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Crane A, Shanahan RM, Hudson JS, Nowicki KW, Gersey ZC, Agarwal P, Jacobs RC, Lang MJ, Gross B. Pharmaceutical Modulation of Intracranial Aneurysm Development and Rupture. J Clin Med 2024; 13:3324. [PMID: 38893035 PMCID: PMC11173282 DOI: 10.3390/jcm13113324] [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: 04/17/2024] [Revised: 05/23/2024] [Accepted: 05/31/2024] [Indexed: 06/21/2024] Open
Abstract
Management of intracranial aneurysms (IAs) is determined by patient age, risk of rupture, and comorbid conditions. While endovascular and microsurgical interventions offer solutions to mitigate the risk of rupture, pharmacological management strategies may complement these approaches or serve as alternatives in appropriate cases. The pathophysiology of IAs allows for the targeting of inflammation to prevent the development and rupture of IAs. The aim of this review is to provide an updated summary of different pharmaceutical management strategies for IAs. Acetylsalicylic acid and renin-angiotensin-aldosterone system (RAAS) inhibitor antihypertensives have some evidence supporting their protective effect. Studies of selective cyclooxygenase-2 (COX-2) inhibitors, statins, ADP inhibitors, and other metabolism-affecting drugs have demonstrated inconclusive findings regarding their association with aneurysm growth or rupture. In this manuscript, we highlight the evidence supporting each drug's effectiveness.
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Affiliation(s)
- Alex Crane
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Regan M. Shanahan
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Joseph S. Hudson
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Kamil W. Nowicki
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT 06510, USA;
| | - Zachary C. Gersey
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Prateek Agarwal
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Rachel C. Jacobs
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Michael J. Lang
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
| | - Bradley Gross
- Department of Neurological Surgery, University of Pittsburgh, Pittsburgh, PA 15213, USA (Z.C.G.); (M.J.L.)
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Hu P, Du Y, Xu Y, Ye P, Xia J. The role of transcription factors in the pathogenesis and therapeutic targeting of vascular diseases. Front Cardiovasc Med 2024; 11:1384294. [PMID: 38745757 PMCID: PMC11091331 DOI: 10.3389/fcvm.2024.1384294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/16/2024] [Indexed: 05/16/2024] Open
Abstract
Transcription factors (TFs) constitute an essential component of epigenetic regulation. They contribute to the progression of vascular diseases by regulating epigenetic gene expression in several vascular diseases. Recently, numerous regulatory mechanisms related to vascular pathology, ranging from general TFs that are continuously activated to histiocyte-specific TFs that are activated under specific circumstances, have been studied. TFs participate in the progression of vascular-related diseases by epigenetically regulating vascular endothelial cells (VECs) and vascular smooth muscle cells (VSMCs). The Krüppel-like family (KLF) TF family is widely recognized as the foremost regulator of vascular diseases. KLF11 prevents aneurysm progression by inhibiting the apoptosis of VSMCs and enhancing their contractile function. The presence of KLF4, another crucial member, suppresses the progression of atherosclerosis (AS) and pulmonary hypertension by attenuating the formation of VSMCs-derived foam cells, ameliorating endothelial dysfunction, and inducing vasodilatory effects. However, the mechanism underlying the regulation of the progression of vascular-related diseases by TFs has remained elusive. The present study categorized the TFs involved in vascular diseases and their regulatory mechanisms to shed light on the potential pathogenesis of vascular diseases, and provide novel insights into their diagnosis and treatment.
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Affiliation(s)
- Poyi Hu
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yifan Du
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ying Xu
- Institute of Reproduction Health Research, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Ye
- Central Hospital of Wuhan, Huazhong University of Science and Technology, Wuhan, China
| | - Jiahong Xia
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Feng Y, Zhang H, Dai S, Li X. Aspirin treatment for unruptured intracranial aneurysms: Focusing on its anti-inflammatory role. Heliyon 2024; 10:e29119. [PMID: 38617958 PMCID: PMC11015424 DOI: 10.1016/j.heliyon.2024.e29119] [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: 01/24/2024] [Revised: 03/07/2024] [Accepted: 04/01/2024] [Indexed: 04/16/2024] Open
Abstract
Intracranial aneurysms (IAs), as a common cerebrovascular disease, claims a worldwide morbidity rate of 3.2%. Inflammation, pivotal in the pathogenesis of IAs, influences their formation, growth, and rupture. This review investigates aspirin's modulation of inflammatory pathways within this context. With IAs carrying significant morbidity and mortality upon IAs rupture and current interventions limited to surgical clipping and endovascular coiling, the quest for pharmacological options is imperative. Aspirin's role in cardiovascular prevention, due to its anti-inflammatory effects, presents a potential therapeutic avenue for IAs. In this review, we examine aspirin's efficacy in experimental models and clinical settings, highlighting its impact on the progression and rupture risks of unruptured IAs. The underlying mechanisms of aspirin's impact on IAs are explored, with its ability examined to attenuate endothelial dysfunction and vascular injury. This review may provide a theoretical basis for the use of aspirin, suggesting a promising strategy for IAs management. However, the optimal dosing, safety, and long-term efficacy remain to be established. The implications of aspirin therapy are significant in light of current surgical and endovascular treatments. Further research is encouraged to refine aspirin's clinical application in the management of unruptured IAs, with the ultimate aim of reducing the incidence of aneurysms rupture.
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Affiliation(s)
- Yuan Feng
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Hongchen Zhang
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Shuhui Dai
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
- National Translational Science Center for Molecular Medicine and Department of Cell Biology, Fourth Military Medical University, Xi'an, China
| | - Xia Li
- Department of Neurosurgery, Xijing Hospital, Fourth Military Medical University, Xi'an, China
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Shekhtman O, Sioutas GS, Piavchenko G, Bhalla S, Cooke DL, Winkler E, Burkhardt JK, Srinivasan VM. Endovascular biopsy in neurointerventional surgery: A systematic review. Interv Neuroradiol 2024:15910199241240508. [PMID: 38515364 DOI: 10.1177/15910199241240508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2024] Open
Abstract
INTRODUCTION Endothelial cells (ECs) continuously line the cerebrovasculature. Molecular aberrations in the ECs are hallmarks and contributory factors to the development of cerebrovascular diseases, including intracranial aneurysms and arteriovenous malformations (AVMs). Endovascular biopsy has been introduced as a method to harvest ECs and obtain relevant biologic information. We aimed to summarize the literature on endovascular biopsy in neurointerventional surgery. METHODS We conducted a comprehensive literature search in multiple databases, identifying eligible studies focusing on neurosurgical applications of endovascular biopsy. The systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The relevant information was collected, including study characteristics, biopsy techniques, and key findings. RESULTS Nine studies met the inclusion criteria and were included. The studies involved the collection of ECs using various endovascular devices including coils, guide wires, different stents, and forceps. Endothelial-enrichment techniques, such fluorescence-activated cell sorting (FACS), collected ECs and facilitated downstream applications of bulk or single-cell RNA sequencing (scRNAseq). The studies provided insights into gene expression profiles and identified potential biomarkers associated with intracranial aneurysms. However, challenges were observed in obtaining an adequate number of ECs and identifying consistent biomarkers. CONCLUSION Endovascular biopsy of endothelial cells (ECs) in cerebrovascular pathologies shows promise for gene expression profiling. However, many studies have been limited in sample size and underpowered to identify "signature genes" for aneurysm growth or rupture. Advancements in minimally invasive biopsy methods have potential to facilitate applications of precision medicine in the treatment of cerebrovascular disorders.
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Affiliation(s)
- Oleg Shekhtman
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Georgios S Sioutas
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Gennadii Piavchenko
- Department of Human Anatomy and Histology, Sechenov University, Moscow, Russia
| | - Shubhang Bhalla
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Daniel L Cooke
- Department of Interventional Radiology, University of California San Francisco, San Francisco, CA, USA
| | - Ethan Winkler
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Jan-Karl Burkhardt
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Visish M Srinivasan
- Department of Neurosurgery, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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Glavan M, Jelic A, Levard D, Frösen J, Keränen S, Franx BAA, Bras AR, Louet ER, Dénes Á, Merlini M, Vivien D, Rubio M. CNS-associated macrophages contribute to intracerebral aneurysm pathophysiology. Acta Neuropathol Commun 2024; 12:43. [PMID: 38500201 PMCID: PMC10946177 DOI: 10.1186/s40478-024-01756-5] [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: 12/17/2023] [Accepted: 03/06/2024] [Indexed: 03/20/2024] Open
Abstract
Intracerebral aneurysms (IAs) are pathological dilatations of cerebral arteries whose rupture leads to subarachnoid hemorrhage, a significant cause of disability and death. Inflammation is recognized as a critical contributor to the formation, growth, and rupture of IAs; however, its precise actors have not yet been fully elucidated. Here, we report CNS-associated macrophages (CAMs), also known as border-associated macrophages, as one of the key players in IA pathogenesis, acting as critical mediators of inflammatory processes related to IA ruptures. Using a new mouse model of middle cerebral artery (MCA) aneurysms we show that CAMs accumulate in the IA walls. This finding was confirmed in a human MCA aneurysm obtained after surgical clipping, together with other pathological characteristics found in the experimental model including morphological changes and inflammatory cell infiltration. In addition, in vivo longitudinal molecular MRI studies revealed vascular inflammation strongly associated with the aneurysm area, i.e., high expression of VCAM-1 and P-selectin adhesion molecules, which precedes and predicts the bleeding extent in the case of IA rupture. Specific CAM depletion by intracerebroventricular injection of clodronate liposomes prior to IA induction reduced IA formation and rupture rate. Moreover, the absence of CAMs ameliorated the outcome severity of IA ruptures resulting in smaller hemorrhages, accompanied by reduced neutrophil infiltration. Our data shed light on the unexplored role of CAMs as main actors orchestrating the progression of IAs towards a rupture-prone state.
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Affiliation(s)
- Martina Glavan
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France
- Department of Neuroscience, Yale School of Medicine, Yale University, 333 Cedar Street, New Haven, CT, 06510, USA
| | - Ana Jelic
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France
| | - Damien Levard
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France
| | - Juhana Frösen
- Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital and AIV Institute for Molecular Medicine, University of Eastern Finland, Kuopio, Finland
- Dept of Neurosurgery, Tampere University Hospital and Hemorrhagic Brain Pathology Research Group, Tampere University, Tampere, Finland
| | - Sara Keränen
- Hemorrhagic Brain Pathology Research Group, Kuopio University Hospital and AIV Institute for Molecular Medicine, University of Eastern Finland, Kuopio, Finland
- Dept of Neurosurgery, Tampere University Hospital and Hemorrhagic Brain Pathology Research Group, Tampere University, Tampere, Finland
| | - Bart A A Franx
- Translational Neuroimaging Group, Center for Image Sciences, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Ana-Rita Bras
- "Momentum" Laboratory of Neuroimmunology, Institute of Experimental Medicine, Budapest, Hungary
- János Szentágothai Doctoral School of Neurosciences, Schools of PhD Studies, Semmelweis University, Budapest, Hungary
| | - Estelle R Louet
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France
| | - Ádám Dénes
- "Momentum" Laboratory of Neuroimmunology, Institute of Experimental Medicine, Budapest, Hungary
| | - Mario Merlini
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France
| | - Denis Vivien
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France
- Department of Clinical Research, Caen Normandie University Hospital, Caen, France
| | - Marina Rubio
- UNICAEN, INSERM U1237, Etablissement Français du Sang, Physiopathology and Imaging of Neurological Disorders (PhIND), Cyceron, Institut Blood and Brain @ Caen-Normandie (BB@C), PHIND Boulevard Henri Becquerel, Normandie University, 14000, Caen Cedex, Caen, France.
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6
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Shu T, Zhou Y, Yan C. The perspective of cAMP/cGMP signaling and cyclic nucleotide phosphodiesterases in aortic aneurysm and dissection. Vascul Pharmacol 2024; 154:107278. [PMID: 38262506 PMCID: PMC10939884 DOI: 10.1016/j.vph.2024.107278] [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: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/19/2024] [Indexed: 01/25/2024]
Abstract
Aortic aneurysm (AA) and dissection (AD) are aortic diseases caused primarily by medial layer degeneration and perivascular inflammation. They are lethal when the rupture happens. Vascular smooth muscle cells (SMCs) play critical roles in the pathogenesis of medial degeneration, characterized by SMC loss and elastin fiber degradation. Many molecular pathways, including cyclic nucleotide signaling, have been reported in regulating vascular SMC functions, matrix remodeling, and vascular structure integrity. Intracellular cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) are second messengers that mediate intracellular signaling transduction through activating effectors, such as protein kinase A (PKA) and PKG, respectively. cAMP and cGMP are synthesized by adenylyl cyclase (AC) and guanylyl cyclase (GC), respectively, and degraded by cyclic nucleotide phosphodiesterases (PDEs). In this review, we will discuss the roles and mechanisms of cAMP/cGMP signaling and PDEs in AA/AD formation and progression and the potential of PDE inhibitors in AA/AD, whether they are beneficial or detrimental. We also performed database analysis and summarized the results showing PDEs with significant expression changes under AA/AD, which should provide rationales for future research on PDEs in AA/AD.
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Affiliation(s)
- Ting Shu
- Aab Cardiovascular Research Institute, School of Medicine and Dentistry, University of Rochester, New York, United States
| | - Yitian Zhou
- Peking Union Medical College, MD Program, Beijing, China
| | - Chen Yan
- Aab Cardiovascular Research Institute, School of Medicine and Dentistry, University of Rochester, New York, United States.
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7
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Digpal R, Arkill KP, Doherty R, Yates J, Milne LK, Broomes N, Katsamenis OL, Macdonald J, Ditchfield A, Narata AP, Darekar A, Carare RO, Fabian M, Galea I, Bulters D. A Systematic Review and Meta-Analysis of the Pathology Underlying Aneurysm Enhancement on Vessel Wall Imaging. Int J Mol Sci 2024; 25:2700. [PMID: 38473947 DOI: 10.3390/ijms25052700] [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: 11/14/2023] [Revised: 01/11/2024] [Accepted: 01/25/2024] [Indexed: 03/14/2024] Open
Abstract
Intracranial aneurysms are common, but only a minority rupture and cause subarachnoid haemorrhage, presenting a dilemma regarding which to treat. Vessel wall imaging (VWI) is a contrast-enhanced magnetic resonance imaging (MRI) technique used to identify unstable aneurysms. The pathological basis of MR enhancement of aneurysms is the subject of debate. This review synthesises the literature to determine the pathological basis of VWI enhancement. PubMed and Embase searches were performed for studies reporting VWI of intracranial aneurysms and their correlated histological analysis. The risk of bias was assessed. Calculations of interdependence, univariate and multivariate analysis were performed. Of 228 publications identified, 7 met the eligibility criteria. Individual aneurysm data were extracted for 72 out of a total of 81 aneurysms. Univariate analysis showed macrophage markers (CD68 and MPO, p = 0.001 and p = 0.002), endothelial cell markers (CD34 and CD31, p = 0.007 and p = 0.003), glycans (Alcian blue, p = 0.003) and wall thickness (p = 0.030) were positively associated with enhancement. Aneurysm enhancement therefore appears to be associated with inflammatory infiltrate and neovascularisation. However, all these markers are correlated with each other, and the literature is limited in terms of the numbers of aneurysms analysed and the parameters considered. The data are therefore insufficient to determine if these associations are independent of each other or of aneurysm size, wall thickness and rupture status. Thus, the cause of aneurysm-wall enhancement currently remains unknown.
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Affiliation(s)
- Ronneil Digpal
- Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Kenton P Arkill
- Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK
| | - Regan Doherty
- Biomedical Imaging Unit, University of Southampton, Southampton SO16 6YD, UK
| | - Joseph Yates
- Department of Neuropathology, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Lorna K Milne
- Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK
| | - Nicole Broomes
- Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Orestis L Katsamenis
- Faculty of Engineering and Physical Sciences, µ-VIS X-ray Imaging Centre, University of Southampton, Southampton SO16 6YD, UK
| | - Jason Macdonald
- Department of Neuroradiology, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Adam Ditchfield
- Department of Neuroradiology, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Ana Paula Narata
- Department of Neuroradiology, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Angela Darekar
- Medical Physics, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Roxana O Carare
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
| | - Mark Fabian
- Department of Neuropathology, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Ian Galea
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
- Department of Neurology, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
| | - Diederik Bulters
- Department of Neurosurgery, Wessex Neurological Centre, University Hospital Southampton, Southampton SO16 6YD, UK
- Clinical Neurosciences, Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton SO16 6YD, UK
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8
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Kamińska J, Tylicka M, Sutkowska K, Gacuta KM, Sawicka MM, Kowalewska E, Ćwiklińska-Dworakowska M, Maciejczyk M, Łysoń T, Kornhuber J, Lewczuk P, Matowicka-Karna J, Koper-Lenkiewicz OM. The preliminary study suggests an association between NF-ĸB pathway activation and increased plasma 20S proteasome activity in intracranial aneurysm patients. Sci Rep 2024; 14:3941. [PMID: 38366068 PMCID: PMC10873410 DOI: 10.1038/s41598-024-54692-8] [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: 11/03/2023] [Accepted: 02/15/2024] [Indexed: 02/18/2024] Open
Abstract
The significant role of increased activation of 20S proteasomes in the development of abdominal aortic aneurysms has been well-established in a mouse model. The available literature lacks similar studies concerning brain aneurysms. The aim of the study was to verify the hypothesis that patients with unruptured intracranial aneurysms (UIA) have increased 20S proteasome ChT-L activity compared to the control group of individuals without vascular lesions in the brain. In the next step, the relationship between the activity of 20S proteasomes ChT-L and precursor proteins from the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) family, namely NF-κB1 (p105), NF-κB2 (p100), NF-κB p65, and the inflammatory chemokine MCP-1, was examined. Patients with UIA had significantly higher 20S ChT-L proteasome activity compared to the control group. Patients with multiple aneurysms had significantly higher 20S proteasome ChT-L activity compared to those with single aneurysms. In patients with UIA, the activity of the 20S proteasome ChT-L negatively correlated with the concentration of NF-κB1 (p105) and NF-κB p65 precursor proteins and positively correlated with the concentration of the cerebrospinal fluid chemokine MCP-1. Our results may suggest that increased 20S proteasome ChT-L activity in UIA patients modulates inflammation in the cerebral arterial vessel via the MCP-1 chemokine as a result of activation of the canonical NF-κB pathway.
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Affiliation(s)
- Joanna Kamińska
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland.
| | - Marzena Tylicka
- Department of Biophysics, Medical University of Bialystok, 2A Adama Mickiewicza St., 15-089, Białystok, Poland
| | - Kinga Sutkowska
- Department of Clinical Laboratory Diagnostics, Clinical Hospital of the Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland
| | - Karolina Marta Gacuta
- Department of Clinical Laboratory Diagnostics, Clinical Hospital of the Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland
| | - Magdalena Maria Sawicka
- Department of Analysis and Bioanalysis of Medicines, Medical University of Bialystok, 2D Mickiewicza St., 15-222, Białystok, Poland
| | - Ewa Kowalewska
- Department of Clinical Laboratory Diagnostics, Clinical Hospital of the Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland
| | - Magdalena Ćwiklińska-Dworakowska
- Department of Oncological Surgery and General Surgery, Independent Public Health Care Facility of the Ministry of the Interior and Administration in Bialystok named Marian Zyndram-Kościałkowski, 27 Fabryczna St., 15-471, Białystok, Poland
| | - Mateusz Maciejczyk
- Department of Hygiene, Epidemiology, and Ergonomics, Medical University of Białystok, 2C Mickiewicza St., 15-022, Białystok, Poland
| | - Tomasz Łysoń
- Department of Neurosurgery, Medical University of Bialystok/Clinical Hospital of the Medical University of Bialystok, 24A Marii Skłodowskiej-Curie St., 15-276, Białystok, Poland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Piotr Lewczuk
- Department of Psychiatry and Psychotherapy, University Hospital Erlangen, and Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland
| | - Joanna Matowicka-Karna
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland
| | - Olga Martyna Koper-Lenkiewicz
- Department of Clinical Laboratory Diagnostics, Medical University of Bialystok, 15A Jerzego Waszyngtona St., 15-269, Białystok, Poland.
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9
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Okada A, Shimizu K, Kawashima A, Kayahara T, Itani M, Kurita H, Miyamoto S, Kataoka H, Aoki T. C5a-C5AR1 axis as a potential trigger of the rupture of intracranial aneurysms. Sci Rep 2024; 14:3105. [PMID: 38326494 PMCID: PMC10850553 DOI: 10.1038/s41598-024-53651-7] [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: 09/11/2023] [Accepted: 02/03/2024] [Indexed: 02/09/2024] Open
Abstract
Recent studies have indicated the involvement of neutrophil-mediated inflammatory responses in the process leading to intracranial aneurysm (IA) rupture. Receptors mediating neutrophil recruitment could thus be therapeutic targets of unruptured IAs. In this study, complement C5a receptor 1 (C5AR1) was picked up as a candidate that may cause neutrophil-dependent inflammation in IA lesions from comprehensive gene expression profile data acquired from rat and human samples. The induction of C5AR1 in IA lesions was confirmed by immunohistochemistry; the up-regulations of C5AR1/C5ar1 stemmed from infiltrated neutrophils, which physiologically express C5AR1/C5ar1, and adventitial fibroblasts that induce C5AR1/C5ar1 in human/rat IA lesions. In in vitro experiments using NIH/3T3, a mouse fibroblast-like cell line, induction of C5ar1 was demonstrated by starvation or pharmacological inhibition of mTOR signaling by Torin1. Immunohistochemistry and an experiment in a cell-free system using recombinant C5 protein and recombinant Plasmin indicated that the ligand of C5AR1, C5a, could be produced through the enzymatic digestion by Plasmin in IA lesions. In conclusion, we have identified a potential contribution of the C5a-C5AR1 axis to neutrophil infiltration as well as inflammatory responses in inflammatory cells and fibroblasts of IA lesions. This cascade may become a therapeutic target to prevent the rupture of IAs.
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Grants
- 21K16622 Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
- 20K09367 Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
- 20K09381 Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
- 22H00584 Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan
- JP18gm0810006 Core Research for Evolutional Science and Technology (CREST) on Mechanobiology from the Japan Agency for Medical Research and Development (AMED)
- JP19gm0810006 Core Research for Evolutional Science and Technology (CREST) on Mechanobiology from the Japan Agency for Medical Research and Development (AMED)
- JP20gm0810006 Core Research for Evolutional Science and Technology (CREST) on Mechanobiology from the Japan Agency for Medical Research and Development (AMED)
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Affiliation(s)
- Akihiro Okada
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Core Research for Evolutional Science and Technology from Japan Agency for Medical Research and Development, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Kampei Shimizu
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Core Research for Evolutional Science and Technology from Japan Agency for Medical Research and Development, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akitsugu Kawashima
- Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Tomomichi Kayahara
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Masahiko Itani
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
- Department of Pharmacology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Tomohiro Aoki
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Osaka, Japan.
- Core Research for Evolutional Science and Technology from Japan Agency for Medical Research and Development, National Cerebral and Cardiovascular Center, Osaka, Japan.
- Department of Pharmacology, The Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan.
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10
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Lauzier DC, Srienc AI, Vellimana AK, Dacey Jr RG, Zipfel GJ. Peripheral macrophages in the development and progression of structural cerebrovascular pathologies. J Cereb Blood Flow Metab 2024; 44:169-191. [PMID: 38000039 PMCID: PMC10993883 DOI: 10.1177/0271678x231217001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 09/10/2023] [Accepted: 09/15/2023] [Indexed: 11/26/2023]
Abstract
The human cerebrovascular system is responsible for maintaining neural function through oxygenation, nutrient supply, filtration of toxins, and additional specialized tasks. While the cerebrovascular system has resilience imparted by elaborate redundant collateral circulation from supportive tertiary structures, it is not infallible, and is susceptible to developing structural vascular abnormalities. The causes of this class of structural cerebrovascular diseases can be broadly categorized as 1) intrinsic developmental diseases resulting from genetic or other underlying aberrations (arteriovenous malformations and cavernous malformations) or 2) extrinsic acquired diseases that cause compensatory mechanisms to drive vascular remodeling (aneurysms and arteriovenous fistulae). Cerebrovascular diseases of both types pose significant risks to patients, in some cases leading to death or disability. The drivers of such diseases are extensive, yet inflammation is intimately tied to all of their progressions. Central to this inflammatory hypothesis is the role of peripheral macrophages; targeting this critical cell type may lead to diagnostic and therapeutic advancement in this area. Here, we comprehensively review the role that peripheral macrophages play in cerebrovascular pathogenesis, provide a schema through which macrophage behavior can be understood in cerebrovascular pathologies, and describe emerging diagnostic and therapeutic avenues in this area.
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Affiliation(s)
- David C Lauzier
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Anja I Srienc
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ananth K Vellimana
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
| | - Ralph G Dacey Jr
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Gregory J Zipfel
- Department of Neurological Surgery, Washington University School of Medicine, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, MO, USA
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11
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Jiang J, Gui S, Wei D, Chen X, Tang Y, Lv J, You W, Chen T, Yang S, Ge H, Li Y. Causal relationships between human blood metabolites and intracranial aneurysm and aneurysmal subarachnoid hemorrhage: a Mendelian randomization study. Front Neurol 2023; 14:1268138. [PMID: 38162442 PMCID: PMC10755882 DOI: 10.3389/fneur.2023.1268138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Objective The aim of this study was to assess the causal relationships between blood metabolites and intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm. Methods Our exposure sample consisted of 7,824 individuals from a genome-wide association study of human blood metabolites. Our outcome sample consisted of 79,429 individuals (7,495 cases and 71,934 controls) from the International Stroke Genetics Consortium, which conducted a genome-wide association study of intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm. We identified blood metabolites with a potential causal effect on intracranial aneurysms and conducted sensitivity analyses to validate our findings. Results After rigorous screening and Mendelian randomization tests, we found four, two, and three serum metabolites causally associated with intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm, respectively (all P < 0.05). Sensitivity analyses confirmed the robustness of these associations. Conclusions Our Mendelian randomization analysis demonstrated causal relationships between human blood metabolites and intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm. Further research is required to explore the potential of targeting these metabolites in the management of intracranial aneurysm.
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Affiliation(s)
- Jia Jiang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Siming Gui
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dachao Wei
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiheng Chen
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yudi Tang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jian Lv
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei You
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ting Chen
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Shu Yang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huijian Ge
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Youxiang Li
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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12
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Yamamoto K, Shimogonya Y, Maeno R, Kawabe K, Ando J. Endothelial cells differentially sense laminar and disturbed flows by altering the lipid order of their plasma and mitochondrial membranes. Am J Physiol Cell Physiol 2023; 325:C1532-C1544. [PMID: 37927239 PMCID: PMC10861177 DOI: 10.1152/ajpcell.00393.2023] [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: 08/21/2023] [Revised: 10/19/2023] [Accepted: 10/28/2023] [Indexed: 11/07/2023]
Abstract
Endothelial cells (ECs) experience two different blood flow patterns: laminar and disturbed flow. Their responses to laminar flow contribute to vascular homeostasis, whereas their responses to disturbed flow result in EC dysfunction and vascular diseases. However, it remains unclear how ECs differentially sense laminar and disturbed flow and trigger signaling that elicits different responses. Here, we showed that ECs differentially sense laminar and disturbed flows by altering the lipid order of their plasma and mitochondrial membranes in opposite directions. This results in distinct changes in mitochondrial function, namely, increased adenosine triphosphate (ATP) production for laminar flow and increased hydrogen peroxide (H2O2) release for disturbed flow, leading to ATP- and H2O2-mediated signaling, respectively. When cultured human aortic ECs were subjected to laminar or disturbed flow in flow-loading devices, the lipid order of their plasma membranes immediately decreased in response to laminar flow and increased in response to disturbed flow. Laminar flow also decreased the lipid order of mitochondrial membranes and increased mitochondrial ATP production. In contrast, disturbed flow increased the lipid order of mitochondrial membranes and increased the release of H2O2 from the mitochondria. The addition of cholesterol to the cells increased the lipid order of both membranes and abrogated laminar flow-induced ATP production, while treatment of the cells with a cholesterol-depleting reagent, methyl-β cyclodextrin, decreased the lipid order of both membranes and abolished disturbed flow-induced H2O2 release, indicating that changes in the membrane lipid order and/or cholesterol content are closely linked to flow-induced changes in mitochondrial functions.NEW & NOTEWORTHY How vascular endothelial cells (ECs) differentially sense laminar and disturbed flows and trigger intracellular signaling remains unclear. Here, we show that EC plasma membranes act as mechanosensors to discriminate between laminar and disturbed flows by undergoing opposite changes in their lipid order. Similar lipid order changes occur simultaneously in the mitochondrial membranes, which are linked to changes in mitochondrial function, that is, increased ATP production for laminar flow and increased H2O2 release for disturbed flow.
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Affiliation(s)
- Kimiko Yamamoto
- Laboratory of System Physiology, Department of Biomedical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuji Shimogonya
- Department of Mechanical Engineering, College of Engineering, Nihon University, Koriyama, Japan
| | - Ryohei Maeno
- Laboratory of System Physiology, Department of Biomedical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kenshiroh Kawabe
- Laboratory of System Physiology, Department of Biomedical Engineering, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Division of Vascular Surgery, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Joji Ando
- Laboratory of Biomedical Engineering, School of Medicine, Dokkyo Medical University, Tochigi, Japan
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13
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Shimizu K, Aoki T, Etminan N, Hackenberg KAM, Tani S, Imamura H, Kataoka H, Sakai N. Associations Between Drug Treatments and the Risk of Aneurysmal Subarachnoid Hemorrhage: a Systematic Review and Meta-analysis. Transl Stroke Res 2023; 14:833-841. [PMID: 36242746 DOI: 10.1007/s12975-022-01097-2] [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: 05/07/2022] [Revised: 10/03/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022]
Abstract
There is increasing interest in drug therapy for preventing aneurysmal subarachnoid hemorrhage (aSAH). We aimed to comprehensively evaluate the association between drug use and the risk of aSAH. We searched PubMed and Scopus from the databases' inception until December 2021. Observational studies reporting the association between any drug therapy and aSAH were included. The odds ratios (ORs) for each drug used in aSAH were meta-analyzed with a random-effect model. According to the systematic review, 25 observational studies were eligible for the present study. Four therapeutic purpose-based classes (e.g., lipid-lowering agents) and 14 mechanism-based classes (e.g., statins) were meta-analyzed. Anti-hypertensive agents (OR, 0.50; 95% confidence interval [95% CI], 0.33-0.74), statins (OR, 0.55; 95% CI, 0.35-0.85), biguanides (OR, 0.57; 95% CI, 0.34-0.96), and acetylsalicylic acid (ASA) (OR, 0.62; 95% CI, 0.41-0.94) were inversely associated with the risk of aSAH. Non-ASA non-steroidal anti-inflammatory drugs (OR, 1.73; 95% CI, 1.07-2.79), selective cyclooxygenase-2 inhibitors (OR, 2.04; 95% CI, 1.24-3.35), vitamin K antagonists (OR, 1.50; 95% CI, 1.18-1.91), and dipyridamole (OR, 1.77; 95% CI, 1.23-2.54) were positively associated with the incidence of aSAH. There was also a trend toward a positive association between glucocorticoids (OR, 1.38; 95% CI, 0.97-1.94) and aSAH. The present study suggests that anti-hypertensive agents, statins, biguanides, and ASA are candidate drugs for preventing aSAH. By contrast, several drugs (e.g., anti-thrombotic drugs) may increase the risk of aSAH. Thus, the indications of these drugs in patients with intracranial aneurysms should be carefully determined.
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Affiliation(s)
- Kampei Shimizu
- Department of Neurosurgery, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan.
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Tomohiro Aoki
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Nima Etminan
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Katharina A M Hackenberg
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Shoichi Tani
- Department of Neurosurgery, Tenri Hospital, 200 Mishima-cho, Tenri, Nara, 632-8552, Japan
| | - Hirotoshi Imamura
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Nobuyuki Sakai
- Department of Neurosurgery, Kobe City Medical Center General Hospital, Kobe, Japan
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14
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Gu JJ, Li HX, Wei W, Sun XL, Li BC, Chen Y, Li J, Gu X. Bone marrow mesenchymal stem cell transplantation alleviates radiation-induced myocardial fibrosis through inhibition of the TGF-β1/Smad2/3 signaling pathway in rabbit model. Regen Ther 2023; 24:1-10. [PMID: 37292187 PMCID: PMC10244902 DOI: 10.1016/j.reth.2023.04.003] [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: 03/15/2023] [Revised: 04/10/2023] [Accepted: 04/23/2023] [Indexed: 06/10/2023] Open
Abstract
Background and purpose: Radiotherapy (RT) is an effective treatment for most malignant chest tumors. However, radiation-induced myocardial fibrosis (RIMF) is a serious side effect of RT. Currently, due to the mechanism of RIMF has not been fully elucidated, there is a lack of effective therapeutic approach. In this study, we aimed to investigate the role and possible mechanisms of bone marrow mesenchymal stem cells (BMSCs) in the therapy of RIMF. Materials and methods Twenty-four New Zealand white rabbits were allotted into four groups (n = 6). Rabbits in the Control group received neither irradiation nor treatment. A single dose of 20 Gy heart X-irradiation was applied to the RT group, RT + PBS group and RT + BMSCs group. Rabbits in the RT + PBS group and RT + BMSCs group were injected with 200 μL PBS or 2 × 106 cells via pericardium puncture 24 h following irradiation, respectively. Echocardiography was used to test the cardiac function; Then the heart samples were collected, and processed for histopathological, Western blot and immunohistochemistry investigations. Results It was observed that BMSCs have therapeutic effect on RIMF. Compared with the Control group, inflammatory mediators, oxidative stress and apoptosis were significantly increased, meanwhile, cardiac function was remarkably decreased in the RT group and RT + PBS group. However, in the BMSCs group, BMSCs significantly improved cardiac function, decreased inflammatory mediators, oxidative stress and apoptosis. Furthermore, BMSCs remarkably reduced the expression level of TGF-β1 and the phosphorylated-Smad2/3. Conclusions In conclusion, our research indicates BMSCs have the potential to alleviate RIMF through TGF-β1/Smad2/3 and would be a new therapeutic approach for patients with myocardial fibrosis.
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Affiliation(s)
- Jian Jun Gu
- Department of Cardiology, Institute of Translational Medicine, Medical College, Yangzhou University, PR China
- Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
| | - Hong Xiao Li
- Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
| | - Wei Wei
- Department of Cardiology, Institute of Translational Medicine, Medical College, Yangzhou University, PR China
- Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
| | - Xiao Lin Sun
- Department of Cardiology, Institute of Translational Medicine, Medical College, Yangzhou University, PR China
- Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
| | - Bi Chun Li
- Key Laboratory of Animal Breeding and Molecular Design for Jiangsu Province, College of Animal Science and Technology, Yangzhou University, Yangzhou, Jiangsu, 225001, PR China
| | - Yong Chen
- Department of Ultrasound, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
| | - Jun Li
- Department of Radiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
| | - Xiang Gu
- Department of Cardiology, Northern Jiangsu People's Hospital, Yangzhou, Jiangsu, 225001, PR China
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15
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Blaj LA, Cucu AI, Tamba BI, Turliuc MD. The Role of the NF-kB Pathway in Intracranial Aneurysms. Brain Sci 2023; 13:1660. [PMID: 38137108 PMCID: PMC10871091 DOI: 10.3390/brainsci13121660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/25/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023] Open
Abstract
The pathophysiology of intracranial aneurysms (IA) has been proven to be closely linked to hemodynamic stress and inflammatory pathways, most notably the NF-kB pathway. Therefore, it is a potential target for therapeutic intervention. In the present review, we investigated alterations in the vascular smooth muscle cells (VSMCs), extracellular matrix, and endothelial cells by the mediators implicated in the NF-kB pathway that lead to the formation, growth, and rupture of IAs. We also present an overview of the NF-kB pathway, focusing on stimuli and transcriptional targets specific to IAs, as well as a summary of the current strategies for inhibiting NF-kB activation in IAs. Our report adds to previously reported data and future research directions for treating IAs using compounds that can suppress inflammation in the vascular wall.
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Affiliation(s)
- Laurentiu Andrei Blaj
- Department of Neurosurgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.A.B.); (M.D.T.)
- “Prof. Dr. N. Oblu” Emergency Clinical Hospital, 700309 Iasi, Romania
| | - Andrei Ionut Cucu
- “Prof. Dr. N. Oblu” Emergency Clinical Hospital, 700309 Iasi, Romania
- Faculty of Medicine and Biological Sciences, University Stefan cel Mare of Suceava, 720229 Suceava, Romania
| | - Bogdan Ionel Tamba
- Advanced Research and Development Center for Experimental Medicine (CEMEX), “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania;
- Department of Pharmacology, Clinical Pharmacology and Algesiology, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Mihaela Dana Turliuc
- Department of Neurosurgery, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania; (L.A.B.); (M.D.T.)
- “Prof. Dr. N. Oblu” Emergency Clinical Hospital, 700309 Iasi, Romania
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16
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Khan D, Cornelius JF, Muhammad S. The Role of NF-κB in Intracranial Aneurysm Pathogenesis: A Systematic Review. Int J Mol Sci 2023; 24:14218. [PMID: 37762520 PMCID: PMC10531594 DOI: 10.3390/ijms241814218] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/12/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Intracranial aneurysms (IAs) are abnormal dilations of the cerebral vessels, which pose a persistent threat of cerebral hemorrhage. Inflammation is known to contribute to IA development. The nuclear factor "kappa-light-chain-enhancer" of activated B-cells (NF-κB) is the major driver of inflammation. It increases the expression of inflammatory markers and matrix metalloproteinases (MMPs), which contribute heavily to the pathogenesis of IAs. NF-κB activation has been linked to IA rupture and resulting subarachnoid hemorrhage. Moreover, NF-κB activation can result in endothelial dysfunction, smooth muscle cell phenotypic switching, and infiltration of inflammatory cells in the arterial wall, which subsequently leads to the initiation and progression of IAs and consequently results in rupture. After a systematic search, abstract screening, and full-text screening, 30 research articles were included in the review. In this systematic review, we summarized the scientific literature reporting findings on NF-κB's role in the pathogenesis of IAs. In conclusion, the activation of the NF-κB pathway was associated with IA formation, progression, and rupture.
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Affiliation(s)
- Dilaware Khan
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany; (D.K.)
| | - Jan Frederick Cornelius
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany; (D.K.)
| | - Sajjad Muhammad
- Department of Neurosurgery, Medical Faculty and University Hospital Düsseldorf, Heinrich-Heine-Universität Düsseldorf, 40225 Düsseldorf, Germany; (D.K.)
- Department of Neurosurgery, University Hospital Helsinki, Topeliuksenkatu 5, 00260 Helsinki, Finland
- Department of Neurosurgery, King Edward Medical University, Lahore 54000, Pakistan
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17
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Reddy A, Masoud HE. Endovascular and Medical Management of Unruptured Intracranial Aneurysms. Semin Neurol 2023; 43:480-492. [PMID: 37517406 DOI: 10.1055/s-0043-1771299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
Unruptured intracranial aneurysms are often discovered incidentally on noninvasive imaging. As use of noninvasive imaging has increased, our understanding of the presumed prevalence of intracranial aneurysms in adults has increased. Incidentally found aneurysms are often asymptomatic; however, they can rarely rupture and cause life-threatening illness. Elective treatment of intracranial aneurysms carries risks which need to be considered along with patient-specific factors (e.g., anatomy, medical comorbidities, personal preferences). In this article, we review the natural history, risk factors for cerebral aneurysm formation and rupture, evidence for medical management, and the safety profile and efficacy of available endovascular treatment options.
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Affiliation(s)
- Aravind Reddy
- Department of Neurology, SUNY Upstate Medical University, Syracuse, New York
| | - Hesham E Masoud
- Department of Neurology, SUNY Upstate Medical University, Syracuse, New York
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18
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Han Y, Li G, Zhang Z, Zhang X, Zhao B, Yang H. Axl promotes intracranial aneurysm rupture by regulating macrophage polarization toward M1 via STAT1/HIF-1α. Front Immunol 2023; 14:1158758. [PMID: 37223093 PMCID: PMC10200875 DOI: 10.3389/fimmu.2023.1158758] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/27/2023] [Indexed: 05/25/2023] Open
Abstract
Background Macrophage infiltration and polarization are crucial for the pathogenesis of intracranial aneurysm (IA) rupture. Axl, a receptor tyrosine kinase, is involved in inflammation and efferocytosis in multiple organs. Upregulated soluble Axl in cerebrospinal fluid (CSF) and plasma is correlated with intracranial aneurysm rupture. This study aimed to investigate the role of Axl in IA rupture and macrophage polarization. Methods Male C57BL/6J mice were used to induce IA. The level of Axl from control vessels and unruptured and ruptured IA samples was detected. In addition, the relationship between Axl and macrophages was confirmed. The pathway of Axl-mediated macrophage polarization was explored after IA induction in vivo and in bone marrow-derived macrophages (BMDMs) stimulated by LPS/IFN-γ in vitro. The animals were randomized into three groups and treated intraperitoneally with the vehicle, selective AXL antagonist R428, and recombinant mouse growth arrest-specific 6 (rmGas6) for 21 consecutive days. Then, we evaluated the influence of Axl on IA rupture by administrating R428 to inhibit or rmGas6 to activate the Axl receptor in vivo. Results Compared with that in normal vessels, Axl expression was significantly upregulated in unruptured IA samples. The ruptured IA tissue exhibited significantly higher expression of Axl than the unruptured IA tissue. Axl and F4/80 were coexpressed in IA tissue and LPS/IFN-γ-stimulated BMDMs. R428 treatment significantly reduced the rate of M1-like macrophage infiltration and IA rupture. In contrast, rmGas6 treatment promoted M1 macrophage infiltration and IA rupture. Mechanistically, R428 inhibited the phosphorylation of Axl and STAT1 and the expression of hypoxia-inducible factor-1α (HIF-1α) and decreased the levels of IL-1β, NOS2, and MMP9 in LPS/IFN-γ-stimulated BMDMs. rmGas6 promoted the phosphorylation of Axl and STAT1 and the expression of HIF-1α. In addition, STAT1 knockdown abolished Axl-mediated M1 macrophage polarization. Conclusion The inhibition of Axl reduced macrophage polarization toward the M1 phenotype via the STAT1/HIF-1α signaling pathway and prevented IA rupture in mice. This finding suggests that pharmacological inhibition of Axl might be used to prevent the progression and rupture of IA.
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Affiliation(s)
- Yongquan Han
- Department of Neurosurgery, the Affiliated Hospital of Guizhou Medical University, Guiyang, China
- Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Gaozhi Li
- Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zeyu Zhang
- Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaohua Zhang
- Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bing Zhao
- Department of Neurosurgery, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hua Yang
- Department of Neurosurgery, the Affiliated Hospital of Guizhou Medical University, Guiyang, China
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19
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Ono I, Kayahara T, Kawashima A, Okada A, Miyamoto S, Kataoka H, Kurita H, Ishii A, Aoki T. Hypoxic microenvironment as a crucial factor triggering events leading to rupture of intracranial aneurysm. Sci Rep 2023; 13:5545. [PMID: 37015954 PMCID: PMC10073088 DOI: 10.1038/s41598-023-32001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
Subarachnoid hemorrhage being the rupture of intracranial aneurysm (IA) as a major cause has quite poor prognosis, despite the modern technical advances. Thereby, the mechanisms underlying the rupture of lesions should be clarified. Recently, we and others have clarified the formation of vasa vasorum in IA lesions presumably for inflammatory cells to infiltrate in lesions as the potential histopathological alternation leading to rupture. In the present study, we clarified the origin of vasa vasorum as arteries located at the brain surface using 3D-immunohistochemistry with tissue transparency. Using Hypoxyprobe, we then found the presence of hypoxic microenvironment mainly at the adventitia of intracranial arteries where IA is formed. In addition, the production of vascular endothelial growth factor (VEGF) from cultured macrophages in such a hypoxic condition was identified. Furthermore, we found the accumulation of VEGF both in rupture-prone IA lesions induced in a rat model and human unruptured IA lesions. Finally, the VEGF-dependent induction of neovessels from arteries on brain surface was confirmed. The findings from the present study have revealed the potential role of hypoxic microenvironment and hypoxia-induced VEGF production as a machinery triggering rupture of IAs via providing root for inflammatory cells in lesions to exacerbate inflammation.
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Affiliation(s)
- Isao Ono
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomichi Kayahara
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akitsugu Kawashima
- Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Akihiro Okada
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akira Ishii
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohiro Aoki
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan.
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan.
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Chen X, Gui S, Deng D, Dong L, Zhang L, Wei D, Jiang J, Ge H, Liu P, Lv M, Li Y. Alcohol flushing syndrome is significantly associated with intracranial aneurysm rupture in the Chinese Han population. Front Neurol 2023; 14:1118980. [PMID: 37006480 PMCID: PMC10065193 DOI: 10.3389/fneur.2023.1118980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/02/2023] [Indexed: 03/19/2023] Open
Abstract
ObjectiveAlthough alcohol flushing syndrome (AFS) has been associated with various diseases, its association with intracranial aneurysm rupture (IAR) is unclear. We aimed to examine this association in the Chinese Han population.MethodsWe retrospectively reviewed Chinese Han patients with intracranial aneurysms who were evaluated and treated at our institution between January 2020 and December 2021. AFS was determined using a semi-structured telephone interview. Clinical data and aneurysm characteristics were assessed. Univariate and multivariate logistic regression were conducted to determine independent factors associated with aneurysmal rupture.ResultsA total of 1,170 patients with 1,059 unruptured and 236 ruptured aneurysms were included. The incidence of aneurysm rupture was significantly higher in patients without AFS (p < 0.001). Meanwhile, there was a significantly difference between the AFS and non-AFS group in habitual alcohol consumption (10.5 vs. 27.2%, p < 0.001). In the univariate analyses, AFS [odds ratio (OR) 0.49; 95% confidence interval (CI), 0.34–0.72] was significantly associated with IAR. In the multivariate analysis, AFS was an independent predictor of IAR (OR 0.50; 95%, CI, 0.35–0.71). Multivariate analysis revealed that AFS was an independent predictor of IAR in both habitual (OR 0.11; 95% CI, 0.03–0.45) and non-habitual drinkers (OR 0.69; 95% CI, 0.49–0.96).ConclusionAlcohol flushing syndrome may be a novel clinical marker to assess the risk of IAR. The association between AFS and IAR exists independently of alcohol consumption. Further single nucleotide polymorphism testing and molecular biology studies are warranted.
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Affiliation(s)
- Xiheng Chen
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Siming Gui
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Dingwei Deng
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Linggen Dong
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Longhui Zhang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
| | - Dachao Wei
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Jia Jiang
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Huijian Ge
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Peng Liu
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
| | - Ming Lv
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
- *Correspondence: Ming Lv,
| | - Youxiang Li
- Beijing Neurosurgical Institute, Capital Medical University, Beijing, China
- Department of Neurosurgery, Beijing Tian Tan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China
- Youxiang Li,
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Beccacece L, Abondio P, Bini C, Pelotti S, Luiselli D. The Link between Prostanoids and Cardiovascular Diseases. Int J Mol Sci 2023; 24:ijms24044193. [PMID: 36835616 PMCID: PMC9962914 DOI: 10.3390/ijms24044193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/17/2023] [Accepted: 02/18/2023] [Indexed: 02/22/2023] Open
Abstract
Cardiovascular diseases are the leading cause of global deaths, and many risk factors contribute to their pathogenesis. In this context, prostanoids, which derive from arachidonic acid, have attracted attention for their involvement in cardiovascular homeostasis and inflammatory processes. Prostanoids are the target of several drugs, but it has been shown that some of them increase the risk of thrombosis. Overall, many studies have shown that prostanoids are tightly associated with cardiovascular diseases and that several polymorphisms in genes involved in their synthesis and function increase the risk of developing these pathologies. In this review, we focus on molecular mechanisms linking prostanoids to cardiovascular diseases and we provide an overview of genetic polymorphisms that increase the risk for cardiovascular disease.
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Affiliation(s)
- Livia Beccacece
- Computational Genomics Lab, Department of Pharmacy and Biotechnology, University of Bologna, 40126 Bologna, Italy
- Correspondence: (L.B.); (P.A.)
| | - Paolo Abondio
- aDNA Lab, Department of Cultural Heritage, University of Bologna, Ravenna Campus, 48121 Ravenna, Italy
- Correspondence: (L.B.); (P.A.)
| | - Carla Bini
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Susi Pelotti
- Unit of Legal Medicine, Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy
| | - Donata Luiselli
- aDNA Lab, Department of Cultural Heritage, University of Bologna, Ravenna Campus, 48121 Ravenna, Italy
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Nie C, Zou Y, Liao S, Gao Q, Li Q. Molecular Targets and Mechanisms of 6,7-Dihydroxy-2,4-dimethoxyphenanthrene from Chinese Yam Modulating NF-κB/COX-2 Signaling Pathway: The Application of Molecular Docking and Gene Silencing. Nutrients 2023; 15:nu15040883. [PMID: 36839242 PMCID: PMC9963849 DOI: 10.3390/nu15040883] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 02/03/2023] [Accepted: 02/07/2023] [Indexed: 02/12/2023] Open
Abstract
Chinese yam (Dioscorea opposita) tuber has a significant effect of invigorating the intestine and improving the symptoms of long-term diarrhea according to the records of the Chinese Pharmacopoeia. Phenanthrene polyphenols from Chinese yam, with higher inhibition of cyclooxygenase-2 (COX-2) than anti-inflammatory drugs, are an important material basis in alleviating ulcerative colitis via nuclear factor kappa-B (NF-κB)/COX-2 pathway, based on our previous research. The present study further explored the target and molecular mechanisms of phenanthrenes' modulation of the NF-κB/COX-2 signaling pathway by means of molecular docking and gene silencing. Firstly, interleukin-8 (IL-8) and tumor necrosis factor-α (TNF-α) expression of 6-hydroxy-2,4,7-trimethoxyphenanthrene (PC2)/6,7-dihydroxy-2,4-dimethoxyphe-nanthrene (PC4) were compared on TNF-α induced human colon adenocarcinoma (Caco-2) cells. Secondly, molecular docking and dynamics simulation were implemented for PC2/PC4 and COX-2. Finally, COX-2 silencing was performed on TNF-α induced Caco-2 cells to confirm the target of PC4 on NF-κB/COX-2 pathway. Lower expression of IL-8 and TNF-α in PC4 treated Caco-2 cells indicated that PC4 had stronger anti-inflammatory activity than PC2. The binding of PC4 and COX-2 was stronger due to the hydrogen bond between hydroxyl group and Tyr385. No significant differences were found in phosphorylation nuclear factor kappa-B inhibitor alpha (pIkBα), phosphorylation NF-κB (pNF-κB) and phosphorylation extracellular signal-regulated kinase 1/2 (pERK1/2) expression between control and PC4 group after silencing, while these protein expressions significantly decreased in PC4 group without silencing, which confirmed that COX-2 was the important target for PC4 in alleviating ulcerative colitis. These findings indicate that PC4 was supposed to have inhibited NF-κB pathway mediated inflammation via suppression of positive feedback targeting COX-2.
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Affiliation(s)
- Congyi Nie
- Guangdong Academy of Agricultural Sciences, Sericultural & Agri-Food Research Institute/Key Laboratory of Functional Foods, Ministry of Agriculture and Rural Affairs/Guangdong Key Laboratory of Agricultural Products Processing, Guangzhou 510610, China
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China
| | - Yuxiao Zou
- Guangdong Academy of Agricultural Sciences, Sericultural & Agri-Food Research Institute/Key Laboratory of Functional Foods, Ministry of Agriculture and Rural Affairs/Guangdong Key Laboratory of Agricultural Products Processing, Guangzhou 510610, China
| | - Sentai Liao
- Guangdong Academy of Agricultural Sciences, Sericultural & Agri-Food Research Institute/Key Laboratory of Functional Foods, Ministry of Agriculture and Rural Affairs/Guangdong Key Laboratory of Agricultural Products Processing, Guangzhou 510610, China
| | - Qunyu Gao
- School of Food Science and Engineering, South China University of Technology, Guangzhou 510640, China
| | - Qian Li
- Guangdong Academy of Agricultural Sciences, Sericultural & Agri-Food Research Institute/Key Laboratory of Functional Foods, Ministry of Agriculture and Rural Affairs/Guangdong Key Laboratory of Agricultural Products Processing, Guangzhou 510610, China
- Correspondence: ; Tel.: +86-13430362787
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Ono I, Abekura Y, Kawashima A, Oka M, Okada A, Hara S, Miyamoto S, Kataoka H, Ishii A, Yamamoto K, Aoki T. Endothelial cell malfunction in unruptured intracranial aneurysm lesions revealed using a 3D-casted mold. J Neuropathol Exp Neurol 2022; 82:49-56. [PMID: 36383185 DOI: 10.1093/jnen/nlac104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Intracranial aneurysms (IA) are major causes of devastating subarachnoid hemorrhages. They are characterized by a chronic inflammatory process in the intracranial arterial walls triggered and modified by hemodynamic force loading. Because IA lesion morphology is complex, the blood flow conditions loaded on endothelial cells in each portion of the lesion in situ vary greatly. We created a 3D-casted mold of the human unruptured IA lesion and cultured endothelial cells on this model; it was then perfused with culture media to model physiological flow conditions. Gene expression profiles of endothelial cells in each part of the IA lesion were then analyzed. Comprehensive gene expression profile analysis revealed similar gene expression patterns in endothelial cells from each part of the IA lesion but gene ontology analysis revealed endothelial cell malfunction within the IA lesion. Histopathological examination, electron microscopy, and immunohistochemical analysis indicated that endothelial cells within IA lesions are damaged and dysfunctional. Thus, our findings reveal endothelial cell malfunction in IA lesions and provided new insights into IA pathogenesis.
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Affiliation(s)
- Isao Ono
- Department of Molecular Pharmacology, Research Institute, National Cerebral, and Cardiovascular Center, Osaka, Japan.,Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Yu Abekura
- Department of Molecular Pharmacology, Research Institute, National Cerebral, and Cardiovascular Center, Osaka, Japan.,Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Akitsugu Kawashima
- Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Mieko Oka
- Department of Molecular Pharmacology, Research Institute, National Cerebral, and Cardiovascular Center, Osaka, Japan.,Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan.,Department of Neurosurgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Akihiro Okada
- Department of Molecular Pharmacology, Research Institute, National Cerebral, and Cardiovascular Center, Osaka, Japan.,Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Shintaro Hara
- Department of Bioengineering, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, Research Institute, National Cerebral, and Cardiovascular Center, Osaka, Japan
| | - Akira Ishii
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kimiko Yamamoto
- System Physiology, Department of Biomedical Engineering, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Tomohiro Aoki
- Department of Molecular Pharmacology, Research Institute, National Cerebral, and Cardiovascular Center, Osaka, Japan.,Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
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Okada A, Koseki H, Ono I, Kayahara T, Kurita H, Miyamoto S, Kataoka H, Aoki T. Identification of The Unique Subtype of Macrophages in Aneurysm Lesions at the Growth Phase. J Stroke Cerebrovasc Dis 2022; 31:106848. [DOI: 10.1016/j.jstrokecerebrovasdis.2022.106848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/05/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022] Open
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25
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Wu A, Zhao C, Mou S, Li S, Cui X, Zhang R. Integrated analysis identifies the IL6/JAK/STAT signaling pathway and the estrogen response pathway associated with the pathogenesis of intracranial aneurysms. Front Immunol 2022; 13:1046765. [DOI: 10.3389/fimmu.2022.1046765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 10/28/2022] [Indexed: 11/16/2022] Open
Abstract
ObjectiveWe intended to identify the potential key biomarker and pathways that correlated with infiltrating immune cells during the pathogenesis of intracranial aneurysms (IA), to develop a diagnostic model, and to predict therapeutic drugs.MethodsThree datasets containing intracranial aneurysm tissue samples and normal artery control samples from Gene Expression Omnibus (GEO) were included. Gene-set variation analysis(GSVA) and gene set enrichment analysis (GSEA) were conducted to find the significant differentially expressed pathways in IA formation. The least absolute shrinkage and selection operator (LASSO) regression and the multivariate logistic regression analysis were performed to identify the characteristic genes in the IL6/JAK/STAT signaling pathway (ISP) and the estrogen response pathway (ERP). A diagnostic model was constructed. xCell was used to identify immune cell types in IA pathogenesis. We used the weighted gene co-expression network analysis (WGCNA) algorithm to explore the correlations between the key modules and the four traits. Potential therapeutic drugs were investigated in Enrichr and Drugbank database.ResultsThe ISP is significant positively correlated with IA onset. The biological function of the ISP is positively correlated with that of the ERP, and is significantly associated with immune cells activities. CSF2RB, FAS, IL6, PTPN1, STAT2, TGFB1 of the ISP gene set and ALDH3A2, COX6C, IGSF1, KRT18, MICB, NPY1R of the ERP gene set were proved to be the characteristic genes. The STAT2 gene can be the potential biomarker of IA onset. The immune score of IA samples was significantly higher than the controls. The STAT2 gene expression is associated with infiltration of immune cells. The WGCNA results were consistent with our finds. Acetaminophen can be a potential therapeutic drug for IA targeting STAT2.ConclusionsWe identified that the ISP was one of the most significant positively correlated pathways in IA onset, and it was activated in this process concordant with the ERP and immune responses. Except for beneficial effects, complex and multiple roles of estrogen may be involved in IA formation. STAT2 could be a potential biomarker and a promising therapeutic target of IA pathogenesis.
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Kamińska J, Maciejczyk M, Ćwiklińska A, Matowicka-Karna J, Koper-Lenkiewicz OM. Pro-Inflammatory and Anti-Inflammatory Cytokines Levels are Significantly Altered in Cerebrospinal Fluid of Unruptured Intracranial Aneurysm (UIA) Patients. J Inflamm Res 2022; 15:6245-6261. [PMID: 36386592 PMCID: PMC9664915 DOI: 10.2147/jir.s380524] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/25/2022] [Indexed: 11/12/2022] Open
Abstract
Introduction Identifying all the relevant “players” in the formation and development of brain aneurysms may help understand the mechanisms responsible for the formation of an aneurysm, as well as in the search for non-invasive targets for aneurysm pharmacotherapy. Aim The evaluation of the concentration of pro-inflammatory and anti-inflammatory cytokines in cerebrospinal fluid (CSF) and serum of patients with unruptured intracranial aneurysms (UIA) in comparison to individuals without vascular lesions in the brain. Methods The concentration of 27 proteins in the CSF and serum of UIA patients (N = 40) and individuals without vascular lesions in the brain (N = 15) was evaluated using a multiplex ELISA kit (Bio-Plex Pro Human Cytokine 27-Plex Panel). Results In the CSF 13 out of 27 proteins evaluated presented a concentration 1.36-fold or greater in UIA patients in comparison to the control group. Significantly higher were IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-7, IL-8, IL-12, IL-13, TNF-α, INF-γ, MCP-1, and VEGF. In the serum none of the proteins evaluated significantly differ between UIA patients and the control group. The correlation coefficient analysis showed that CSF IL-1β, IL-8, and TNF-α positively, while IL-13 negatively correlated with the size of aneurysms. CSF IL-6 and MCP-1 concentrations positively correlated with the number of aneurysms. Conclusion In patients with UIA, pro-inflammatory and anti-inflammatory mechanisms are activated simultaneously, because the concentration of promoting and suppressing inflammatory response proteins was significantly higher in CSF of UIA patients compared to the control group. The preventive therapy of brain aneurysm development should be focused on IL-1β, IL-6, IL-8, MCP-1, and TNF-α, the concentration of which in CSF positively correlated with the size and number of aneurysms.
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Affiliation(s)
- Joanna Kamińska
- Department of Clinical Laboratory Diagnostics, Medical University of Białystok, Białystok, Poland
- Correspondence: Joanna Kamińska, Department of Clinical Laboratory Diagnostics, Medical University of Białystok, 15A Jerzego Waszyngtona St, Białystok, 15-269S, Poland, Tel/Fax + 48 85 7468584, Email
| | - Mateusz Maciejczyk
- Department of Hygiene, Epidemiology, and Ergonomics, Medical University of Białystok, Białystok, Poland
| | | | - Joanna Matowicka-Karna
- Department of Clinical Laboratory Diagnostics, Medical University of Białystok, Białystok, Poland
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Ismail M, Aljuboori Z, Muthana A, Sharma M, Hoz SS, Andaluz N. The next bet for cerebral aneurysms treatment: Psychedelics. Surg Neurol Int 2022; 13:451. [PMID: 36324949 PMCID: PMC9609803 DOI: 10.25259/sni_830_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022] Open
Affiliation(s)
- Mustafa Ismail
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Zaid Aljuboori
- Department of Neurosurgery, University of Washington, Seattle, Washington,
| | - Ahmed Muthana
- Department of Neurosurgery, University of Baghdad, College of Medicine, Baghdad, Iraq,
| | - Mayur Sharma
- Department of Neurosurgery, University of Louisville, Kentucky,
| | - Samer S. Hoz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, United States
| | - Norberto Andaluz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, Ohio, United States
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28
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Chitwood CA, Shih ED, Amili O, Larson AS, Ogle BM, Alford PW, Grande AW. Biology and Hemodynamics of Aneurysm Rupture. Neurosurg Clin N Am 2022; 33:431-441. [DOI: 10.1016/j.nec.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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29
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Shen Y, Molenberg R, Bokkers RPH, Wei Y, Uyttenboogaart M, van Dijk JMC. The Role of Hemodynamics through the Circle of Willis in the Development of Intracranial Aneurysm: A Systematic Review of Numerical Models. J Pers Med 2022; 12:jpm12061008. [PMID: 35743791 PMCID: PMC9225067 DOI: 10.3390/jpm12061008] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/13/2022] [Accepted: 06/17/2022] [Indexed: 11/16/2022] Open
Abstract
Background: The role of regional hemodynamics in the intracranial aneurysmal formation, growth, and rupture has been widely discussed based on numerical models over the past decades. Variation of the circle of Willis (CoW), which results in hemodynamic changes, is associated with the aneurysmal formation and rupture. However, such correlation has not been further clarified yet. The aim of this systematic review is to investigate whether simulated hemodynamic indices of the CoW are relevant to the formation, growth, or rupture of intracranial aneurysm. Methods: We conducted a review of MEDLINE, Web of Science, and EMBASE for studies on the correlation between hemodynamics indices of the CoW derived from numerical models and intracranial aneurysm up to December 2020 in compliance with PRISMA guidelines. Results: Three case reports out of 1046 publications met our inclusion and exclusion criteria, reporting 13 aneurysms in six patients. Eleven aneurysms were unruptured, and the state of the other two aneurysms was unknown. Wall shear stress, oscillatory shear index, von-Mises tension, flow velocity, and flow rate were reported as hemodynamic indices. Due to limited cases and significant heterogeneity between study settings, meta-analysis could not be performed. Conclusion: Numerical models can provide comprehensive information on the cerebral blood flow as well as local flow characteristics in the intracranial aneurysm. Based on only three case reports, no firm conclusion can be drawn regarding the correlation between hemodynamic parameters in the CoW derived from numerical models and aneurysmal formation or rupture. Due to the inherent nature of numerical models, more sensitive analysis and rigorous validations are required to determine its measurement error and thus extend their application into clinical practice for personalized management. Prospero registration number: CRD42021125169.
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Affiliation(s)
- Yuanyuan Shen
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Y.S.); (R.M.)
| | - Rob Molenberg
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Y.S.); (R.M.)
| | - Reinoud P. H. Bokkers
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.P.H.B.); (M.U.)
| | - Yanji Wei
- Engineering and Technology Institute Groningen, Faculty of Science & Engineering, University of Groningen, 9747 AG Groningen, The Netherlands;
| | - Maarten Uyttenboogaart
- Department of Radiology, Medical Imaging Center, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (R.P.H.B.); (M.U.)
- Department of Neurology, University Medical Center Groningen, University of Groningen, 9700 RB Groningen, The Netherlands
| | - J. Marc C. van Dijk
- Department of Neurosurgery, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Y.S.); (R.M.)
- Correspondence:
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Räisänen S, Huttunen J, Huuskonen TJ, von Und Zu Fraunberg M, Koivisto T, Jääskeläinen JE, Lindgren A, Frösen J. Risk factor management matters more than pharmaceutical cyclooxygenase-2 inhibition in the prevention of de novo intracranial aneurysms. Eur J Neurol 2022; 29:2734-2743. [PMID: 35678735 DOI: 10.1111/ene.15442] [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: 05/18/2022] [Accepted: 06/02/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Pathophysiological studies of saccular intracranial aneurysm (sIA) disease have shown that inflammation plays a crucial role in sIA development. Pharmaceutical inhibition of COX-2-PGE2-NF-κB signaling (COX-2, cyclooxygenase-2; PGE2, prostaglandin E2; NF-κB, nuclear factor κB) has been shown in animal models to inhibit sIA formation and progression suggesting that use of medication inhibiting COX-2 could reduce intracranial aneurysm formation also in patients. METHODS The impact of COX-2 inhibition on de novo sIA formation was studied in two cohorts: in a previously described angiographically followed cohort of 1419 sIA patients and in a cohort of 117 sIA patients treated with stenting or stent-assisted embolization. Patients were identified from our population-based Kuopio Intracranial Aneurysm Database. Data on the use of anti-inflammatory medications and hospital diagnoses were obtained from national registries. Risk factors were identified by univariate and multivariate analyses. RESULTS De novo sIA patients were younger and more often smokers. Use of COX-2 selective inhibitors or nonsteroidal anti-inflammatory drugs did not significantly reduce de novo sIA formation, but the percentage of patients with de novo sIA formation was smaller in patients with prescribed regular acetylsalicylic acid medication (1.1% vs. 3.6%). In the multivariate analysis, however, neither acetylsalicylic acid use nor other type of pharmaceutical inhibition of COX-2 reduced the formation of de novo sIAs. The risk was mostly affected by age, smoking history and irregular usage of antihypertensive medication regardless of used COX-2 inhibition level. CONCLUSION For the prevention of de novo sIA formation, risk factor management with focus on cessation of smoking and treating hypertension adequately seems more important than pharmaceutical COX-2 inhibition.
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Affiliation(s)
- Sari Räisänen
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.,Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Jukka Huttunen
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Terhi J Huuskonen
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Mikael von Und Zu Fraunberg
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.,Neurosurgery at Neurocenter, University of Oulu and Oulu University Hospital, Oulu, Finland
| | - Timo Koivisto
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Juha E Jääskeläinen
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Antti Lindgren
- Neurosurgery of NeuroCenter, Kuopio University Hospital, and Neurosurgery, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.,Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.,Department of Clinical Radiology, Kuopio University Hospital, Kuopio, Finland.,Faculty of Health Sciences, School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Juhana Frösen
- Neurosurgery of NeuroCenter, Kuopio University Hospital, Kuopio, Finland.,Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.,Department of Neurosurgery, Tampere University Hospital, Tampere, Finland.,Faculty of Medicine and Medical Technology, Tampere University, Tampere, Finland
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Torregrossa F, Grasso G. Therapeutic Approaches for Cerebrovascular Dysfunction After Aneurysmal Subarachnoid Hemorrhage: An Update and Future Perspectives. World Neurosurg 2022; 159:276-287. [PMID: 35255629 DOI: 10.1016/j.wneu.2021.11.096] [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: 09/28/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 11/26/2022]
Abstract
Aneurysmal subarachnoid hemorrhage (aSAH) is a severe subtype of stroke occurring at a relatively young age with a significant socioeconomic impact. Treatment of aSAH includes early aneurysm exclusion, intensive care management, and prevention of complications. Once the aneurysm rupture occurs, blood spreading within the subarachnoid space triggers several molecular pathways causing early brain injury and delayed cerebral ischemia. Pathophysiologic mechanisms underlying brain injury after aSAH are not entirely characterized, reflecting the difficulties in identifying effective therapeutic targets for patients with aSAH. Although the improvements of the last decades in perioperative management, early diagnosis, aneurysm exclusion techniques, and medical treatments have increased survival, vasospasm and delayed cerebral infarction are associated with high mortality and morbidity. Clinical practice can rely on a few specific therapeutic agents, such as nimodipine, a calcium-channel blocker proved to reduce severe neurologic deficits in these patients. Therefore, new pharmacologic approaches are needed to improve the outcome of this life-threatening condition, as well as a tailored rehabilitation plan to maintain the quality of life in aSAH survivors. Several clinical trials are investigating the efficacy and safety of emerging drugs, such as magnesium, clazosentan, cilostazol, interleukin 1 receptor antagonists, deferoxamine, erythropoietin, and nicardipine, and continuous lumbar drainage in the setting of aSAH. This narrative review focuses on the most promising therapeutic interventions after aSAH.
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Affiliation(s)
- Fabio Torregrossa
- Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy.
| | - Giovanni Grasso
- Neurosurgical Unit, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University of Palermo, Palermo, Italy
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Fréneau M, Baron-Menguy C, Vion AC, Loirand G. Why Are Women Predisposed to Intracranial Aneurysm? Front Cardiovasc Med 2022; 9:815668. [PMID: 35224050 PMCID: PMC8866977 DOI: 10.3389/fcvm.2022.815668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 01/11/2022] [Indexed: 12/21/2022] Open
Abstract
Intracranial aneurysm (IA) is a frequent and generally asymptomatic cerebrovascular abnormality characterized as a localized dilation and wall thinning of intracranial arteries that preferentially arises at the arterial bifurcations of the circle of Willis. The devastating complication of IA is its rupture, which results in subarachnoid hemorrhage that can lead to severe disability and death. IA affects about 3% of the general population with an average age for detection of rupture around 50 years. IAs, whether ruptured or unruptured, are more common in women than in men by about 60% overall, and more especially after the menopause where the risk is double-compared to men. Although these data support a protective role of estrogen, differences in the location and number of IAs observed in women and men under the age of 50 suggest that other underlying mechanisms participate to the greater IA prevalence in women. The aim of this review is to provide a comprehensive overview of the current data from both clinical and basic research and a synthesis of the proposed mechanisms that may explain why women are more prone to develop IA.
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Wang H, Balzani D, Vedula V, Uhlmann K, Varnik F. On the Potential Self-Amplification of Aneurysms Due to Tissue Degradation and Blood Flow Revealed From FSI Simulations. Front Physiol 2021; 12:785780. [PMID: 34955893 PMCID: PMC8709128 DOI: 10.3389/fphys.2021.785780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Tissue degradation plays a crucial role in the formation and rupture of aneurysms. Using numerical computer simulations, we study the combined effects of blood flow and tissue degradation on intra-aneurysm hemodynamics. Our computational analysis reveals that the degradation-induced changes of the time-averaged wall shear stress (TAWSS) and oscillatory shear index (OSI) within the aneurysm dome are inversely correlated. Importantly, their correlation is enhanced in the process of tissue degradation. Regions with a low TAWSS and a high OSI experience still lower TAWSS and higher OSI during degradation. Furthermore, we observed that degradation leads to an increase of the endothelial cell activation potential index, in particular, at places experiencing low wall shear stress. These findings are robust and occur for different geometries, degradation intensities, heart rates and pressures. We interpret these findings in the context of recent literature and argue that the degradation-induced hemodynamic changes may lead to a self-amplification of the flow-induced progressive damage of the aneurysmal wall.
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Affiliation(s)
- Haifeng Wang
- Theory and Simulation of Complex Fluids, Department of Scale-Bridging Thermodynamic and Kinetic Simulation, Interdisciplinary Center for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Bochum, Germany
| | - Daniel Balzani
- Department of Civil and Environmental Engineering, Chair of Continuum Mechanics, Ruhr-Universität Bochum, Bochum, Germany
| | - Vijay Vedula
- Department of Mechanical Engineering, Columbia University in the City of New York, New York, NY, United States
| | - Klemens Uhlmann
- Department of Civil and Environmental Engineering, Chair of Continuum Mechanics, Ruhr-Universität Bochum, Bochum, Germany
| | - Fathollah Varnik
- Theory and Simulation of Complex Fluids, Department of Scale-Bridging Thermodynamic and Kinetic Simulation, Interdisciplinary Center for Advanced Materials Simulation (ICAMS), Ruhr-Universität Bochum, Bochum, Germany
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Jung HY, Kim W, Hahn KR, Nam SM, Yi SS, Kwon HJ, Kang MS, Choi JH, Kim DW, Yoon YS, Hwang IK. Spatial and temporal changes in the PGE2 EP2 receptor in mice hippocampi during postnatal development and its relationship with cyclooxygenase-2. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2021; 24:908-913. [PMID: 34712420 PMCID: PMC8528246 DOI: 10.22038/ijbms.2021.56286.12556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/30/2021] [Indexed: 11/06/2022]
Abstract
Objective(s): Prostaglandin E2 E-prostanoid 2 receptor (PGE2 EP2), downstream of cyclooxygenase-2 (COX-2), plays an important role in inflammatory responses, but there are some reports about synaptic functions of COX-2 and PGE2 EP2 in the hippocampus. Materials and Methods: C57BL/6J mice were sacrificed at postnatal days (P) 1, 7, 14, 28, and 56 for immunohistochemical staining for EP2 and doublecortin as well as western blot for EP2. In addition, COX-2 knockout and its wild-type mice were euthanized for immunohistochemical staining for EP2. Results: EP2 immunoreactivity was observed in the majority of the cells in the dentate gyrus at P1 and P7, while at P14, it was detected in the outer granule cell layer and was confined to its subgranular zone at P28 and P56. EP2 protein levels in the hippocampal homogenates were also highest at P7 and lowest at P56. EP2 immunoreactivity was partially colocalized, with doublecortin (DCX)-immunoreactive neuroblasts appearing in the mid-zone of the granule cell layer at P14 and in the subgranular zone of the dentate gyrus at P28. Co-localization of EP2 and DCX was significantly decreased in the dentate gyrus in the P28 group compared with that in the P14 group. In COX-2 knockout mice, EP2 immunoreactivity was significantly decreased in the hippocampal CA1 region (P=0.000165) and dentate gyrus (P=0.00898). Conclusion: EP2 decreases with age, which is expressed in DCX-immunoreactive neuroblasts in the dentate gyrus. This suggests that EP2 is closely linked to structural lamination and adult neurogenesis in the dentate gyrus.
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Affiliation(s)
- Hyo Young Jung
- Department of Veterinary Medicine & Institute of Veterinary Science, Chungnam National University, Daejeon 34134, South Korea
| | - Woosuk Kim
- Department of Anatomy, College of Veterinary Medicine, and Veterinary Science Research Institute, Konkuk University, Seoul 05030, South Korea
| | - Kyu Ri Hahn
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
| | - Sung Min Nam
- Department of Anatomy, School of Medicine, Wonkwang University, Iksan 54538, South Korea
| | - Sun Shin Yi
- Department of Biomedical Laboratory Science, College of Medical Sciences, Soonchunhyang University, Asan 31538, South Korea
| | - Hyun Jung Kwon
- Department of Biochemistry and Molecular Biology, Research Institute of Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung 25457, South Korea
| | - Min Soo Kang
- Department of Anatomy, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon 24341, South Korea
| | - Jung Hoon Choi
- Department of Anatomy, College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon 24341, South Korea
| | - Dae Won Kim
- Department of Biochemistry and Molecular Biology, Research Institute of Oral Sciences, College of Dentistry, Gangneung-Wonju National University, Gangneung 25457, South Korea
| | - Yeo Sung Yoon
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
| | - In Koo Hwang
- Department of Anatomy and Cell Biology, College of Veterinary Medicine, and Research Institute for Veterinary Science, Seoul National University, Seoul 08826, South Korea
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Sluter MN, Hou R, Li L, Yasmen N, Yu Y, Liu J, Jiang J. EP2 Antagonists (2011-2021): A Decade's Journey from Discovery to Therapeutics. J Med Chem 2021; 64:11816-11836. [PMID: 34352171 PMCID: PMC8455147 DOI: 10.1021/acs.jmedchem.1c00816] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
In the wake of health disasters associated with the chronic use of cyclooxygenase-2 (COX-2) inhibitor drugs, it has been widely proposed that modulation of downstream prostanoid synthases or receptors might provide more specificity than simply shutting down the entire COX cascade for anti-inflammatory benefits. The pathogenic actions of COX-2 have long been thought attributable to the prostaglandin E2 (PGE2) signaling through its Gαs-coupled EP2 receptor subtype; however, the truly selective EP2 antagonists did not emerge until 2011. These small molecules provide game-changing tools to better understand the EP2 receptor in inflammation-associated conditions. Their applications in preclinical models also reshape our knowledge of PGE2/EP2 signaling as a node of inflammation in health and disease. As we celebrate the 10-year anniversary of this breakthrough, the exploration of their potential as drug candidates for next-generation anti-inflammatory therapies has just begun. The first decade of EP2 antagonists passes, while their future looks brighter than ever.
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Affiliation(s)
- Madison N Sluter
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
| | - Ruida Hou
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
| | - Lexiao Li
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
| | - Nelufar Yasmen
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
| | - Ying Yu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
| | - Jiawang Liu
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
- Medicinal Chemistry Core, Office of Research, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
| | - Jianxiong Jiang
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Tennessee Health Science Center, Memphis, Tennessee 38163, United States
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36
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Involvement of Microglia in the Pathophysiology of Intracranial Aneurysms and Vascular Malformations-A Short Overview. Int J Mol Sci 2021; 22:ijms22116141. [PMID: 34200256 PMCID: PMC8201350 DOI: 10.3390/ijms22116141] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/01/2021] [Accepted: 06/04/2021] [Indexed: 12/19/2022] Open
Abstract
Aneurysms and vascular malformations of the brain represent an important source of intracranial hemorrhage and subsequent mortality and morbidity. We are only beginning to discern the involvement of microglia, the resident immune cell of the central nervous system, in these pathologies and their outcomes. Recent evidence suggests that activated proinflammatory microglia are implicated in the expansion of brain injury following subarachnoid hemorrhage (SAH) in both the acute and chronic phases, being also a main actor in vasospasm, considerably the most severe complication of SAH. On the other hand, anti-inflammatory microglia may be involved in the resolution of cerebral injury and hemorrhage. These immune cells have also been observed in high numbers in brain arteriovenous malformations (bAVM) and cerebral cavernomas (CCM), although their roles in these lesions are currently incompletely ascertained. The following review aims to shed a light on the most significant findings related to microglia and their roles in intracranial aneurysms and vascular malformations, as well as possibly establish the course for future research.
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Kanso F, Khalil A, Noureddine H, El-Makhour Y. Therapeutic perspective of thiosemicarbazones derivatives in inflammatory pathologies: A summary of in vitro/in vivo studies. Int Immunopharmacol 2021; 96:107778. [PMID: 34162145 DOI: 10.1016/j.intimp.2021.107778] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 04/24/2021] [Accepted: 05/06/2021] [Indexed: 02/06/2023]
Abstract
Following induction of inflammation, the nuclear factor kappa B (NF-κB) in activated macrophages induces the transcription of pro-inflammatory cytokines such as tumor necrosis factor-alpha (TNF-α), interleukin-1β (IL-1β), interleukin-6 (IL-6), and cyclooxygenase (COX), an inflammatory enzyme implicated in the synthesis of prostaglandins (PGs). The latter are involved in the transition and the maintenance of chronic inflammation underling various chronic disorders that require treatment. Concerning this, many anti-inflammatory drugs are available to treat the inflammatory disorders, but their therapeutic use is associated with a variety of side effects. Therefore, the discovery of new safer and potential anti-inflammatory drugs is necessary. In this regard, thiosemicarbazones (TSC) compounds and their metals complexes attracted high interest due to their wide range of biological activities, interestingly, the anti-inflammatory activity. They are formed by the action of thiosemicarbazide on an aldehyde or ketone, and contain a sulfur atom in place of the oxygen atom. Their ability to form a stable complex with transition metal is known to enhances the biological activity and reduces the side effects of the parent compound. Thus, this review article describes the inflammatory response mediated by NF-κB-COX-PGs and summarizes the anti-inflammatory activity of different thiosemicarbazones derivatives synthesized in research area.
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Affiliation(s)
- Fatima Kanso
- Environmental Health Research Lab (EHRL), Faculty of Sciences V, Lebanese University, Nabatieh, Lebanon.
| | - Alia Khalil
- Environmental Health Research Lab (EHRL), Faculty of Sciences V, Lebanese University, Nabatieh, Lebanon.
| | - Hiba Noureddine
- Environmental Health Research Lab (EHRL), Faculty of Sciences V, Lebanese University, Nabatieh, Lebanon.
| | - Yolla El-Makhour
- Environmental Health Research Lab (EHRL), Faculty of Sciences V, Lebanese University, Nabatieh, Lebanon.
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38
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Ando J, Yamamoto K. Hemodynamic Forces, Endothelial Mechanotransduction, and Vascular Diseases. Magn Reson Med Sci 2021; 21:258-266. [PMID: 34024868 DOI: 10.2463/mrms.rev.2021-0018] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Cells in the tissues and organs of a living body are subjected to mechanical forces, such as pressure, friction, and tension from their surrounding environment. Cells are equipped with a mechanotransduction mechanism by which they perceive mechanical forces and transmit information into the cell interior, thereby causing physiological or pathogenetic mechano-responses. Endothelial cells (ECs) lining the inner surface of blood vessels are constantly exposed to shear stress caused by blood flow and a cyclic strain caused by intravascular pressure. A number of studies have shown that ECs are sensitive to changes in these hemodynamic forces and alter their morphology and function, sometimes by modifying gene expression. The mechanism of endothelial mechanotransduction has been elucidated, and the plasma membrane has recently been shown to act as a mechanosensor. The lipid order and cholesterol content of plasma membranes change immediately upon the exposure of ECs to hemodynamic forces, resulting in a change in membrane fluidity. These changes in a plasma membrane's physical properties affect the conformation and function of various ion channels, receptors, and microdomains (such as caveolae and primary cilia), thereby activating a wide variety of downstream signaling pathways. Such endothelial mechanotransduction works to maintain circulatory homeostasis; however, errors in endothelial mechanotransduction can cause abnormalities in vascular physiological function, leading to the initiation and progression of various vascular diseases, such as hypertension, thrombosis, aneurysms, and atherosclerosis. Recent advances in detailed imaging technology and computational fluid dynamics analysis have enabled us to evaluate the hemodynamic forces acting on vascular tissue accurately, contributing greatly to our understanding of vascular mechanotransduction and the pathogenesis of vascular diseases, as well as the development of new therapies for vascular diseases.
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Affiliation(s)
- Joji Ando
- Laboratory of Biomedical Engineering, School of Medicine, Dokkyo Medical University, Mibu
| | - Kimiko Yamamoto
- Laboratory of System Physiology, Department of Biomedical Engineering, Graduate School of Medicine, The University of Tokyo
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Ewbank F, Birks J, Bulters D. A meta-analysis of aspirin and subarachnoid hemorrhage in patients with intracranial aneurysms yields different results to the general population. Int J Stroke 2021; 17:341-353. [PMID: 33705214 DOI: 10.1177/17474930211004888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Some studies have shown a protective association between aspirin use and subarachnoid hemorrhage. Other studies have found no relationship or the reverse. These studies differ in their study populations and definitions of subarachnoid hemorrhage. AIMS Our aim was to establish (1) if there is an association between aspirin and subarachnoid hemorrhage, (2) how this differs between the general population and those with intracranial aneurysms. SUMMARY OF REVIEW Studies reporting aspirin use and the occurrence of subarachnoid hemorrhage were included and grouped based on population (general population vs. aneurysm population). Odds ratios, hazard ratios, and confidence intervals were combined in random-effects models. Eleven studies were included. Overall, there was an association between aspirin and subarachnoid hemorrhage (OR 0.68 [0.48, 0.96]). However, populations were diverse and heterogeneity between studies high (p < 0.00001), questioning the validity of combining these studies and justifying analysis by population. In the general population, there was no difference in aspirin use between individuals with and without subarachnoid hemorrhage (OR 1.15 [0.96, 1.38]). In patients with intracranial aneurysms, aspirin use was greater in patients without subarachnoid hemorrhage (OR 0.37 [0.24, 0.58]), although these studies were at higher risk of bias. CONCLUSIONS There is an association between aspirin use and subarachnoid hemorrhage in patients with intracranial aneurysms. This apparent protective relationship is not seen in the general population. Prospective randomized studies are required to further investigate the effect of aspirin on unruptured intracranial aneurysms.
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Yang S, Liu T, Wu Y, Xu N, Xia L, Yu X. The Role of Aspirin in the Management of Intracranial Aneurysms: A Systematic Review and Meta-Analyses. Front Neurol 2021; 12:646613. [PMID: 33859609 PMCID: PMC8042149 DOI: 10.3389/fneur.2021.646613] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 03/08/2021] [Indexed: 01/19/2023] Open
Abstract
Objective: To evaluate the association between aspirin use and the risks of unruptured intracranial aneurysm (UIA) growth and aneurysmal subarachnoid hemorrhage (aSAH). Methods: We searched PubMed and Scopus from inception to 1 September 2020. Studies evaluating the associations between aspirin prescription and the risk of UIA growth or the risk of aSAH were included. The study only included patients with intracranial aneurysms. We assessed the quality of included studies using the Newcastle-Ottawa scale. Random-effects meta-analysis was conducted to pool the estimates of effect size quantitatively. Sensitivity analyses using the leave-one-out strategy were performed to identify any potential source of heterogeneity. Results: After a review of 2,226 citations, five cohort studies, two case-control studies, and one nested case-control study involving 8,898 participants were included. Pooled analyses showed that aspirin use, regardless of frequency and duration, was associated with a statistically significantly lower risk of UIA growth (OR 0.25, 95% CI 0.11–0.54; I2 = 0.0%, p = 0.604) and aSAH (OR, 0.37, 95% CI, 0.23–0.58; I2 = 79.3%, p = 0.001) in patients presented with intracranial aneurysms. The results did not significantly change in sensitivity analyses. Conclusions: Summarizing available evidence in the literature, our findings indicate that aspirin use, regardless of frequency and duration, was associated with a statistically significantly lower risk of UIA growth and aSAH in patients with UIA. Well-designed and large-scale clinical trials are needed to help define the role of aspirin as a protective pharmaceutical for UIAs.
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Affiliation(s)
- Shuwen Yang
- Department of Neurosurgery, People's Hospital of Huangpi District, Jianghan University, Wuhan, China
| | - Tianyu Liu
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuehui Wu
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Nina Xu
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liangtao Xia
- Division of Cardiothoracic and Vascular Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinyu Yu
- Department of Neurosurgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Muhammad S, Chaudhry SR, Dobreva G, Lawton MT, Niemelä M, Hänggi D. Vascular Macrophages as Therapeutic Targets to Treat Intracranial Aneurysms. Front Immunol 2021; 12:630381. [PMID: 33763073 PMCID: PMC7982735 DOI: 10.3389/fimmu.2021.630381] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 01/11/2021] [Indexed: 01/08/2023] Open
Abstract
Aneurysmal subarachnoid hemorrhage (aSAH) is a highly fatal and morbid type of hemorrhagic strokes. Intracranial aneurysms (ICAs) rupture cause subarachnoid hemorrhage. ICAs formation, growth and rupture involves cellular and molecular inflammation. Macrophages orchestrate inflammation in the wall of ICAs. Macrophages generally polarize either into classical inflammatory (M1) or alternatively-activated anti-inflammatory (M2)-phenotype. Macrophage infiltration and polarization toward M1-phenotype increases the risk of aneurysm rupture. Strategies that deplete, inhibit infiltration, ameliorate macrophage inflammation or polarize to M2-type protect against ICAs rupture. However, clinical translational data is still lacking. This review summarizes the contribution of macrophage led inflammation in the aneurysm wall and discuss pharmacological strategies to modulate the macrophageal response during ICAs formation and rupture.
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Affiliation(s)
- Sajjad Muhammad
- Department of Neurosurgery, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany.,Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.,Department of Anatomy and Developmental Biology, Medical Faculty Mannheim and European Center for Angioscience (ECAS), University of Heidelberg, Mannheim, Germany
| | - Shafqat Rasul Chaudhry
- Shifa College of Pharmaceutical Sciences, Shifa Tameer-e-Millat University, Islamabad, Pakistan
| | - Gergana Dobreva
- Department of Anatomy and Developmental Biology, Medical Faculty Mannheim and European Center for Angioscience (ECAS), University of Heidelberg, Mannheim, Germany
| | - Michael T Lawton
- Department of Neurosurgery, Barrow Brain and Spine, Barrow Neurological Institute, Phoenix, AZ, United States
| | - Mika Niemelä
- Department of Neurosurgery, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Daniel Hänggi
- Department of Neurosurgery, Faculty of Medicine, Heinrich-Heine-University, Düsseldorf, Germany
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42
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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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43
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Keränen S, Suutarinen S, Mallick R, Laakkonen JP, Guo D, Pawlikowska L, Jahromi BR, Rauramaa T, Ylä-Herttuala S, Marchuk D, Krings T, Koivisto T, Lawton M, Radovanovic I, Kim H, Faughnan ME, Frösen J. Cyclo-oxygenase 2, a putative mediator of vessel remodeling, is expressed in the brain AVM vessels and associates with inflammation. Acta Neurochir (Wien) 2021; 163:2503-2514. [PMID: 34185176 PMCID: PMC8357659 DOI: 10.1007/s00701-021-04895-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 05/26/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Brain arteriovenous malformations (bAVM) may rupture causing disability or death. BAVM vessels are characterized by abnormally high flow that in general triggers expansive vessel remodeling mediated by cyclo-oxygenase-2 (COX2), the target of non-steroidal anti-inflammatory drugs. We investigated whether COX2 is expressed in bAVMs and whether it associates with inflammation and haemorrhage in these lesions. METHODS Tissue was obtained from surgery of 139 bAVMs and 21 normal Circle of Willis samples. The samples were studied with immunohistochemistry and real-time quantitative polymerase chain reaction (RT-PCR). Clinical data was collected from patient records. RESULTS COX2 expression was found in 78% (109/139) of the bAVMs and localized to the vessels' lumen or medial layer in 70% (95/135) of the bAVMs. Receptors for prostaglandin E2, a COX2-derived mediator of vascular remodeling, were found in the endothelial and smooth muscle cells and perivascular inflammatory cells of bAVMs. COX2 was expressed by infiltrating inflammatory cells and correlated with the extent of inflammation (r = .231, p = .007, Spearman rank correlation). COX2 expression did not associate with haemorrhage. CONCLUSION COX2 is induced in bAVMs, and possibly participates in the regulation of vessel wall remodelling and ongoing inflammation. Role of COX2 signalling in the pathobiology and clinical course of bAVMs merits further studies.
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Affiliation(s)
- Sara Keränen
- Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland
| | - Santeri Suutarinen
- Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland
| | - Rahul Mallick
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland
| | - Johanna P Laakkonen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland
| | - Diana Guo
- Center for Cerebrovascular Research, Dept of Anesthesiology and Perioperative Care, UCSF, San Francisco, CA, USA
| | - Ludmila Pawlikowska
- Center for Cerebrovascular Research, Dept of Anesthesiology and Perioperative Care, UCSF, San Francisco, CA, USA
| | - Behnam Rezai Jahromi
- Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland
| | - Tuomas Rauramaa
- Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
- Department of Pathology, Kuopio University Hospital, University of Eastern Finland, Kuopio, Finland
| | - Seppo Ylä-Herttuala
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland
| | - Doug Marchuk
- Division of Human Genetics, Duke University School of Medicine, Durham, NC, USA
| | - Timo Krings
- Department of Neuroradiology, University Hospital Network Toronto, Toronto, Canada
| | - Timo Koivisto
- Department of Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland
| | - Michael Lawton
- Department of Neurosurgery, Barrow Brain and Spine Institute, Phoenix, AZ, USA
| | - Ivan Radovanovic
- Department of Neurosurgery, University Hospital Network Toronto, Toronto, Canada
| | - Helen Kim
- Center for Cerebrovascular Research, Dept of Anesthesiology and Perioperative Care, UCSF, San Francisco, CA, USA
| | - Marie E Faughnan
- Toronto HHT Centre, St. Michael's Hospital and Li Ka Shing Knowledge Institute, Toronto, Canada
- Division of Respirology, Department of Medicine, University of Toronto, Toronto, Canada
| | - Juhana Frösen
- Hemorrhagic Brain Pathology Research Group, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Joensuu, Kuopio, Finland.
- Department of Neurosurgery, NeuroCenter, Kuopio University Hospital, Kuopio, Finland.
- Department of Neurosurgery, Tampere University Hospital and University of Tampere, Elämänaukio 2, PoBox 33521, Tampere, Finland.
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44
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Peñate Medina T, Kolb JP, Hüttmann G, Huber R, Peñate Medina O, Ha L, Ulloa P, Larsen N, Ferrari A, Rafecas M, Ellrichmann M, Pravdivtseva MS, Anikeeva M, Humbert J, Both M, Hundt JE, Hövener JB. Imaging Inflammation - From Whole Body Imaging to Cellular Resolution. Front Immunol 2021; 12:692222. [PMID: 34248987 PMCID: PMC8264453 DOI: 10.3389/fimmu.2021.692222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 05/12/2021] [Indexed: 01/31/2023] Open
Abstract
Imaging techniques have evolved impressively lately, allowing whole new concepts like multimodal imaging, personal medicine, theranostic therapies, and molecular imaging to increase general awareness of possiblities of imaging to medicine field. Here, we have collected the selected (3D) imaging modalities and evaluated the recent findings on preclinical and clinical inflammation imaging. The focus has been on the feasibility of imaging to aid in inflammation precision medicine, and the key challenges and opportunities of the imaging modalities are presented. Some examples of the current usage in clinics/close to clinics have been brought out as an example. This review evaluates the future prospects of the imaging technologies for clinical applications in precision medicine from the pre-clinical development point of view.
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Affiliation(s)
- Tuula Peñate Medina
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- *Correspondence: Tuula Peñate Medina, ; Jan-Bernd Hövener,
| | - Jan Philip Kolb
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - Gereon Hüttmann
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
- Airway Research Center North (ARCN), Member of the German Center of Lung Research (DZL), Gießen, Germany
| | - Robert Huber
- Institute of Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - Oula Peñate Medina
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- Institute for Experimental Cancer Research (IET), University of Kiel, Kiel, Germany
| | - Linh Ha
- Department of Dermatology, Allergology and Venereology, University Hospital Schleswig-Holstein Lübeck (UKSH), Lübeck, Germany
| | - Patricia Ulloa
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Naomi Larsen
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Arianna Ferrari
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
| | - Magdalena Rafecas
- Institute of Medical Engineering (IMT), University of Lübeck, Lübeck, Germany
| | - Mark Ellrichmann
- Interdisciplinary Endoscopy, Medical Department1, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Mariya S. Pravdivtseva
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Mariia Anikeeva
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
| | - Jana Humbert
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Marcus Both
- Department of Radiology and Neuroradiology, University Medical Centers Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jennifer E. Hundt
- Lübeck Institute for Experimental Dermatology (LIED), University of Lübeck, Lübeck, Germany
| | - Jan-Bernd Hövener
- Section Biomedical Imaging, Molecular Imaging North Competence Center (MOIN CC), Department of Radiology and Neuroradiology, University Medical Center, Schleswig-Holstein Kiel University, Kiel, Germany
- *Correspondence: Tuula Peñate Medina, ; Jan-Bernd Hövener,
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45
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Rubio JE, Skotak M, Alay E, Sundaramurthy A, Subramaniam DR, Kote VB, Yeoh S, Monson K, Chandra N, Unnikrishnan G, Reifman J. Does Blast Exposure to the Torso Cause a Blood Surge to the Brain? Front Bioeng Biotechnol 2020; 8:573647. [PMID: 33392161 PMCID: PMC7773947 DOI: 10.3389/fbioe.2020.573647] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 11/16/2020] [Indexed: 02/04/2023] Open
Abstract
The interaction of explosion-induced blast waves with the torso is suspected to contribute to brain injury. In this indirect mechanism, the wave-torso interaction is assumed to generate a blood surge, which ultimately reaches and damages the brain. However, this hypothesis has not been comprehensively and systematically investigated, and the potential role, if any, of the indirect mechanism in causing brain injury remains unclear. In this interdisciplinary study, we performed experiments and developed mathematical models to address this knowledge gap. First, we conducted blast-wave exposures of Sprague-Dawley rats in a shock tube at incident overpressures of 70 and 130 kPa, where we measured carotid-artery and brain pressures while limiting exposure to the torso. Then, we developed three-dimensional (3-D) fluid-structure interaction (FSI) models of the neck and cerebral vasculature and, using the measured carotid-artery pressures, performed simulations to predict mass flow rates and wall shear stresses in the cerebral vasculature. Finally, we developed a 3-D finite element (FE) model of the brain and used the FSI-computed vasculature pressures to drive the FE model to quantify the blast-exposure effects in the brain tissue. The measurements from the torso-only exposure experiments revealed marginal increases in the peak carotid-artery overpressures (from 13.1 to 28.9 kPa). Yet, relative to the blast-free, normotensive condition, the FSI simulations for the blast exposures predicted increases in the peak mass flow rate of up to 255% at the base of the brain and increases in the wall shear stress of up to 289% on the cerebral vasculature. In contrast, our simulations suggest that the effect of the indirect mechanism on the brain-tissue-strain response is negligible (<1%). In summary, our analyses show that the indirect mechanism causes a sudden and abundant stream of blood to rapidly propagate from the torso through the neck to the cerebral vasculature. This blood surge causes a considerable increase in the wall shear stresses in the brain vasculature network, which may lead to functional and structural effects on the cerebral veins and arteries, ultimately leading to vascular pathology. In contrast, our findings do not support the notion of strain-induced brain-tissue damage due to the indirect mechanism.
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Affiliation(s)
- Jose E Rubio
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Maciej Skotak
- Department of Biomedical Engineering, Center for Injury Biomechanics, Materials, and Medicine, New Jersey Institute of Technology, Newark, NJ, United States.,Blast Induced Neurotrauma Division, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Eren Alay
- Department of Biomedical Engineering, Center for Injury Biomechanics, Materials, and Medicine, New Jersey Institute of Technology, Newark, NJ, United States
| | - Aravind Sundaramurthy
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Dhananjay Radhakrishnan Subramaniam
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Vivek Bhaskar Kote
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Stewart Yeoh
- Department of Biomedical Engineering, College of Engineering, The University of Utah, Salt Lake City, UT, United States
| | - Kenneth Monson
- Department of Biomedical Engineering, College of Engineering, The University of Utah, Salt Lake City, UT, United States.,Department of Mechanical Engineering, College of Engineering, The University of Utah, Salt Lake City, UT, United States
| | - Namas Chandra
- Department of Biomedical Engineering, Center for Injury Biomechanics, Materials, and Medicine, New Jersey Institute of Technology, Newark, NJ, United States
| | - Ginu Unnikrishnan
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States.,The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, United States
| | - Jaques Reifman
- Department of Defense Biotechnology High Performance Computing Software Applications Institute, Telemedicine and Advanced Technology Research Center, United States Army Medical Research and Development Command, Fort Detrick, MD, United States
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46
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Chu C, Xu G, Li X, Duan Z, Tao L, Cai H, Yang M, Zhang X, Chen B, Zheng Y, Shi H, Li X. Sustained expression of MCP-1 induced low wall shear stress loading in conjunction with turbulent flow on endothelial cells of intracranial aneurysm. J Cell Mol Med 2020; 25:110-119. [PMID: 33332775 PMCID: PMC7810920 DOI: 10.1111/jcmm.15868] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 07/30/2020] [Accepted: 08/24/2020] [Indexed: 12/28/2022] Open
Abstract
Shear stress was reported to regulate the expression of AC007362, but its underlying mechanisms remain to be explored. In this study, to isolate endothelial cells of blood vessels, unruptured and ruptured intracranial aneurysm (IA) tissues were collected from IA patients. Subsequently, quantitative real‐time PCR (qRT‐PCR), Western blot and luciferase assay were performed to investigate the relationships between AC007362, miRNAs‐493 and monocyte chemoattractant protein‐1 (MCP‐1) in human umbilical vein endothelial cells (HUVECs) exposed to shear stress. Reduced representation bisulphite sequencing (RRBS) was performed to assess the level of DNA methylation in AC007362 promoter. Accordingly, AC007362 and MCP‐1 were significantly up‐regulated while miR‐493 was significantly down‐regulated in HUVECs exposed to shear stress. AC007362 could suppress the miR‐493 expression and elevate the MCP‐1 expression, and miR‐493 was shown to respectively target AC007362 and MCP‐1. Moreover, shear stress in HUVECs led to the down‐regulated DNA methyltransferase 1 (DNMT1), as well as the decreased DNA methylation level of AC007362 promoter. Similar results were also observed in ruptured IA tissues when compared with unruptured IA tissues. In conclusion, this study presented a deep insight into the operation of the regulatory network of AC007362, miR‐493 and MCP‐1 upon shear stress. Under shear stress, the expression of AC007362 was enhanced by the inhibited promoter DNA methylation, while the expression of MCP‐1 was enhanced by sponging the expression of miR‐493.
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Affiliation(s)
- Cheng Chu
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Gang Xu
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Xiaocong Li
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Zuowei Duan
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Lihong Tao
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Hongxia Cai
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Ming Yang
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Xinjiang Zhang
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Bin Chen
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Yanyu Zheng
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Hongcan Shi
- Department of Neurology, Affiliated Hospital of Yangzhou University, Yangzhou University, Yangzhou, China
| | - Xiaoyu Li
- Department of Pathophysiology, Key Laboratory of Cardiovascular Disease and Molecular Intervention, Nanjing Medical University, Nanjing, China
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47
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Shear stress activates mitochondrial oxidative phosphorylation by reducing plasma membrane cholesterol in vascular endothelial cells. Proc Natl Acad Sci U S A 2020; 117:33660-33667. [PMID: 33318210 PMCID: PMC7776821 DOI: 10.1073/pnas.2014029117] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The mechanotransduction of shear stress in vascular endothelial cells is still not completely understood. We show a pathway of shear stress signal transduction mediated by plasma membrane cholesterol-dependent mitochondrial oxidative phosphorylation. The latest imaging technology using domain 4 mutant-derived cholesterol biosensors and a fluorescence resonance energy transfer-based adenosine triphosphate (ATP) biosensor revealed that shear stress rapidly decreases cholesterol levels in the plasma membrane via both efflux and internalization, and reduction in plasma membrane cholesterol was linked to the activation of mitochondrial ATP production. The addition of cholesterol blocked these shear stress effects. Increased mitochondrial ATP production led to ATP release from the endothelial cells, thereby activating purinoceptors in the plasma membrane and leading to purinergic Ca2+ signaling in response to shear stress. Vascular endothelial cells (ECs) sense and respond to hemodynamic shear stress, which is critical for circulatory homeostasis and the pathophysiology of vascular diseases. The mechanisms of shear stress mechanotransduction, however, remain elusive. We previously demonstrated a direct role of mitochondria in the purinergic signaling of shear stress: shear stress increases mitochondrial adenosine triphosphate (ATP) production, triggering ATP release and Ca2+ signaling via EC purinoceptors. Here, we showed that shear stress rapidly decreases cholesterol in the plasma membrane, thereby activating mitochondrial ATP production. Imaging using domain 4 mutant-derived cholesterol biosensors showed that the application of shear stress to cultured ECs markedly decreased cholesterol levels in both the outer and inner plasma membrane bilayers. Flow cytometry showed that the cholesterol levels in the outer bilayer decreased rapidly after the onset of shear stress, reached a minimum (around 60% of the control level) at 10 min, and plateaued thereafter. After the shear stress ceased, the decreased cholesterol levels returned to those seen in the control. A biochemical analysis showed that shear stress caused both the efflux and the internalization of plasma membrane cholesterol. ATP biosensor imaging demonstrated that shear stress significantly increased mitochondrial ATP production. Similarly, the treatment of cells with methyl-β-cyclodextrin (MβCD), a membrane cholesterol-depleting agent, increased mitochondrial ATP production. The addition of cholesterol to cells inhibited the increasing effects of both shear stress and MβCD on mitochondrial ATP production in a dose-dependent manner. These findings indicate that plasma membrane cholesterol dynamics are closely coupled to mitochondrial oxidative phosphorylation in ECs.
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48
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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: 147] [Impact Index Per Article: 36.8] [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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49
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Rodemerk J, Junker A, Chen B, Pierscianek D, Dammann P, Darkwah Oppong M, Radbruch A, Forsting M, Maderwald S, Quick HH, Zhu Y, Jabbarli R, Sure U, Wrede KH. Pathophysiology of Intracranial Aneurysms. Stroke 2020; 51:2505-2513. [DOI: 10.1161/strokeaha.120.030590] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Background and Purpose:
The pathophysiology of development, growth, and rupture of intracranial aneurysms (IAs) is only partly understood. Cyclooxygenase 2 (COX-2) converts arachidonic acid to prostaglandin H
2
, which, in turn, is isomerized to prostaglandin E
2
. In the human body, COX-2 plays an essential role in inflammatory pathways. This explorative study aimed to investigate COX-2 expression in the wall of IAs and its correlation to image features in clinical (1.0T, 1.5T, and 3.0T) magnetic resonance imaging (MRI) and ultra-high-field 7T MRI.
Methods:
The study group comprised 40 patients with partly thrombosed saccular IAs. The cohort included 17 ruptured- and 24 unruptured IAs, which had all been treated microsurgically. Formaldehyde-fixed paraffin-embedded samples were immunohistochemically stained with a monoclonal antibody against COX-2 (Dako, Santa Clara, CA; Clone: CX-294). We correlated Perls Prussian blue staining, MRI, and clinical data with immunohistochemistry, analyzed using the Trainable Weka Segmentation algorithm.
Results:
Aneurysm dome size ranged between 2 and 67 mm. The proportion of COX-2 positive cells ranged between 3.54% to 85.09%. An upregulated COX-2 expression correlated with increasing IA dome size (
P
=0.047). Furthermore, there was a tendency of higher COX-2 expression in most ruptured IAs (
P
=0.064). At all field strengths, MRI shows wall hypointensities due to iron deposition correlating with COX-2 expression (
P
=0.022).
Conclusions:
Iron deposition and COX-2 expression in IAs walls correlate with signal hypointensity in MRI, which might, therefore, serve as a biomarker for IA instability. Furthermore, as COX-2 was also expressed in small unruptured IAs, it could be a potential target for specific medical treatment.
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Affiliation(s)
- Jan Rodemerk
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Andreas Junker
- Clinic for Neuropathology (A.J.), University Hospital Essen, Germany
| | - Bixia Chen
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Daniela Pierscianek
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Philipp Dammann
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Marvin Darkwah Oppong
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Alexander Radbruch
- Department of Diagnostic and Interventional Radiology and Neuroradiology (A.R., M.F.), University Hospital Essen, Germany
| | - Michael Forsting
- Department of Diagnostic and Interventional Radiology and Neuroradiology (A.R., M.F.), University Hospital Essen, Germany
| | - Stefan Maderwald
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Germany (S.M., H.H.Q.)
| | - Harald H. Quick
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, Germany (S.M., H.H.Q.)
| | - Yuan Zhu
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Ramazan Jabbarli
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Ulrich Sure
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
| | - Karsten H. Wrede
- Department of Neurosurgery (J.R., B.C., D.P., P.D., M.D.O., Y.Z., R.J., U.S., K.H.W.), University Hospital Essen, Germany
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Kataoka H, Yagi T, Ikedo T, Imai H, Kawamura K, Yoshida K, Nakamura M, Aoki T, Miyamoto S. Hemodynamic and Histopathological Changes in the Early Phase of the Development of an Intracranial Aneurysm. Neurol Med Chir (Tokyo) 2020; 60:319-328. [PMID: 32536660 PMCID: PMC7358784 DOI: 10.2176/nmc.st.2020-0072] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hemodynamic stress and chronic inflammation are closely associated with the
pathogenesis of intracranial aneurysms (IAs). However, the hemodynamic and
biological mechanisms triggering IA formation remain to be elucidated. To
clarify them, computational fluid dynamics (CFD) and histopathological analyses
in the early phase of IA development using an experimentally induced IA model in
rats were conducted. Histological changes in the early phase of IA development
were observed under a scanning electron microscope (SEM) and a transmission
electron microscope (TEM). Using data from 7-T magnetic resonance angiography
(7T-MRA), CFD analyses were performed to determine wall shear stress (WSS) and
wall pressure (WP) at the prospective site of IA. A bump-like protrusion named
an “intimal pad” was located in the anterior cerebral artery (ACA)
immediately distal to the apex of the bifurcation. TEM showed the degeneration
of the internal elastic lamina (IEL) and longitudinally elongated smooth muscle
cells (SMCs) that switched from the contractile to the proliferative phenotype
and penetrated between two divided layers of the degenerated IEL in the
prospective site of the IA. However, no inflammatory cells were observed. CFD
analyses showed no particular pattern of WSS and WP at the prospective IA site.
IEL degeneration and the phenotypic change and longitudinal elongation of SMCs
were identified as the early events in IA development. CFD analyses and TEM data
suggest that these biological events may be derived from increased
circumferential wall stress due to increased blood pressure and increased
longitudinal wall strain due to the existence of the intimal pad.
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Affiliation(s)
- Hiroharu Kataoka
- Department of Neurosurgery, Kyoto University, Graduate School of Medicine
| | - Takanobu Yagi
- Center for Advanced Biomedical Science, Waseda University
| | - Taichi Ikedo
- Department of Neurosurgery, Kyoto University, Graduate School of Medicine
| | - Hirohiko Imai
- Department of Systems Science, Graduate School of Informatics, Kyoto University
| | | | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University, Graduate School of Medicine
| | - Masanori Nakamura
- Department of Mechanical Engineering, Nagoya Institute of Technology
| | - Tomohiro Aoki
- Department of molecular pharmacology, National Cerebral and Cardiovascular Center
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University, Graduate School of Medicine
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