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Toader C, Eva L, Bratu BG, Covache-Busuioc RA, Costin HP, Dumitrascu DI, Glavan LA, Corlatescu AD, Ciurea AV. Intracranial Aneurysms and Genetics: An Extensive Overview of Genomic Variations, Underlying Molecular Dynamics, Inflammatory Indicators, and Forward-Looking Insights. Brain Sci 2023; 13:1454. [PMID: 37891822 PMCID: PMC10605587 DOI: 10.3390/brainsci13101454] [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: 08/15/2023] [Revised: 09/22/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
This review initiates by outlining the clinical relevance of IA, underlining the pressing need to comprehend its foundational elements. We delve into the assorted risk factors tied to IA, spotlighting both environmental and genetic influences. Additionally, we illuminate distinct genetic syndromes linked to a pronounced prevalence of intracranial aneurysms, underscoring the pivotal nature of genetics in this ailment's susceptibility. A detailed scrutiny of genome-wide association studies allows us to identify key genomic changes and locations associated with IA risk. We further detail the molecular and physiopathological dynamics instrumental in IA's evolution and escalation, with a focus on inflammation's role in affecting the vascular landscape. Wrapping up, we offer a glimpse into upcoming research directions and the promising horizons of personalized therapeutic strategies in IA intervention, emphasizing the central role of genetic insights. This thorough review solidifies genetics' cardinal role in IA, positioning it as a cornerstone resource for professionals in the realms of neurology and genomics.
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Affiliation(s)
- Corneliu Toader
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
- Department of Vascular Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania
| | - Lucian Eva
- Department of Neurosurgery, Dunarea de Jos University, 800010 Galati, Romania
- Department of Neurosurgery, Clinical Emergency Hospital “Prof. Dr. Nicolae Oblu”, 700309 Iasi, Romania
| | - Bogdan-Gabriel Bratu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
| | - Razvan-Adrian Covache-Busuioc
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
| | - Horia Petre Costin
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
| | - David-Ioan Dumitrascu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
| | - Luca-Andrei Glavan
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
| | - Antonio Daniel Corlatescu
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
| | - Alexandru Vlad Ciurea
- Department of Neurosurgery, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucharest, Romania; (C.T.); (R.-A.C.-B.); (H.P.C.); (D.-I.D.); (L.-A.G.); (A.D.C.); (A.V.C.)
- Neurosurgery Department, Sanador Clinical Hospital, 010991 Bucharest, Romania
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Huang L, Cheng F, Zhang X, Zielonka J, Nystoriak MA, Xiang W, Raygor K, Wang S, Lakshmanan A, Jiang W, Yuan S, Hou KS, Zhang J, Wang X, Syed AU, Juric M, Takahashi T, Navedo MF, Wang RA. Nitric oxide synthase and reduced arterial tone contribute to arteriovenous malformation. SCIENCE ADVANCES 2023; 9:eade7280. [PMID: 37235659 PMCID: PMC10219588 DOI: 10.1126/sciadv.ade7280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 04/20/2023] [Indexed: 05/28/2023]
Abstract
Mechanisms underlying arteriovenous malformations (AVMs) are poorly understood. Using mice with endothelial cell (EC) expression of constitutively active Notch4 (Notch4*EC), we show decreased arteriolar tone in vivo during brain AVM initiation. Reduced vascular tone is a primary effect of Notch4*EC, as isolated pial arteries from asymptomatic mice exhibited reduced pressure-induced arterial tone ex vivo. The nitric oxide (NO) synthase (NOS) inhibitor NG-nitro-l-arginine (L-NNA) corrected vascular tone defects in both assays. L-NNA treatment or endothelial NOS (eNOS) gene deletion, either globally or specifically in ECs, attenuated AVM initiation, assessed by decreased AVM diameter and delayed time to moribund. Administering nitroxide antioxidant 4-hydroxy-2,2,6,6-tetramethylpiperidine-1-oxyl also attenuated AVM initiation. Increased NOS-dependent production of hydrogen peroxide, but not NO, superoxide, or peroxynitrite was detected in isolated Notch4*EC brain vessels during AVM initiation. Our data suggest that eNOS is involved in Notch4*EC-mediated AVM formation by up-regulating hydrogen peroxide and reducing vascular tone, thereby permitting AVM initiation and progression.
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Affiliation(s)
- Lawrence Huang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Feng Cheng
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Xuetao Zhang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jacek Zielonka
- Free Radical Research Laboratory, Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Matthew A. Nystoriak
- Department of Pharmacology, University of California, Davis, Davis, CA 95616, USA
| | - Weiwei Xiang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kunal Raygor
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Shaoxun Wang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Aditya Lakshmanan
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Weiya Jiang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Sai Yuan
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Kevin S. Hou
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Jiayi Zhang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Xitao Wang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
| | - Arsalan U. Syed
- Department of Pharmacology, University of California, Davis, Davis, CA 95616, USA
| | - Matea Juric
- Free Radical Research Laboratory, Department of Biophysics, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Takamune Takahashi
- Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Manuel F. Navedo
- Department of Pharmacology, University of California, Davis, Davis, CA 95616, USA
| | - Rong A. Wang
- Laboratory for Accelerated Vascular Research, Department of Surgery, University of California San Francisco, San Francisco, CA 94143, USA
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SHIMODA Y, NAKAYAMA N, MORIWAKI T, ABUMIYA T, KAWABORI M, KURISU K, GEKKA M, HOKARI M, ITO Y, HOUKIN K. Induction of large cerebral aneurysms by intraperitoneal administration of β-aminopropionitrile fumarate in male rats. J Neurosurg Sci 2022; 66:220-227. [DOI: 10.23736/s0390-5616.19.04819-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Lopes MMDC, Rojas HA, Polizzi LF, Magalhães KCS, Sandrim VC, Dellaretti M, Rubatino FVM, Simões RT. Analysis of the associations of the T-786C and Glu298Asp polymorphisms of the eNOS gene as risk factors in the rupture of intracranial aneurysms. Meta Gene 2022. [DOI: 10.1016/j.mgene.2021.101003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Endogenous animal models of intracranial aneurysm development: a review. Neurosurg Rev 2021; 44:2545-2570. [PMID: 33501561 DOI: 10.1007/s10143-021-01481-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/05/2021] [Accepted: 01/18/2021] [Indexed: 12/13/2022]
Abstract
The pathogenesis and natural history of intracranial aneurysm (IA) remains poorly understood. To this end, animal models with induced cerebral vessel lesions mimicking human aneurysms have provided the ability to greatly expand our understanding. In this review, we comprehensively searched the published literature to identify studies that endogenously induced IA formation in animals. Studies that constructed aneurysms (i.e., by surgically creating a sac) were excluded. From the eligible studies, we reported information including the animal species, method for aneurysm induction, aneurysm definitions, evaluation methods, aneurysm characteristics, formation rate, rupture rate, and time course. Between 1960 and 2019, 174 articles reported endogenous animal models of IA. The majority used flow modification, hypertension, and vessel wall weakening (i.e., elastase treatment) to induce IAs, primarily in rats and mice. Most studies utilized subjective or qualitative descriptions to define experimental aneurysms and histology to study them. In general, experimental IAs resembled the pathobiology of the human disease in terms of internal elastic lamina loss, medial layer degradation, and inflammatory cell infiltration. After the early 2000s, many endogenous animal models of IA began to incorporate state-of-the-art technology, such as gene expression profiling and 9.4-T magnetic resonance imaging (MRI) in vivo imaging, to quantitatively analyze the biological mechanisms of IA. Future studies aimed at longitudinally assessing IA pathobiology in models that incorporate aneurysm growth will likely have the largest impact on our understanding of the disease. We believe this will be aided by high-resolution, small animal, survival imaging, in situ live-cell imaging, and next-generation omics technology.
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Frösen J, Cebral J, Robertson AM, Aoki T. Flow-induced, inflammation-mediated arterial wall remodeling in the formation and progression of intracranial aneurysms. Neurosurg Focus 2020; 47:E21. [PMID: 31261126 DOI: 10.3171/2019.5.focus19234] [Citation(s) in RCA: 155] [Impact Index Per Article: 38.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 05/01/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Unruptured intracranial aneurysms (UIAs) are relatively common lesions that may cause devastating intracranial hemorrhage, thus producing considerable suffering and anxiety in those affected by the disease or an increased likelihood of developing it. Advances in the knowledge of the pathobiology behind intracranial aneurysm (IA) formation, progression, and rupture have led to preclinical testing of drug therapies that would prevent IA formation or progression. In parallel, novel biologically based diagnostic tools to estimate rupture risk are approaching clinical use. Arterial wall remodeling, triggered by flow and intramural stresses and mediated by inflammation, is relevant to both. METHODS This review discusses the basis of flow-driven vessel remodeling and translates that knowledge to the observations made on the mechanisms of IA initiation and progression on studies using animal models of induced IA formation, study of human IA tissue samples, and study of patient-derived computational fluid dynamics models. RESULTS Blood flow conditions leading to high wall shear stress (WSS) activate proinflammatory signaling in endothelial cells that recruits macrophages to the site exposed to high WSS, especially through macrophage chemoattractant protein 1 (MCP1). This macrophage infiltration leads to protease expression, which disrupts the internal elastic lamina and collagen matrix, leading to focal outward bulging of the wall and IA initiation. For the IA to grow, collagen remodeling and smooth muscle cell (SMC) proliferation are essential, because the fact that collagen does not distend much prevents the passive dilation of a focal weakness to a sizable IA. Chronic macrophage infiltration of the IA wall promotes this SMC-mediated growth and is a potential target for drug therapy. Once the IA wall grows, it is subjected to changes in wall tension and flow conditions as a result of the change in geometry and has to remodel accordingly to avoid rupture. Flow affects this remodeling process. CONCLUSIONS Flow triggers an inflammatory reaction that predisposes the arterial wall to IA initiation and growth and affects the associated remodeling of the UIA wall. This chronic inflammation is a putative target for drug therapy that would stabilize UIAs or prevent UIA formation. Moreover, once this coupling between IA wall remodeling and flow is understood, data from patient-specific flow models can be gathered as part of the diagnostic workup and utilized to improve risk assessment for UIA initiation, progression, and eventual rupture.
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Affiliation(s)
- Juhana Frösen
- 1Department of Neurosurgery, and.,2Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital, Kuopio, Finland
| | - Juan Cebral
- 3Bioengineering Department, Volgenau School of Engineering, George Mason University, Fairfax, Virginia
| | - Anne M Robertson
- 4Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Tomohiro Aoki
- 5Department of Molecular Pharmacology, Research Institute, and.,6Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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7
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Papoutsis K, Kapelouzou A, Georgiopoulos G, Kontogiannis C, Kourek C, Mylonas KS, Patelis N, Cokkinos DV, Karavokyros I, Georgopoulos S. Tissue-specific relaxin-2 is differentially associated with the presence/size of an arterial aneurysm and the severity of atherosclerotic disease in humans. Acta Pharmacol Sin 2020; 41:745-752. [PMID: 32024951 PMCID: PMC7471450 DOI: 10.1038/s41401-019-0350-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Accepted: 12/12/2019] [Indexed: 12/31/2022] Open
Abstract
Circulating or tissue-related biomarkers are of clinical value for risk stratification in patients with abdominal aortic aneurysms. Relaxin-2 (RL2) has been linked to the presence and size of arterial aneurysms, and to the extent of atherosclerosis in human subjects. Here, we assessed the expression levels of RL2 in aneurysmal (AA, n = 16) and atherosclerotic (ATH, n = 22) arteries, and established the correlation between RL2 levels and the presence/size of AA and the clinical severity of atherosclerosis. The expression levels of metalloproteinases (MMPs) and endothelial nitric oxide synthetase (eNOS) were also detected for correlations with different phenotypes of atherosclerosis and AA. Temporal artery biopsy specimens (n = 6) and abdominal aortic tissues harvested from accident victims during autopsy (n = 10) were used as controls. Quantitative tissue biomarker analysis revealed that tissue-specific RL2 was increased in patients with larger or symptomatic AA compared to subjects with atherosclerotic disease and healthy controls. In situ RL2 levels were proportional to the size and the severity of aneurysmatic disease, and were substantially elevated in patients with symptomatic aneurysm of any diameter or asymptomatic aneurysm of a diameter >350% of that of the normal artery. In contrast, tissue RL2 was inversely associated with the clinical severity of atherosclerotic lesions. Correlation between RL2 and MMP2 was different between ATH1 and ATH2, depending on atherosclerosis grade. Overall, tissue RL2 is differentially associated with discrete phenotypes of arterial disease and might exert multipotent biological effects on vascular wall integrity and remodeling in human subjects.
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8
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Zeng Q, Zhang Y, Zhang W, Guo Q. Baicalein suppresses the proliferation and invasiveness of colorectal cancer cells by inhibiting Snail‑induced epithelial‑mesenchymal transition. Mol Med Rep 2020; 21:2544-2552. [PMID: 32323825 PMCID: PMC7185271 DOI: 10.3892/mmr.2020.11051] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 03/06/2020] [Indexed: 12/18/2022] Open
Abstract
Scutellaria baicalensis (S. baicalensis) is a plant that is widely used for medicinal purposes. Baicalein, one of the primary bioactive compounds found in S. baicalensis, is thought to possess antitumor activity, although the specific mechanisms remain unclear. Therefore, the present study aimed to evaluate the ability of baicalein to disrupt the proliferation and metastatic potential of colorectal cancer (CRC) cells; a rapid and sensitive ultra-high performance liquid chromatography-tandem mass spectrometric method was employed for the identification of baicalein in an S. baicalensis aqueous extract and in rat plasma. To investigate the effects of baicalein, Cell Counting Kit-8 (CCK-8), western blotting, wound-healing and Transwell assays were performed. The data indicated that baicalein was absorbed into the blood and was able to effectively disrupt the proliferation, migration and invasion abilities of CRC cells in a dose- and time-dependent manner. Baicalein treatment was also revealed to decrease the expression of epithelial-mesenchymal transition (EMT)-promoting factors including vimentin, Twist1, and Snail, but to upregulate the expression of E-cadherin in CRC cells. The expression levels of cell cycle inhibitory proteins p53 and p21 also increased following baicalein treatment. In addition, Snail-induced vimentin and Twist1 upregulation, as well as E-cadherin downregulation, were reversed following treatment with baicalein. In conclusion, the results of the present study indicate that baicalein may suppress EMT, at least in part, by decreasing Snail activity.
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Affiliation(s)
- Qiongyao Zeng
- Faculty of Life Science and Biotechnology, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Yu Zhang
- Department of Gastroenterology, The First People's Hospital of Yunnan Province, Kunming, Yunnan 650032, P.R. China
| | - Wenjing Zhang
- Faculty of Medicine, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
| | - Qiang Guo
- Faculty of Life Science and Biotechnology, Kunming University of Science and Technology, Kunming, Yunnan 650500, P.R. China
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Preclinical Intracranial Aneurysm Models: A Systematic Review. Brain Sci 2020; 10:brainsci10030134. [PMID: 32120907 PMCID: PMC7139747 DOI: 10.3390/brainsci10030134] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 12/30/2022] Open
Abstract
Intracranial aneurysms (IA) are characterized by weakened cerebral vessel walls that may lead to rupture and subarachnoid hemorrhage. The mechanisms behind their formation and progression are yet unclear and warrant preclinical studies. This systematic review aims to provide a comprehensive, systematic overview of available animal models for the study of IA pathobiology. We conducted a systematic literature search using the PubMed database to identify preclinical studies employing IA animal models. Suitable articles were selected based on predefined eligibility criteria following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were reviewed and categorized according to the experimental animal and aneurysm model. Of 4266 returned results, 3930 articles were excluded based on the title and/or abstract and further articles after screening the full text, leaving 123 studies for detailed analysis. A total of 20 different models were found in rats (nine), mice (five), rabbits (four), and dogs (two). Rat models constituted the most frequently employed intracranial experimental aneurysm model (79 studies), followed by mice (31 studies), rabbits (12 studies), and two studies in dogs. The most common techniques to induce cerebral aneurysms were surgical ligation of the common carotid artery with subsequent induction of hypertension by ligation of the renal arteries, followed by elastase-induced creation of IAs in combination with corticosterone- or angiotensin-induced hypertension. This review provides a comprehensive summary of the multitude of available IA models to study various aspects of aneurysm formation, growth, and rupture. It will serve as a useful reference for researchers by facilitating the selection of the most appropriate model and technique to answer their scientific question.
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Thompson JW, Elwardany O, McCarthy DJ, Sheinberg DL, Alvarez CM, Nada A, Snelling BM, Chen SH, Sur S, Starke RM. In vivo cerebral aneurysm models. Neurosurg Focus 2019; 47:E20. [DOI: 10.3171/2019.4.focus19219] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/09/2019] [Indexed: 11/06/2022]
Abstract
Cerebral aneurysm rupture is a devastating event resulting in subarachnoid hemorrhage and is associated with significant morbidity and death. Up to 50% of individuals do not survive aneurysm rupture, with the majority of survivors suffering some degree of neurological deficit. Therefore, prior to aneurysm rupture, a large number of diagnosed patients are treated either microsurgically via clipping or endovascularly to prevent aneurysm filling. With the advancement of endovascular surgical techniques and devices, endovascular treatment of cerebral aneurysms is becoming the first-line therapy at many hospitals. Despite this fact, a large number of endovascularly treated patients will have aneurysm recanalization and progression and will require retreatment. The lack of approved pharmacological interventions for cerebral aneurysms and the need for retreatment have led to a growing interest in understanding the molecular, cellular, and physiological determinants of cerebral aneurysm pathogenesis, maturation, and rupture. To this end, the use of animal cerebral aneurysm models has contributed significantly to our current understanding of cerebral aneurysm biology and to the development of and training in endovascular devices. This review summarizes the small and large animal models of cerebral aneurysm that are being used to explore the pathophysiology of cerebral aneurysms, as well as the development of novel endovascular devices for aneurysm treatment.
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Affiliation(s)
- John W. Thompson
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Omar Elwardany
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - David J. McCarthy
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Dallas L. Sheinberg
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Carlos M. Alvarez
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Ahmed Nada
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Brian M. Snelling
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
- 4Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, Florida
| | - Stephanie H. Chen
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Samir Sur
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Robert M. Starke
- Departments of 1Neurological Surgery and
- 2Radiology, University of Miami
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
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Sheinberg DL, McCarthy DJ, Elwardany O, Bryant JP, Luther E, Chen SH, Thompson JW, Starke RM. Endothelial dysfunction in cerebral aneurysms. Neurosurg Focus 2019; 47:E3. [PMID: 31389675 DOI: 10.3171/2019.4.focus19221] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Endothelial cell (EC) dysfunction is known to contribute to cerebral aneurysm (CA) pathogenesis. Evidence shows that damage or injury to the EC layer is the first event in CA formation. The mechanisms behind EC dysfunction in CA disease are interrelated and include hemodynamic stress, hazardous nitric oxide synthase (NOS) activity, oxidative stress, estrogen imbalance, and endothelial cell-to-cell junction compromise. Abnormal variations in hemodynamic stress incite pathological EC transformation and inflammatory zone formation, ultimately leading to destruction of the vascular wall and aneurysm dilation. Hemodynamic stress activates key molecular pathways that result in the upregulation of chemotactic cytokines and adhesion molecules, leading to inflammatory cell recruitment and infiltration. Concurrently, oxidative stress damages EC-to-EC junction proteins, resulting in interendothelial gap formation. This further promotes leukocyte traffic into the vessel wall and the release of matrix metalloproteinases, which propagates vascular remodeling and breakdown. Abnormal hemodynamic stress and inflammation also trigger adverse changes in NOS activity, altering proper EC mediation of vascular tone and the local inflammatory environment. Additionally, the vasoprotective hormone estrogen modulates gene expression that often suppresses these harmful processes. Crosstalk between these sophisticated pathways contributes to CA initiation, progression, and rupture. This review aims to outline the complex mechanisms of EC dysfunction in CA pathogenesis.
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12
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The correlation between gene polymorphisms of endothelial nitric oxide synthase and aneurismal subarachnoid hemorrhage. Neurosurg Rev 2018; 42:493-498. [PMID: 29948497 DOI: 10.1007/s10143-018-0992-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Revised: 05/21/2018] [Accepted: 06/06/2018] [Indexed: 10/28/2022]
Abstract
To discuss the association of the T786C and G894T polymorphisms of endothelial nitric oxide synthase (eNOS) with the occurrence and prognosis of aneurismal subarachnoid hemorrhage (aSAH). One hundred sixty-nine patients with aSAH were collected as the case group, which was divided into the good prognosis group and adverse prognosis group according to the condition 3 months after the treatment. One hundred fifty-six healthy volunteers were collected as the control group. The allele and genotype of T786C and G894T polymorphisms of eNOS were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The genotype and allele frequency of eNOS were compared between different groups. And then, the risk factors of aSAH occurrence and prognosis were analyzed by using the logistic regression model. Both the genotype and allele frequency distributions of T786C and G894T between the case group and control group were significantly different (P < 0.05). There were significant differences in the distribution of G894T and T786C allele frequency and G894T genotype between the good prognosis group and adverse prognosis group, and there was no difference in T786C genotype. The results of the logistic regression analysis indicated that T786C and G894T polymorphisms of eNOS were independent influencing factors on the occurrence of aSAH and the G894T polymorphism was also closely related to the prognosis. T786C and G894T polymorphisms of eNOS gene were correlated with the occurrence and prognosis of aSAH, and the G894T polymorphism might be an independent influencing factor.
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13
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Cooke DL, Bauer D, Sun Z, Stillson C, Nelson J, Barry D, Hetts SW, Higashida RT, Dowd CF, Halbach VV, Su H, Saeed MM. Endovascular biopsy: Technical feasibility of novel endothelial cell harvesting devices assessed in a rabbit aneurysm model. Interv Neuroradiol 2018; 21:120-8. [PMID: 25934786 DOI: 10.15274/inr-2014-10103] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The lack of safe and reliable methods to sample vascular tissue in situ limits discovery of the underlying genetic and pathophysiological mechanisms of many vascular disorders, including aneurysms. We investigated the feasibility and comparable efficacy of in vivo vascular endothelial cell sampling using a spectrum of endovascular devices. Using the rabbit elastase carotid aneurysm model we evaluated the performance of existing aneurysmal coils, intracranial stents, and stent-like devices to collect vascular endothelial cells. Additionally, we modified a subset of devices to assess the effects of alterations to coil pitch, coil wire contour, and stent surface finishing. Device performance was evaluated by (1) the number of viable endothelial cells harvested, (2) the degree of vascular wall damage analyzed using digital subtraction angiography and histopathological analysis, and (3) the ease of device navigability and retrieval. Isolated cells underwent immunohistochemical analysis to confirm cell type and viability. Coil and stent specifications, technique, and endothelial cell counts were tabulated and statistical analysis performed. Using conventional detachable-type and modified aneurysm coils 11 of 14 (78.6%) harvested endothelial cells with a mean of 7.93 (±8.33) cells/coil, while 15 of 15 (100%) conventional stents, stent-like devices and modified stents harvested endothelial cells with a mean of 831.33 (±887.73) cells/device. Coil stiffness was significantly associated with endothelial cell count in univariate analysis (p = 0.044). For stents and stent-like devices univariate analysis demonstrated stent-to-aorta diameter ratios (p = 0.001), stent length (p = 0.049), and the use of a pulling retrieval technique (p = 0.019) significantly predictive of endothelial cell counts, though a multivariate model using these variables demonstrated only the stent-to-aorta diameter ratio (p = 0.029) predictive of endothelial cell counts. Modified devices did not significantly impact harvesting. The efficacy and safety of existing aneurysm coils, intracranial stents and stent-like devices in collecting viable endothelial cells was confirmed. The technique is reproducible and the quantity and quality of collected endothelial cells is adequate for targeted genetic analysis.
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Affiliation(s)
- Daniel L Cooke
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Diana Bauer
- Laboratory Animal Resource Center, University of California, San Francisco, CA, USA
| | - Zhengda Sun
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Carol Stillson
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Jeffrey Nelson
- Department of Anesthesiology and Perioperative Care, University of California, San Francisco, CA, USA
| | | | - Steven W Hetts
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
| | - Randall T Higashida
- Department of Radiology, Neurology, and Neurological Surgery, University of California, San Francisco, CA, USA
| | - Christopher F Dowd
- Department of Radiology, Neurology, and Neurological Surgery, University of California, San Francisco, CA, USA
| | - Van V Halbach
- Department of Radiology, Neurology, and Neurological Surgery, University of California, San Francisco, CA, USA
| | - Hua Su
- Department of Anesthesiology and Perioperative Care, University of California, San Francisco, CA, USA
| | - Maythem M Saeed
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, CA, USA
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Lautz T, Lasch M, Borgolte J, Troidl K, Pagel JI, Caballero-Martinez A, Kleinert EC, Walzog B, Deindl E. Midkine Controls Arteriogenesis by Regulating the Bioavailability of Vascular Endothelial Growth Factor A and the Expression of Nitric Oxide Synthase 1 and 3. EBioMedicine 2017; 27:237-246. [PMID: 29233575 PMCID: PMC5828057 DOI: 10.1016/j.ebiom.2017.11.020] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/21/2017] [Accepted: 11/21/2017] [Indexed: 01/30/2023] Open
Abstract
Midkine is a pleiotropic factor, which is involved in angiogenesis. However, its mode of action in this process is still ill defined. The function of midkine in arteriogenesis, the growth of natural bypasses from pre-existing collateral arteries, compensating for the loss of an occluded artery has never been investigated. Arteriogenesis is an inflammatory process, which relies on the proliferation of endothelial cells and smooth muscle cells. We show that midkine deficiency strikingly interferes with the proliferation of endothelial cells in arteriogenesis, thereby interfering with the process of collateral artery growth. We identified midkine to be responsible for increased plasma levels of vascular endothelial growth factor A (VEGFA), necessary and sufficient to promote endothelial cell proliferation in growing collaterals. Mechanistically, we demonstrate that leukocyte domiciled midkine mediates increased plasma levels of VEGFA relevant for upregulation of endothelial nitric oxide synthase 1 and 3, necessary for proper endothelial cell proliferation, and that non-leukocyte domiciled midkine additionally improves vasodilation. The data provided on the role of midkine in endothelial proliferation are likely to be relevant for both, the process of arteriogenesis and angiogenesis. Moreover, our data might help to estimate the therapeutic effect of clinically applied VEGFA in patients with vascular occlusive diseases. Leukocyte domiciled midkine is decisive for collateral endothelial cell proliferation in arteriogenesis. Midkine controls the bioavailability of VEGFA mediating endothelial Nos1 and Nos3 expression. Nos1 and Nos3, relevant for endothelial cell proliferation, can substitute for each other.
Arteriogenesis is a life and tissue saving process as it compensates for the loss of an occluded artery. Decoding the underlying molecular mechanisms is a prerequisite for the development of novel therapeutic options to treat patients with vascular occlusive diseases. Lautz et al. identified midkine to be responsible for the increased bioavailability of VEGFA during arteriogenesis, necessary and sufficient to promote endothelial cell proliferation. These data might help to estimate the therapeutic effect of clinically applied VEGFA. As the identified mechanisms might also apply for angiogenesis, they are likely to be of broader relevance, e.g. in terms of tumor treatment.
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Affiliation(s)
- Thomas Lautz
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; Biomedical Center, LMU Munich, 81377 Munich, Germany
| | - Manuel Lasch
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; Biomedical Center, LMU Munich, 81377 Munich, Germany
| | - Julia Borgolte
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Kerstin Troidl
- Department of Vascular and Endovascular Surgery, Goethe-University-Hospital, 60590 Frankfurt am Main, Germany; Division of Arteriogenesis Research, Max Planck Institute for Heart and Lung Research, 61231 Bad Nauheim, Germany
| | - Judith-Irina Pagel
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; Hospital of the University of Munich, Department of Anesthesiology, LMU Munich, 81377 Munich, Germany
| | - Amelia Caballero-Martinez
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Eike Christian Kleinert
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany
| | - Barbara Walzog
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; Biomedical Center, LMU Munich, 81377 Munich, Germany
| | - Elisabeth Deindl
- Walter-Brendel-Centre of Experimental Medicine, University Hospital, LMU Munich, 81377 Munich, Germany; Biomedical Center, LMU Munich, 81377 Munich, Germany.
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15
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Bourcier R, Brecheteau N, Costalat V, Daumas-Duport B, Guyomarch-Delasalle B, Desal H, Naggara O, Serfaty JM. MRI quantitative T2* mapping on thrombus to predict recanalization after endovascular treatment for acute anterior ischemic stroke. J Neuroradiol 2017; 44:241-246. [PMID: 28478114 DOI: 10.1016/j.neurad.2017.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 03/13/2017] [Accepted: 03/26/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND In anterior acute ischemic stroke (AAIS) treated with endovascular treatment (EVT), the susceptibility vessel sign (SVS+ or SVS-) is related to recanalization results (TICI 2b/3) and clinical outcome. However, a binary qualitative assessment of thrombus using SVS does not reflect its complex composition. Our aim was to assess whether a quantitative MRI marker, Thrombus-T2* relaxation time, may be assessable in clinical routine and may to predict early successful recanalization after EVT, defined as a TICI 2b/3 recanalization obtained in 2 attempts or less. MATERIAL AND METHODS Thrombus-T2* relaxation time was prospectively obtained from consecutive AAIS patients treated by EVT (concomitant aspiration and stent retriever). Quantitative values were compared between early recanalization and late or unsuccessful recanalization. RESULTS Thirty patients with AAIS were included and Thrombus-T2* relaxation time was obtained in all patients. Earlier TICI 2b/3 recanalization were obtained in 22 patients (73%) and was significantly associated with SVS+ (1/8 vs. 16/22, P=0.01) and a shorter Thombus-T2* relaxation time (mean SD, range: 257, 18-50ms vs. 45 9, 35-60ms, P<0.001). CONCLUSION A new quantitative MRI biomarker, the Thrombus-T2* relaxation time is assessable in clinical routine. In a preliminary study of 30 patients, a shorter Thombus-T2* relaxation time is related to earlier recanalization after EVT using combination of stent retriever and aspiration.
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Affiliation(s)
- R Bourcier
- Departments of Diagnostic and Interventional Neuroradiology of the University Hospital of Nantes, l'institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France; Institut National de la Santé et de la Recherche Médicale, UMR1087, 44000 Nantes, France
| | - N Brecheteau
- Departments of Diagnostic and Interventional Neuroradiology of the University Hospital of Nantes, l'institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France; Institut National de la Santé et de la Recherche Médicale, UMR1087, 44000 Nantes, France.
| | - V Costalat
- Department of Neuroradiology, Centre Hospitalier Universitaire, Montpellier, France
| | - B Daumas-Duport
- Departments of Diagnostic and Interventional Neuroradiology of the University Hospital of Nantes, l'institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France; Institut National de la Santé et de la Recherche Médicale, UMR1087, 44000 Nantes, France
| | - B Guyomarch-Delasalle
- Centre Hospitalier Universitaire Nantes Hôpital G et R Laënnec, Nantes, France; Centre d'investigation clinique Thorax, l'institut du thorax, Nantes, France; Centre national de la recherche scientifique, 75016 Paris, France
| | - H Desal
- Departments of Diagnostic and Interventional Neuroradiology of the University Hospital of Nantes, l'institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France; Institut National de la Santé et de la Recherche Médicale, UMR1087, 44000 Nantes, France
| | - O Naggara
- Department of Neuroradiology, Université Paris-Descartes, INSERM UMR 894, Centre Hospitalier Sainte-Anne, Paris, France
| | - J M Serfaty
- Institut National de la Santé et de la Recherche Médicale, UMR1087, 44000 Nantes, France; Departments of Diagnostic Cardiac and Vascular Imaging, l'institut du thorax, Centre Hospitalier Universitaire Nantes, Nantes, France
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16
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Fennell VS, Kalani MYS, Atwal G, Martirosyan NL, Spetzler RF. Biology of Saccular Cerebral Aneurysms: A Review of Current Understanding and Future Directions. Front Surg 2016; 3:43. [PMID: 27504449 PMCID: PMC4958945 DOI: 10.3389/fsurg.2016.00043] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 07/06/2016] [Indexed: 12/24/2022] Open
Abstract
Understanding the biology of intracranial aneurysms is a clinical quandary. How these aneurysms form, progress, and rupture is poorly understood. Evidence indicates that well-established risk factors play a critical role, along with immunologic factors, in their development and clinical outcomes. Much of the expanding knowledge of the inception, progression, and rupture of intracranial aneurysms implicates inflammation as a critical mediator of aneurysm pathogenesis. Thus, therapeutic targets exploiting this arm of aneurysm pathogenesis have been implemented, often with promising outcomes.
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Affiliation(s)
- Vernard S Fennell
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
| | - M Yashar S Kalani
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
| | - Gursant Atwal
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
| | - Nikolay L Martirosyan
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
| | - Robert F Spetzler
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center , Phoenix, AZ , USA
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17
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Aoki T, Yamamoto K, Fukuda M, Shimogonya Y, Fukuda S, Narumiya S. Sustained expression of MCP-1 by low wall shear stress loading concomitant with turbulent flow on endothelial cells of intracranial aneurysm. Acta Neuropathol Commun 2016; 4:48. [PMID: 27160403 PMCID: PMC4862234 DOI: 10.1186/s40478-016-0318-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 08/18/2015] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Enlargement of a pre-existing intracranial aneurysm is a well-established risk factor of rupture. Excessive low wall shear stress concomitant with turbulent flow in the dome of an aneurysm may contribute to progression and rupture. However, how stress conditions regulate enlargement of a pre-existing aneurysm remains to be elucidated. RESULTS Wall shear stress was calculated with 3D-computational fluid dynamics simulation using three cases of unruptured intracranial aneurysm. The resulting value, 0.017 Pa at the dome, was much lower than that in the parent artery. We loaded wall shear stress corresponding to the value and also turbulent flow to the primary culture of endothelial cells. We then obtained gene expression profiles by RNA sequence analysis. RNA sequence analysis detected hundreds of differentially expressed genes among groups. Gene ontology and pathway analysis identified signaling related with cell division/proliferation as overrepresented in the low wall shear stress-loaded group, which was further augmented by the addition of turbulent flow. Moreover, expression of some chemoattractants for inflammatory cells, including MCP-1, was upregulated under low wall shear stress with concomitant turbulent flow. We further examined the temporal sequence of expressions of factors identified in an in vitro study using a rat model. No proliferative cells were detected, but MCP-1 expression was induced and sustained in the endothelial cell layer. CONCLUSIONS Low wall shear stress concomitant with turbulent flow contributes to sustained expression of MCP-1 in endothelial cells and presumably plays a role in facilitating macrophage infiltration and exacerbating inflammation, which leads to enlargement or rupture.
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18
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Wang Z, Zhao J, Sun J, Nie S, Li K, Gao F, Zhang T, Duan S, Di Y, Huang Y, Gao X. Sex-dichotomous effects of NOS1AP promoter DNA methylation on intracranial aneurysm and brain arteriovenous malformation. Neurosci Lett 2016; 621:47-53. [PMID: 27080431 DOI: 10.1016/j.neulet.2016.04.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Revised: 04/08/2016] [Accepted: 04/08/2016] [Indexed: 11/16/2022]
Abstract
The goal of this study was to investigate the contribution of NOS1AP-promoter DNA methylation to the risk of intracranial aneurysm (IA) and brain arteriovenous malformation (BAVM) in a Han Chinese population. A total of 48 patients with IAs, 22 patients with BAVMs, and 26 control individuals were enrolled in the study. DNA methylation was tested using bisulfite pyrosequencing technology. We detected significantly higher DNA methylation levels in BAVM patients than in IA patients based on the multiple testing correction (CpG4-5 methylation: 5.86±1.04% vs. 4.37±2.64%, P=0.006). In women, CpG4-5 methylation levels were much lower in IA patients (3.64±1.97%) than in BAVM patients (6.11±1.20%, P<0.0001). However, in men, CpG1-3 methylation levels were much higher in the controls (6.92±0.78%) than in BAVM patients (5.99±0.70%, P=0.008). Additionally, there was a gender-based difference in CpG1 methylation within the controls (men vs. women: 5.75±0.50% vs. 4.99±0.53%, P=0.003) and BAVM patients (men vs. women: 4.70±0.74% vs. 5.50±0.87%, P=0.026). A subgroup analysis revealed significantly higher CpG3 methylation in patients who smoked than in those who did not (P=0.041). Our results suggested that gender modulated the interaction between NOS1AP promoter DNA methylation in IA and BAVM patients. Our results also confirmed that regular tobacco smoking was associated with increased NOS1AP methylation in humans. Additional studies with larger sample sizes are required to replicate and extend these findings.
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Affiliation(s)
- Zhepei Wang
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Jikuang Zhao
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Jie Sun
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Sheng Nie
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Keqing Li
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Feng Gao
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Tiefeng Zhang
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China
| | - Shiwei Duan
- Zhejiang provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, Zhejiang 315211, China
| | - Yazhen Di
- Department of Pediatric Rheumatoid Immunology, Ningbo Women and Children's Hospital, Ningbo, Zhejiang 315010, China
| | - Yi Huang
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China.
| | - Xiang Gao
- Department of Neurosurgery, Ningbo First Hospital, Ningbo Hospital of Zhejiang University, Ningbo, Zhejiang 315010, China.
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19
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Adibi A, Sen A, Mitha AP. Cell Therapy for Intracranial Aneurysms: A Review. World Neurosurg 2015; 86:390-8. [PMID: 26547001 DOI: 10.1016/j.wneu.2015.10.082] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 10/21/2015] [Accepted: 10/22/2015] [Indexed: 01/16/2023]
Abstract
One in five patients undergoing endovascular coiling (the current standard of care for treating intracranial aneurysms) experience a recurrence of the aneurysm as a result of improper healing. Recurrence remains the only major drawback of the coiling treatment and has been the focus of many studies over the last two decades. Cell therapy, a novel treatment modality in which therapeutic cells are introduced to the site of the injury to promote tissue regeneration, has opened up new possibilities for treating aneurysms. The healing response that ensues aneurysm embolization includes several cellular processes that can be targeted with cell therapy to prevent the aneurysm from recurring. Ten preclinical studies involving cell therapy to treat aneurysms were published between 1999 and 2014. In this review, we summarize the results of these studies and discuss advances, shortcomings, and the future of cell therapy for intracranial aneurysms.
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Affiliation(s)
- Amin Adibi
- Pharmaceutical Production Research Facility (PPRF), Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada
| | - Arindom Sen
- Pharmaceutical Production Research Facility (PPRF), Schulich School of Engineering, University of Calgary, Calgary, Alberta, Canada
| | - Alim P Mitha
- Department of Clinical Neurosciences, Foothills Medical Centre, University of Calgary, Calgary, Alberta, Canada.
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20
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Chang W, Huang M, Chien A. Emerging techniques for evaluation of the hemodynamics of intracranial vascular pathology. Neuroradiol J 2015; 28:19-27. [PMID: 25924168 DOI: 10.15274/nrj-2014-10115] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Advances in imaging modalities have improved the assessment of intracranial hemodynamics using non-invasive techniques. This review examines new imaging modalities and clinical applications of currently available techniques, describes pathophysiology and future directions in hemodynamic analysis of intracranial stenoses, aneurysms and arteriovenous malformations and explores how hemodynamic analysis may have prognostic value in predicting clinical outcomes and assist in risk stratification. The advent of new technologies such as pseudo-continuous arterial spin labeling, accelerated magnetic resonance angiography (MRA) techniques, 4D digital subtraction angiography, and improvements in clinically available techniques such as phase-contrast MRA may change the landscape of vascular imaging and modify current clinical practice guidelines.
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Affiliation(s)
| | | | - Aichi Chien
- UCLA Department of Radiology; Los Angeles, CA, USA
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21
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Wang Y, Emeto TI, Lee J, Marshman L, Moran C, Seto S, Golledge J. Mouse models of intracranial aneurysm. Brain Pathol 2015; 25:237-47. [PMID: 25041057 PMCID: PMC8029187 DOI: 10.1111/bpa.12175] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/09/2014] [Indexed: 01/04/2023] Open
Abstract
Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture and subsequent subarachnoid hemorrhage. There is growing interest in the pathogenesis of intracranial aneurysm focused on the development of drug therapies to decrease the incidence of aneurysm rupture. The study of rodent models of intracranial aneurysms has the potential to improve our understanding of intracranial aneurysm development and progression. This review summarizes current mouse models of intact and ruptured intracranial aneurysms and discusses the relevance of these models to human intracranial aneurysms. The article also reviews the importance of these models in investigating the molecular mechanisms involved in the disease. Finally, potential pharmaceutical targets for intracranial aneurysm suggested by previous studies are discussed. Examples of potential drug targets include matrix metalloproteinases, stromal cell-derived factor-1, tumor necrosis factor-α, the renin-angiotensin system and the β-estrogen receptor. An agreed clear, precise and reproducible definition of what constitutes an aneurysm in the models would assist in their use to better understand the pathology of intracranial aneurysm and applying findings to patients.
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Affiliation(s)
- Yutang Wang
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
| | - Theophilus I. Emeto
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Discipline of Public Health and Tropical MedicineSchool of Public HealthTropical Medicine and Rehabilitation SciencesJames Cook UniversityTownsvilleQueenslandAustralia
| | - James Lee
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Department of NeurosurgeryThe Townsville HospitalTownsvilleQueenslandAustralia
| | - Laurence Marshman
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Department of NeurosurgeryThe Townsville HospitalTownsvilleQueenslandAustralia
| | - Corey Moran
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
| | - Sai‐wang Seto
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
| | - Jonathan Golledge
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Department of Vascular and Endovascular SurgeryThe Townsville HospitalTownsvilleQueenslandAustralia
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22
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Attia MS, Lass E, Loch Macdonald R. Nitric oxide synthases: three pieces to the puzzle? ACTA NEUROCHIRURGICA. SUPPLEMENT 2015; 120:131-5. [PMID: 25366612 DOI: 10.1007/978-3-319-04981-6_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Subarachnoid hemorrhage remains to be a devastating diagnosis in this day and age, with very few effective interventions. Rising evidence is now pointing towards the marked importance of secondary complications after the hemorrhage, and its active role in morbidity and mortality of this stroke. This review will focus on the role of Nitric Oxide Synthases (NOSes) the role they play in the pathogenesis of SAH.
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Affiliation(s)
- Mohammed Sabri Attia
- Division of Neurosurgery, St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 1W8, Canada
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23
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Wu H, Wang H, Zhang B, Zhang G, Zhang R, Zhang L. Puerarin decreases hypoxia inducible factor-1 alpha in the hippocampus of vascular dementia rats. Neural Regen Res 2015; 7:421-5. [PMID: 25774183 PMCID: PMC4350127 DOI: 10.3969/j.issn.1673-5374.2012.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2011] [Accepted: 01/16/2012] [Indexed: 12/31/2022] Open
Abstract
In this study, a rat vascular dementia model was established by permanent bilateral common carotid arterial occlusion. Rats were intraperitoneally injected with puerarin 3 days before modeling, for 45 successive days. Results demonstrated that in treated animals hippocampal structures were clear, nerve cells arranged neatly, and cytoplasm was rich in Nissl bodies. The number of cells positive for hypoxia inducible factor-1 alpha, erythropoietin and endothelial nitric oxide synthase was reduced; and the learning and memory abilities of rats were significantly improved. Our experimental findings indicate that puerarin can significantly improve learning and memory in a vascular dementia model, and that the underlying mechanism may be associated with the regulation of the expression of hypoxia inducible factor-1 alpha.
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Affiliation(s)
- Haiqin Wu
- Department of Neurology, the Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Huqing Wang
- Department of Neurology, the Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Bei Zhang
- Department of Neurology, the Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Guilian Zhang
- Department of Neurology, the Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Ru Zhang
- Department of Neurology, the Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
| | - Lingfeng Zhang
- Department of Neurology, the Second Affiliated Hospital, Medical College of Xi'an Jiaotong University, Xi'an 710004, Shaanxi Province, China
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24
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Kataoka H. Molecular mechanisms of the formation and progression of intracranial aneurysms. Neurol Med Chir (Tokyo) 2015; 55:214-29. [PMID: 25761423 PMCID: PMC4533330 DOI: 10.2176/nmc.ra.2014-0337] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Until recently, only a little was understood about molecular mechanisms of the development of an intracranial aneurysm (IA). Recent advancements over the last decade in the field of genetics and molecular biology have provided us a wide variety of evidences supporting the notion that chronic inflammation is closely associated with the pathogenesis of IA development. In the field of genetics, large-scale Genome-wide association studies (GWAS) has identified some IA susceptible loci and genes related to cell cycle and endothelial function. Researches in molecular biology using human samples and animal models have revealed the common pathway of the initiation, progression, and rupture of IAs. IA formation begins with endothelial dysfunction followed by pathological remodeling with degenerative changes of vascular walls. Medical treatments inhibiting inflammatory cascades in IA development are likely to prevent IA progression and rupture. Statins and aspirin are expected to suppress IA progression by their anti-inflammatory effects. Decoy oligodeoxynucleotides (ODNs) inhibiting inflammatory transcription factors such as nuclear factor kappa-B (NF-κB) and Ets-1 are the other promising choice of the prevention of IA development. Further clarification of molecular mechanisms of the formation and progression of IAs will shed light to the pathogenesis of IA development and provide insight into novel diagnostic and therapeutic strategies for IAs.
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Affiliation(s)
- Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center
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Cooke DL, Bauer D, Sun Z, Stillson C, Nelson J, Barry D, Hetts SW, Higashida RT, Dowd CF, Halbach VV, Su H, Saeed MM. Endovascular biopsy: Technical feasibility of novel endothelial cell harvesting devices assessed in a rabbit aneurysm model. Interv Neuroradiol 2015. [DOI: 10.1177/inr-2014-10103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Cooke DL, Bauer D, Sun Z, Stillson C, Nelson J, Barry D, Hetts SW, Higashida RT, Dowd CF, Halbach VV, Su H, Saeed MM. Endovascular Biopsy: Technical Feasibility of Novel Endothelial Cell Harvesting Devices Assessed in a Rabbit Aneurysm Model. Interv Neuroradiol 2015. [DOI: 10.15274/inr-2015-10103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Toda N, Okamura T. Recent advances in research on nitrergic nerve-mediated vasodilatation. Pflugers Arch 2014; 467:1165-78. [PMID: 25339222 DOI: 10.1007/s00424-014-1621-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2014] [Revised: 09/25/2014] [Accepted: 09/29/2014] [Indexed: 12/29/2022]
Abstract
Cerebral vascular resistance and blood flow were widely considered to be regulated solely by tonic innervation of vasoconstrictor adrenergic nerves. However, pieces of evidence suggesting that parasympathetic nitrergic nerve activation elicits vasodilatation in dog and monkey cerebral arteries were found in 1990. Nitric oxide (NO) as a neurotransmitter liberated from parasympathetic postganglionic neurons decreases cerebral vascular tone and resistance and increases cerebral blood flow, which overcome vasoconstrictor responses to norepinephrine liberated from adrenergic nerves. Functional roles of nitrergic vasodilator nerves are found also in peripheral vasculature, including pulmonary, renal, mesenteric, hepatic, ocular, uterine, nasal, skeletal muscle, and cutaneous arteries and veins; however, adrenergic nerve-induced vasoconstriction is evidently greater than nitrergic vasodilatation in these vasculatures. In coronary arteries, neurogenic NO-mediated vasodilatation is not clearly noted; however, vasodilatation is induced by norepinephrine released from adrenergic nerves that activates β1-adrenoceptors. Impaired actions of NO liberated from the endothelium and nitrergic neurons are suggested to participate in cerebral hypoperfusion, leading to brain dysfunction, like that in Alzheimer's disease. Nitrergic neural dysfunction participates in impaired circulation in peripheral organs and tissues and also in systemic blood pressure increase. NO and vasodilator peptides, as sensory neuromediators, are involved in neurogenic vasodilatation in the skin. Functioning of nitrergic vasodilator nerves is evidenced not only in a variety of mammals, including humans and monkeys, but also in non-mammals. The present review article includes recent advances in research on the functional importance of nitrergic nerves concerning the control of cerebral blood flow, as well as other regions, and vascular resistance. Although information is still insufficient, the nitrergic nerve histology and function in vasculatures of non-mammals are also summarized.
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Affiliation(s)
- Noboru Toda
- Toyama Institute for Cardiovascular Pharmacology Research, 7-13, 1-Cho-me, Azuchi-machi, Chuo-ku, Osaka, 541-0052, Japan,
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Liaw N, Dolan Fox JM, Siddiqui AH, Meng H, Kolega J. Endothelial nitric oxide synthase and superoxide mediate hemodynamic initiation of intracranial aneurysms. PLoS One 2014; 9:e101721. [PMID: 24992254 PMCID: PMC4081806 DOI: 10.1371/journal.pone.0101721] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 06/10/2014] [Indexed: 01/08/2023] Open
Abstract
Background Hemodynamic insults at arterial bifurcations are believed to play a critical role in initiating intracranial aneurysms. Recent studies in a rabbit model indicate that aneurysmal damage initiates under specific wall shear stress conditions when smooth muscle cells (SMCs) become pro-inflammatory and produce matrix metalloproteinases (MMPs). The mechanisms leading to SMC activation and MMP production during hemodynamic aneurysm initiation are unknown. The goal is to determine if nitric oxide and/or superoxide induce SMC changes, MMP production and aneurysmal remodeling following hemodynamic insult. Methods Bilateral common carotid artery ligation was performed on rabbits (n = 19, plus 5 sham operations) to induce aneurysmal damage at the basilar terminus. Ligated animals were treated with the nitric oxide synthase (NOS) inhibitor LNAME (n = 7) or the superoxide scavenger TEMPOL (n = 5) and compared to untreated animals (n = 7). Aneurysm development was assessed histologically 5 days after ligation. Changes in NOS isoforms, peroxynitrite, reactive oxygen species (ROS), MMP-2, MMP-9, and smooth muscle α-actin were analyzed by immunohistochemistry. Results LNAME attenuated ligation-induced IEL loss, media thinning and bulge formation. In untreated animals, immunofluorescence showed increased endothelial NOS (eNOS) after ligation, but no change in inducible or neuronal NOS. Furthermore, during aneurysm initiation ROS increased in the media, but not the intima, and there was no change in peroxynitrite. In LNAME-treated animals, ROS production did not change. Together, this suggests that eNOS is important for aneurysm initiation but not by producing superoxide. TEMPOL treatment reduced aneurysm development, indicating that the increased medial superoxide is also necessary for aneurysm initiation. LNAME and TEMPOL treatment in ligated animals restored α-actin and decreased MMPs, suggesting that eNOS and superoxide both lead to SMC de-differentiation and MMP production. Conclusion Aneurysm-inducing hemodynamics lead to increased eNOS and superoxide, which both affect SMC phenotype, increasing MMP production and aneurysmal damage.
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Affiliation(s)
- Nicholas Liaw
- Toshiba Stroke and Vascular Research Center and Department of Mechanical and Aerospace Engineering, State University of New York, Buffalo, New York, United States of America
| | - Jennifer M. Dolan Fox
- Toshiba Stroke and Vascular Research Center and Department of Neurosurgery, State University of New York, Buffalo, New York, United States of America
| | - Adnan H. Siddiqui
- Toshiba Stroke and Vascular Research Center and Departments Neurosurgery and Radiology, State University of New York, Buffalo, New York, United States of America
| | - Hui Meng
- Toshiba Stroke and Vascular Research Center and Departments of Mechanical and Aerospace Engineering, Neurosurgery, and Biomedical Engineering, State University of New York, Buffalo, New York, United States of America
| | - John Kolega
- Toshiba Stroke and Vascular Research Center and Department Pathology and Anatomical Sciences, State University of New York, Buffalo, New York, United States of America
- * E-mail:
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Overlapping biological mechanisms underlying sickle cell disease, stress, and depression: a stress-vulnerability framework. Harv Rev Psychiatry 2014; 22:205-15. [PMID: 24887328 DOI: 10.1097/hrp.0000000000000022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
After participating in this activity, learners should be better able to:1. Evaluate the overlap between sickle cell disease (SCD) and depression.2. Identify sources of psychological stress and biological vulnerabilities toward developing depression in patients with SCD.3. Assess the potential mechanisms underlying SCD, stress, and depression.Depression is a common co-occurring disorder in persons with sickle-cell disease (SCD). Individuals with this chronic illness may be particularly vulnerable to depression. In addition to risk factors for depression specifically related to SCD, these individuals typically experience further psychological stress due to multiple risk factors in their environment. To date, however, little research has focused on the co-occurring biological mechanisms across these conditions and how those mechanisms may interact to produce depressive symptoms. In this review we use a stress-vulnerability framework to describe the sources of psychological stress and the SCD factors that increase the risk of depression. We suggest that several biological factors, such as nitric oxide and cytokines, may play an important role in co-occurring stress, SCD, and depression. The interaction of these factors may be of particular importance for understanding the comorbidity of SCD and depression. Implications for current treatment and future research are discussed.
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Frösen J. Smooth Muscle Cells and the Formation, Degeneration, and Rupture of Saccular Intracranial Aneurysm Wall—a Review of Current Pathophysiological Knowledge. Transl Stroke Res 2014; 5:347-56. [DOI: 10.1007/s12975-014-0340-3] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2013] [Revised: 03/08/2014] [Accepted: 03/11/2014] [Indexed: 10/25/2022]
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Affiliation(s)
- Alexis S Turjman
- Department of Materials Science & Engineering (A.S.T.) and Institute for Medical Engineering and Science, (A.S.T., E.R.E.), Massachusetts Institute of Technology, Cambridge, MA; Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Boston, MA (E.R.E.); Department of Interventional Neuroradiology, Hôpital Neurologique Pierre Wertheimer, Bron, France (F.T.); and Institut des Neurosciences Cognitives, CNRS, Bron, France (F.T.)
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Yan T, Chopp M, Ning R, Zacharek A, Roberts C, Chen J. Intracranial aneurysm formation in type-one diabetes rats. PLoS One 2013; 8:e67949. [PMID: 23844137 PMCID: PMC3699459 DOI: 10.1371/journal.pone.0067949] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 05/23/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND & OBJECTIVE Diabetes mellitus (DM) plays an important role in the pathogenesis of vascular complications including arteriosclerosis and ischemic stroke. Whether DM impacts intracranial aneurysm (IA) formation has not been extensively investigated. In this study, we tested the underlying mechanism of type one DM (T1DM) induced IA formation in rats. EXPERIMENTAL APPROACHES T1DM was induced by streptozotocin injection. Rats were euthanized at 0, 4 and 10 weeks after T1DM induction. To evaluate cerebral vascular perfusion, Fluorescein isothiocyanate - dye was injected at 5 min prior to euthanasia. Vascular perfusion was measured by laser scanning confocal microscopy. Trichrome, Elastica van Gieson, alpha-smooth muscle actin (a-SMA) and receptor of advanced glycation end-products (RAGE), toll-like receptor 4 (TLR4) and matrix metalloproteinase 9 (MMP9) immunostaining were performed. The IA formation was classified by 0-3 stages: 0: Normal; 1: Endothelial damage; 2: Moderate protrusion; and 3: Saccular aneurysm formation. RESULTS T1DM significantly increased IA formation identified by the classification of aneurysmal changes compared with non-DM rats (p<0.05). However, T1DM induced IA formations were classified as stage 1 and stage 2, but not stage 3. Cerebral vascular perfusion was significantly decreased in T1DM rats compared to non-DM rats (p<0.01). DM10W rats exhibited a significant decrease of cerebral vascular perfusion compared to DM4W rats (p<0.05). T1DM rats also significantly increased the internal carotid artery (ICA) intimae and media thickness, and decreased the internal carotid artery diameter compared to non-DM rats. RAGE, MMP9 and TLR4 expression were significantly increased in T1DM rats compared to non-DM rats. The increased RAGE, TLR4 and MMP9 significantly correlated with IA formation (p<0.05). CONCLUSION T1DM increases IA formation. The increased RAGE, MMP9 and TLR4 expressions might contribute to IA formation in T1DM rats.
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Affiliation(s)
- Tao Yan
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, United States of America
| | - Michael Chopp
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, United States of America
- Department of Physics, Oakland University, Rochester, Michigan, United States of America
| | - Ruizhuo Ning
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, United States of America
| | - Alex Zacharek
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, United States of America
| | - Cynthia Roberts
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, United States of America
| | - Jieli Chen
- Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China
- Department of Neurology, Henry Ford Hospital, Detroit, Michigan, United States of America
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Identification of MicroRNAs with Altered Expression Profiles in a Rat Model of Experimentally Induced Early Cerebral Aneurysms. Korean J Neurotrauma 2013. [DOI: 10.13004/kjnt.2013.9.2.41] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Chalouhi N, Ali MS, Starke RM, Jabbour PM, Tjoumakaris SI, Gonzalez LF, Rosenwasser RH, Koch WJ, Dumont AS. Cigarette smoke and inflammation: role in cerebral aneurysm formation and rupture. Mediators Inflamm 2012; 2012:271582. [PMID: 23316103 PMCID: PMC3532877 DOI: 10.1155/2012/271582] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Accepted: 10/27/2012] [Indexed: 12/17/2022] Open
Abstract
Smoking is an established risk factor for subarachnoid hemorrhage yet the underlying mechanisms are largely unknown. Recent data has implicated a role of inflammation in the development of cerebral aneurysms. Inflammation accompanying cigarette smoke exposure may thus be a critical pathway underlying the development, progression, and rupture of cerebral aneurysms. Various constituents of the inflammatory response appear to be involved including adhesion molecules, cytokines, reactive oxygen species, leukocytes, matrix metalloproteinases, and vascular smooth muscle cells. Characterization of the molecular basis of the inflammatory response accompanying cigarette smoke exposure will provide a rational approach for future targeted therapy. In this paper, we review the current body of knowledge implicating cigarette smoke-induced inflammation in cerebral aneurysm formation/rupture and attempt to highlight important avenues for future investigation.
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Affiliation(s)
- Nohra Chalouhi
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Muhammad S. Ali
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Robert M. Starke
- Department of Neurological Surgery, University of Virginia School of Medicine, Charlottesville, VA 22903, USA
| | - Pascal M. Jabbour
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Stavropoula I. Tjoumakaris
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - L. Fernando Gonzalez
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Robert H. Rosenwasser
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Walter J. Koch
- Center for Translational Medicine and George Zallie and Family Laboratory for Cardiovascular Gene Therapy, Department of Medicine, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Aaron S. Dumont
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, PA 19107, USA
- Division of Neurovascular & Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University, 901 Walnut Street, 3rd Floor, Philadelphia, PA 19107, USA
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High wall shear stress and spatial gradients in vascular pathology: a review. Ann Biomed Eng 2012; 41:1411-27. [PMID: 23229281 DOI: 10.1007/s10439-012-0695-0] [Citation(s) in RCA: 232] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2012] [Accepted: 11/06/2012] [Indexed: 12/18/2022]
Abstract
Cardiovascular pathologies such as intracranial aneurysms (IAs) and atherosclerosis preferentially localize to bifurcations and curvatures where hemodynamics are complex. While extensive knowledge about low wall shear stress (WSS) has been generated in the past, due to its strong relevance to atherogenesis, high WSS (typically >3 Pa) has emerged as a key regulator of vascular biology and pathology as well, receiving renewed interests. As reviewed here, chronic high WSS not only stimulates adaptive outward remodeling, but also contributes to saccular IA formation (at bifurcation apices or outer curves) and atherosclerotic plaque destabilization (in stenosed vessels). Recent advances in understanding IA pathogenesis have shed new light on the role of high WSS in pathological vascular remodeling. In complex geometries, high WSS can couple with significant spatial WSS gradient (WSSG). A combination of high WSS and positive WSSG has been shown to trigger aneurysm initiation. Since endothelial cells (ECs) are sensors of WSS, we have begun to elucidate EC responses to high WSS alone and in combination with WSSG. Understanding such responses will provide insight into not only aneurysm formation, but also plaque destabilization and other vascular pathologies and potentially lead to improved strategies for disease management and novel targets for pharmacological intervention.
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"Sit back, observe, and wait." Or is there a pharmacologic preventive treatment for cerebral aneurysms? Neurosurg Rev 2012; 36:1-9; discussion 9-10. [PMID: 23070279 DOI: 10.1007/s10143-012-0429-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Revised: 06/29/2012] [Accepted: 07/29/2012] [Indexed: 10/27/2022]
Abstract
Intracranial aneurysms (IA) are a relatively frequent vascular abnormality. The prevailing opinion is that cerebral aneurysmal disease is related to hemodynamic and genetic factors, associated with structural weakness in the arterial wall which was acquired by a specific, often unknown, event. Possibly the trigger moment of aneurysm formation may depend on the dynamic arterial growth, which is closely related to aging/atherosclerosis. In most individuals, an endovascular/microsurgical approach is possible in order to obliterate the IA. However, in a number of patients with an unruptured IA (UIA), the neurosurgeon's decision is to just "sit back, observe, and wait", based on the favorable natural history of some of the UIAs. Furthermore, some individuals need to be kept under close observation since they have a higher chance of developing IA, especially those with at least two affected first-degree relatives with an IA, subjects with polycystic kidney disease, and patients who have undergone an aneurysm intervention. In these examples prophylactic strategies should be adopted, if it is at all possible. The main question is deciding the best option of clinical treatment for these cases, when surgical approach is contraindicated, or for those subjects who are more prone to develop an IA. In the present article, we hypothetically suggest a pharmacologic form of treatment with statins, beta-adrenergic blocker agents, and/or angiotensin-converting-enzyme inhibitor/angiotensin II receptor blockers to inhibit or slow down IA formation, taking into consideration some pathophysiological aspects related to aneurysmal development, such as: hemodynamic stress, arterial wall inflammation, nitric oxide formation, and atheromatous disease.
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Chalouhi N, Ali MS, Jabbour PM, Tjoumakaris SI, Gonzalez LF, Rosenwasser RH, Koch WJ, Dumont AS. Biology of intracranial aneurysms: role of inflammation. J Cereb Blood Flow Metab 2012; 32:1659-76. [PMID: 22781330 PMCID: PMC3434628 DOI: 10.1038/jcbfm.2012.84] [Citation(s) in RCA: 361] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Intracranial aneurysms (IAs) linger as a potentially devastating clinical problem. Despite intense investigation, our understanding of the mechanisms leading to aneurysm development, progression and rupture remain incompletely defined. An accumulating body of evidence implicates inflammation as a critical contributor to aneurysm pathogenesis. Intracranial aneurysm formation and progression appear to result from endothelial dysfunction, a mounting inflammatory response, and vascular smooth muscle cell phenotypic modulation producing a pro-inflammatory phenotype. A later final common pathway appears to involve apoptosis of cellular constituents of the vessel wall. These changes result in degradation of the integrity of the vascular wall leading to aneurysmal dilation, progression and eventual rupture in certain aneurysms. Various aspects of the inflammatory response have been investigated as contributors to IA pathogenesis including leukocytes, complement, immunoglobulins, cytokines, and other humoral mediators. Furthermore, gene expression profiling of IA compared with control arteries has prominently featured differential expression of genes involved with immune response/inflammation. Preliminary data suggest that therapies targeting the inflammatory response may have efficacy in the future treatment of IA. Further investigation, however, is necessary to elucidate the precise role of inflammation in IA pathogenesis, which can be exploited to improve the prognosis of patients harboring IA.
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Affiliation(s)
- Nohra Chalouhi
- Joseph and Marie Field Cerebrovascular Research Laboratory, Division of Neurovascular and Endovascular Surgery, Department of Neurological Surgery, Thomas Jefferson University and Jefferson Hospital for Neuroscience, Philadelphia, Pennsylvania 19107, USA.
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