cell apoptosis in the basal cortex of rats. Altogether, our results suggest that TAT-HSP27 peptide improves neurologic deficits via reducing apoptosis.
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Affiliation(s)
- Xiao-yan Zhou
- Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Shandong University, Ji'nan, China
- Department of Neurosurgery, First Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
- Biomedical Sciences College and Shandong Medicinal Biotechnology Centre, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
- Key Lab for Biotech-Drugs of National Health Commission, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
| | - Jing-yi Sun
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Wei-qi Wang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
| | - Shu-xian Li
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Han-xia Li
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Hui-juan Yang
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Ming-feng Yang
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Hui Yuan
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Zong-yong Zhang
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Bao-liang Sun
- Department of Neurology, Key Laboratory of Cerebral Microcirculation, Second Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Taian, China
| | - Jin-Xiang Han
- Department of Neurosurgery, First Affiliated Hospital of Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
- Biomedical Sciences College and Shandong Medicinal Biotechnology Centre, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
- Key Lab for Biotech-Drugs of National Health Commission, Shandong First Medical University and Shandong Academy of Medical Sciences, Ji'nan, China
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Santacruz CA, Vincent JL, Bader A, Rincón-Gutiérrez LA, Dominguez-Curell C, Communi D, Taccone FS. Association of cerebrospinal fluid protein biomarkers with outcomes in patients with traumatic and non-traumatic acute brain injury: systematic review of the literature. CRITICAL CARE : THE OFFICIAL JOURNAL OF THE CRITICAL CARE FORUM 2021; 25:278. [PMID: 34353354 PMCID: PMC8340466 DOI: 10.1186/s13054-021-03698-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
BACKGROUND Acute brain injuries are associated with high mortality rates and poor long-term functional outcomes. Measurement of cerebrospinal fluid (CSF) biomarkers in patients with acute brain injuries may help elucidate some of the pathophysiological pathways involved in the prognosis of these patients. METHODS We performed a systematic search and descriptive review using the MEDLINE database and the PubMed interface from inception up to June 29, 2021, to retrieve observational studies in which the relationship between CSF concentrations of protein biomarkers and neurological outcomes was reported in patients with acute brain injury [traumatic brain injury, subarachnoid hemorrhage, acute ischemic stroke, status epilepticus or post-cardiac arrest]. We classified the studies according to whether or not biomarker concentrations were associated with neurological outcomes. The methodological quality of the studies was evaluated using the Newcastle-Ottawa quality assessment scale. RESULTS Of the 39 studies that met our criteria, 30 reported that the biomarker concentration was associated with neurological outcome and 9 reported no association. In TBI, increased extracellular concentrations of biomarkers related to neuronal cytoskeletal disruption, apoptosis and inflammation were associated with the severity of acute brain injury, early mortality and worse long-term functional outcome. Reduced concentrations of protein biomarkers related to impaired redox function were associated with increased risk of neurological deficit. In non-traumatic acute brain injury, concentrations of CSF protein biomarkers related to dysregulated inflammation and apoptosis were associated with a greater risk of vasospasm and a larger volume of brain ischemia. There was a high risk of bias across the studies. CONCLUSION In patients with acute brain injury, altered CSF concentrations of protein biomarkers related to cytoskeletal damage, inflammation, apoptosis and oxidative stress may be predictive of worse neurological outcomes.
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Affiliation(s)
- Carlos A Santacruz
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route De Lennik 808, 1070, Brussels, Belgium.,Department of Intensive and Critical Care Medicine, Academic Hospital Fundación Santa Fe de Bogotá, Bogotá, Colombia
| | - Jean-Louis Vincent
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route De Lennik 808, 1070, Brussels, Belgium.
| | - Andres Bader
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route De Lennik 808, 1070, Brussels, Belgium
| | - Luis A Rincón-Gutiérrez
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route De Lennik 808, 1070, Brussels, Belgium
| | - Claudia Dominguez-Curell
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route De Lennik 808, 1070, Brussels, Belgium
| | - David Communi
- Institut de Recherche Interdisciplinaire en Biologie Humaine Et Moléculaire, Université Libre de Bruxelles, Brussels, Belgium
| | - Fabio S Taccone
- Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, Route De Lennik 808, 1070, Brussels, Belgium
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5
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Sokół B, Urbaniak B, Zaremba B, Wąsik N, Kokot ZJ, Jankowski R. CSF Proteomics of Patients with Hydrocephalus and Subarachnoid Haemorrhage. Transl Neurosci 2019; 10:244-253. [PMID: 31637049 PMCID: PMC6778397 DOI: 10.1515/tnsci-2019-0040] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 07/23/2019] [Indexed: 12/17/2022] Open
Abstract
Background The pathophysiology of brain injury following aneurysmal subarachnoid haemorrhage (SAH) is associated with numerous mediators. The aim of the study is to analyse protein changes after SAH in cerebrospinal fluid (CSF) using mass spectrometry (MS). Methods CSF samples were obtained from forty-four control subjects, seven good outcome and ten poor outcome SAH patients. CSF samples were collected at specific time intervals after SAH (days 1, 5 and 10). MALDI-TOF (Matrix Assisted Laser Desorption/Ionization Time-of-Flight) and ClinProTools software were utilised for MS, MS/MS (Mass Spectrometry) spectra collection and analysis. Selected masses were identified. The MALDI-TOF profiling experiments allowed for the targeted selection of potential markers in SAH. The study was performed in three steps by comparison of CSF samples: (1) from the control group and SAH patients (both good and poor outcome groups); (2) collected on days 1, 5 and 10 within the groups of poor SAH and good SAH patients, respectively; (3) from poor outcome SAH and good outcome patients at days 1, 5 and 10. Results 15 new proteins whose CSF level is alternated by SAH presence, SAH treatment outcome and time passed since aneurysm rupture were identified. Conclusions We demonstrated new proteins which might play a role in different stages of subarachnoid haemorrhage and could be a new target for further investigation.
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Affiliation(s)
- Bartosz Sokół
- Department of Neurosurgery, Poznan University of Medical Sciences. Ul. Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Bartosz Urbaniak
- Department of Inorganic and Analytical Chemistry (Faculty of Pharmacy), Poznan University of Medical Sciences. Ul. Grunwaldzka 6, 60-780 Poznan, Poland
| | - Bartosz Zaremba
- Department of Inorganic and Analytical Chemistry (Faculty of Pharmacy), Poznan University of Medical Sciences. Ul. Grunwaldzka 6, 60-780 Poznan, Poland
| | - Norbert Wąsik
- Department of Neurosurgery, Poznan University of Medical Sciences. Ul. Przybyszewskiego 49, 60-355 Poznan, Poland
| | - Zenon J Kokot
- Department of Inorganic and Analytical Chemistry (Faculty of Pharmacy), Poznan University of Medical Sciences. Ul. Grunwaldzka 6, 60-780 Poznan, Poland
| | - Roman Jankowski
- Department of Neurosurgery, Poznan University of Medical Sciences. Ul. Przybyszewskiego 49, 60-355 Poznan, Poland
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Iłżecka J, Iłżecki M, Grabarska A, Dave S, Feldo M, Zubilewicz T. Clusterin as a potential marker of brain ischemia-reperfusion injury in patients undergoing carotid endarterectomy. Ups J Med Sci 2019; 124:193-198. [PMID: 31460820 PMCID: PMC6758642 DOI: 10.1080/03009734.2019.1646359] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Introduction: Carotid endarterectomy (CEA) is a surgical procedure used in the prevention of ischemic stroke. However, this procedure can cause complications of ischemia-reperfusion injury to the brain. Clusterin (CLU) is a cytoprotective chaperone protein that is released from neurons in response to various neurological injuries. The objective of the study was to report the changes in serum CLU concentrations of patients undergoing CEA. Materials and methods: The study involved 25 patients with severe internal carotid artery stenosis. Serum samples were taken from patients at three different times: within 24 hours preoperatively to CEA, 12 hours postoperatively, and 48 hours postoperatively. Serum CLU concentrations were measured using a commercially available enzyme-linked immunosorbent assay. Results: When compared to concentrations preoperatively, the serum CLU concentration initially decreased during the 12 hours following CEA. However, 48 hours following the procedure there was an increase in the CLU concentration. After statistical analysis, differences were detected in serum CLU concentration between all three recorded measurements (P < 0.05). Conclusion: Data from our study indicate that serum CLU concentrations are affected after CEA. We hypothesize that serum CLU concentrations may depend on brain ischemia-reperfusion injury following this surgical procedure.
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Affiliation(s)
- Joanna Iłżecka
- Independent Neurological Rehabilitation Unit, Medical University of Lublin, Lublin, Poland
- CONTACT Joanna Iłżecka, MD, PhD Independent Neurological Rehabilitation Unit, S. Staszica 4/6, 20-081 Lublin, Poland
| | - Marek Iłżecki
- Department of Vascular Surgery and Angiology, Medical University of Lublin, Lublin, Poland
| | - Aneta Grabarska
- Department of Biochemistry and Molecular Biology, Medical University of Lublin, Lublin, Poland
| | - Shawn Dave
- University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma, USA
| | - Marcin Feldo
- Department of Vascular Surgery and Angiology, Medical University of Lublin, Lublin, Poland
| | - Tomasz Zubilewicz
- Department of Vascular Surgery and Angiology, Medical University of Lublin, Lublin, Poland
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Saand AR, Yu F, Chen J, Chou SHY. Systemic inflammation in hemorrhagic strokes - A novel neurological sign and therapeutic target? J Cereb Blood Flow Metab 2019; 39:959-988. [PMID: 30961425 PMCID: PMC6547186 DOI: 10.1177/0271678x19841443] [Citation(s) in RCA: 106] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Growing evidences suggest that stroke is a systemic disease affecting many organ systems beyond the brain. Stroke-related systemic inflammatory response and immune dysregulations may play an important role in brain injury, recovery, and stroke outcome. The two main phenomena in stroke-related peripheral immune dysregulations are systemic inflammation and post-stroke immunosuppression. There is emerging evidence suggesting that the spleen contracts following ischemic stroke, activates peripheral immune response and this may further potentiate brain injury. Whether similar brain-immune crosstalk occurs in hemorrhagic strokes such as intracerebral hemorrhage (ICH) and subarachnoid hemorrhage (SAH) is not established. In this review, we systematically examined animal and human evidence to date on peripheral immune responses associated with hemorrhagic strokes. Specifically, we reviewed the impact of clinical systemic inflammatory response syndrome (SIRS), inflammation- and immune-associated biomarkers, the brain-spleen interaction, and cellular mediators of peripheral immune responses to ICH and SAH including regulatory T cells (Tregs). While there is growing data suggesting that peripheral immune dysregulation following hemorrhagic strokes may be important in brain injury pathogenesis and outcome, details of this brain-immune system cross-talk remain insufficiently understood. This is an important unmet scientific need that may lead to novel therapeutic strategies in this highly morbid condition.
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Affiliation(s)
- Aisha R Saand
- 1 Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Fang Yu
- 2 Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jun Chen
- 2 Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Sherry H-Y Chou
- 1 Department of Critical Care Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,2 Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.,3 Department of Neurosurgery, School of Medicine, University of Pittsburgh, PA, USA
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