1
|
Luo L, Ma X, Kong D, Dai Y, Li T, Yu H, Liu J, Li M, Xu Y, Xiang G, Zhao Z, Zhong W, Wang D, Wang Y. Multiomics integrated analysis and experimental validation identify TLR4 and ALOX5 as oxidative stress-related biomarkers in intracranial aneurysms. J Neuroinflammation 2024; 21:225. [PMID: 39278904 PMCID: PMC11403828 DOI: 10.1186/s12974-024-03226-0] [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: 05/14/2024] [Accepted: 09/06/2024] [Indexed: 09/18/2024] Open
Abstract
BACKGROUND Intracranial aneurysm (IA) is a severe cerebrovascular disease, and effective gene therapy and drug interventions for its treatment are still lacking. Oxidative stress (OS) is closely associated with the IA, but the key regulatory genes involved are still unclear. Through multiomics analysis and experimental validation, we identified two diagnostic markers for IA associated with OS. METHODS In this study, we first analyzed the IA dataset GSE75436 and conducted a joint analysis of oxidative stress-related genes (ORGs). Differential analysis, functional enrichment analysis, immune infiltration, WGCNA, PPI, LASSO, and other methods were used to identify IA diagnostic markers related to OS. Next, the functions of TLR4 and ALOX5 expression in IA and their potential targeted therapeutic drugs were analyzed. We also performed single-cell sequencing of patient IA and control (superficial temporal artery, STA) tissues. 23,342 cells were captured from 2 IA and 3 STA samples obtained from our center. Cell clustering and annotation were conducted using R software to observe the distribution of TLR4 and ALOX5 expression in IAs. Finally, the expression of TLR4 and ALOX5 were validated in IA patients and in an elastase-induced mouse IA model using experiments such as WB and immunofluorescence. RESULTS Through bioinformatics analysis, we identified 16 key ORGs associated with IA pathogenesis. Further screening revealed that ALOX5 and TLR4 were highly expressed to activate a series of inflammatory responses and reduce the production of myocytes. Methotrexate (MTX) may be a potential targeted drug. Single-cell analysis revealed a notable increase in immune cells in the IA group, with ALOX5 and TLR4 primarily localized to monocytes/macrophages. Validation through patient samples and mouse models confirmed high expression of ALOX5 and TLR4 in IAs. CONCLUSIONS Bioinformatics analysis indicated that ALOX5 and TLR4 are the most significant ORGs associated with the pathogenesis of IA. Single-cell sequencing and experiments revealed that the high expression of ALOX5 and TLR4 are closely related to IA. These two genes are promising new targets for IA therapy.
Collapse
Affiliation(s)
- Lvyin Luo
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Xinlong Ma
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Debin Kong
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Yuxiang Dai
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Tao Li
- Department of Neurosurgery, the Third Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Han Yu
- Department of Ophthalmology, Qilu Hospital, Shandong University, Jinan, China
| | - Jingzheng Liu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Maogui Li
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Yangyang Xu
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Guo Xiang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Zhimin Zhao
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Weiying Zhong
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Donghai Wang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China
| | - Yunyan Wang
- Department of Neurosurgery, Qilu Hospital, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, Jinan, 250012, China.
- Shandong Key Laboratory of Brain Function Remodeling, Jinan, China.
| |
Collapse
|
2
|
Zhou C, Sun J, Wu L, Liu C, Cheng Q, Xie S, Zhang J. LTBP2 down-regulated FGF2 to repress vascular smooth muscle cell proliferation and vascular remodeling in a rat model of intracranial aneurysm. Neurosci Lett 2024; 842:137988. [PMID: 39288883 DOI: 10.1016/j.neulet.2024.137988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 08/11/2024] [Accepted: 09/09/2024] [Indexed: 09/19/2024]
Abstract
This work probed into the role of latent transforming growth factor beta binding protein 2 (LTBP2) in intracranial aneurysm (IA). The rats underwent IA modeling and then stereotactic injection of short hairpin RNA against LTBP2 (shLTBP2). Hematoxylin-eosin (HE) staining was employed to assess IA model and vascular remodeling. Rat vascular smooth muscle cells (VSMCs) were transfected with shLTBP2, LTBP2 overexpression plasmid and fibroblast growth factor 2 (FGF2) overexpression plasmid. The mRNA and protein expressions of LTBP2, FGF2 and mitochondrial apoptosis-related factors (Caspase-3, Cyt-c, Mcl-1) were tested through qRT-PCR and Western blot. Cell viability, proliferation and apoptosis were examined by cell counting kit-8, EdU assay and flow cytometry. The up-regulated LTBP2 and down-regulated FGF2 were detected in IA rats. LTBP2 knockdown promoted vascular remodeling and Mcl-1 level, and restrained cell apoptosis and expressions of Caspase-3 and Cyt-c in IA model rats. Moreover, LTBP2 knockdown potentiated cell viability, proliferation and FGF2 level, and repressed apoptosis in rat VSMCs, while overexpressed LTBP2 exerted opposite effects. FGF2 overexpression promoted proliferation and Mcl-1 level, and inhibited apoptosis and expressions of Caspase-3 and Cyt-c in rat VSMCs, which also reversed the effects of overexpressed LTBP2 on these aspects. Collectively, LTBP2 down-regulates FGF2 to repress VSMCs proliferation and vascular remodeling in an IA rat model.
Collapse
Affiliation(s)
- Chunhui Zhou
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China
| | - Junzhao Sun
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China
| | - Lin Wu
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China
| | - Congwei Liu
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China
| | - Qiao Cheng
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China
| | - Shengqiang Xie
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China
| | - Jianning Zhang
- Department of Neurosurgery, The Sixth Medical Center of PLA General Hospital, China.
| |
Collapse
|
3
|
Uchikawa H, Rahmani R. Animal Models of Intracranial Aneurysms: History, Advances, and Future Perspectives. Transl Stroke Res 2024:10.1007/s12975-024-01276-3. [PMID: 39060663 DOI: 10.1007/s12975-024-01276-3] [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: 04/24/2024] [Revised: 06/17/2024] [Accepted: 06/29/2024] [Indexed: 07/28/2024]
Abstract
Intracranial aneurysms (IA) are a disease process with potentially devastating outcomes, particularly when rupture occurs leading to subarachnoid hemorrhage. While some candidates exist, there is currently no established pharmacological prevention of growth and rupture. The development of prophylactic treatments is a critical area of research, and preclinical models using animals play a pivotal role. These models, which utilize various species and induction methods, each possess unique characteristics that can be leveraged depending on the specific aim of the study. A comprehensive understanding of these models, including their historical development, is crucial for appreciating the advantages and limitations of aneurysm research in animal models.We summarize the significant roles of animal models in IA research, with a particular focus on rats, mice, and large animals. We discuss the pros and cons of each model, providing insights into their unique characteristics and contributions to our understanding of IA. These models have been instrumental in elucidating the pathophysiology of IA and in the development of potential therapeutic strategies.A deep understanding of these models is essential for advancing research on preventive treatments for IA. By leveraging the unique strengths of each model and acknowledging their limitations, researchers can conduct more effective and targeted studies. This, in turn, can accelerate the development of novel therapeutic strategies, bringing us closer to the goal of establishing an effective prophylactic treatment for IA. This review aims to provide a comprehensive view of the current state of animal models in IA research.
Collapse
Affiliation(s)
- Hiroki Uchikawa
- Department of Translational Neuroscience, Barrow Aneurysm and AVM Research Center, Barrow Neurological Institute, Phoenix, AZ, USA
| | - Redi Rahmani
- Department of Translational Neuroscience, Barrow Aneurysm and AVM Research Center, Barrow Neurological Institute, Phoenix, AZ, USA.
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ, USA.
| |
Collapse
|
4
|
Chen C, Tang F, Zhu M, Wang C, Zhou H, Zhang C, Feng Y. Role of inflammatory mediators in intracranial aneurysms: A review. Clin Neurol Neurosurg 2024; 242:108329. [PMID: 38781806 DOI: 10.1016/j.clineuro.2024.108329] [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: 01/28/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
The formation, growth, and rupture of intracranial aneurysms (IAs) involve hemodynamics, blood pressure, external stimuli, and a series of hormonal changes. In addition, inflammatory response causes the release of a series of inflammatory mediators, such as IL, TNF-α, MCP-1, and MMPs, which directly or indirectly promote the development process of IA. However, the specific role of these inflammatory mediators in the pathophysiological process of IA remains unclear. Recently, several anti-inflammatory, lipid-lowering, hormone-regulating drugs have been found to have a potentially protective effect on reducing IA formation and rupture in the population. These therapeutic mechanisms have not been fully elucidated, but we can look for potential therapeutic targets that may interfere with the formation and breakdown of IA by studying the relevant inflammatory response and the mechanism of IA formation and rupture involved in inflammatory mediators.
Collapse
Affiliation(s)
- Cheng Chen
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Fengjiao Tang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Meng Zhu
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Chao Wang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Han Zhou
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Chonghui Zhang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Yugong Feng
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China.
| |
Collapse
|
5
|
Oberman DZ, Palavani LB, Akly MSP, Rabelo NN, Elizondo C, Correa JLA, Ajler P, Baccanelli MM. In Reply to Letter to the Editor Regarding "Morphologic Variations in the Circle of Willis as a Risk Factor for Aneurysm Rupture in the Anterior and Posterior Communicating Arteries". World Neurosurg 2024; 186:270. [PMID: 38849998 DOI: 10.1016/j.wneu.2024.03.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 06/09/2024]
Affiliation(s)
| | | | | | | | - Cristina Elizondo
- Department of Internal Medicine Research Area, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | | - Pablo Ajler
- Department of Neurosurgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | | |
Collapse
|
6
|
Dodd WS, Patel D, Laurent D, Lucke-Wold B, Hosaka K, Johnson RD, Chalouhi N, Butler AA, Candelario-Jalil E, Hoh BL. Subarachnoid hemorrhage-associated brain injury and neurobehavioral deficits are reversed with synthetic adropin treatment through sustained Ser1179 phosphorylation of endothelial nitric oxide synthase. FRONTIERS IN STROKE 2024; 3:1371140. [PMID: 39345725 PMCID: PMC11434178 DOI: 10.3389/fstro.2024.1371140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/01/2024]
Abstract
Background Subarachnoid hemorrhage (SAH) is a life-threatening vascular condition without satisfactory treatment options. The secreted peptide adropin is highly expressed in the human brain and has neuroprotective effects in brain injury models, including actions involving the cerebrovasculature. Here, we report an endothelial nitric oxide synthase (eNOS)-dependent effect of synthetic adropin treatment that reverses the deleterious effects of SAH. Methods We tested the molecular, cellular, and physiological responses of cultured brain microvascular endothelial cells and two mouse models of SAH to treatment using synthetic adropin peptide or vehicle. Results SAH decreases adropin expression in cultured brain microvascular endothelial cells and in murine brain tissue. In two validated mouse SAH models, synthetic adropin reduced cerebral edema, preserved tight junction protein expression, and abolished microthrombosis at 1 day post-SAH. Adropin treatment also prevented delayed cerebral vasospasm, decreased neuronal apoptosis, and reduced sensorimotor deficits at seven days post-SAH. Delaying initial treatment of adropin until 24 h post-SAH preserved the beneficial effect of adropin in preventing vasospasm and sensorimotor deficits. Mechanistically, adropin treatment increased eNOS phosphorylation (Ser1179) at 1 & 7 days post-SAH. Treating eNOS-/- mice with adropin failed to prevent vasospasm or behavioral deficits, indicating a requirement of eNOS signaling. Conclusions Adropin is an effective treatment for SAH, reducing cerebrovascular injury in both the acute (1 day) and delayed (7 days) phases. These findings establish the potential of adropin or adropin mimetics to improve outcomes following subarachnoid hemorrhage.
Collapse
Affiliation(s)
- William S Dodd
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Devan Patel
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States
| | - Dimitri Laurent
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Brandon Lucke-Wold
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Koji Hosaka
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Richard D Johnson
- Department of Physiological Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States
| | - Nohra Chalouhi
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Andrew A Butler
- Department of Pharmacology and Physiology and Henry and Amelia Nasrallah Center for Neuroscience, Saint Louis University, St. Louis, MO, United States
| | - Eduardo Candelario-Jalil
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Brian L Hoh
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, United States
| |
Collapse
|
7
|
Khan D, Li X, Hashimoto T, Tanikawa R, Niemela M, Lawton M, Muhammad S. Current Mouse Models of Intracranial Aneurysms: Analysis of Pharmacological Agents Used to Induce Aneurysms and Their Impact on Translational Research. J Am Heart Assoc 2024; 13:e031811. [PMID: 38258667 PMCID: PMC11056163 DOI: 10.1161/jaha.123.031811] [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: 08/18/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024]
Abstract
Intracranial aneurysms (IAs) are rare vascular lesions that are more frequently found in women. The pathophysiology behind the formation and growth of IAs is complex. Hence, to date, no single pharmacological option exists to treat them. Animal models, especially mouse models, represent a valuable tool to explore such complex scientific questions. Genetic modification in a mouse model of IAs, including deletion or overexpression of a particular gene, provides an excellent means for examining basic mechanisms behind disease pathophysiology and developing novel pharmacological approaches. All existing animal models need some pharmacological treatments, surgical interventions, or both to develop IAs, which is different from the spontaneous and natural development of aneurysms under the influence of the classical risk factors. The benefit of such animal models is the development of IAs in a limited time. However, clinical translation of the results is often challenging because of the artificial course of IA development and growth. Here, we summarize the continuous improvement in mouse models of IAs. Moreover, we discuss the pros and cons of existing mouse models of IAs and highlight the main translational roadblocks and how to improve them to increase the success of translational IA research.
Collapse
Affiliation(s)
- Dilaware Khan
- Department of NeurosurgeryMedical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐Universität DüsseldorfDüsseldorfGermany
| | - Xuanchen Li
- Department of NeurosurgeryMedical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐Universität DüsseldorfDüsseldorfGermany
| | - Tomoki Hashimoto
- Department of Neurosurgery and NeurobiologyBarrow Neurological InstitutePhoenixAZUSA
| | - Rokuya Tanikawa
- Department of Neurosurgery, Stroke CenterSapporo Teishinkai HospitalSapporoHokkaidoJapan
| | - Mika Niemela
- Department of NeurosurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Michael Lawton
- Department of Neurological SurgeryBarrow Neurological Institute, St. Joseph’s Hospital and Medical CenterPhoenixAZUSA
| | - Sajjad Muhammad
- Department of NeurosurgeryMedical Faculty and University Hospital Düsseldorf, Heinrich‐Heine‐Universität DüsseldorfDüsseldorfGermany
- Department of NeurosurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| |
Collapse
|
8
|
Li Z, Huang J, Yang L, Li X, Li W. WNTA5-mediated miR-374a-5p regulates vascular smooth muscle cell phenotype transformation and M1 macrophage polarization impacting intracranial aneurysm progression. Sci Rep 2024; 14:559. [PMID: 38177414 PMCID: PMC10766994 DOI: 10.1038/s41598-024-51243-z] [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: 07/13/2023] [Accepted: 01/02/2024] [Indexed: 01/06/2024] Open
Abstract
miR-374a-5p expression and localization in intracranial aneurysm (IA) tissues were detected, and its correlation with vascular smooth muscle cells (VSMCs) and macrophage markers was analyzed. Using platelet-derived growth factor-BB (PDGF-BB) induced VSMC model, elastase-induced IA rat model. Subsequently, miR-374a-5p was knocked down or overexpressed. We investigated the effects of miR-374a-5p on phenotypic conversion, and in vivo experiments were also carried out to verify the findings. The targeted relationship between miR-374a-5p and WNTA5 was analyzed. The effect of WNT5A inhibition on VSMC phenotypic transformation and THP-1-derived macrophage polarization was explored. Clinical studies have shown that miR-374a-5p was upregulated in IA patients. miR-374a-5p was negatively correlated with SM22α, α-SMA, CD206, and positively correlated with CD86. In vitro experiments showed that knocking down miR-374a-5p reversed the promotion of SM22α and α-SMA expression by PDGF-BB, while overexpression of miR-374a-5p had the opposite effect. In addition, knocking down miR-374a-5p also reversed the decrease in Calponin, TIMP3, TIMP4, and IL-10 levels caused by PDGF-BB, and further reduced the levels of MMP1, MMP3, MMP9, IL-1β, IL-6, and TNF-α. These findings were further validated in vivo. In IA rats, there were notable increases in both systolic and diastolic blood pressure, along with an elevated M1/M2 ratio and the occurrence of vascular lesions. However, these symptoms were improved after knocking down miR-374a-5p. Furthermore, miR-374a-5p could target the WNT signals (WNT2B, WNT3, and WNT5A). miR-374a-5p regulated the VSMC phenotypic conversion and M1 macrophage polarization by targeting WNT5A, thereby impacting the progression of IA.
Collapse
Affiliation(s)
- Zengshi Li
- Department of Neurosurgery, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Junqiang Huang
- Department of Neurosurgery, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Lijian Yang
- Department of Neurosurgery, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Xi Li
- Department of Neurosurgery, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China
| | - Wei Li
- Department of Neurosurgery, The Affiliated Changsha Hospital of Xiangya School of Medicine, Central South University, Changsha, China.
| |
Collapse
|
9
|
Patel D, Dodd WS, Lucke‐Wold B, Chowdhury MAB, Hosaka K, Hoh BL. Neutrophils: Novel Contributors to Estrogen-Dependent Intracranial Aneurysm Rupture Via Neutrophil Extracellular Traps. J Am Heart Assoc 2023; 12:e029917. [PMID: 37889179 PMCID: PMC10727420 DOI: 10.1161/jaha.123.029917] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 08/22/2023] [Indexed: 10/28/2023]
Abstract
Background Intracranial aneurysms (IAs) are more prevalent in women than men, and aneurysmal subarachnoid hemorrhage disproportionately affects postmenopausal women. These sex differences suggest estrogen protects against IA progression that can lead to rupture, but the underlying mechanisms are not fully understood. Although studies have demonstrated estrogen regulates inflammatory processes that contribute to IA pathogenesis, the role of neutrophils remains to be characterized. Using a murine model, we tested our hypothesis that neutrophils contribute to IA pathophysiology in an estrogen-dependent manner. Methods and Results We compared neutrophil infiltration in C57BL/6 female mice that develop IAs to those with a normal circle of Willis. Next, we investigated the estrogen-dependent role of neutrophils in IA formation, rupture, and symptom-free survival using a neutrophil depletion antibody. Finally, we studied the role of neutrophil extracellular trap formation (NETosis) as an underlying mechanism of aneurysm progression. Mice that developed aneurysms had increased neutrophil infiltration compared with those with a normal circle of Willis. In estrogen-deficient female mice, both neutrophil depletion and NETosis inhibition decreased aneurysm rupture. In estrogen-deficient female mice treated with estrogen rescue and estrogen-intact female mice, neither neutrophil depletion nor NETosis inhibition affected IA formation, rupture, or symptom-free survival. Conclusions Neutrophils contribute to aneurysm rupture in an estrogen-dependent manner. NETosis appears to be an underlying mechanism for neutrophil-mediated IA rupture in estrogen deficiency. Targeting NETosis may lead to the development of novel therapeutics to protect against IA rupture in the setting of estrogen deficiency.
Collapse
Affiliation(s)
- Devan Patel
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| | - William S. Dodd
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| | | | | | - Koji Hosaka
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| | - Brian L. Hoh
- Department of NeurosurgeryUniversity of FloridaGainesvilleFLUSA
| |
Collapse
|
10
|
Deng B, Liao F, Liu Y, He P, Wei S, Liu C, Dong W. Comprehensive analysis of endoplasmic reticulum stress-associated genes signature of ulcerative colitis. Front Immunol 2023; 14:1158648. [PMID: 37287987 PMCID: PMC10243217 DOI: 10.3389/fimmu.2023.1158648] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/04/2023] [Indexed: 06/09/2023] Open
Abstract
Background Endoplasmic reticulum stress (ERS) is a critical factor in the development of ulcerative colitis (UC); however, the underlying molecular mechanisms remain unclear. This study aims to identify pivotal molecular mechanisms related to ERS in UC pathogenesis and provide novel therapeutic targets for UC. Methods Colon tissue gene expression profiles and clinical information of UC patients and healthy controls were obtained from the Gene Expression Omnibus (GEO) database, and the ERS-related gene set was downloaded from GeneCards for analysis. Weighted gene co-expression network analysis (WGCNA) and differential expression analysis were utilized to identify pivotal modules and genes associated with UC. A consensus clustering algorithm was used to classify UC patients. The CIBERSORT algorithm was employed to evaluate the immune cell infiltration. Gene Set Variation Analysis (GSVA), Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) were used to explore potential biological mechanisms. The external sets were used to validate and identify the relationship of ERS-related genes with biologics. Small molecule compounds were predicted using the Connectivity Map (CMap) database. Molecular docking was performed to simulate the binding conformation of small molecule compounds and key targets. Results The study identified 915 differentially expressed genes (DEGs) and 11 ERS-related genes (ERSRGs) from the colonic mucosa of UC patients and healthy controls, and these genes had good diagnostic value and were highly correlated. Five potential small-molecule drugs sharing tubulin inhibitors were identified, including albendazole, fenbendazole, flubendazole, griseofulvin, and noscapine, among which noscapine exhibited the highest correlation with a high binding affinity to the targets. Active UC and 10 ERSRGs were associated with a large number of immune cells, and ERS was also associated with colon mucosal invasion of active UC. Significant differences in gene expression patterns and immune cell infiltration abundance were observed among ERS-related subtypes. Conclusion The results suggest that ERS plays a vital role in UC pathogenesis, and noscapine may be a promising therapeutic agent for UC by affecting ERS.
Collapse
Affiliation(s)
- Beiying Deng
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Fei Liao
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yinghui Liu
- Department of Geriatric, Renmin Hospital of Wuhan University, Wuhan, China
| | - Pengzhan He
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Shuchun Wei
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chuan Liu
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Weiguo Dong
- Department of Gastroenterology, Renmin Hospital of Wuhan University, Wuhan, China
| |
Collapse
|
11
|
Lebas H, Boutigny A, Maupu C, Salfati J, Orset C, Mazighi M, Bonnin P, Boulaftali Y. Imaging Cerebral Arteries Tortuosity and Velocities by Transcranial Doppler Ultrasound Is a Reliable Assessment of Brain Aneurysm in Mouse Models. STROKE (HOBOKEN, N.J.) 2023; 3:e000476. [PMID: 37496732 PMCID: PMC10368188 DOI: 10.1161/svin.122.000476] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 10/11/2022] [Accepted: 10/28/2022] [Indexed: 07/28/2023]
Abstract
Background During the past few decades, several pathophysiological processes contributing to intracranial aneurysm (IA) rupture have been identified, including irregular IA shape, altered hemodynamic stress within the IA, and vessel wall inflammation. The use of preclinical models of IA and imaging tools is paramount to better understand the underlying disease mechanisms. Methods We used 2 established mouse models of IA, and we analyzed the progression of the IA by magnetic resonance imaging, transcranial Doppler, and histology. Results In both models of IA, we observed, by transcranial Doppler, a significant decrease of the blood velocities and wall shear stress of the internal carotid arteries. We also observed the formation of tortuous arteries in both models that were correlated with the presence of an aneurysm as confirmed by magnetic resonance imaging and histology. A high grade of tortuosity is associated with a significant decrease of the mean blood flow velocities and a greater artery dilation. Conclusions Transcranial Doppler is a robust and convenient imaging method to evaluate the progression of IA. Detection of decreased blood flow velocities and increased tortuosity can be used as reliable indicators of IA.
Collapse
Affiliation(s)
- Héloïse Lebas
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| | - Alexandre Boutigny
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
- Service de Physiologie Clinique Explorations FonctionnellesAP‐HPHôpital Lariboisière–F WidalParisFrance
| | - Clémence Maupu
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| | - Jonas Salfati
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| | - Cyrille Orset
- UMR‐S U1237 “Physiopathology and Imaging of Neurological Disorders,”Centre CYCERONCaenFrance
| | - Mikael Mazighi
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
- Département de Neuroradiologie Interventionnelle de la Fondation Rothschild et Département de NeurologieHôpital LariboisièreParisFrance
| | - Philippe Bonnin
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
- Service de Physiologie Clinique Explorations FonctionnellesAP‐HPHôpital Lariboisière–F WidalParisFrance
| | - Yacine Boulaftali
- INSERM U1148Laboratory for Vascular Translational ScienceUniversité de Paris and Université Sorbonne Paris NordParisFrance
| |
Collapse
|
12
|
Zhang Q, Liu H, Zhang M, Liu F, Liu T. Identification of co-expressed central genes and transcription factors in atherosclerosis-related intracranial aneurysm. Front Neurol 2023; 14:1055456. [PMID: 36937519 PMCID: PMC10017537 DOI: 10.3389/fneur.2023.1055456] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/06/2023] [Indexed: 03/06/2023] Open
Abstract
Background Numerous clinical studies have shown that atherosclerosis is one of the risk factors for intracranial aneurysms. Calcifications in the intracranial aneurysm walls are frequently correlated with atherosclerosis. However, the pathogenesis of atherosclerosis-related intracranial aneurysms remains unclear. This study aims to investigate this mechanism. Methods The Gene Expression Omnibus (GEO) database was used to download the gene expression profiles for atherosclerosis (GSE100927) and intracranial aneurysms (GSE75436). Following the identification of the common differentially expressed genes (DEGs) of atherosclerosis and intracranial aneurysm, the network creation of protein interactions, functional annotation, the identification of hub genes, and co-expression analysis were conducted. Thereafter, we predicted the transcription factors (TF) of hub genes and verified their expressions. Results A total of 270 common (62 downregulated and 208 upregulated) DEGs were identified for subsequent analysis. Functional analyses highlighted the significant role of phagocytosis, cytotoxicity, and T-cell receptor signaling pathways in this disease progression. Eight hub genes were identified and verified, namely, CCR5, FCGR3A, IL10RA, ITGAX, LCP2, PTPRC, TLR2, and TYROBP. Two TFs were also predicted and verified, which were IKZF1 and SPI1. Conclusion Intracranial aneurysms are correlated with atherosclerosis. We identified several hub genes for atherosclerosis-related intracranial aneurysms and explored the underlying pathogenesis. These discoveries may provide new insights for future experiments and clinical practice.
Collapse
Affiliation(s)
- Quan Zhang
- Department of Neurology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hengfang Liu
- Department of Neurology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- *Correspondence: Hengfang Liu
| | - Min Zhang
- Department of Neurology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Fang Liu
- Department of Neurology, Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Tiantian Liu
- Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| |
Collapse
|
13
|
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]
|
14
|
Coenzyme Q10 inhibits intracranial aneurysm formation and progression in a mouse model. Pediatr Res 2022; 91:839-845. [PMID: 33859365 DOI: 10.1038/s41390-021-01512-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/21/2021] [Accepted: 03/08/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND The aim of this study was to investigate the effect of coenzyme Q10 (CoQ10), a commonly used nutritional supplement, on intracranial aneurysm (IA) initiation and progression in a mouse model, as well as the mechanism. METHODS Hydrogen peroxide (H2O2) was used to treat mouse-derived vascular smooth muscle cells (VSMCs) to induce oxidative injury, followed by incubation with CoQ10. In the mouse IA model established by elastase injection, CoQ10 was orally administered at 10 mg/kg every other day for 14 days, during which the incidence of IA, rupture rate, symptom-free survival, and systolic blood pressure were recorded. RESULTS CoQ10 promoted the expression of nuclear factor erythroid 2-related factor 2 and antioxidant enzymes. In H2O2-treated VSMCs, reactive oxygen species and cell apoptosis were reduced by CoQ10. In IA mice, CoQ10 treatment decreased the rupture rate of IA, improved the symptom-free survival, and reduced systolic blood pressure. Macrophage infiltration and expression of pro-inflammatory cytokines in the cerebral arteries were mitigated by CoQ10 treatment. CONCLUSIONS CoQ10 is effective in reducing oxidative stress in VSMCs, thereby attenuating IA formation and rupture in mice. CoQ10 also alleviates inflammation and restores normal phenotypes of VSMCs in the cerebral arteries. Our data suggest that CoQ10 is a potentially effective drug for managing IA. IMPACT To investigate the effect of CoQ10, a commonly used nutritional supplement, on IA initiation and progression in a mouse model, as well as the mechanism. CoQ10 promoted the expression of Nrf2 and antioxidant enzymes. In H2O2-treated VSMCs, ROS and cell apoptosis were reduced by CoQ10. CoQ10 is effective in reducing oxidative stress in VSMCs, thereby attenuating IA formation and rupture in mice.
Collapse
|
15
|
Zhang J, Wei J, Wang Y, Xu J, Jin J. Identification and Validation of TREM2 in Intracranial Aneurysms. Genet Test Mol Biomarkers 2021; 25:646-653. [PMID: 34672769 DOI: 10.1089/gtmb.2021.0076] [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: 11/12/2022] Open
Abstract
Background: Intracranial aneurysm (IA) is a cerebrovascular disease that seriously endangers human heath and life. However, the pathogenesis of IA has not been clarified. Objective: In this study, we explored the role of the triggering receptor expressed on myeloid cells-2 (TREM2) gene to explore a novel mechanism underlying IA. Methods: First, we verified the role of the candidate gene, TREM2 in a modified mouse model of IA. Second, we verified elevated expression of TREM2 using the Gene Expression Omnibus (GEO) database (GSE54083 and GSE75436) and developed protein interaction (PPI) network analysis using the top one hundred DEGs from GSE75436 dataset. Finally, we predicted a likely mechanism by which TREM2 is involved in the pathology of IA using single-gene Gene Set Enrichment Analysis (GSEA). Results: The expression of TREM2 and inflammatory factors was significantly increased in the modified mouse IA model, and showed a positive correlation. Elevated expression of TREM2 was also found in IA patients tissues from the GSE54083 and GSE75436 data sets. PPI network analyses suggested that the DEGs were involved in a variety of inflammatory processes. The GSEA results suggest that TREM2 may participate in IA progression by regulating macrophage function. Conclusion: TREM2 is highly expressed in both human and mouse IA tissues, and may participate in IA progression by regulating macrophage function and inflammatory factor expression. The molecular mechanism of TREM2 involvement in the IA process can be further studied using our modified mouse IA model.
Collapse
Affiliation(s)
- Junhao Zhang
- Department of Pharmacology, Zhejiang University School of Medicine, Hangzhou, China
| | - Jie Wei
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yaqi Wang
- Department of Neurobiology, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| | - Jing Xu
- Department of Neurosurgery, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinghua Jin
- Department of Neurobiology, School of Brain Science and Brain Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
16
|
Patel D, Dodd WS, Motwani K, Hosaka K, Hoh BL. A Modification to a Murine Model for Intracranial Aneurysm Formation and Rupture. Cureus 2021; 13:e16250. [PMID: 34373811 PMCID: PMC8346265 DOI: 10.7759/cureus.16250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2021] [Indexed: 11/22/2022] Open
Abstract
Between 3.6% and 6.0% of the population has an intracranial aneurysm. The mechanisms underlying intracranial aneurysm formation and rupture are not fully known. Several rodent models have been developed to better understand intracranial aneurysm pathophysiology. Hypertension, hemodynamic changes, and vessel injury are all necessary for aneurysm induction; however, multiple invasive procedures may disrupt an animal’s physiology. Therefore, we hypothesized that our method for inducing hypertension could be modified to create a simpler model. We previously developed a highly reproducible murine model of intracranial aneurysm formation and rupture that involves hemodynamic changes through ligation of the left common carotid artery, vessel wall degradation using elastase and a lysyl oxidase inhibitor, and hypertension through a high-salt diet, continuous angiotensin II infusion, and right renal artery ligation. In order to create a simpler model, we sought to eliminate renal artery ligation. We assessed aneurysm formation, aneurysm rupture, and blood pressure in two separate cohorts of C57BL/6 mice: one cohort underwent our model as above, while another cohort did not receive right renal artery ligation. Our results demonstrate that intracranial aneurysm formation and rupture rates did not differ between each group. Further, the blood pressures between cohorts did not differ at various timepoints in the model. Both cohorts, however, did have a significant increase in blood pressure from baseline, suggesting that renal artery ligation is not needed for inducing hypertension. These findings demonstrate that our murine model can be modified to eliminate right renal artery ligation. Thus, we propose this modification to our murine model for studying intracranial aneurysm pathophysiology.
Collapse
Affiliation(s)
- Devan Patel
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - William S Dodd
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Kartik Motwani
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Koji Hosaka
- Department of Neurosurgery, University of Florida, Gainesville, USA
| | - Brian L Hoh
- Department of Neurosurgery, University of Florida, Gainesville, USA
| |
Collapse
|
17
|
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.
Collapse
|
18
|
Zhang W, Zhao W, Ge C, Li X, Sun Z. Scopoletin Attenuates Intracerebral Hemorrhage-Induced Brain Injury and Improves Neurological Performance in Rats. Neuroimmunomodulation 2021; 28:74-81. [PMID: 33744895 DOI: 10.1159/000505731] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 01/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Among the hypertension-related complications, the onset of intracerebral hemorrhage (ICH) is a destructive stage and is the most disabling type of stroke that has the highest death rate. At present, there is no promising treatment for ICH. OBJECTIVES The present investigation was aimed at evaluating the safeguarding effect of scopoletin against ICH-induced brain injury. METHODS We used Wistar male rats and divided them into 4 groups. Group 1 served as control, group 2 was induced with ICH, group 3 served as scopoletin-pretreated ICH rats, and group 4 as scopoletin drug control. During the experimental period, neurobehavioral outcome, cerebral edema, and neuroinflammation parameters were evaluated using RT-PCR and other biochemical analyses. RESULTS The rats that received scopoletin treatment demonstrated a significant attenuation in neurological deficits, neurodegeneration markers expression (TREM-1, SERPINE-1), and restored cerebral edema compared to ICH animals. On the other hand, an upsurge in inflammatory cytokines, for example, TNF-α, IL-13, IL-1β, and IL-17, was observed in ICH rats and was reduced to the level near normalcy in the scopoletin-treated groups. CONCLUSION Our investigations propose that the effectiveness of scopoletin in improving acute neurological function after ICH is promising, and this could be a lead molecule for the development of treatment plans in ICH treatment.
Collapse
Affiliation(s)
- Wanzeng Zhang
- Department of Neurosurgery, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui City, China
| | - Wangmiao Zhao
- Department of Neurosurgery, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui City, China
| | - Chunyan Ge
- Department of Neurosurgery, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui City, China
| | - Xiaowei Li
- Department of Neurosurgery, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui City, China
| | - Zhaosheng Sun
- Department of Neurosurgery, Harrison International Peace Hospital Affiliated to Hebei Medical University, Hengshui City, China,
| |
Collapse
|
19
|
Wang J, Wei L, Lu H, Zhu Y. Roles of inflammation in the natural history of intracranial saccular aneurysms. J Neurol Sci 2020; 424:117294. [PMID: 33799211 DOI: 10.1016/j.jns.2020.117294] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 12/15/2020] [Accepted: 12/23/2020] [Indexed: 12/18/2022]
Abstract
Aneurysmal subarachnoid hemorrhage is caused by intracranial aneurysm (IA) rupture and results in high rates of mortality and morbidity. Factors contributing to IA generation, growth and rupture can involve genetics, injury, hemodynamics, environmental factors, and inflammation, in which inflammatory factors are believed to play central roles in the whole natural history. Inflammatory reactions that contribute to IA development may involve synthesis of many functional proteins and expression of genes induced by changes of blood flow, external stimuli such as smoking, internal balance such as hormonal status changes, and blood pressure. Meanwhile, inflammatory reactions itself can evoke inflammatory cytokines release and aggregation such as MMPs, MCP-1, TNF-α and ZO-1, directly or indirectly promoting aneurysm growth and rupture. However, the details of these inflammatory reactions and their action on inflammatory chemokines are still unknown. Moreover, some agents with the function of anti-inflammation, lipid-lowering, antihypertension or inflammatory factor inhibition may have the potential benefit to reduce the risk of aneurysm development or rupture in a group of population despite the underlying mechanism remains unclear. Consequently, we reviewed the potential inflammatory responses and their mechanisms contributing to aneurysm development and rupture and sought intervention targets that may prevent IA rupture or generation.
Collapse
Affiliation(s)
- Jienan Wang
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road; Shanghai 200233, China
| | - Liming Wei
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road; Shanghai 200233, China
| | - Haitao Lu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road; Shanghai 200233, China.
| | - Yueqi Zhu
- Department of Radiology, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, No. 600, Yishan Road; Shanghai 200233, China.
| |
Collapse
|
20
|
Wajima D, Hourani S, Dodd W, Patel D, Jones C, Motwani K, Fazal HZ, Hosaka K, Hoh BL. Interleukin-6 Promotes Murine Estrogen Deficiency-Associated Cerebral Aneurysm Rupture. Neurosurgery 2020; 86:583-592. [PMID: 31264696 PMCID: PMC7317988 DOI: 10.1093/neuros/nyz220] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 03/08/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Estrogen deficiency is associated with cerebral aneurysm rupture, but the precise mechanism is unknown. OBJECTIVE To test the hypothesis that IL-6 is required for the increase in aneurysm rupture rate observed in estrogen-deficient mice. METHODS We analyzed IL-6 expression in human cerebral aneurysms. We induced cerebral aneurysms in estrogen-deficient female C57BL/6 mice that had undergone 4-vinylcyclohexene diepoxide (VCD) treatment or bilateral ovariectomy (OVE). Mice were blindly randomized to selective IL-6 inhibition (IL-6 receptor [IL-6R] neutralizing antibody, n = 25) or control (isotype-matched IgG, n = 28). Murine cerebral arteries at the circle of Willis were assessed for aneurysm rupture and macrophage infiltration. RESULTS IL-6 is expressed in human cerebral aneurysms, but not in control arteries. Serum IL-6 is elevated in ovariectomized female mice compared to sham control (14.3 ± 1.7 pg/mL vs 7.4 ± 1.5 pg/mL, P = .008). Selective IL-6R inhibition suppressed cerebral aneurysm rupture in estrogen-deficient mice compared with control (VCD: 31.6% vs 70.0%, P = .026; OVE: 28.6% vs 65.2%, P = .019). IL-6R inhibition had no effect on formation or rupture rate in wild-type mice. IL-6R neutralizing antibody significantly reduced macrophage infiltration at the circle of Willis (1.9 ± 0.2 vs 5.7 ± 0.6 cells/2500 μm2; n = 8 vs n = 15; P < .001). CONCLUSION IL-6 is increased in the serum of estrogen-deficient mice and appears to play a role in promoting murine estrogen deficiency-associated cerebral aneurysm rupture via enhanced macrophage infiltration at the circle of Willis. Inhibition of IL-6 signaling via IL-6 receptor neutralizing antibody inhibits aneurysm rupture in estrogen-deficient mice. IL-6 receptor inhibition had no effect on aneurysm formation or rupture in wild-type animals.
Collapse
Affiliation(s)
- Daisuke Wajima
- Department of Neurosurgery, University of Florida, Gainesville, Florida.,Department of Neurosurgery, School of Medicine, Nara Medical University, Kashihara, Japan
| | - Siham Hourani
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - William Dodd
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Devan Patel
- College of Medicine, Florida State University, Tallahassee, Florida
| | - Chad Jones
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Kartik Motwani
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Hanain Z Fazal
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Koji Hosaka
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| | - Brian L Hoh
- Department of Neurosurgery, University of Florida, Gainesville, Florida
| |
Collapse
|
21
|
Li H, Xu H, Li Y, Jiang Y, Hu Y, Liu T, Tian X, Zhao X, Zhu Y, Wang S, Zhang C, Ge J, Wang X, Wen H, Bai C, Sun Y, Song L, Zhang Y, Hui R, Cai J, Chen J. Alterations of gut microbiota contribute to the progression of unruptured intracranial aneurysms. Nat Commun 2020; 11:3218. [PMID: 32587239 PMCID: PMC7316982 DOI: 10.1038/s41467-020-16990-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 06/04/2020] [Indexed: 12/13/2022] Open
Abstract
Unruptured intracranial aneurysm (UIA) is a life-threatening cerebrovascular condition. Whether changes in gut microbial composition participate in the development of UIAs remains largely unknown. We perform a case-control metagenome-wide association study in two cohorts of Chinese UIA patients and control individuals and mice that receive fecal transplants from human donors. After fecal transplantation, the UIA microbiota is sufficient to induce UIAs in mice. We identify UIA-associated gut microbial species link to changes in circulating taurine. Specifically, the abundance of Hungatella hathewayi is markedly decreased and positively correlated with the circulating taurine concentration in both humans and mice. Consistently, gavage with H. hathewayi normalizes the taurine levels in serum and protects mice against the formation and rupture of intracranial aneurysms. Taurine supplementation also reverses the progression of intracranial aneurysms. Our findings provide insights into a potential role of H. hathewayi-associated taurine depletion as a key factor in the pathogenesis of UIAs. Unruptured intracranial aneurysm (UIA) is a life-threatening cerebrovascular condition. Here the authors report altered gut microbiota including low abundance of Hungatella hathewayi in patients with UIAs, and show that supplementation with Hungatella hathewayi or the metabolite taurine prevents UIAs in mice.
Collapse
Affiliation(s)
- Hao Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Haochen Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Youxiang Li
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Yuhua Jiang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China
| | - Yamin Hu
- Department of Cardiology, Cangzhou Central Hospital, Cangzhou, 061000, China
| | - Tingting Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xueqing Tian
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xihai Zhao
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Yandong Zhu
- Department of Biomedical Engineering, School of Medicine, Tsinghua University, Beijing, 100084, China
| | - Shuxia Wang
- Chinese PLA General Hospital and Chinese PLA Medical College, Beijing, 100853, China
| | - Chunrui Zhang
- Novogene Bioinformatics Institute, Beijing, 100083, China
| | - Jing Ge
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Xuliang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Hongyan Wen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Congxia Bai
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Yingying Sun
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Li Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Yinhui Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Rutai Hui
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Jun Cai
- Hypertension Center, Fuwai Hospital, State Key Laboratory of Cardiovascular Disease of China, National Center for Cardiovascular Diseases of China, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Jingzhou Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China.
| |
Collapse
|
22
|
Li S, Shi Y, Liu P, Song Y, Liu Y, Ying L, Quan K, Yu G, Fan Z, Zhu W. Metformin inhibits intracranial aneurysm formation and progression by regulating vascular smooth muscle cell phenotype switching via the AMPK/ACC pathway. J Neuroinflammation 2020; 17:191. [PMID: 32546267 PMCID: PMC7298751 DOI: 10.1186/s12974-020-01868-4] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/07/2020] [Indexed: 01/07/2023] Open
Abstract
Background The regulation of vascular smooth muscle cell (VSMC) phenotype plays an important role in intracranial aneurysm (IA) formation and progression. However, the underlying mechanism remains unclear. Metformin is a 5′ AMP-activated protein kinase (AMPK) agonist that has a protective effect on vasculature. The present study investigated whether metformin modulates VSMC phenotype switching via the AMPK/acetyl-CoA carboxylase (ACC) pathway during IA pathogenesis. Methods Adult male Sprague-Dawley rats (n = 80) were used to establish an elastase-induced IA model. The effects of metformin on AMPK activation and VSMC phenotype modulation were examined. We also established a platelet-derived growth factor (PDGF)-BB-induced VSMC model and analyzed changes in phenotype including proliferation, migration, and apoptosis as well as AMPK/ACC axis activation under different doses of metformin, AMPK antagonist, ACC antagonist, and their combinations. Results Metformin decreased the incidence and rupture rate of IA in the rat model and induced a switch in VSMC phenotype from contractile to synthetic through activation of the AMPK/ACC pathway, as evidenced by upregulation of VSMC-specific genes and decreased levels of pro-inflammatory cytokines. AMPK/ACC axis activation inhibited the proliferation, migration, and apoptosis of VSMCs, in which phenotypic switching was induced by PDGF-BB. Conclusions Metformin protects against IA formation and rupture by inhibiting VSMC phenotype switching and proliferation, migration, and apoptosis. Thus, metformin has therapeutic potential for the prevention of IA.
Collapse
Affiliation(s)
- Sichen Li
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Yuan Shi
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Peixi Liu
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Yaying Song
- Department of Neurology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, No. 160 Pujian Rd, Shanghai, 200025, People's Republic of China.,Neuroscience and Neuroengineering Research Center, Med-X Research Institute and School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Yingjun Liu
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Lingwen Ying
- Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, People's Republic of China
| | - Kai Quan
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Guo Yu
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Zhiyuan Fan
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China.,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China
| | - Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, 12 Wulumuqi Road Middle, Shanghai, 200040, People's Republic of China. .,Neurosurgical Institute of Fudan University, Shanghai, People's Republic of China.
| |
Collapse
|
23
|
Low Serum Uric Acid Levels Promote Hypertensive Intracerebral Hemorrhage by Disrupting the Smooth Muscle Cell-Elastin Contractile Unit and Upregulating the Erk1/2-MMP Axis. Transl Stroke Res 2020; 11:1077-1094. [PMID: 32323149 DOI: 10.1007/s12975-020-00791-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 02/07/2020] [Accepted: 02/12/2020] [Indexed: 01/02/2023]
Abstract
Intracerebral hemorrhage (ICH) is a catastrophic stroke with high mortality, and the mechanism underlying ICH is largely unknown. Previous studies have shown that high serum uric acid (SUA) levels are an independent risk factor for hypertension, cardiovascular disease (CVD), and ischemic stroke. However, our metabolomics data showed that SUA levels were lower in recurrent intracerebral hemorrhage (R-ICH) patients than in ICH patients, indicating that lower SUA might contribute to ICH. In this study, we confirmed the association between low SUA levels and the risk for recurrence of ICH and for cardiac-cerebral vascular mortality in hypertensive patients. To determine the mechanism by which low SUA effects ICH pathogenesis, we developed the first low SUA mouse model and conducted transcriptome profiling of the cerebrovasculature of ICH mice. When combining these assessments with pathological morphology, we found that low SUA levels led to ICH in mice with angiotensin II (Ang II)-induced hypertension and aggravated the pathological progression of ICH. In vitro, our results showed that p-Erk1/2-MMP axis were involved in the low UA-induce degradation of elastin, and that physiological concentrations of UA and p-Erk1/2-specific inhibitor exerted a protective role. This is the first report describing to the disruption of the smooth muscle cell (SMC)-elastin contractile units in ICH. Most importantly, we revealed that the upregulation of the p-Erk1/2-MMP axis, which promotes the degradation of elastin, plays a vital role in mediating low SUA levels to exacerbate cerebrovascular rupture during the ICH process.
Collapse
|
24
|
Preclinical Intracranial Aneurysm Models: A Systematic Review. Brain Sci 2020; 10:brainsci10030134. [PMID: 32120907 PMCID: PMC7139747 DOI: 10.3390/brainsci10030134] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/21/2020] [Accepted: 02/23/2020] [Indexed: 12/30/2022] Open
Abstract
Intracranial aneurysms (IA) are characterized by weakened cerebral vessel walls that may lead to rupture and subarachnoid hemorrhage. The mechanisms behind their formation and progression are yet unclear and warrant preclinical studies. This systematic review aims to provide a comprehensive, systematic overview of available animal models for the study of IA pathobiology. We conducted a systematic literature search using the PubMed database to identify preclinical studies employing IA animal models. Suitable articles were selected based on predefined eligibility criteria following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Included studies were reviewed and categorized according to the experimental animal and aneurysm model. Of 4266 returned results, 3930 articles were excluded based on the title and/or abstract and further articles after screening the full text, leaving 123 studies for detailed analysis. A total of 20 different models were found in rats (nine), mice (five), rabbits (four), and dogs (two). Rat models constituted the most frequently employed intracranial experimental aneurysm model (79 studies), followed by mice (31 studies), rabbits (12 studies), and two studies in dogs. The most common techniques to induce cerebral aneurysms were surgical ligation of the common carotid artery with subsequent induction of hypertension by ligation of the renal arteries, followed by elastase-induced creation of IAs in combination with corticosterone- or angiotensin-induced hypertension. This review provides a comprehensive summary of the multitude of available IA models to study various aspects of aneurysm formation, growth, and rupture. It will serve as a useful reference for researchers by facilitating the selection of the most appropriate model and technique to answer their scientific question.
Collapse
|
25
|
Suzuki T, Takizawa T, Kamio Y, Qin T, Hashimoto T, Fujii Y, Murayama Y, Patel AB, Ayata C. Noninvasive Vagus Nerve Stimulation Prevents Ruptures and Improves Outcomes in a Model of Intracranial Aneurysm in Mice. Stroke 2020; 50:1216-1223. [PMID: 30943885 DOI: 10.1161/strokeaha.118.023928] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background and Purpose- Inflammation is a critical determinant of aneurysmal wall destabilization, growth, and rupture risk. Targeting inflammation may suppress aneurysm rupture. Vagus nerve stimulation (VNS) has been shown to suppress inflammation both systemically and in the central nervous system. Therefore, we tested the effect of a novel noninvasive transcutaneous VNS approach on aneurysm rupture and outcome in a mouse model of intracranial aneurysm formation with wall inflammation. Methods- Aneurysms were induced by a single stereotaxic injection of elastase into the cerebrospinal fluid at the skull base, combined with systemic deoxycorticosterone-salt hypertension, without or with high-salt diet, for mild or severe outcomes, respectively. Cervical VNS (two 2-minute stimulations 5 minutes apart) was delivered once a day starting from the day after elastase injection for the duration of follow-up. Transcutaneous stimulation of the femoral nerve (FNS) served as control. Multiple aneurysms developed in the circle of Willis and its major branches, resulting in spontaneous ruptures and subarachnoid hemorrhage, neurological deficits, and mortality. Results- In the milder model, VNS significantly reduced aneurysm rupture rate compared with FNS (29% versus 80%, respectively). Subarachnoid hemorrhage grades were also lower in the VNS group. In the more severe model, both VNS and FNS arms developed very high rupture rates (77% and 85%, respectively). However, VNS significantly improved the survival rate compared with FNS after rupture (median survival 13 versus 6 days, respectively), without diminishing the subarachnoid hemorrhage grades. Chronic daily VNS reduced MMP-9 (matrix metalloproteinase-9) expression compared with FNS, providing a potential mechanism of action. As an important control, chronic daily VNS did not alter systemic arterial blood pressure compared with FNS. Conclusions- VNS can reduce aneurysm rupture rates and improve the outcome from ruptured aneurysms.
Collapse
Affiliation(s)
- Tomoaki Suzuki
- From the Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.S., T.T., T.Q., C.A.).,Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan (T.S., Y.M.).,Department of Neurosurgery, Brain Research Institute, Niigata University, Japan (T.S., Y.F.)
| | - Tsubasa Takizawa
- From the Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.S., T.T., T.Q., C.A.)
| | - Yoshinobu Kamio
- Departments of Anesthesia and Perioperative Care, University of California, San Francisco (Y.K.)
| | - Tao Qin
- From the Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.S., T.T., T.Q., C.A.)
| | - Tomoki Hashimoto
- Department of Neurosurgery and Neurobiology, Barrow Neurological Institute, Phoenix, AZ (T.H.)
| | - Yukihiko Fujii
- Department of Neurosurgery, Brain Research Institute, Niigata University, Japan (T.S., Y.F.)
| | - Yuichi Murayama
- Department of Neurosurgery, Jikei University School of Medicine, Tokyo, Japan (T.S., Y.M.)
| | - Aman B Patel
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston (A.B.P.)
| | - Cenk Ayata
- From the Neurovascular Research Laboratory, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown (T.S., T.T., T.Q., C.A.).,Stroke Service, Department of Neurology, Massachusetts General Hospital, Boston (C.A.)
| |
Collapse
|
26
|
Lerman LO, Kurtz TW, Touyz RM, Ellison DH, Chade AR, Crowley SD, Mattson DL, Mullins JJ, Osborn J, Eirin A, Reckelhoff JF, Iadecola C, Coffman TM. Animal Models of Hypertension: A Scientific Statement From the American Heart Association. Hypertension 2019; 73:e87-e120. [PMID: 30866654 DOI: 10.1161/hyp.0000000000000090] [Citation(s) in RCA: 171] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Hypertension is the most common chronic disease in the world, yet the precise cause of elevated blood pressure often cannot be determined. Animal models have been useful for unraveling the pathogenesis of hypertension and for testing novel therapeutic strategies. The utility of animal models for improving the understanding of the pathogenesis, prevention, and treatment of hypertension and its comorbidities depends on their validity for representing human forms of hypertension, including responses to therapy, and on the quality of studies in those models (such as reproducibility and experimental design). Important unmet needs in this field include the development of models that mimic the discrete hypertensive syndromes that now populate the clinic, resolution of ongoing controversies in the pathogenesis of hypertension, and the development of new avenues for preventing and treating hypertension and its complications. Animal models may indeed be useful for addressing these unmet needs.
Collapse
|
27
|
Thompson JW, Elwardany O, McCarthy DJ, Sheinberg DL, Alvarez CM, Nada A, Snelling BM, Chen SH, Sur S, Starke RM. In vivo cerebral aneurysm models. Neurosurg Focus 2019; 47:E20. [DOI: 10.3171/2019.4.focus19219] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 04/09/2019] [Indexed: 11/06/2022]
Abstract
Cerebral aneurysm rupture is a devastating event resulting in subarachnoid hemorrhage and is associated with significant morbidity and death. Up to 50% of individuals do not survive aneurysm rupture, with the majority of survivors suffering some degree of neurological deficit. Therefore, prior to aneurysm rupture, a large number of diagnosed patients are treated either microsurgically via clipping or endovascularly to prevent aneurysm filling. With the advancement of endovascular surgical techniques and devices, endovascular treatment of cerebral aneurysms is becoming the first-line therapy at many hospitals. Despite this fact, a large number of endovascularly treated patients will have aneurysm recanalization and progression and will require retreatment. The lack of approved pharmacological interventions for cerebral aneurysms and the need for retreatment have led to a growing interest in understanding the molecular, cellular, and physiological determinants of cerebral aneurysm pathogenesis, maturation, and rupture. To this end, the use of animal cerebral aneurysm models has contributed significantly to our current understanding of cerebral aneurysm biology and to the development of and training in endovascular devices. This review summarizes the small and large animal models of cerebral aneurysm that are being used to explore the pathophysiology of cerebral aneurysms, as well as the development of novel endovascular devices for aneurysm treatment.
Collapse
Affiliation(s)
- John W. Thompson
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Omar Elwardany
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - David J. McCarthy
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Dallas L. Sheinberg
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Carlos M. Alvarez
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Ahmed Nada
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Brian M. Snelling
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
- 4Marcus Neuroscience Institute, Boca Raton Regional Hospital, Boca Raton, Florida
| | - Stephanie H. Chen
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Samir Sur
- Departments of 1Neurological Surgery and
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| | - Robert M. Starke
- Departments of 1Neurological Surgery and
- 2Radiology, University of Miami
- 3The University of Miami Cerebrovascular Initiative, University of Miami; and
| |
Collapse
|
28
|
Ma J, Hou D, Wei Z, Zhu J, Lu H, Li Z, Wang X, Li Y, Qiao G, Liu N. Tanshinone IIA attenuates cerebral aneurysm formation by inhibiting the NF‑κB‑mediated inflammatory response. Mol Med Rep 2019; 20:1621-1628. [PMID: 31257487 PMCID: PMC6625418 DOI: 10.3892/mmr.2019.10407] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 05/24/2019] [Indexed: 11/05/2022] Open
Abstract
The inflammatory response plays a vital role in cerebral aneurysm (CA) formation and progression. Tanshinone IIA (Tan IIA) is one of the major active components of Chinese medicine Danshen (Salvia miltiorrhiza Bunge) and is widely used for the treatment of cardiovascular diseases, due to its anti‑inflammatory effects. The aim of the present study was to investigate whether Tan IIA can attenuate CA formation in rat models, and determine its underlying mechanisms. CAs were induced in rats surgically and through high‑salt diet treatments. The Tan IIA‑treated group displayed relatively mild symptoms, as compared with the control group. Tan IIA treatment reduced macrophage infiltration and nuclear factor (NF)‑κB activation in aneurysmal walls. Next, lipopolysaccharide (LPS)‑stimulated RAW 264.7 murine macrophage cells were used to examine the anti‑inflammatory effects of Tan IIA on macrophages. It was found that Tan IIA reversed LPS‑induced differentiation of RAW 264.7 cells and suppressed NF‑κB pathway activation. In conclusion, these findings demonstrated that Tan IIA can suppress CA formation by inhibiting inflammatory responses in macrophages.
Collapse
Affiliation(s)
- Jun Ma
- Department of Neurosurgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Daorong Hou
- Key Laboratory of the Model Animal Research, Animal Core Facility of Nanjing Medical University, Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Zhiqing Wei
- Department of Vascular Surgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jianguo Zhu
- Department of Radiology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Hua Lu
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Zheng Li
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Xiefeng Wang
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yingbin Li
- Department of Neurosurgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Guanqun Qiao
- Department of Neurosurgery, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Ning Liu
- Department of Neurosurgery, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| |
Collapse
|
29
|
Quan K, Li S, Wang D, Shi Y, Yang Z, Song J, Tian Y, Liu Y, Fan Z, Zhu W. Berberine Attenuates Macrophages Infiltration in Intracranial Aneurysms Potentially Through FAK/Grp78/UPR Axis. Front Pharmacol 2018; 9:565. [PMID: 29899701 PMCID: PMC5988844 DOI: 10.3389/fphar.2018.00565] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 05/11/2018] [Indexed: 01/09/2023] Open
Abstract
Background: Inflammatory cells, such as macrophages, play key roles in the pathogenesis of intracranial aneurysms (IAs). Berberine (BBR), an active component of a Chinese herb Coptis chinensis French, has been shown to have anti-inflammatory properties through suppressing macrophage migration in various inflammation animal model. The goal of this study was to examine BBR’s effect on inflammation and IAs formation in a rodent aneurysm model. Methods and Results: Human aneurysm tissues were collected by microsurgical clipping and immunostained for phospho-Focal adhesion kinase (FAK) and CD68+ macrophages. A rodent aneurysm model was induced in 5-week-old male Sprague Dawley (SD) rats by intracranial surgery, then these rats were orally administrated 200 mg/kg/day BBR for 35 days. Immunostaining data showed that BBR inhibited CD68+ macrophages accumulation in IAs tissues and suppressed FAK phosphorylation. In lipopolysaccharide (LPS)-stimulated RAW264.7 cells, BBR treatment remarkably attenuated macrophages infiltration, suppressed the expression of matrix metalloproteinases (MMPs), and reduced proinflammatory cytokine secretion, including MCP-1, interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumor necrosis factor-a (TNF-α). Mechanistically, BBR downregulated FAK/Grp78/Unfolded Protein Response (UPR) signaling pathway in RAW264.7 cells. Conclusion: BBR prevents IAs formation potentially through inhibiting FAK phosphorylation and inactivating UPR pathway in macrophages, which causes less macrophage infiltration and reduced proinflammatory cytokine release.
Collapse
Affiliation(s)
- Kai Quan
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Sichen Li
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Dongdong Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yuan Shi
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zixiao Yang
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianping Song
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanlong Tian
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yingjun Liu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhiyuan Fan
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
30
|
Hoh BL, Rojas K, Lin L, Fazal HZ, Hourani S, Nowicki KW, Schneider MB, Hosaka K. Estrogen Deficiency Promotes Cerebral Aneurysm Rupture by Upregulation of Th17 Cells and Interleukin-17A Which Downregulates E-Cadherin. J Am Heart Assoc 2018; 7:JAHA.118.008863. [PMID: 29654199 PMCID: PMC6015422 DOI: 10.1161/jaha.118.008863] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Estrogen deficiency is associated with the development of cerebral aneurysms; however, the mechanism remains unknown. We explored the pathway of cerebral aneurysm development by investigating the potential link between estrogen deficiency and inflammatory factors. METHODS AND RESULTS First, we established the role of interleukin-17 (IL-17)A. We performed a cytokine screen demonstrating that IL-17A is significantly expressed in mouse and human aneurysms (P=0.03). Likewise, IL-17A inhibition was shown to prevent aneurysm formation by 42% (P=0.02) and rupture by 34% (P<0.05). Second, we found that estrogen deficiency upregulates T helper 17 cells and IL-17A and promotes aneurysm rupture. Estrogen-deficient mice had more ruptures than control mice (47% versus 7%; P=0.04). Estradiol supplementation or IL-17A inhibition decreased the number of ruptures in estrogen-deficient mice (estradiol 6% versus 37%; P=0.04; IL-17A inhibition 18% versus 47%; P=0.018). Third, we found that IL-17A-blockade protects against aneurysm formation and rupture by increased E-cadherin expression. IL-17-inhibited mice had increased E-cadherin expression (P=0.003). E-cadherin inhibition reversed the protective effect of IL-17A inhibition and increased the rate of aneurysm formation (65% versus 28%; P=0.04) and rupture (12% versus 0%; P=0.22). However, E-cadherin inhibition alone does not significantly increase aneurysm formation in normal mice or in estrogen-deficient mice. In cell migration assays, E-cadherin inhibition promoted macrophage infiltration across endothelial cells (P<0.05), which may be the mechanism for the estrogen deficiency/IL-17/E-cadherin aneurysm pathway. CONCLUSIONS Our data suggest that estrogen deficiency promotes cerebral aneurysm rupture by upregulating IL-17A, which downregulates E-cadherin, encouraging macrophage infiltration in the aneurysm vessel wall.
Collapse
Affiliation(s)
- Brian L Hoh
- Department of Neurosurgery, University of Florida, Gainesville, FL
| | - Kelley Rojas
- Department of Neurosurgery, University of Florida, Gainesville, FL
| | - Li Lin
- Department of Neurosurgery, University of Florida, Gainesville, FL
| | - Hanain Z Fazal
- Department of Neurosurgery, University of Florida, Gainesville, FL
| | - Siham Hourani
- Department of Neurosurgery, University of Florida, Gainesville, FL
| | - Kamil W Nowicki
- Department of Neurosurgery, University of Florida, Gainesville, FL
| | | | - Koji Hosaka
- Department of Neurosurgery, University of Florida, Gainesville, FL
| |
Collapse
|
31
|
Jiang G, Li Z, Jiang X, Li Z, Xu S, Fang X. Development of fusiform aneurysms induced by topical application of elastase in a rabbit model. Chin Neurosurg J 2017. [DOI: 10.1186/s41016-017-0093-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
32
|
Nowicki KW, Hosaka K, Walch FJ, Scott EW, Hoh BL. M1 macrophages are required for murine cerebral aneurysm formation. J Neurointerv Surg 2017; 10:93-97. [PMID: 28196918 DOI: 10.1136/neurintsurg-2016-012911] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Revised: 01/21/2017] [Accepted: 01/23/2017] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Macrophages and neutrophils have been separately implicated in cerebral aneurysm formation. The interactions between different myeloid subsets and the contributions of macrophage phenotypes in these lesions over time are not known. The purpose of the study was to examine macrophage phenotypic changes in cerebral aneurysms. METHODS We induced aneurysm formation in C57BL/6 mice and quantified contributions of M1 and M2 macrophages in aneurysm specimens with or without neutrophil blockade. In our aneurysm model, the left common carotid and right renal arteries were ligated, and mice were placed on a hypertensive high fat diet. One week later, stereotactic injection with elastase solution into the basal cisterns was performed. An angiotensin II secreting osmotic pump was implanted. The mice were then treated with anti-CXCL1 antibody or IgG control antibody. Animals were euthanized at 3 days, or 1 or 2 weeks. The circle of Willis was analyzed using immunohistochemistry for M1 and M2 macrophage phenotype contributions. RESULTS Proinflammatory M1/M2 ratio increased in cerebral aneurysm formation over time, from 0.56 at 3 days to 1.75 at 2 weeks (p<0.0001). In contrast, anti-CXCL1 antibody blockade led to polarization towards an anti-inflammatory phenotype with an M1/M2 ratio of 0.95 at 2 weeks compared with IgG treated mice (p=0.0007). CONCLUSIONS CXCL1 dependent neutrophil inflammation appears to have an important role in macrophage polarization to M1 phenotype in cerebral aneurysm development.
Collapse
Affiliation(s)
- Kamil W Nowicki
- Department of Neurosurgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Koji Hosaka
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| | - Frank J Walch
- Department of Neurosurgery, University of Colorado, Denver, Colorado, USA
| | - Edward W Scott
- Department of Molecular Genetics and Microbiology, University of Florida, Gainesville, Florida, USA
| | - Brian L Hoh
- Department of Neurosurgery, University of Florida, Gainesville, Florida, USA
| |
Collapse
|
33
|
Abstract
The cerebral arterial circle (circulus arteriosus cerebri) or circle of Willis (CoW) is a circulatory anastomosis surrounding the optic chiasma and hypothalamus that supplies blood to the brain and surrounding structures. It has been implicated in several cerebrovascular disorders, including cerebral amyloid angiopathy (CAA)-associated vasculopathies, intracranial atherosclerosis and intracranial aneurysms. Studies of the molecular mechanisms underlying these diseases for the identification of novel drug targets for their prevention require animal models. Some of these models may be transgenic, whereas others will involve isolation of the cerebro-vasculature, including the CoW.The method described here is suitable for CoW isolation in any mouse lineage and has considerable potential for screening (expression of genes, protein production, posttranslational protein modifications, secretome analysis, etc.) studies on the large vessels of the mouse cerebro-vasculature. It can also be used for ex vivo studies, by adapting the organ bath system developed for isolated mouse olfactory arteries.
Collapse
|
34
|
Jiang JL, Yue Z, Bauquier SH, Lai A, Chen Y, McLean KJ, Halliday AJ, Sui Y, Moulton S, Wallace GG, Cook MJ. Injectable phenytoin loaded polymeric microspheres for the control of temporal lobe epilepsy in rats. Restor Neurol Neurosci 2016; 33:823-34. [PMID: 26484695 DOI: 10.3233/rnn-150520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE Epilepsy is a prevalent neurological disorder with a high frequency of drug resistance. While significant advancements have been made in drug delivery systems to overcome anti-epileptic drug resistance, efficacies of materials in biological systems have been poorly studied. The purpose of the study was to evaluate the anti-epileptic effects of injectable poly(epsilon-caprolactone) (PCL) microspheres for controlled release of an anticonvulsant, phenytoin (PHT), in an animal model of epilepsy. METHODS PHT-PCL and Blank-PCL microspheres formulated using an oil-in-water (O/W) emulsion solvent evaporation method were evaluated for particle size, encapsulation efficiency, surface morphology and in-vitro drug release profile. Microspheres with the most suitable morphology and release characteristics weresubsequently injected into the hippocampus of a rat tetanus toxin model of temporal lobe epilepsy. Electrocorticography (ECoG)from the cerebral cortex were recorded for all animals. The number of seizure events, severity of seizures, and seizure duration were then compared between the two treatment groups. RESULTS We have shown that small injections of drug-loaded microspheres are biologically tolerated and released PHT can control seizures for the expected period of time that is in accord with in-vitro release data. CONCLUSION The study demonstrated the feasibility of polymer-based delivery systems incontrolling focal seizures.
Collapse
Affiliation(s)
- Jonathan L Jiang
- St Vincent's Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Zhilian Yue
- Intelligent Polymer Research Institute and ARC Centre of Excellence for Electromaterials Science, AIIM Facility, Innovation Campus, University of Wollongong, Wollongong, NSW, Australia
| | - Sebastien H Bauquier
- Faculty of Veterinary Science, University of Melbourne, 250 Princes Hwy, Werribee, VIC, Australia
| | - Alan Lai
- St Vincent's Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia
| | - Yu Chen
- Intelligent Polymer Research Institute and ARC Centre of Excellence for Electromaterials Science, AIIM Facility, Innovation Campus, University of Wollongong, Wollongong, NSW, Australia
| | - Karen J McLean
- St Vincent's Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Amy J Halliday
- St Vincent's Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia
| | - Yi Sui
- Department of Neurology, Shenyang First People's Hospital, Shenyang, Liaoning, China (PRC)
| | - Simon Moulton
- Intelligent Polymer Research Institute and ARC Centre of Excellence for Electromaterials Science, AIIM Facility, Innovation Campus, University of Wollongong, Wollongong, NSW, Australia
| | - Gordon G Wallace
- Intelligent Polymer Research Institute and ARC Centre of Excellence for Electromaterials Science, AIIM Facility, Innovation Campus, University of Wollongong, Wollongong, NSW, Australia
| | - Mark J Cook
- St Vincent's Department of Medicine, University of Melbourne, Fitzroy, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St. Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| |
Collapse
|
35
|
Lee JA, Marshman LAG, Moran CS, Kuma L, Guazzo EP, Anderson DS, Golledge J. A small animal model for early cerebral aneurysm pathology. J Clin Neurosci 2016; 34:259-263. [PMID: 27476892 DOI: 10.1016/j.jocn.2016.05.039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2016] [Accepted: 05/18/2016] [Indexed: 11/25/2022]
Abstract
Prior studies, using systemic hypertension and elastase infusion, have induced cerebral aneurysm (CA) formation in mice. However, the CAs induced were rapidly formed, relatively large, and often ruptured. These features are not completely representative of human CAs. We set out to develop a mouse model representative of the early pathological features of human CA. Twenty male C57/BL6 mice were placed in a stereotactic frame. Low dose elastase solution (2μl/min) was manually injected into the right basal cistern. Human angiotensin II (0.11μl/h) was infused subcutaneously. Mice were observed for 2-3weeks prior to euthanasia. Early CA histopathological features including endothelial change (EC) and internal elastic lamina degeneration (IELD) were systematically sought at major cerebral arterial bifurcations. Brains were harvested from 11 of 15 mice, yielding 27 bifurcations. Sub-arachnoid haemorrhage (SAH) without CA formation was observed in one brain. Macroscopic CA without SAH was observed in another brain. Early CA features were observed in 8/11 (73%) brains. All bifurcations with IELD demonstrated EC: where EC was absent, IELD was also absent. EC severity appeared to correlate with IELD severity. EC and IELD were both severe within the CA. Using lower dose elastase solution than previously employed, we developed a model of early CA pathology. Our model demonstrated that the spectrum of known early CA pathology can be created at multiple bifurcations in mice, with EC severity appearing to correlate with IELD severity. This model permits the study of factors which potentially advance or retard the progression of CA formation.
Collapse
Affiliation(s)
- James A Lee
- Department of Neurosurgery, The Townsville Hospital, 100 Angus Smith Drive, Douglas, Townsville, QLD 4814, Australia; Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD, Australia; School of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD, Australia
| | - Laurence A G Marshman
- Department of Neurosurgery, The Townsville Hospital, 100 Angus Smith Drive, Douglas, Townsville, QLD 4814, Australia; School of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD, Australia.
| | - Corey S Moran
- Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD, Australia
| | - Leslie Kuma
- Department of Pathology, The Townsville Hospital, Douglas, Townsville, QLD, Australia
| | - Eric P Guazzo
- Department of Neurosurgery, The Townsville Hospital, 100 Angus Smith Drive, Douglas, Townsville, QLD 4814, Australia; School of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD, Australia
| | - David S Anderson
- Department of Neurosurgery, The Townsville Hospital, 100 Angus Smith Drive, Douglas, Townsville, QLD 4814, Australia
| | - Jonathan Golledge
- Department of Vascular and Endovascular Surgery, The Townsville Hospital, Douglas, Townsville, QLD, Australia; Vascular Biology Unit, Queensland Research Centre for Peripheral Vascular Disease, College of Medicine and Dentistry, James Cook University, Douglas, Townsville, QLD, Australia
| |
Collapse
|
36
|
Shimada K, Furukawa H, Wada K, Wei Y, Tada Y, Kuwabara A, Shikata F, Kanematsu Y, Lawton MT, Kitazato KT, Nagahiro S, Hashimoto T. Angiotensin-(1-7) protects against the development of aneurysmal subarachnoid hemorrhage in mice. J Cereb Blood Flow Metab 2015; 35:1163-8. [PMID: 25757758 PMCID: PMC4640268 DOI: 10.1038/jcbfm.2015.30] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2014] [Revised: 01/02/2015] [Accepted: 02/02/2015] [Indexed: 11/09/2022]
Abstract
Angiotensin-(1-7) (Ang-(1-7)) can regulate vascular inflammation and remodeling, which are processes that have important roles in the pathophysiology of intracranial aneurysms. In this study, we assessed the effects of Ang-(1-7) in the development of intracranial aneurysm rupture using a mouse model of intracranial aneurysms in which aneurysmal rupture (i.e., aneurysmal subarachnoid hemorrhage) occurs spontaneously and causes neurologic symptoms. Treatment with Ang-(1-7) (0.5 mg/kg/day), Mas receptor antagonist (A779 0.5 mg/kg/day or 2.5 mg/kg/day), or angiotensin II type 2 receptor (AT2R) antagonist (PD 123319, 10 mg/kg/day) was started 6 days after aneurysm induction and continued for 2 weeks. Angiotensin-(1-7) significantly reduced the rupture rate of intracranial aneurysms without affecting the overall incidence of aneurysms. The protective effect of Ang-(1-7) was blocked by the AT2R antagonist, but not by the Mas receptor antagonist. In AT2R knockout mice, the protective effect of Ang-(1-7) was absent. While AT2R mRNA was abundantly expressed in the cerebral arteries and aneurysms, Mas receptor mRNA expression was very scarce in these tissues. Angiotensin-(1-7) reduced the expression of tumor necrosis factor-α and interleukin-1β in cerebral arteries. These findings indicate that Ang-(1-7) can protect against the development of aneurysmal rupture in an AT2R-dependent manner.
Collapse
Affiliation(s)
- Kenji Shimada
- 1] Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA [2] Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Hajime Furukawa
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Kosuke Wada
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Yuan Wei
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Yoshiteru Tada
- Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Atsushi Kuwabara
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Fumiaki Shikata
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| | - Yasuhisa Kanematsu
- Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Michael T Lawton
- Department of Neurological Surgery, University of California, San Francisco, California, USA
| | - Keiko T Kitazato
- Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Shinji Nagahiro
- Department of Neurosurgery, School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Tomoki Hashimoto
- Department of Anesthesia and Perioperative Care, University of California, San Francisco, California, USA
| |
Collapse
|
37
|
Regulation of smooth muscle contractility by competing endogenous mRNAs in intracranial aneurysms. J Neuropathol Exp Neurol 2015; 74:411-24. [PMID: 25868147 DOI: 10.1097/nen.0000000000000185] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Alterations in vascular smooth muscle cells (SMCs) contribute to the pathogenesis of intracranial aneurysms (IAs), but the genetic mechanisms underlying these alterations are unclear. We used microarray analysis to compare tissue small noncoding RNA and messenger RNA expression profiles in vessel wall samples from patients with late-stage IAs. We identified myocardin (MYOCD), a key contractility regulator of vascular SMCs, as a critical factor in IA progression. Using a multifaceted computational and experimental approach, we determined that depletion of competitive endogenous RNAs (ARHGEF12, FGF12, and ADCY5) enhanced factors that downregulate MYOCD, which induces the conversion of SMCs from differentiated contractile states into dedifferentiated phenotypes that exhibit enhanced proliferation, synthesis of new extracellular matrix, and organization of mural thrombi. These effects may lead to the repair and maintenance of IAs. This study presents guidelines for the prediction and validation of the IA regulator MYOCD in competitive endogenous RNA networks and facilitates the development of novel therapeutic and diagnostic tools for IAs.
Collapse
|
38
|
Wang Y, Emeto TI, Lee J, Marshman L, Moran C, Seto S, Golledge J. Mouse models of intracranial aneurysm. Brain Pathol 2015; 25:237-47. [PMID: 25041057 PMCID: PMC8029187 DOI: 10.1111/bpa.12175] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 07/09/2014] [Indexed: 01/04/2023] Open
Abstract
Subarachnoid hemorrhage secondary to rupture of an intracranial aneurysm is a highly lethal medical condition. Current management strategies for unruptured intracranial aneurysms involve radiological surveillance and neurosurgical or endovascular interventions. There is no pharmacological treatment available to decrease the risk of aneurysm rupture and subsequent subarachnoid hemorrhage. There is growing interest in the pathogenesis of intracranial aneurysm focused on the development of drug therapies to decrease the incidence of aneurysm rupture. The study of rodent models of intracranial aneurysms has the potential to improve our understanding of intracranial aneurysm development and progression. This review summarizes current mouse models of intact and ruptured intracranial aneurysms and discusses the relevance of these models to human intracranial aneurysms. The article also reviews the importance of these models in investigating the molecular mechanisms involved in the disease. Finally, potential pharmaceutical targets for intracranial aneurysm suggested by previous studies are discussed. Examples of potential drug targets include matrix metalloproteinases, stromal cell-derived factor-1, tumor necrosis factor-α, the renin-angiotensin system and the β-estrogen receptor. An agreed clear, precise and reproducible definition of what constitutes an aneurysm in the models would assist in their use to better understand the pathology of intracranial aneurysm and applying findings to patients.
Collapse
Affiliation(s)
- Yutang Wang
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
| | - Theophilus I. Emeto
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Discipline of Public Health and Tropical MedicineSchool of Public HealthTropical Medicine and Rehabilitation SciencesJames Cook UniversityTownsvilleQueenslandAustralia
| | - James Lee
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Department of NeurosurgeryThe Townsville HospitalTownsvilleQueenslandAustralia
| | - Laurence Marshman
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Department of NeurosurgeryThe Townsville HospitalTownsvilleQueenslandAustralia
| | - Corey Moran
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
| | - Sai‐wang Seto
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
| | - Jonathan Golledge
- The Vascular Biology UnitQueensland Research Centre for Peripheral Vascular DiseaseSchool of Medicine and DentistryJames Cook UniversityTownsvilleQueenslandAustralia
- Department of Vascular and Endovascular SurgeryThe Townsville HospitalTownsvilleQueenslandAustralia
| |
Collapse
|
39
|
Shimada K, Furukawa H, Wada K, Korai M, Wei Y, Tada Y, Kuwabara A, Shikata F, Kitazato KT, Nagahiro S, Lawton MT, Hashimoto T. Protective Role of Peroxisome Proliferator-Activated Receptor-γ in the Development of Intracranial Aneurysm Rupture. Stroke 2015; 46:1664-72. [PMID: 25931465 DOI: 10.1161/strokeaha.114.007722] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2014] [Accepted: 04/02/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND PURPOSE Inflammation is emerging as a key component of the pathophysiology of intracranial aneurysms. Peroxisome proliferator-activated receptor-γ (PPARγ) is a nuclear hormone receptor of which activation modulates various aspects of inflammation. METHODS Using a mouse model of intracranial aneurysm, we examined the potential roles of PPARγ in the development of rupture of intracranial aneurysm. RESULTS A PPARγ agonist, pioglitazone, significantly reduced the incidence of ruptured aneurysms and the rupture rate without affecting the total incidence aneurysm (unruptured aneurysms and ruptured aneurysms). PPARγ antagonist (GW9662) abolished the protective effect of pioglitazone. The protective effect of pioglitazone was absent in mice lacking macrophage PPARγ. Pioglitazone treatment reduced the mRNA levels of inflammatory cytokines (monocyte chemoattractant factor-1, interleukin-1, and interleukin-6) that are primarily produced by macrophages in the cerebral arteries. Pioglitazone treatment reduced the infiltration of M1 macrophage into the cerebral arteries and the macrophage M1/M2 ratio. Depletion of macrophages significantly reduced the rupture rate. CONCLUSIONS Our data showed that the activation of macrophage PPARγ protects against the development of aneurysmal rupture. PPARγ in inflammatory cells may be a potential therapeutic target for the prevention of aneurysmal rupture.
Collapse
Affiliation(s)
- Kenji Shimada
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Hajime Furukawa
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Kosuke Wada
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Masaaki Korai
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Yuan Wei
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Yoshiteru Tada
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Atsushi Kuwabara
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Fumiaki Shikata
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Keiko T Kitazato
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Shinji Nagahiro
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Michael T Lawton
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan
| | - Tomoki Hashimoto
- From the Departments of Anesthesia and Perioperative Care (K.S., H.F., K.W., M.K., Y.W., A.K., F.S., T.H.) and Neurological Surgery (M.T.L.), University of California, San Francisco; and Department of Neurosurgery (K.S., M.K., Y.T., K.T.K., S.N.), School of Medicine, The University of Tokushima, Tokushima City, Japan.
| |
Collapse
|
40
|
Dai D, Kadirvel R, Rezek I, Ding YH, Lingineni R, Kallmes D. Elastase-Induced Intracranial Dolichoectasia Model in Mice. Neurosurgery 2015; 76:337-43; discussion 343. [DOI: 10.1227/neu.0000000000000615] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
41
|
Nowicki KW, Hosaka K, He Y, McFetridge PS, Scott EW, Hoh BL. Novel high-throughput in vitro model for identifying hemodynamic-induced inflammatory mediators of cerebral aneurysm formation. Hypertension 2014; 64:1306-13. [PMID: 25225207 DOI: 10.1161/hypertensionaha.114.03775] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Cerebral aneurysms are thought to develop at locations of hemodynamic shear stress, via an inflammatory process. The molecular mechanism that links shear stress to inflammation, however, is not completely understood. Progress in studying this disease is limited by a lack of a suitable in vitro model. To address this, we designed novel in vitro parallel-plate flow chamber models of a straight artery, a bifurcation, and a bifurcation aneurysm. We compared endothelial cell phenotypes across the 3 different models and among microenvironments within each flow model by cytokine array, ELISA, and relative immunofluorescence. Human aneurysms express interleukin-8 and chemokine (C-X-C motif) ligand 1 (CXCL1), whereas normal arteries do not. The bifurcation aneurysm model showed significantly higher interleukin-8 and CXCL1 levels than both the straight artery and bifurcation models. Within the bifurcation and bifurcation aneurysm models, endothelial cells near the bifurcation or within the aneurysm sac microenvironments have significantly higher expression of CXCL1, and interleukin-8 and CXCL1, respectively, than at the straight proximal segment or the limbs of the bifurcation. Murine aneurysms express CXCL1, and it is the primary ELR+ CXC chemokine expressed, whereas normal arteries do not. CXCL1 antibody blockade results in significantly fewer murine aneurysms (13.3 versus 66.7%; P=0.0078), decreased neutrophil infiltration, and vascular cell adhesion molecule 1 expression than an immunoglobulin G control. We successfully designed and validated a novel hemodynamic model of cerebral aneurysms in vitro. We also show that shear stress-induced CXCL1 plays a critical role in cerebral aneurysm formation.
Collapse
Affiliation(s)
- Kamil W Nowicki
- From the Departments of Neurosurgery (K.W.N., K.H., B.L.H.), Surgery (Y.H.), Biomedical Engineering (P.S.M.), and Molecular Genetics and Microbiology (E.W.S.), University of Florida, Gainesville
| | - Koji Hosaka
- From the Departments of Neurosurgery (K.W.N., K.H., B.L.H.), Surgery (Y.H.), Biomedical Engineering (P.S.M.), and Molecular Genetics and Microbiology (E.W.S.), University of Florida, Gainesville
| | - Yong He
- From the Departments of Neurosurgery (K.W.N., K.H., B.L.H.), Surgery (Y.H.), Biomedical Engineering (P.S.M.), and Molecular Genetics and Microbiology (E.W.S.), University of Florida, Gainesville
| | - Peter S McFetridge
- From the Departments of Neurosurgery (K.W.N., K.H., B.L.H.), Surgery (Y.H.), Biomedical Engineering (P.S.M.), and Molecular Genetics and Microbiology (E.W.S.), University of Florida, Gainesville
| | - Edward W Scott
- From the Departments of Neurosurgery (K.W.N., K.H., B.L.H.), Surgery (Y.H.), Biomedical Engineering (P.S.M.), and Molecular Genetics and Microbiology (E.W.S.), University of Florida, Gainesville
| | - Brian L Hoh
- From the Departments of Neurosurgery (K.W.N., K.H., B.L.H.), Surgery (Y.H.), Biomedical Engineering (P.S.M.), and Molecular Genetics and Microbiology (E.W.S.), University of Florida, Gainesville.
| |
Collapse
|
42
|
Hosaka K, Hoh BL. Inflammation and cerebral aneurysms. Transl Stroke Res 2013; 5:190-8. [PMID: 24323732 DOI: 10.1007/s12975-013-0313-y] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Revised: 11/08/2013] [Accepted: 11/14/2013] [Indexed: 01/07/2023]
Abstract
Cerebral aneurysms (CAs) occur in up to 5% of the population in the US, and up to 7% of all strokes are caused by CA rupture. Little is known about the pathophysiology of cerebral aneurysm formation, though inflammatory cells such as macrophages and neutrophils have been found in the walls of CAs. After many studies of both human specimens and experimentally induced animal models of aneurysms, the predominant model for CA formation and progression is as follows: (1) endothelial damage and degeneration of the elastic lamina, (2) inflammatory cell recruitment and infiltration, (3) and chronic remodeling of vascular wall. Endothelial damage can be caused by changes in hemodynamic stress, which results in the upregulation of proinflammatory cytokine secretion followed by the recruitment of various inflammatory cells. This recruitment and subsequent infiltration induces smooth muscle cell proliferation, apoptosis, and remodeling of the artery wall. These complex events are thought to lead to aneurysm rupture. This review will focus on the role of the immune system in the formation and progression of saccular CA and the ways in which the immune response may be modulated to treat aneurysms and prevent rupture.
Collapse
Affiliation(s)
- Koji Hosaka
- Department of Neurosurgery, University of Florida, PO Box 100265, Gainesville, FL, 32610, USA,
| | | |
Collapse
|