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Dubois C, Dawit H, Korevaar DA, Vali Y, Al Sibaaie A, Frank RA, McInnes MDF, Hyde C, Bossuyt PM, Cohen JF. Evaluation of adherence to STARD for abstracts in a diverse sample of diagnostic accuracy abstracts published in 2012 and 2019 reveals suboptimal reporting practices. J Clin Epidemiol 2024; 173:111459. [PMID: 39004321 DOI: 10.1016/j.jclinepi.2024.111459] [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: 04/22/2024] [Revised: 06/18/2024] [Accepted: 07/07/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES To evaluate the completeness of reporting in a sample of abstracts on diagnostic accuracy studies before and after the release of Standards for Reporting of Diagnostic Accuracy Studies (STARD) for abstracts in 2017. METHODS We included 278 diagnostic accuracy abstracts published in 2012 (N = 138) and 2019 (N = 140) and indexed in EMBASE. We analyzed their adherence to 10 items of the 11-item STARD for abstracts checklist, and we explored variability in reporting across abstract characteristics using multivariable Poisson modeling. RESULTS Most of the 278 abstracts (75%) were published in discipline-specific journals, with a median impact factor of 2.9 (IQR: 1.9-3.7). The majority (41%) of abstracts reported on imaging tests. Overall, a mean of 5.4/10 (SD: 1.4) STARD for abstracts items was reported (range: 1.2-9.7). Items reported in less than one-third of abstracts included 'eligible patient demographics' (24%), 'setting of recruitment' (30%), 'method of enrollment' (18%), 'estimates of precision for accuracy measures' (26%), and 'protocol registration details' (4%). We observed substantial variability in reporting across several abstract characteristics, with higher adherence associated with the use of a structured abstract, no journal limit for abstract word count, abstract word count above the median, one-gate enrollment design, and prospective data collection. There was no evidence of increase in the number of reported items between 2012 and 2019 (5.2 vs 5.5 items; adjusted reporting ratio: 1.04 [95% CI: 0.98-1.10]). CONCLUSION This sample of diagnostic accuracy abstracts revealed suboptimal reporting practices without improvement between 2012 and 2019. The test evaluation field could benefit from targeted knowledge translation strategies to improve completeness of reporting in abstracts.
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Affiliation(s)
- Constance Dubois
- Center of Research in Epidemiology and Statistics (CRESS), INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Université Paris Cité, Paris, France
| | - Haben Dawit
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Yasaman Vali
- Department of Epidemiology and Data Science, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Alma Al Sibaaie
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Robert A Frank
- Division of Abdominal Imaging and Intervention, Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew D F McInnes
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Chris Hyde
- Exeter Test Group, College House, University of Exeter, Exeter, UK
| | - Patrick M Bossuyt
- Department of Epidemiology and Data Science, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jérémie F Cohen
- Center of Research in Epidemiology and Statistics (CRESS), INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Université Paris Cité, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France.
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Ourednik J, Ourednik V, Ghosh N, Snyder EY. Protocol to optimize the Rice-Vannucci rat pup model of perinatal asphyxia to ensure predictable hypoxic-ischemic cerebral lesions. STAR Protoc 2024; 5:103025. [PMID: 38852156 PMCID: PMC11217776 DOI: 10.1016/j.xpro.2024.103025] [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: 09/18/2023] [Revised: 02/01/2024] [Accepted: 04/04/2024] [Indexed: 06/11/2024] Open
Abstract
The Rice-Vannucci model in rodent pups is subject to substantial loss of animals, result inconsistency, and high lab-to-lab variability in extent and composition of induced injury. This protocol allows for highly predictable and reproducible hypoxic-ischemic cerebral injury lesions in post-natal day 10 Wistar rat pups with no mortality. We describe steps for common carotid artery ligation, brief post-operative normothermia, exposure to hypoxia, and post-hypoxic normothermia. Precise timing and temperature control in each step are crucial for a successful procedure. For complete details on the use and execution of this protocol, please refer to Hartman et al.1.
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Affiliation(s)
- Jitka Ourednik
- Center for Stem Cells & Regenerative Medicine, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA; Sanford Consortium for Regenerative Medicine, La Jolla, CA 92037, USA.
| | - Václav Ourednik
- Center for Stem Cells & Regenerative Medicine, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA; Sanford Consortium for Regenerative Medicine, La Jolla, CA 92037, USA
| | - Nirmalya Ghosh
- Department of Electrical Engineering, Indian Institute of Technology (IIT) Kharagpur, Kharagpur, West Bengal 721302, India
| | - Evan Y Snyder
- Center for Stem Cells & Regenerative Medicine, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA 92037, USA; Sanford Consortium for Regenerative Medicine, La Jolla, CA 92037, USA; Biomedical Sciences Graduate Program, University of California San Diego, San Diego, La Jolla, CA 92037, USA.
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Reid MM, Kautzmann MAI, Andrew G, Obenaus A, Mukherjee PK, Khoutorova L, Ji JX, Roque CR, Oria RB, Habeb BF, Belayev L, Bazan NG. NPD1 Plus RvD1 Mediated Ischemic Stroke Penumbra Protection Increases Expression of Pro-homeostatic Microglial and Astrocyte Genes. Cell Mol Neurobiol 2023; 43:3555-3573. [PMID: 37270727 PMCID: PMC10477115 DOI: 10.1007/s10571-023-01363-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 05/13/2023] [Indexed: 06/05/2023]
Abstract
Neuroprotection to attenuate or block the ischemic cascade and salvage neuronal damage has been extensively explored for treating ischemic stroke. However, despite increasing knowledge of the physiologic, mechanistic, and imaging characterizations of the ischemic penumbra, no effective neuroprotective therapy has been found. This study focuses on the neuroprotective bioactivity of docosanoid mediators: Neuroprotectin D1 (NPD1), Resolvin D1 (RvD1), and their combination in experimental stroke. Molecular targets of NPD1 and RvD1 are defined by following dose-response and therapeutic window. We demonstrated that treatment with NPD1, RvD1, and combination therapy provides high-grade neurobehavioral recovery and decreases ischemic core and penumbra volumes even when administered up to 6 h after stroke. The expression of the following genes was salient: (a) Cd163, an anti-inflammatory stroke-associated gene, was the most differentially expressed gene by NPD1+RvD1, displaying more than a 123-fold upregulation in the ipsilesional penumbra (Lisi et al., Neurosci Lett 645:106-112, 2017); (b) 100-fold upregulation takes place in astrocyte gene PTX3, a key regulator of neurogenesis and angiogenesis after cerebral ischemia (. Rodriguez-Grande et al., J Neuroinflammation 12:15, 2015); and (c) Tmem119 and P2y12, two markers of homeostatic microglia, were found to be enhanced by ten- and fivefold, respectively (Walker et al. Int J Mol Sci 21:678, 2020). Overall, we uncovered that protection after middle cerebral artery occlusion (MCAo) by the lipid mediators elicits expression of microglia and astrocyte-specific genes (Tmem119, Fcrls, Osmr, Msr1, Cd68, Cd163, Amigo2, Thbs1, and Tm4sf1) likely participating in enhancing homeostatic microglia, modulating neuroinflammation, promoting DAMP clearance, activating NPC differentiation and maturation, synapse integrity and contributing to cell survival.
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Affiliation(s)
- Madigan M Reid
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Marie-Audrey I Kautzmann
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Gethein Andrew
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Andre Obenaus
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA, 92618, USA
| | - Pranab K Mukherjee
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Larissa Khoutorova
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Jeff X Ji
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Cassia R Roque
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, Brazil
| | - Reinaldo B Oria
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, Brazil
| | - Bola F Habeb
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA
| | - Ludmila Belayev
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier St, Suite 9B16, Room 935A, New Orleans, LA, 70112, USA.
| | - Nicolas G Bazan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, 70112, USA.
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, Neuroscience Center of Excellence, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA.
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Reid MM, Belayev L, Khoutorova L, Mukherjee PK, Obenaus A, Shelvin K, Knowles S, Hong SH, Bazan NG. Integrated inflammatory signaling landscape response after delivering Elovanoid free-fatty-acid precursors leading to experimental stroke neuroprotection. Sci Rep 2023; 13:15841. [PMID: 37740008 PMCID: PMC10516907 DOI: 10.1038/s41598-023-42126-w] [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: 06/12/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023] Open
Abstract
Despite efforts to identify modulatory neuroprotective mechanisms of damaging ischemic stroke cascade signaling, a void remains on an effective potential therapeutic. The present study defines neuroprotection by very long-chain polyunsaturated fatty acid (VLC-PUFA) Elovanoid (ELV) precursors C-32:6 and C-34:6 delivered intranasally following experimental ischemic stroke. We demonstrate that these precursors improved neurological deficit, decreased T2WI lesion volume, and increased SMI-71 positive blood vessels and NeuN positive neurons, indicating blood-brain barrier (BBB) protection and neurogenesis modulated by the free fatty acids (FFAs) C-32:6 and C-34:6. Gene expression revealed increased anti-inflammatory and pro-homeostatic genes and decreases in expression of pro-inflammatory genes in the subcortex. Additionally, the FFAs elicit a comprehensive downregulation of inflammatory microglia/monocyte-derived macrophages and astrocyte-associated genes in the subcortical region. Functional analysis reveals inhibition of immune-related pathways and production of upstream molecules related to detrimental signaling events in post-stroke acute and subacute phases.
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Affiliation(s)
- Madigan M Reid
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
| | - Ludmila Belayev
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
| | - Larissa Khoutorova
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
| | - Pranab K Mukherjee
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
| | - Andre Obenaus
- Department of Pediatrics, School of Medicine, University of California Irvine, Irvine, CA, USA
| | - Kierany Shelvin
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
| | - Stacey Knowles
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
| | - Sung-Ha Hong
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA
- UT Health, McGovern Medical School, University of Texas Health Sciences Center at Houston, Houston, USA
| | - Nicolas G Bazan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, 2020 Gravier Street, Suite D, New Orleans, LA, 70112, USA.
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Obenaus A, Kinney-Lang E, Jullienne A, Haddad E, Wendel KM, Shereen AD, Solodkin A, Dunn JF, Baram TZ. Seeking the Amygdala: Novel Use of Diffusion Tensor Imaging to Delineate the Basolateral Amygdala. Biomedicines 2023; 11:biomedicines11020535. [PMID: 36831071 PMCID: PMC9953214 DOI: 10.3390/biomedicines11020535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 01/31/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
The amygdaloid complex, including the basolateral nucleus (BLA), contributes crucially to emotional and cognitive brain functions, and is a major target of research in both humans and rodents. However, delineating structural amygdala plasticity in both normal and disease-related contexts using neuroimaging has been hampered by the difficulty of unequivocally identifying the boundaries of the BLA. This challenge is a result of the poor contrast between BLA and the surrounding gray matter, including other amygdala nuclei. Here, we describe a novel diffusion tensor imaging (DTI) approach to enhance contrast, enabling the optimal identification of BLA in the rodent brain from magnetic resonance (MR) images. We employed this methodology together with a slice-shifting approach to accurately measure BLA volumes. We then validated the results by direct comparison to both histological and cellular-identity (parvalbumin)-based conventional techniques for defining BLA in the same brains used for MRI. We also confirmed BLA connectivity targets using DTI-based tractography. The novel approach enables the accurate and reliable delineation of BLA. Because this nucleus is involved in and changed by developmental, degenerative and adaptive processes, the instruments provided here should be highly useful to a broad range of neuroimaging studies. Finally, the principles used here are readily applicable to numerous brain regions and across species.
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Affiliation(s)
- Andre Obenaus
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
- Department of Pediatrics, University of California, Irvine, CA 92697, USA
- Department of Anatomy/Neurobiology, University of California, Irvine, CA 92697, USA
- Correspondence:
| | - Eli Kinney-Lang
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
- Department of Pediatrics, University of California, Irvine, CA 92697, USA
| | - Amandine Jullienne
- Department of Pediatrics, University of California, Irvine, CA 92697, USA
| | - Elizabeth Haddad
- Department of Pediatrics, University of California, Irvine, CA 92697, USA
| | - Kara M. Wendel
- Department of Anatomy/Neurobiology, University of California, Irvine, CA 92697, USA
| | - A. Duke Shereen
- Department of Anatomy/Neurobiology, University of California, Irvine, CA 92697, USA
| | - Ana Solodkin
- Department of Anatomy/Neurobiology, University of California, Irvine, CA 92697, USA
- Department of Neurology, University of California, Irvine, CA 92697, USA
| | - Jeffrey F. Dunn
- Department of Radiology, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Alberta T2N 4N1, Canada
| | - Tallie Z. Baram
- Department of Pediatrics, University of California, Irvine, CA 92697, USA
- Department of Anatomy/Neurobiology, University of California, Irvine, CA 92697, USA
- Department of Neurology, University of California, Irvine, CA 92697, USA
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Reid MM, Obenaus A, Mukherjee PK, Khoutorova L, Roque CR, Petasis NA, Oria RB, Belayev L, Bazan NG. Synergistic Neuroprotection by a PAF Antagonist Plus a Docosanoid in Experimental Ischemic Stroke: Dose-Response and Therapeutic Window. J Stroke Cerebrovasc Dis 2022; 31:106585. [PMID: 35717719 PMCID: PMC9976619 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106585] [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: 04/08/2022] [Revised: 05/17/2022] [Accepted: 05/26/2022] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE We tested the hypothesis that blocking pro-inflammatory platelet-activating factor receptor (PAFR) with LAU-0901 (LAU) plus administering a selected docosanoid, aspirin-triggered neuroprotectin D1 (AT-NPD1), which activates cell-survival pathways after middle cerebral artery occlusion (MCAo), would lead to neurological recovery. Dose-response and therapeutic window were investigated. MATERIALS AND METHODS Male SD rats were subjected to 2 hours of MCAo. Behavior testing (days 1-7) and ex vivo MRI on day 7 were conducted. In dose-response, rats were treated with LAU (45 and 60 mg/kg; IP), AT-NPD1 (111, 222, 333 µg/kg; IV), LAU+AT-NPD1 (LAU at 3 hours and AT-NPD1 at 3.15 hours) or vehicle. In the therapeutic window, vehicle, LAU (60 mg/kg), AT-NPD1 (222 µg/kg), and LAU+AT-NPD1 were administered at 3, 4, 5, and 6 hours after onset of MCAo. RESULTS LAU and AT-NPD1 treatments alone improved behavior by 40-42% and 20-30%, respectively, and LAU+AT-NPD1 by 40% compared to the vehicle group. T2-weighted imaging (T2WI) volumes were reduced with all doses of LAU and AT-NPD1 by 73-90% and 67-83% and LAU+AT-NPD1 by 94% compared to vehicle. In the therapeutic window, LAU+AT-NPD1, when administered at 3, 4, 5, and 6 hours, improved behavior by 50, 56, 33, and 26% and reduced T2WI volumes by 93, 90, 82, and 84% compared to vehicle. CONCLUSIONS We have shown here for the first time that LAU plus AT-NPD1 treatment affords high-grade neuroprotection in MCAo, equaling or exceeding that afforded by LAU or AT-NPD1 alone at considerably moderate doses. It has a broad therapeutic window extending to 6 hours after stroke onset.
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Affiliation(s)
- Madigan M. Reid
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, USA
| | - Andre Obenaus
- Department of Pediatrics, School of Medicine, University of California, Irvine, CA, USA.
| | - Pranab K. Mukherjee
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, USA
| | - Larissa Khoutorova
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, USA.
| | - Cassia R. Roque
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, Brazil
| | - Nicos A. Petasis
- Department of Chemistry, University of Southern California, Los Angeles, CA, USA
| | - Reinaldo B. Oria
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, Fortaleza, Brazil
| | - Ludmila Belayev
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, USA.
| | - Nicolas G. Bazan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health New Orleans, New Orleans, LA, USA
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Multi-view iterative random walker for automated salvageable tissue delineation in ischemic stroke from multi-sequence MRI. J Neurosci Methods 2021; 360:109260. [PMID: 34146591 DOI: 10.1016/j.jneumeth.2021.109260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Revised: 05/19/2021] [Accepted: 06/13/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND OBJECTIVE Non-invasive and robust identification of salvageable tissue (penumbra) is crucial for interventional stroke therapy. Besides identifying stroke injury as a whole, the ability to automatically differentiate core and penumbra tissues, using both diffusion and perfusion magnetic resonance imaging (MRI) sequences is essential for ischemic stroke treatment. METHOD A fully automated and novel one-shot multi-view iterative random walker (MIRW) method with an automated injury seed point detection is developed for lesion delineation. MIRW utilizes the heirarchical decomposition of multi-sequence MRI physical properties of the underlying tissue within the lesion to maximize the inter-class variations of the volumetric histogram to estimate the probable seed points. These estimates are further utilized to conglomerate the lesion estimations iteratively from axial, coronal and sagittal MRI volumes for a computationally efficient segmentation and quantification of salvageable and necrotic tissues from multi-sequence MRI. RESULTS Comprehensive experimental analysis of MIRW is performed on three challenging adult(sub-)acute ischemic stroke datasets using performance measures like precision, sensitivity, specificity and Dice similarity score (DSC), which are computed with respect to the manual ground-truth. COMPARISON WITH EXISTING METHODS MIRW method resulted in a high DSC of 83.5% in a very less computational time of 98.23 s/volume, which is a significant improvement on the ISLES benchmark dataset for penumbra detection, compared to the state-of-the-art techniques. CONCLUSION Quantitative measures demonstrate the promising potential of MIRW for computational analysis of adult stroke and quantifying penumbra in stroke patients which is essential for selecting the good candidates for recanalization.
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Obenaus A, Badaut J. Role of the noninvasive imaging techniques in monitoring and understanding the evolution of brain edema. J Neurosci Res 2021; 100:1191-1200. [PMID: 34048088 DOI: 10.1002/jnr.24837] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 03/13/2021] [Indexed: 12/21/2022]
Abstract
Human brain injury elicits accumulation of water within the brain due to a variety of pathophysiological processes. As our understanding of edema emerged two temporally (and cellular) distinct processes were identified, cytotoxic and vasogenic edema. The emergence of both types of edema is reflected by the temporal evolution and is influenced by the underlying pathology (type and extent). However, this two-edema compartment model does not adequately describe the transition between cytotoxic and vasogenic edema. Hence, a third category has been proposed, termed ionic edema, that is observed in the transition between cytotoxic and vasogenic edema. Magnetic resonance neuroimaging of edema today primarily utilizes T2-weighted (T2WI) and diffusion-weighted imaging (DWI). Clinical diagnostics and translational science studies have clearly demonstrated the temporal ability of both T2WI and DWI to monitor edema content and evolution. DWI measures water mobility within the brain reflecting cytotoxic edema. T2WI at later time points when vasogenic edema develops visualizes increased water content in the brain. Clinically relevant imaging modalities, including ultrasound and positron emission tomography, are not typically used to assess edema. In sum, edema imaging is an important cornerstone of clinical diagnostics and translational studies and can guide effective therapeutics manage edema and improve patient outcomes.
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Affiliation(s)
- Andre Obenaus
- Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.,Department of Pediatrics, University of California, Irvine, Irvine, CA, USA
| | - Jérôme Badaut
- Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA, USA.,CNRS UMR5287, INCIA, University of Bordeaux, Bordeaux, France
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A Biomarker for Predicting Responsiveness to Stem Cell Therapy Based on Mechanism-of-Action: Evidence from Cerebral Injury. Cell Rep 2021; 31:107622. [PMID: 32402283 DOI: 10.1016/j.celrep.2020.107622] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/16/2020] [Accepted: 04/16/2020] [Indexed: 11/20/2022] Open
Abstract
To date, no stem cell therapy has been directed to specific recipients-and, conversely, withheld from others-based on a clinical or molecular profile congruent with that cell's therapeutic mechanism-of-action (MOA) for that condition. We address this challenge preclinically with a prototypical scenario: human neural stem cells (hNSCs) against perinatal/neonatal cerebral hypoxic-ischemic injury (HII). We demonstrate that a clinically translatable magnetic resonance imaging (MRI) algorithm, hierarchical region splitting, provides a rigorous, expeditious, prospective, noninvasive "biomarker" for identifying subjects with lesions bearing a molecular profile indicative of responsiveness to hNSCs' neuroprotective MOA. Implanted hNSCs improve lesional, motor, and/or cognitive outcomes only when there is an MRI-measurable penumbra that can be forestalled from evolving into necrotic core; the core never improves. Unlike the core, a penumbra is characterized by a molecular profile associated with salvageability. Hence, only lesions characterized by penumbral > core volumes should be treated with cells, making such measurements arguably a regenerative medicine selection biomarker.
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Belayev L, Obenaus A, Mukherjee PK, Knott EJ, Khoutorova L, Reid MM, Roque CR, Nguyen L, Lee JB, Petasis NA, Oria RB, Bazan NG. Blocking pro-inflammatory platelet-activating factor receptors and activating cell survival pathways: A novel therapeutic strategy in experimental ischemic stroke. Brain Circ 2021; 6:260-268. [PMID: 33506149 PMCID: PMC7821809 DOI: 10.4103/bc.bc_36_20] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 09/10/2020] [Accepted: 10/18/2020] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Acute ischemic stroke triggers complex neurovascular, neuroinflammatory, and synaptic alterations. This study explores whether blocking pro-inflammatory platelet-activating factor receptor (PAF-R) plus selected docosanoids after middle cerebral artery occlusion (MCAo) would lead to neurological recovery. The following small molecules were investigated: (a) LAU-0901, a PAF-R antagonist that blocks pro-inflammatory signaling; and (b) derivatives of docosahexaenoic acid (DHA), neuroprotectin D1 (NPD1), and aspirin-triggered NPD1 (AT-NPD1), which activates cell survival pathways and are exert potent anti-inflammatory activity in the brain. MATERIALS AND METHODS Sprague-Dawley rats received 2 h MCAo and LAU-0901 (30 or 60 mg/kg, 2 h after stroke), NPD1, and AT-NPD1 (333 μg/kg), DHA (5 mg/kg), and their combination were administered intravenous at 3 h after stroke. Behavior testing and ex vivo magnetic resonance imaging were conducted on day 3 or 14 to assess lesion characteristics and lipidomic analysis on day 1. Series 1 (LAU-0901 + NPD1, 14d), Series 2 (LAU-0901 + AT-NPD1, 3d), and Series 3 (LAU-0901 + DHA, 1d). RESULTS All combinatory groups improved behavior compared to NPD1, AT-NPD1, or DHA treatments alone. Total lesion volumes were reduced with LAU-0901 + NPD1 by 62% and LAU-0901 + AT-NPD1 by 90% treatments versus vehicle groups. LAU-0901 and LAU-0901 + DHA increased the production of vasoactive lipid mediators (prostaglandins: PGE2, PGF2- α, 6-keto-PGF1- α, and PGD2) as well an inflammatory regulating mediator hydroxyoctadecadienoic acid. In contrast, LAU-0901 and LAU-0901 + DHA decreased the production of 12-hydroxyeicosatetraenoic acid, a pro-inflammatory mediator. CONCLUSION Combination therapy with LAU-0901 and selected docosanoids is more effective than the single therapy, affording synergistic neuroprotection, with restored pro-homeostatic lipid mediators and improved neurological recovery. Altogether, our findings support the combinatory therapy as the basis for future therapeutics for ischemic stroke.
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Affiliation(s)
- Ludmila Belayev
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Andre Obenaus
- Department of Pediatrics, School of Medicine, University of California, Irvine, USA
| | - Pranab K Mukherjee
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Eric J Knott
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Larissa Khoutorova
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Madigan M Reid
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
| | - Cassia R Roque
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.,Department of Morphology and Institute of Biomedicine, School of Medicine, Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Federal University of Ceara, Fortaleza, Brazil
| | - Lawrence Nguyen
- Department of Pediatrics, School of Medicine, University of California, Irvine, USA
| | - Jeong Bin Lee
- Department of Pediatrics, School of Medicine, University of California, Irvine, USA
| | - Nicos A Petasis
- Department of Chemistry, University of Southern California, Los Angeles, CA, USA
| | - Reinaldo B Oria
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA.,Department of Morphology and Institute of Biomedicine, School of Medicine, Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Federal University of Ceara, Fortaleza, Brazil
| | - Nicolas G Bazan
- Neuroscience Center of Excellence, School of Medicine, Louisiana State University Health Sciences Center, New Orleans, USA
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11
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Petrushina I, Hovakimyan A, Harahap-Carrillo IS, Davtyan H, Antonyan T, Chailyan G, Kazarian K, Antonenko M, Jullienne A, Hamer MM, Obenaus A, King O, Zagorski K, Blurton-Jones M, Cribbs DH, Lander H, Ghochikyan A, Agadjanyan MG. Characterization and preclinical evaluation of the cGMP grade DNA based vaccine, AV-1959D to enter the first-in-human clinical trials. Neurobiol Dis 2020; 139:104823. [PMID: 32119976 PMCID: PMC8772258 DOI: 10.1016/j.nbd.2020.104823] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Revised: 02/03/2020] [Accepted: 02/27/2020] [Indexed: 02/08/2023] Open
Abstract
The DNA vaccine, AV-1959D, targeting N-terminal epitope of Aβ peptide, has been proven immunogenic in mice, rabbits, and non-human primates, while its therapeutic efficacy has been shown in mouse models of Alzheimer's disease (AD). Here we report for the first time on IND-enabling biodistribution and safety/toxicology studies of cGMP-grade AV-1959D vaccine in the Tg2576 mouse model of AD. We also tested acute neuropathology safety profiles of AV-1959D in another AD disease model, Tg-SwDI mice with established vascular and parenchymal Aβ pathology in a pre-clinical translational study. Biodistribution studies two days after the injection demonstrated high copy numbers of AV-1959D plasmid after single immunization of Tg2576 mice at the injection sites but not in the tissues of distant organs. Plasmids persisted at the injection sites of some mice 60 days after vaccination. In Tg2576 mice with established amyloid pathology, we did not observe short- or long-term toxicities after multiple immunizations with three doses of AV-1959D. Assessment of the repeated dose acute safety of AV-1959D in cerebral amyloid angiopathy (CAA) prone Tg-SwDI mice did not reveal any immunotherapy-induced vasogenic edema detected by magnetic resonance imaging (MRI) or increased microhemorrhages. Multiple immunizations of Tg-SwDI mice with AV-1959D did not induce T and B cell infiltration, glial activation, vascular deposition of Aβ, or neuronal degeneration (necrosis and apoptosis) greater than that in the control group determined by immunohistochemistry of brain tissues. Taken together, the safety data from two different mouse models of AD substantiate a favorable safety profile of the cGMP grade AV-1959D vaccine supporting its progression to first-in-human clinical trials.
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Affiliation(s)
- Irina Petrushina
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Armine Hovakimyan
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | | | - Hayk Davtyan
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA; Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, CA, USA
| | - Tatevik Antonyan
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Gor Chailyan
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Konstantin Kazarian
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Maxim Antonenko
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Amandine Jullienne
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Mary M Hamer
- Department of Pediatrics, University of California, Irvine, CA, USA
| | - Andre Obenaus
- Department of Pediatrics, University of California, Irvine, CA, USA; Preclinical and Translational Imaging Center, University of California, Irvine, CA, USA
| | - Olga King
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Karen Zagorski
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Mathew Blurton-Jones
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Sue and Bill Gross Stem Cell Research Center, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - David H Cribbs
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Harry Lander
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA
| | - Anahit Ghochikyan
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA.
| | - Michael G Agadjanyan
- Department of Molecular Immunology, Institute for Molecular Medicine, Huntington Beach, CA, USA.
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12
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Wang JJ, Zhu JD, Zhang XH, Long TT, Ge G, Yu Y. Neuroprotective effect of Notch pathway inhibitor DAPT against focal cerebral ischemia/reperfusion 3 hours before model establishment. Neural Regen Res 2019; 14:452-461. [PMID: 30539813 PMCID: PMC6334612 DOI: 10.4103/1673-5374.245469] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
As an inhibitor of the Notch signaling pathway, N-[N-(3,5-difluorohenacetyl)-l-alanyl]-S-phenylglycine tert-butyl ester (DAPT) may protect brain tissue from serious ischemic injury. This study aimed to explore neuroprotection by DAPT after cerebral ischemia/reperfusion (I/R) injury. DAPT was intraperitoneally injected 3 hours before the establishment of a focal cerebral I/R model in the right middle cerebral artery of obstructed mice. Longa scores were used to assess neurological changes of mice. Nissl staining and TdT-mediated dUTP-biotin nick-end labeling staining were used to examine neuronal damage and cell apoptosis in the right prefrontal cortex, while immunofluorescence staining was used to detect glial fibrillary acidic protein- and Notch1-positive cells. Protein expression levels of Hes1 and Hes5 were detected by western blot assay in the right prefrontal cortex. Our results demonstrated that DAPT significantly improved neurobehavioral scores and relieved neuronal morphological damage. DAPT decreased the number of glial fibrillary acidic protein- and Notch1-positive cells in the right prefrontal cortex, while also reducing the number of apoptotic cells and decreasing interleukin-6 and tumor necrosis factor-α contents, and simultaneously downregulating Hes1 and Hes5 protein expression. These findings verify that DAPT alleviates pathological lesions and strengthens the anti-inflammatory response after cerebral I/R injury. Thus, DAPT might be developed as an effective drug for the prevention of cerebral I/R injury.
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Affiliation(s)
- Jun-Jie Wang
- Department of Anatomy, School of Basic Medicine, Guizhou Medical University, Guian New District, Guizhou Province, China
| | - Jun-De Zhu
- Department of Anatomy, School of Basic Medicine, Guizhou Medical University, Guian New District, Guizhou Province, China
| | - Xian-Hu Zhang
- Department of Anatomy, School of Basic Medicine, Guizhou Medical University, Guian New District, Guizhou Province, China
| | - Ting-Ting Long
- Department of Anatomy, School of Basic Medicine, Guizhou Medical University, Guian New District, Guizhou Province, China
| | - Guo Ge
- Department of Anatomy, School of Basic Medicine, Guizhou Medical University, Guian New District, Guizhou Province, China
| | - Yan Yu
- Department of Anatomy, School of Basic Medicine, Guizhou Medical University, Guian New District, Guizhou Province, China
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13
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Leigh R, Knutsson L, Zhou J, van Zijl PC. Imaging the physiological evolution of the ischemic penumbra in acute ischemic stroke. J Cereb Blood Flow Metab 2018; 38:1500-1516. [PMID: 28345479 PMCID: PMC6125975 DOI: 10.1177/0271678x17700913] [Citation(s) in RCA: 98] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We review the hemodynamic, metabolic and cellular parameters affected during early ischemia and their changes as a function of approximate cerebral blood flow ( CBF) thresholds. These parameters underlie the current practical definition of an ischemic penumbra, namely metabolically affected but still viable brain tissue. Such tissue is at risk of infarction under continuing conditions of reduced CBF, but can be rescued through timely intervention. This definition will be useful in clinical diagnosis only if imaging techniques exist that can rapidly, and with sufficient accuracy, visualize the existence of a mismatch between such a metabolically affected area and regions that have suffered cell depolarization. Unfortunately, clinical data show that defining the outer boundary of the penumbra based solely on perfusion-related thresholds may not be sufficiently accurate. Also, thresholds for CBF and cerebral blood volume ( CBV) differ for white and gray matter and evolve with time for both inner and outer penumbral boundaries. As such, practical penumbral imaging would involve parameters in which the physiology is immediately displayed in a manner independent of baseline CBF or CBF threshold, namely pH, oxygen extraction fraction ( OEF), diffusion constant and mean transit time ( MTT). Suitable imaging technologies will need to meet this requirement in a 10-20 min exam.
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Affiliation(s)
- Richard Leigh
- 1 National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, USA
| | - Linda Knutsson
- 2 Department of Medical Radiation Physics, Lund University, Lund, Sweden.,3 Department of Radiology, Johns Hopkins University, Baltimore, MD, USA
| | - Jinyuan Zhou
- 3 Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.,4 F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Peter Cm van Zijl
- 3 Department of Radiology, Johns Hopkins University, Baltimore, MD, USA.,4 F.M. Kirby Center for Functional Brain Imaging, Kennedy Krieger Institute, Baltimore, MD, USA
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14
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Vupputuri A, Dighade S, Prasanth PS, Ghosh N. Symmetry determined superpixels for efficient lesion segmentation of ischemic stroke from MRI. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2018; 2018:742-745. [PMID: 30440503 DOI: 10.1109/embc.2018.8512283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Non-invasive, quantitative and robust identification of ischemic stroke and estimation of injury extent is essential for assisting neuroradiologists. Manual Iesion delineation techniques are susceptible to subjective errors and therefore computer aided preliminary screening of necrosis is warranted. Superpixel based segmentation has gained importance in the recent past by reducing the computational complexity and preserving the characteristics of a group of pixels with similar properties. Axial and coronal MR images of brain exhibit the important feature of symmetry which was integrated with superpixels for segmenting ischemic Iesion. This method was evaluated on a challenging 10 patient data set along with MICCAI challenge data of 28 patients yielding promising results. Proposed symmetry determined superpixel based method demonstrated accuracy close to manual Iesion demarcation with high performance indices with average sensitivity of 82.32%, specificity of 93.7% and Dice similarity score of81.14%.
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15
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Salehi A, Zhang JH, Obenaus A. Response of the cerebral vasculature following traumatic brain injury. J Cereb Blood Flow Metab 2017; 37:2320-2339. [PMID: 28378621 PMCID: PMC5531360 DOI: 10.1177/0271678x17701460] [Citation(s) in RCA: 186] [Impact Index Per Article: 26.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
The critical role of the vasculature and its repair in neurological disease states is beginning to emerge particularly for stroke, dementia, epilepsy, Parkinson's disease, tumors and others. However, little attention has been focused on how the cerebral vasculature responds following traumatic brain injury (TBI). TBI often results in significant injury to the vasculature in the brain with subsequent cerebral hypoperfusion, ischemia, hypoxia, hemorrhage, blood-brain barrier disruption and edema. The sequalae that follow TBI result in neurological dysfunction across a host of physiological and psychological domains. Given the importance of restoring vascular function after injury, emerging research has focused on understanding the vascular response after TBI and the key cellular and molecular components of vascular repair. A more complete understanding of vascular repair mechanisms are needed and could lead to development of new vasculogenic therapies, not only for TBI but potentially vascular-related brain injuries. In this review, we delineate the vascular effects of TBI, its temporal response to injury and putative biomarkers for arterial and venous repair in TBI. We highlight several molecular pathways that may play a significant role in vascular repair after brain injury.
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Affiliation(s)
- Arjang Salehi
- 1 Cell, Molecular and Developmental Biology Program, University of California, Riverside, CA, USA.,2 Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA
| | - John H Zhang
- 3 Department of Physiology and Pharmacology Loma Linda University School of Medicine, CA, USA.,4 Department of Anesthesiology Loma Linda University School of Medicine, CA, USA.,5 Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Andre Obenaus
- 1 Cell, Molecular and Developmental Biology Program, University of California, Riverside, CA, USA.,2 Department of Pediatrics, Loma Linda University, Loma Linda, CA, USA.,6 Department of Pediatrics, University of California, Irvine, Irvine, CA, USA
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16
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Vupputuri A, Ashwal S, Tsao B, Haddad E, Ghosh N. MRI based objective ischemic core-penumbra quantification in adult clinical stroke. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2017; 2017:3012-3015. [PMID: 29060532 DOI: 10.1109/embc.2017.8037491] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Objective and non-invasive quantification of ischemic stroke and differentiation of salvageable from non-salvageable tissue is critical to treatment planning. However current Magnetic Resonance Imaging(MRI) techniques are time consuming and rely on manual detection methods. Computer aided preliminary screening of the injured tissue could assist neuroradiologists in performing more detailed analysis of the lesion components. An established Hierarchical Region Splitting (HRS) method was extended to segment lesions from adult patients who suffered a clinical stroke using diffusion- and perfusion weighted image (DWI-PWI) maps and associated computed maps. Apart from lesion quantification PWI-DWI based HRS was also able to automatically quantify core (irrecoverable) the penumbra (potentially recoverable) which helped to estimate salvageable tissue. The PWI-DWI/HRS results were validated by comparing with manually demarcated ground truth in terms of performance indices like lesion volume (82.1% accuracy), sensitivity (78.8%), specificity (99.3%) and similarity (78.54%) for a dataset of 10 acute adult stroke patients. Data sets were classified into severe, moderate and mild injuries based on total lesion volume. Proposed PWI-DWI/HRS method demonstrated accuracy close to manual lesion demarcation with high performance indices for core and penumbra in severe and moderate classes.
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17
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Obenaus A, Ng M, Orantes AM, Kinney-Lang E, Rashid F, Hamer M, DeFazio RA, Tang J, Zhang JH, Pearce WJ. Traumatic brain injury results in acute rarefication of the vascular network. Sci Rep 2017; 7:239. [PMID: 28331228 PMCID: PMC5427893 DOI: 10.1038/s41598-017-00161-4] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Accepted: 02/13/2017] [Indexed: 01/04/2023] Open
Abstract
The role of the cerebrovascular network and its acute response to TBI is poorly defined and emerging evidence suggests that cerebrovascular reactivity is altered. We explored how cortical vessels are physically altered following TBI using a newly developed technique, vessel painting. We tested our hypothesis that a focal moderate TBI results in global decrements to structural aspects of the vasculature. Rats (naïve, sham-operated, TBI) underwent a moderate controlled cortical impact. Animals underwent vessel painting perfusion to label the entire cortex at 1 day post TBI followed by whole brain axial and coronal images using a wide-field fluorescence microscope. Cortical vessel network characteristics were analyzed for classical angiographic features (junctions, lengths) wherein we observed significant global (both hemispheres) reductions in vessel junctions and vessel lengths of 33% and 22%, respectively. Biological complexity can be quantified using fractal geometric features where we observed that fractal measures were also reduced significantly by 33%, 16% and 13% for kurtosis, peak value frequency and skewness, respectively. Acutely after TBI there is a reduction in vascular network and vascular complexity that are exacerbated at the lesion site and provide structural evidence for the bilateral hemodynamic alterations that have been reported in patients after TBI.
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Affiliation(s)
- Andre Obenaus
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA.
| | - Michelle Ng
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | - Amanda M Orantes
- Molecular and Integrative Physiology, Loma Linda University, Loma Linda, CA, 92350, USA
| | - Eli Kinney-Lang
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | - Faisal Rashid
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | - Mary Hamer
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | | | - Jiping Tang
- Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | - John H Zhang
- Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA.,Anesthesiology, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA.,Neurosurgery, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA
| | - William J Pearce
- Physiology and Pharmacology, Loma Linda University School of Medicine, Loma Linda, CA, 92350, USA.,Center for Perinatal Biology, Loma Linda University, Loma Linda, CA, 92350, USA
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18
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Mulder IA, Khmelinskii A, Dzyubachyk O, de Jong S, Rieff N, Wermer MJH, Hoehn M, Lelieveldt BPF, van den Maagdenberg AMJM. Automated Ischemic Lesion Segmentation in MRI Mouse Brain Data after Transient Middle Cerebral Artery Occlusion. Front Neuroinform 2017; 11:3. [PMID: 28197090 PMCID: PMC5281583 DOI: 10.3389/fninf.2017.00003] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 01/05/2017] [Indexed: 11/13/2022] Open
Abstract
Magnetic resonance imaging (MRI) has become increasingly important in ischemic stroke experiments in mice, especially because it enables longitudinal studies. Still, quantitative analysis of MRI data remains challenging mainly because segmentation of mouse brain lesions in MRI data heavily relies on time-consuming manual tracing and thresholding techniques. Therefore, in the present study, a fully automated approach was developed to analyze longitudinal MRI data for quantification of ischemic lesion volume progression in the mouse brain. We present a level-set-based lesion segmentation algorithm that is built using a minimal set of assumptions and requires only one MRI sequence (T2) as input. To validate our algorithm we used a heterogeneous data set consisting of 121 mouse brain scans of various age groups and time points after infarct induction and obtained using different MRI hardware and acquisition parameters. We evaluated the volumetric accuracy and regional overlap of ischemic lesions segmented by our automated method against the ground truth obtained in a semi-automated fashion that includes a highly time-consuming manual correction step. Our method shows good agreement with human observations and is accurate on heterogeneous data, whilst requiring much shorter average execution time. The algorithm developed here was compiled into a toolbox and made publically available, as well as all the data sets.
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Affiliation(s)
- Inge A Mulder
- Department of Neurology, Leiden University Medical Center Leiden, Netherlands
| | - Artem Khmelinskii
- Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical CenterLeiden, Netherlands; Percuros B.V.Enschede, Netherlands
| | - Oleh Dzyubachyk
- Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical Center Leiden, Netherlands
| | - Sebastiaan de Jong
- Department of Human Genetics, Leiden University Medical Center Leiden, Netherlands
| | - Nathalie Rieff
- Department of Human Genetics, Leiden University Medical Center Leiden, Netherlands
| | - Marieke J H Wermer
- Department of Neurology, Leiden University Medical Center Leiden, Netherlands
| | - Mathias Hoehn
- Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical CenterLeiden, Netherlands; Percuros B.V.Enschede, Netherlands; In-vivo-NMR Laboratory, Max Planck Institute for Metabolism ResearchCologne, Germany
| | - Boudewijn P F Lelieveldt
- Division of Image Processing (LKEB), Department of Radiology, Leiden University Medical CenterLeiden, Netherlands; Intelligent Systems Group, Faculty of Electrical Engineering, Mathematics and Computer Science, Delft University of TechnologyDelft, Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical CenterLeiden, Netherlands; Department of Human Genetics, Leiden University Medical CenterLeiden, Netherlands
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19
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Hirt L, Fukuda AM, Ambadipudi K, Rashid F, Binder D, Verkman A, Ashwal S, Obenaus A, Badaut J. Improved long-term outcome after transient cerebral ischemia in aquaporin-4 knockout mice. J Cereb Blood Flow Metab 2017; 37:277-290. [PMID: 26767580 PMCID: PMC5363745 DOI: 10.1177/0271678x15623290] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/23/2015] [Accepted: 10/26/2015] [Indexed: 01/07/2023]
Abstract
A hallmark of stroke is water accumulation (edema) resulting from dysregulation of osmotic homeostasis. Brain edema contributes to tissue demise and may lead to increased intracranial pressure and lethal herniation. Currently, there are only limited treatments to prevent edema formation following stroke. Aquaporin 4 (AQP4), a brain water channel, has become a focus of interest for therapeutic approaches targeting edema. At present, there are no pharmacological tools to block AQP4. The role of AQP4 in edema after brain injury remains unclear with conflicting results from studies using AQP4-/- mice and of AQP4 expression following stroke. Here, we studied AQP4 and its role in edema formation by testing AQP4-/- mice in a model of middle cerebral artery occlusion using novel quantitative MRI water content measurements, histology and behavioral changes as outcome measures. Absence of AQP4 was associated with decreased mortality and increased motor recovery 3 to 14 days after stroke. Behavioral improvement was associated with decreased lesion volume, neuronal cell death and neuroinflammation in AQP4-/- compared to wild type mice. Our data suggest that the lack of AQP4 confers an overall beneficial role at long term with improved neuronal survival and reduced neuroinflammation, but without a direct effect on edema formation.
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Affiliation(s)
- Lorenz Hirt
- Department of Clinical Neurosciences, Neurology Service, Centre Hospitalier Universitaire Vaudois and Lausanne University, Switzerland
| | - Andrew M Fukuda
- Department of Physiology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Kamalakar Ambadipudi
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Faisil Rashid
- Department of Physiology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Devin Binder
- Center for Glial-Neuronal Interactions, Division of Biomedical Sciences, University of California, Riverside, Riverside, CA, USA
| | - Alan Verkman
- Medicine and Physiology, Cardiovascular Research Institute, University of California San Francisco, CA, USA
| | - Stephen Ashwal
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Andre Obenaus
- Department of Physiology, Loma Linda University School of Medicine, Loma Linda, CA, USA.,Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA.,Center for Glial-Neuronal Interactions, Division of Biomedical Sciences, University of California, Riverside, Riverside, CA, USA
| | - Jerome Badaut
- Department of Physiology, Loma Linda University School of Medicine, Loma Linda, CA, USA .,Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA, USA.,CNRS UMR5287, University of Bordeaux, Bordeaux, France
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Hu GQ, Du X, Li YJ, Gao XQ, Chen BQ, Yu L. Inhibition of cerebral ischemia/reperfusion injury-induced apoptosis: nicotiflorin and JAK2/STAT3 pathway. Neural Regen Res 2017; 12:96-102. [PMID: 28250754 PMCID: PMC5319249 DOI: 10.4103/1673-5374.198992] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Nicotiflorin is a flavonoid extracted from Carthamus tinctorius. Previous studies have shown its cerebral protective effect, but the mechanism is undefined. In this study, we aimed to determine whether nicotiflorin protects against cerebral ischemia/reperfusion injury-induced apoptosis through the JAK2/STAT3 pathway. The cerebral ischemia/reperfusion injury model was established by middle cerebral artery occlusion/reperfusion. Nicotiflorin (10 mg/kg) was administered by tail vein injection. Cell apoptosis in the ischemic cerebral cortex was examined by hematoxylin-eosin staining and terminal deoxynucleotidyl transferase dUTP nick end labeling assay. Bcl-2 and Bax expression levels in ischemic cerebral cortex were examined by immunohistochemial staining. Additionally, p-JAK2, p-STAT3, Bcl-2, Bax, and caspase-3 levels in ischemic cerebral cortex were examined by western blot assay. Nicotiflorin altered the shape and structure of injured neurons, decreased the number of apoptotic cells, down-regulates expression of p-JAK2, p-STAT3, caspase-3, and Bax, decreased Bax immunoredactivity, and increased Bcl-2 protein expression and immunoreactivity. These results suggest that nicotiflorin protects against cerebral ischemia/reperfusion injury-induced apoptosis via the JAK2/STAT3 pathway.
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Affiliation(s)
- Guang-Qiang Hu
- Department of Anatomy, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Xi Du
- Department of Chemistry, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Yong-Jie Li
- Drug Discovery Research Center, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Xiao-Qing Gao
- Department of Anatomy and Neurobiology, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Bi-Qiong Chen
- Department of Chemistry, Southwest Medical University, Luzhou, Sichuan Province, China
| | - Lu Yu
- Department of Chemistry, Southwest Medical University, Luzhou, Sichuan Province, China
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Determination of oxygen extraction fraction using magnetic resonance imaging in canine models with internal carotid artery occlusion. Sci Rep 2016; 6:30332. [PMID: 27443195 PMCID: PMC4957224 DOI: 10.1038/srep30332] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 07/04/2016] [Indexed: 01/13/2023] Open
Abstract
Perfusion of the penumbra tissue below the flow threshold for functional disturbance but above that for the maintenance of morphological integrity is the target for therapy in acute ischaemic stroke. The measurement of the oxygen extraction fraction (OEF) may provide a direct assessment of tissue viability, so that irreversible tissue damage and penumbra can be reliably identified. By using an asymmetric spin echo single-shot echo planar imaging (ASE-SSEPI) sequence, the quantitative OEF was obtained in the ischaemic brain tissues of canine models with internal carotid artery occlusion. TTC staining, which delineated the regions of infarct and penumbra, was used for defining the corresponding regions on OEF maps. The threshold of the OEF to discriminate the infarct cores and penumbral tissues was then determined according to the OEF values at different times. With repeated-measures ANOVA, the OEF of the infarcted regions was found to be time dependent. An OEF greater than 0.48 best predicted cortical infarction at 1.5 hr, with an area under the receiving operating characteristic curve of 0.968, a sensitivity of 97.5%, and a specificity of 92.5%. Our results may be helpful in the evaluation of tissue viability during stroke events.
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Changes in Brain Swelling and Infarction Volume over Four Days After Hypoxia Ischemia in Neonatal Rats. ACTA NEUROCHIRURGICA. SUPPLEMENT 2016; 121:111-4. [PMID: 26463932 DOI: 10.1007/978-3-319-18497-5_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The leading cause of morbidity and mortality in infants is hypoxia-ischemia (HI). The current therapies for HI have limited success, in part due to a lack of understanding of HI pathophysiology and underlying mechanisms. Herein, a neonatal rat model of HI was used to examine the changes in brain swelling and infarct volume over 4 days after HI. Forty-four P10 rat pups were sacrificed at 2, 3, or 4 days post-HI. After sacrifice, the brains were removed, sliced, and stained with TTC (2,3,5-triphenyl-2H-tetrazolium chloride). Images of TTC-stained brains were used for measurement of the ipsilateral hemisphere brain volumes and infarct volumes, calculated using standard equations. The hemispheric brain volumes of HI animals in all groups was lower than that of sham animals and decreased as the post-HI sacrifice time increased. The infarct volume of HI animals was larger than that of sham animals. Infarct volumes tended to decrease over the days post-HI. The change in infarct volume is likely the result of a combination of brain growth and repair mechanisms. However, changes in the hemispheric brain volume may include tissue growth and repair mechanism, so also may be a limitation of the current algorithm used for calculating ipsilateral hemisphere brain volume.
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Li Y, Ma Q, Halavi S, Concepcion K, Hartman RE, Obenaus A, Xiao D, Zhang L. Fetal stress-mediated hypomethylation increases the brain susceptibility to hypoxic-ischemic injury in neonatal rats. Exp Neurol 2015; 275 Pt 1:1-10. [PMID: 26597542 DOI: 10.1016/j.expneurol.2015.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/16/2015] [Accepted: 10/23/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Fetal hypoxia increases brain susceptibility to hypoxic-ischemic (HI) injury in neonatal rats. Yet mechanisms remain elusive. The present study tested the hypothesis that DNA hypomethylation plays a role in fetal stress-induced increase in neonatal HI brain injury. METHODS Pregnant rats were exposed to hypoxia (10.5% O2) from days 15 to 21 of gestation and DNA methylation was determined in the developing brain. In addition, 5-aza-2'-deoxycytidine (5-Aza) was administered in day 7 pups brains and the HI treatment was conducted in day 10 pups. Brain injury was determined by in vivo MRI 48 h after the HI treatment and neurobehavioral function was evaluated 6 weeks after the HI treatment. RESULTS Fetal hypoxia resulted in DNA hypomethylation in the developing brain, which persisted into 30-day old animals after birth. The treatment of neonatal brains with 5-Aza induced similar hypomethylation patterns. Of importance, the 5-Aza treatment significantly increased HI-induced brain injury and worsened neurobehavioral function recovery six weeks after the HI-treatment. In addition, 5-Aza significantly increased HIF-1α mRNA and protein abundance as well as matrix metalloproteinase (MMP)-2 and MMP-9, but decreased MMP-13 protein abundance in neonatal brains. Consistent with the 5-Aza treatment, hypoxia resulted in significantly increased expression of HIF-1α in both fetal and neonatal brains. Inhibition of HIF-1α blocked 5-Aza-mediated changes in MMPs and abrogated 5-Aza-induced increase in HI-mediated brain injury. CONCLUSION The results suggest that fetal stress-mediated DNA hypomethylation in the developing brain causes programming of hypoxic-ischemic sensitive phenotype in the brain and increases the susceptibility of neonatal brain to hypoxic-ischemic injury in a HIF-1α-dependent manner.
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Affiliation(s)
- Yong Li
- Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Qingyi Ma
- Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Shina Halavi
- Department of Psychology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Katherine Concepcion
- Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Richard E Hartman
- Department of Psychology, Loma Linda University, Loma Linda, CA 92354, USA
| | - Andre Obenaus
- Department of Pediatrics, Loma Linda University School of Medicine, Loma Linda, CA 92354, USA; Cell, Molecular and Developmental Biology Program, Department of Neuroscience, University of California, Riverside, CA 92521, USA
| | - Daliao Xiao
- Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Lubo Zhang
- Center for Perinatal Biology, Division of Pharmacology, Department of Basic Sciences, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA.
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Yuan X, Ghosh N, McFadden B, Tone B, Bellinger DL, Obenaus A, Ashwal S. Hypothermia modulates cytokine responses after neonatal rat hypoxic-ischemic injury and reduces brain damage. ASN Neuro 2014; 6:6/6/1759091414558418. [PMID: 25424430 PMCID: PMC4357606 DOI: 10.1177/1759091414558418] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
While hypothermia (HT) is the standard-of-care for neonates with hypoxic ischemic injury (HII), the mechanisms underlying its neuroprotective effect are poorly understood. We examined ischemic core/penumbra and cytokine/chemokine evolution in a 10-day-old rat pup model of HII. Pups were treated for 24 hr after HII with HT (32℃; n = 18) or normothermia (NT, 35℃; n = 15). Outcomes included magnetic resonance imaging (MRI), neurobehavioral testing, and brain cytokine/chemokine profiling (0, 24, 48, and 72 hr post-HII). Lesion volumes (24 hr) were reduced in HT pups (total 74%, p < .05; penumbra 68%, p < .05; core 85%, p = .19). Lesion volumes rebounded at 72 hr (48 hr post-HT) with no significant differences between NT and HT pups. HT reduced interleukin-1β (IL-1β) at all time points (p < .05); monocyte chemoattractant protein-1 (MCP-1) trended toward being decreased in HT pups (p = .09). The stem cell signaling molecule, stromal cell-derived factor-1 (SDF-1) was not altered by HT. Our data demonstrate that HT reduces total and penumbral lesion volumes (at 24 and 48 hr), potentially by decreasing IL-1β without affecting SDF-1. Disassociation between the increasing trend in HII volumes from 48 to 72 hr post-HII when IL-1β levels remained low suggests that after rewarming, mechanisms unrelated to IL-1β expression are likely to contribute to this delayed increase in injury. Additional studies should be considered to determine what these mechanisms might be and also to explore whether extending the duration or degree of HT might ameliorate this delayed increase in injury.
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Affiliation(s)
- Xiangpeng Yuan
- Department of Pediatrics, Loma Linda University, CA, USA
| | - Nirmalya Ghosh
- Department of Pediatrics, Loma Linda University, CA, USA
| | - Brian McFadden
- Department of Pediatrics, Loma Linda University, CA, USA Department of Biological Sciences, California State University, Fullerton, CA, USA
| | - Beatriz Tone
- Department of Pediatrics, Loma Linda University, CA, USA
| | - Denise L Bellinger
- Department of Pathology and Human Anatomy, Loma Linda University, CA, USA
| | - Andre Obenaus
- Department of Pediatrics, Loma Linda University, CA, USA Cell, Molecular, and Developmental Biology Graduate Program, Neuroscience Graduate Program, University of California, Riverside, CA, USA
| | - Stephen Ashwal
- Department of Pediatrics, Loma Linda University, CA, USA
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Mechanisms of perinatal arterial ischemic stroke. J Cereb Blood Flow Metab 2014; 34:921-32. [PMID: 24667913 PMCID: PMC4050239 DOI: 10.1038/jcbfm.2014.41] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 12/30/2013] [Accepted: 01/02/2014] [Indexed: 01/21/2023]
Abstract
The incidence of perinatal stroke is high, similar to that in the elderly, and produces a significant morbidity and severe long-term neurologic and cognitive deficits, including cerebral palsy, epilepsy, neuropsychological impairments, and behavioral disorders. Emerging clinical data and data from experimental models of cerebral ischemia in neonatal rodents have shown that the pathophysiology of perinatal brain damage is multifactorial. These studies have revealed that, far from just being a smaller version of the adult brain, the neonatal brain is unique with a very particular and age-dependent responsiveness to hypoxia-ischemia and focal arterial stroke. In this review, we discuss fundamental clinical aspects of perinatal stroke as well as some of the most recent and relevant findings regarding the susceptibility of specific brain cell populations to injury, the dynamics and the mechanisms of neuronal cell death in injured neonates, the responses of neonatal blood-brain barrier to stroke in relation to systemic and local inflammation, and the long-term effects of stroke on angiogenesis and neurogenesis. Finally, we address translational strategies currently being considered for neonatal stroke as well as treatments that might effectively enhance repair later after injury.
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Ghosh N, Sun Y, Bhanu B, Ashwal S, Obenaus A. Automated detection of brain abnormalities in neonatal hypoxia ischemic injury from MR images. Med Image Anal 2014; 18:1059-69. [PMID: 25000294 DOI: 10.1016/j.media.2014.05.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2013] [Revised: 04/23/2014] [Accepted: 05/10/2014] [Indexed: 11/30/2022]
Abstract
We compared the efficacy of three automated brain injury detection methods, namely symmetry-integrated region growing (SIRG), hierarchical region splitting (HRS) and modified watershed segmentation (MWS) in human and animal magnetic resonance imaging (MRI) datasets for the detection of hypoxic ischemic injuries (HIIs). Diffusion weighted imaging (DWI, 1.5T) data from neonatal arterial ischemic stroke (AIS) patients, as well as T2-weighted imaging (T2WI, 11.7T, 4.7T) at seven different time-points (1, 4, 7, 10, 17, 24 and 31 days post HII) in rat-pup model of hypoxic ischemic injury were used to assess the temporal efficacy of our computational approaches. Sensitivity, specificity, and similarity were used as performance metrics based on manual ('gold standard') injury detection to quantify comparisons. When compared to the manual gold standard, automated injury location results from SIRG performed the best in 62% of the data, while 29% for HRS and 9% for MWS. Injury severity detection revealed that SIRG performed the best in 67% cases while 33% for HRS. Prior information is required by HRS and MWS, but not by SIRG. However, SIRG is sensitive to parameter-tuning, while HRS and MWS are not. Among these methods, SIRG performs the best in detecting lesion volumes; HRS is the most robust, while MWS lags behind in both respects.
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Affiliation(s)
- Nirmalya Ghosh
- Department of Pediatrics, Loma Linda University, School of Medicine, Loma Linda, CA 92354, USA
| | - Yu Sun
- Center for Research in Intelligent Systems (CRIS), University of California, Riverside, CA 92521, USA
| | - Bir Bhanu
- Center for Research in Intelligent Systems (CRIS), University of California, Riverside, CA 92521, USA
| | - Stephen Ashwal
- Department of Pediatrics, Loma Linda University, School of Medicine, Loma Linda, CA 92354, USA
| | - Andre Obenaus
- Department of Pediatrics, Loma Linda University, School of Medicine, Loma Linda, CA 92354, USA; Cell, Molecular and Developmental Biology Program and Department of Neuroscience, University of California, 1140 Bachelor Hall, Riverside, CA 92521, USA.
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Reparative effects of neural stem cells in neonatal rats with hypoxic-ischemic injury are not influenced by host sex. Pediatr Res 2014; 75:603-11. [PMID: 24463490 PMCID: PMC4404035 DOI: 10.1038/pr.2014.7] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 10/23/2013] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gender is increasingly recognized as an important influence on brain development, disease susceptibility, and response to pharmacologic/rehabilitative treatments. In regenerative medicine, it remains entirely unknown whether there is an interaction between transplanted stem cells and host gender that might bias efficacy and safety in some patients but not others. METHODS We examined the role of recipient gender in a neonatal rat hypoxic-ischemic injury (HII) model, treated with female human neuronal stem cells (hNSCs), labeled with superparamagnetic iron oxide particles implanted into the contralateral cerebral ventricle. We monitored HII evolution (by magnetic resonance imaging, histopathology, behavioral testing) and hNSC fate (migration, replication, viability). RESULTS Recipient gender after implantation did not influence the volume or location of ischemic injury (1, 30, or 90 d) or behavior (90 d). Superparamagnetic iron oxide labeling did not influence HII evolution. Implantation had its greatest benefit on mild/moderate injuries, which remained stable rather than increasing as in severe HII as is the natural history for such lesions. CONCLUSION Our results suggest that hNSC treatment (including using hNSCs that are prelabeled with iron to allow tracking in real time by magnetic resonance imaging) would be equally safe and effective for male and female human newborns with mild-to-moderate HII.
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28
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van der Aa NE, Northington FJ, Stone BS, Groenendaal F, Benders MJ, Porro G, Yoshida S, Mori S, de Vries LS, Zhang J. Quantification of white matter injury following neonatal stroke with serial DTI. Pediatr Res 2013; 73:756-62. [PMID: 23478641 PMCID: PMC6117163 DOI: 10.1038/pr.2013.45] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND Diffusion tensor imaging (DTI) can be used to predict outcome following perinatal arterial ischemic stroke (PAIS), although little is known about white matter changes over time. METHODS Infants with PAIS were serially scanned in the neonatal period (n = 15), at 3 mo (n = 16), and at 24 mo (n = 8). Fractional anisotropy (FA) values in five regions of interest (anterior and posterior limb of the internal capsule, corpus callosum, optic radiation, and posterior thalamic radiation) were obtained and compared with FA values of healthy controls and neurodevelopmental outcome. RESULTS In the neonatal period, no differences in FA values were found. At 3 mo, the six infants who ultimately developed motor deficits showed lower FA values in all affected regions. Four infants developed a visual field defect and showed lower FA values in the affected optic radiation at 3 mo (0.22 vs. 0.29; P = 0.03). Finally, a correlation between FA values of the corpus callosum at 3 mo and the Griffiths developmental quotients was found (r = 0.66; P = 0.03). At 24 mo, a similar pattern was observed. CONCLUSION Neonatal FA measurements may underestimate the extent of injury following PAIS. FA measurements at 3 mo could be considered a more reliable predictor of neurodevelopmental outcome and correlate with DTI findings at 24 mo.
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Affiliation(s)
- Niek E van der Aa
- Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, The Netherlands
| | - Frances J. Northington
- Department of Pediatrics, Eudowood Neonatal Pulmonary Division-NICN, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Brian S. Stone
- Department of Pediatrics, Eudowood Neonatal Pulmonary Division-NICN, Johns Hopkins University School of Medicine, Baltimore, MD, USA,Department of Neonatology, Children’s National Medical Center, Washington, DC, USA
| | - Floris Groenendaal
- Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, The Netherlands
| | - Manon J.N.L. Benders
- Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, The Netherlands
| | - Giorgio Porro
- Department of Ophthalmology, University Medical Center Utrecht, The Netherlands
| | - Shoko Yoshida
- Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Susumu Mori
- Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA,F.M. Kirby Functional Imaging Center, Kennedy Krieger Institute, Baltimore, MD, USA
| | - Linda S. de Vries
- Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, The Netherlands
| | - Jiangyang Zhang
- Dept. of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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