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Ruscu M, Glavan D, Surugiu R, Doeppner TR, Hermann DM, Gresita A, Capitanescu B, Popa-Wagner A. Pharmacological and stem cell therapy of stroke in animal models: Do they accurately reflect the response of humans? Exp Neurol 2024; 376:114753. [PMID: 38490317 DOI: 10.1016/j.expneurol.2024.114753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/22/2024] [Accepted: 03/10/2024] [Indexed: 03/17/2024]
Abstract
Cerebrovascular diseases are the second leading cause of death worldwide. Despite significant research investment, the only available therapeutic options are mechanical thrombectomy and tissue plasminogen activator thrombolysis. None of the more than a thousand drugs tested on animal models have proven successful in human clinical trials. Several factors contribute to this poor translation of data from stroke-related animal models to human stroke patients. Firstly, our understanding of the molecular and cellular processes involved in recovering from an ischemic stroke is severely limited. Secondly, although the risk of stroke is particularly high among older patients with comorbidities, most drugs are tested on young, healthy animals in controlled laboratory conditions. Furthermore, in animal models, the tracking of post-stroke recovery typically spans only 3 to 28 days, with occasional extensions to 60 days, whereas human stroke recovery is a more extended and complex process. Thirdly, young animal models often exhibit a considerably higher rate of spontaneous recovery compared to humans following a stroke. Fourth, only a very limited number of animals are utilized for each condition, including control groups. Another contributing factor to the much smaller beneficial effects in humans is that positive outcomes from numerous animal studies are more readily accepted than results reported in human trials that do not show a clear benefit to the patient. Useful recommendations for conducting experiments in animal models, with increased chances of translatability to humans, have been issued by both the STEPS investigative team and the STAIR committee. However, largely, due to economic factors, these recommendations are largely ignored. Furthermore, one might attribute the overall failures in predicting and subsequently developing effective acute stroke therapies beyond thrombolysis to potential design deficiencies in clinical trials.
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Affiliation(s)
- Mihai Ruscu
- Department of Neurology, University Hospital Essen, Essen 45147, Germany; Department of Psychiatry, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; Department of Neurology, University of Giessen Medical School, 35392 Giessen, Germany
| | - Daniela Glavan
- Department of Psychiatry, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania
| | - Roxana Surugiu
- Department of Psychiatry, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; Department of Neurology, University Medical Center Göttingen, Göttingen 37075, Germany
| | - Thorsten R Doeppner
- Department of Neurology, University Medical Center Göttingen, Göttingen 37075, Germany; Department of Neurology, University of Giessen Medical School, 35392 Giessen, Germany
| | - Dirk M Hermann
- Department of Neurology, University Hospital Essen, Essen 45147, Germany
| | - Andrei Gresita
- Department of Biomedical Sciences, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 115680-8000, USA
| | - Bogdan Capitanescu
- Department of Psychiatry, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; Department of Biomedical Sciences, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 115680-8000, USA.
| | - Aurel Popa-Wagner
- Department of Psychiatry, University of Medicine and Pharmacy Craiova, 200349 Craiova, Romania; Department of Biomedical Sciences, New York Institute of Technology, College of Osteopathic Medicine, Old Westbury, NY 115680-8000, USA.
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Ryu WS, Schellingerhout D, Hong KS, Jeong SW, Kim BJ, Kim JT, Lee KB, Park TH, Park SS, Park JM, Kang K, Cho YJ, Park HK, Lee BC, Yu KH, Oh MS, Lee SJ, Kim JG, Cha JK, Kim DH, Lee J, Han MK, Park MS, Choi KH, Nahrendorf M, Lee J, Bae HJ, Kim DE. Relation of Pre-Stroke Aspirin Use With Cerebral Infarct Volume and Functional Outcomes. Ann Neurol 2021; 90:763-776. [PMID: 34536234 PMCID: PMC9292882 DOI: 10.1002/ana.26219] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 01/13/2023]
Abstract
Objective We investigated (1) the associations of pre‐stroke aspirin use with thrombus burden, infarct volume, hemorrhagic transformation, early neurological deterioration (END), and functional outcome, and (2) whether stroke subtypes modify these associations in first‐ever ischemic stroke. Methods This multicenter magnetic resonance imaging (MRI)‐based study included 5,700 consecutive patients with acute first‐ever ischemic stroke, who did not undergo intravenous thrombolysis or endovascular thrombectomy, from May 2011 through February 2014. Propensity score‐based augmented inverse probability weighting was performed to estimate adjusted effects of pre‐stroke aspirin use. Results The mean age was 67 years (41% women), and 15.9% (n = 907) were taking aspirin before stroke. Pre‐stroke aspirin use (vs nonuse) was significantly related to a reduced infarct volume (by 30%), particularly in large artery atherosclerosis stroke (by 45%). In cardioembolic stroke, pre‐stroke aspirin use was associated with a ~50% lower incidence of END (adjusted difference = −5.4%, 95% confidence interval [CI] = −8.9 to −1.9). Thus, pre‐stroke aspirin use was associated with ~30% higher likelihood of favorable outcome (3‐month modified Rankin Scale score < 3), particularly in large artery atherosclerosis stroke and cardioembolic stroke (adjusted difference = 7.2%, 95% CI = 1.8 to 12.5 and adjusted difference = 6.4%, 95% CI = 1.7 to 11.1, respectively). Pre‐stroke aspirin use (vs nonuse) was associated with 85% less frequent cerebral thrombus‐related susceptibility vessel sign (SVS) in large artery atherosclerosis stroke (adjusted difference = −1.4%, 95% CI = −2.1 to −0.8, p < 0.001) and was associated with ~40% lower SVS volumes, particularly in cardioembolic stroke (adjusted difference = −0.16 cm3, 95% CI = −0.29 to −0.02, p = 0.03). Moreover, pre‐stroke aspirin use was not significantly associated with hemorrhagic transformation (adjusted difference = −1.1%, p = 0.09). Interpretation Pre‐stroke aspirin use associates with improved functional independence in patients with first‐ever ischemic large arterial stroke by reducing infarct volume and/or END, likely by decreasing thrombus burden, without increased risk of hemorrhagic transformation. ANN NEUROL 2021;90:763–776
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Affiliation(s)
- Wi-Sun Ryu
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea.,National Priority Research Center for Stroke, Goyang, South Korea
| | - Dawid Schellingerhout
- Departments of Radiology and Cancer Systems Imaging, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Keun-Sik Hong
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang
| | - Sang-Wuk Jeong
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea
| | - Beom Joon Kim
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Joon-Tae Kim
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Kyung Bok Lee
- Department of Neurology, Soonchunhyang University Hospital, Seoul, South Korea
| | - Tai Hwan Park
- Department of Neurology, Seoul Medical Center, Seoul, South Korea
| | - Sang-Soon Park
- Department of Neurology, Seoul Medical Center, Seoul, South Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, South Korea
| | - Kyusik Kang
- Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Daejeon, South Korea
| | - Yong-Jin Cho
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang
| | - Hong-Kyun Park
- Department of Neurology, Inje University Ilsan Paik Hospital, Goyang
| | - Byung-Chul Lee
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Kyung-Ho Yu
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Mi Sun Oh
- Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, South Korea
| | - Soo Joo Lee
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, South Korea
| | - Jae Guk Kim
- Department of Neurology, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, South Korea
| | - Jae-Kwan Cha
- Department of Neurology, Dong-A University Hospital, Busan, South Korea
| | - Dae-Hyun Kim
- Department of Neurology, Dong-A University Hospital, Busan, South Korea
| | - Jun Lee
- Department of Neurology, Yeungnam University Hospital, Daegu, South Korea
| | - Moon-Ku Han
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Man Seok Park
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Kang-Ho Choi
- Department of Neurology, Chonnam National University Hospital, Gwangju, South Korea
| | - Matthias Nahrendorf
- Center for Systems Biology and Department of Radiology, Massachusetts General Hospital Research Institute, Harvard Medical School, Boston, MA
| | - Juneyoung Lee
- Department of Biostatistics, Korea University, Seoul, South Korea
| | - Hee-Joon Bae
- Department of Neurology, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dong-Eog Kim
- Department of Neurology, Dongguk University Ilsan Hospital, Goyang, South Korea.,National Priority Research Center for Stroke, Goyang, South Korea
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3
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Ageing as a risk factor for cerebral ischemia: Underlying mechanisms and therapy in animal models and in the clinic. Mech Ageing Dev 2020; 190:111312. [PMID: 32663480 DOI: 10.1016/j.mad.2020.111312] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/24/2020] [Accepted: 07/06/2020] [Indexed: 12/12/2022]
Abstract
Age is the only one non-modifiable risk of cerebral ischemia. Advances in stroke medicine and behavioral adaptation to stroke risk factors and comorbidities was successful in decreasing stroke incidence and increasing the number of stroke survivors in western societies. Comorbidities aggravates the outcome after cerebral ischemia. However, due to the increased in number of elderly, the incidence of stroke has increased again paralleled by an increase in the number of stroke survivors, many with severe disabilities, that has led to an increased economic and social burden in society. Animal models of stroke often ignore age and comorbidities frequently associated with senescence. This might explain why drugs working nicely in animal models fail to show efficacy in stroke survivors. Since stroke afflicts mostly the elderly comorbid patients, it is highly desirable to test the efficacy of stroke therapies in an appropriate animal stroke model. Therefore, in this review, we make parallels between animal models of stroke und clinical data and summarize the impact of ageing and age-related comorbidities on stroke outcome.
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Heidari P, Blayney S, Butler J, Hitomi E, Luby M, Leigh R. Frequency of thrombolytic targets in stroke patients presenting in an extended time window. Brain Circ 2020; 6:163-168. [PMID: 33210039 PMCID: PMC7646384 DOI: 10.4103/bc.bc_12_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/04/2020] [Accepted: 07/01/2020] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE: The objective of this study was to determine the proportion of stroke patients presenting in an extended time window who have a thrombolytic treatment target. BACKGROUND: Patients presenting up to 24 h after stroke onset have been found to have penumbral tissue on multimodal imaging. Stroke patients presenting in this extended time window without a large vessel occlusion (LVO) may benefit from reperfusion therapy using thrombolysis. METHODS: Patients seen at our institutions from 2011 through 2015 were reviewed to identify those who presented >4 h and <24 h from last seen normal (LSN) and did not receive acute treatment. Magnetic resonance imaging (MRI) scans were used to dichotomize patients using a diffusion–perfusion mismatch ratio of 1.2. RESULTS: During the study period, 3469 patients were evaluated by our stroke service, with 893 seen 4–24 h from LSN who were not treated. MRI was performed with diffusion and perfusion imaging in 439 patients, of whom 26 were excluded due to hemorrhage and 37 were excluded due to LVO. This left 376 patients who potentially could have been treated with thrombolysis in an extended time window and were included in the analysis. Of these, 156 (42%) demonstrated a mismatch ratio >1.2. Patients with a mismatch presented earlier (P = 0.012), were more likely to be female (P = 0.03), and had higher National Institutes of Health Stroke Scale (P < 0.001). CONCLUSIONS: Almost half of the patients presenting 4–24 h from LSN had a target for thrombolysis in our study. Multimodal imaging may be able to expand the population of treatable stroke patients given the results of recent clinical trials.
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Affiliation(s)
- Parisa Heidari
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Sarah Blayney
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Jarrhett Butler
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Emi Hitomi
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Marie Luby
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Richard Leigh
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
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5
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Rocha EA, Ji R, Ay H, Li Z, Arsava EM, Silva GS, Sorensen AG, Wu O, Singhal AB. Reduced Ischemic Lesion Growth with Heparin in Acute Ischemic Stroke. J Stroke Cerebrovasc Dis 2019; 28:1500-1508. [PMID: 30935810 PMCID: PMC6544494 DOI: 10.1016/j.jstrokecerebrovasdis.2019.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 02/19/2019] [Accepted: 03/05/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE The role of heparin in acute ischemic stroke is controversial. We investigated the effect of heparin on ischemic lesion growth. METHODS Data were analyzed on nonthrombolyzed ischemic stroke patients in whom diffusion-weighted imaging (DWI)/perfusion-weighted imaging (PWI) MRI was performed less than 12 hours of last known well and showed a PWI-DWI lesion mismatch, and who underwent follow-up neuroimaging at least 4 days after admission. Lesion growth was assessed by (1) absolute lesion growth and (2) percentage mismatch lost (PML). Univariate and multivariate regression analysis, and propensity score matching, were used to determine the effects of heparin on ischemic lesion growth. RESULTS Of the 113 patients meeting study criteria, 59 received heparin within 24 hours. Heparin use was associated with ∼5-fold reductions in PML (3.5% versus 19.2%, P = .002) and absolute lesion growth (4.7 versus 20.5 mL, P = .009). In multivariate regression models, heparin independently predicted reduced PML (P = .04) and absolute lesion growth (P = .04) in the entire cohort, and in multiple subgroups (patients with and without proximal artery occlusion; DWI volume greater than 5 mL; cardio-embolic mechanism; DEFUSE-3 target mismatch). In propensity score matching analysis where patients were matched by admission NIHSS, DWI volume and proximal artery occlusion, heparin remained an independent predictor of PML (P = .048) and tended to predict absolute lesion growth (P = .06). Heparin treatment did not predict functional outcome at discharge or 90 days. CONCLUSION Early heparin treatment in acute ischemic stroke patients with PWI-DWI mismatch attenuates ischemic lesion growth. Clinical trials with careful patient selection are warranted to investigate the potential ischemic protective effects of heparin.
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Affiliation(s)
- Eva A Rocha
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Department of Neurology, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil
| | - Ruijun Ji
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hakan Ay
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Zixiao Li
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | | | - Gisele S Silva
- Department of Neurology, Universidade Federal de Sao Paulo, Sao Paulo, SP, Brazil; Hospital Israelita Albert Einstein, Sao Paulo, SP, Brazil
| | | | - Ona Wu
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Aneesh B Singhal
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts.
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6
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Rikhtegar R, Yousefi M, Dolati S, Kasmaei HD, Charsouei S, Nouri M, Shakouri SK. Stem cell-based cell therapy for neuroprotection in stroke: A review. J Cell Biochem 2018; 120:8849-8862. [PMID: 30506720 DOI: 10.1002/jcb.28207] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 11/15/2018] [Indexed: 12/15/2022]
Abstract
Neurological disorders, such as stroke, are triggered by a loss of neurons and glial cells. Ischemic stroke remains a substantial problem for industrialized countries. Over the previous few decades our understanding about the pathophysiology of stroke has enhanced, nevertheless, more awareness is required to advance the field of stroke recovery. Existing therapies are incapable to adequately relief the disease outcome and are not appropriate to all patients. Meanwhile, the majority of patients continue to show neurological deficits even subsequent effective thrombolysis, recuperative therapies are immediately required that stimulate brain remodeling and repair once stroke damage has happened. Cell therapy is emergent as a hopeful new modality for increasing neurological recovery in ischemic stroke. Numerous types of stem cells from various sources have been identified and their possibility and efficiency for the treatment of stroke have been investigated. Stem cell therapy in patients with stroke using adult stem cells have been first practiced in clinical trials since 15 years ago. Even though stem cells have revealed a hopeful role in ischemic stroke in investigational studies besides early clinical pilot studies, cellular therapy in human is still at a primary stage. In this review, we summarize the types of stem cells, various delivery routes, and clinical application of stem cell-based therapy for stroke treatment.
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Affiliation(s)
- Reza Rikhtegar
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehdi Yousefi
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sanam Dolati
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Student's Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hosein Delavar Kasmaei
- Department of Neurology, Shohada-e-Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saeid Charsouei
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Nouri
- Stem Cell Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Seyed Kazem Shakouri
- Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.,Physical Medicine and Rehabilitation Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
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7
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Lorenzano S, Rost NS, Khan M, Li H, Lima FO, Maas MB, Green RE, Thankachan TK, Dipietro AJ, Arai K, Som AT, Pham LDD, Wu O, Harris GJ, Lo EH, Blumberg JB, Milbury PE, Feske SK, Furie KL. Oxidative Stress Biomarkers of Brain Damage: Hyperacute Plasma F2-Isoprostane Predicts Infarct Growth in Stroke. Stroke 2018; 49:630-637. [PMID: 29371434 PMCID: PMC5828992 DOI: 10.1161/strokeaha.117.018440] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 11/07/2017] [Accepted: 11/30/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND PURPOSE Oxidative stress is an early response to cerebral ischemia and is likely to play an important role in the pathogenesis of cerebral ischemic injury. We sought to evaluate whether hyperacute plasma concentrations of biomarkers of oxidative stress, inflammation, and tissue damage predict infarct growth (IG). METHODS We prospectively measured plasma F2-isoprostane (F2-isoP), urinary 8-oxo-7,8-dihydro-2'-deoxyguoanosine, plasma oxygen radical absorbance capacity assay, high sensitivity C reactive protein, and matrix metalloproteinase 2 and 9 in consecutive patients with acute ischemic stroke presenting within 9 hours of symptom onset. Patients with baseline diffusion-weighted magnetic resonance imaging and follow-up diffusion-weighted imaging or computed tomographic scan were included to evaluate the final infarct volume. Baseline diffusion-weighted imaging volume and final infarct volume were analyzed using semiautomated volumetric method. IG volume was defined as the difference between final infarct volume and baseline diffusion-weighted imaging volume. RESULTS A total of 220 acute ischemic stroke subjects were included in the final analysis. One hundred seventy of these had IG. Baseline F2-isoP significantly correlated with IG volume (Spearman ρ=0.20; P=0.005) and final infarct volume (Spearman ρ=0.19; P=0.009). In a multivariate binary logistic regression model, baseline F2-isoP emerged as an independent predictor of the occurrence of IG (odds ratio, 2.57; 95% confidence interval, 1.37-4.83; P=0.007). In a multivariate linear regression model, baseline F2-isoP was independently associated with IG volume (B, 0.38; 95% confidence interval, 0.04-0.72; P=0.03). CONCLUSIONS Elevated hyperacute plasma F2-isoP concentrations independently predict the occurrence of IG and IG volume in patients with acute ischemic stroke. If validated in future studies, measuring plasma F2-isoP might be helpful in the acute setting to stratify patients with acute ischemic stroke for relative severity of ischemic injury and expected progression.
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Affiliation(s)
- Svetlana Lorenzano
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.).
| | - Natalia S Rost
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Muhib Khan
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Hua Li
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Fabricio O Lima
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Matthew B Maas
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Rebecca E Green
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Tijy K Thankachan
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Allison J Dipietro
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Ken Arai
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Angel T Som
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Loc-Duyen D Pham
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Ona Wu
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Gordon J Harris
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Eng H Lo
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Jeffrey B Blumberg
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Paul E Milbury
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Steven K Feske
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
| | - Karen L Furie
- From the J. Philip Kistler Stroke Research Center, Department of Neurology (S.L., N.S.R., F.O.L., M.B.M., R.E.G., T.K.T., A.J.D.), Department of Radiology (H.L., G.J.H.), and Neuroprotection Research Laboratory, Neuroscience Center, Departments of Neurology and Radiology (K.A., A.T.S., L.-D.D.P., E.H.L.), Massachusetts General Hospital, Harvard Medical School, Boston; Department of Neurology, Rhode Island Hospital, Alpert Medical School of Brown University, Providence (M.K., K.L.F.); Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown (O.W.); Antioxidant Research Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging (J.B.B.) and Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy (P.E.M.), Tufts University, Boston, MA; and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.K.F.)
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8
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Buga AM, Ciobanu O, Bădescu GM, Bogdan C, Weston R, Slevin M, Di Napoli M, Popa-Wagner A. Up-regulation of serotonin receptor 2B mRNA and protein in the peri-infarcted area of aged rats and stroke patients. Oncotarget 2017; 7:17415-30. [PMID: 27013593 PMCID: PMC4951222 DOI: 10.18632/oncotarget.8277] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 03/14/2016] [Indexed: 12/14/2022] Open
Abstract
Despite the fact that a high proportion of elderly stroke patients develop mood disorders, the mechanisms underlying late-onset neuropsychiatric and neurocognitive symptoms have so far received little attention in the field of neurobiology. In rodents, aged animals display depressive symptoms following stroke, whereas young animals recover fairly well. This finding has prompted us to investigate the expression of serotonin receptors 2A and 2B, which are directly linked to depression, in the brains of aged and young rats following stroke. Although the development of the infarct was more rapid in aged rats in the first 3 days after stroke, by day 14 the cortical infarcts were similar in size in both age groups i.e. 45% of total cortical volume in young rats and 55.7% in aged rats. We also found that the expression of serotonin receptor type B mRNA was markedly increased in the perilesional area of aged rats as compared to the younger counterparts. Furthermore, histologically, HTR2B protein expression in degenerating neurons was closely associated with activated microglia both in aged rats and human subjects. Treatment with fluoxetine attenuated the expression of Htr2B mRNA, stimulated post-stroke neurogenesis in the subventricular zone and was associated with an improved anhedonic behavior and an increased activity in the forced swim test in aged animals. We hypothesize that HTR2B expression in the infarcted territory may render degenerating neurons susceptible to attack by activated microglia and thus aggravate the consequences of stroke.
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Affiliation(s)
- Ana-Maria Buga
- Department of Psychiatry and Psychotheraphy, University of Medicine Rostock, Rostock, Germany.,Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy Craiova, Craiova, Romania
| | - Ovidiu Ciobanu
- Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy Craiova, Craiova, Romania.,Vivantes Humboldt-Klinikum, Center for Affective Disorders, Berlin, Germany
| | - George Mihai Bădescu
- Psychiatry Clinical Hospital, University of Medicine and Pharmacy of Craiova, Craiova, Romania
| | - Catalin Bogdan
- Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy Craiova, Craiova, Romania
| | - Ria Weston
- Department of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Mark Slevin
- Department of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Mario Di Napoli
- Neurological Service, San Camillo de' Lellis General Hospital, Rieti, Italy.,Neurological Section, SMDN-Center for Cardiovascular Medicine and Cerebrovascular Disease Prevention, Sulmona, L'Aquila, Italy
| | - Aurel Popa-Wagner
- Department of Psychiatry and Psychotheraphy, University of Medicine Rostock, Rostock, Germany
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9
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Sandu RE, Balseanu AT, Bogdan C, Slevin M, Petcu E, Popa-Wagner A. Stem cell therapies in preclinical models of stroke. Is the aged brain microenvironment refractory to cell therapy? Exp Gerontol 2017; 94:73-77. [PMID: 28093317 DOI: 10.1016/j.exger.2017.01.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/09/2017] [Accepted: 01/12/2017] [Indexed: 01/01/2023]
Abstract
Stroke is a devastating disease demanding vigorous search for new therapies. Initial enthusiasm to stimulate restorative processes in the ischemic brain by means of cell-based therapies has meanwhile converted into a more balanced view recognizing impediments that may be related to unfavorable age-associated environments. Recent results using a variety of drug, cell therapy or combination thereof suggest that, (i) treatment with Granulocyte-Colony Stimulating Factor (G-CSF) in aged rats has primarily a beneficial effect on functional outcome most likely via supportive cellular processes such as neurogenesis; (ii) the combination therapy, G-CSF with mesenchymal cells (G-CSF+BM-MSC or G-CSF+BM-MNC) did not further improve behavioral indices, neurogenesis or infarct volume as compared to G-CSF alone in aged animals; (iii) better results with regard to integration of transplanted cells in the aged rat environment have been obtained using iPS of human origin; (iv) mesenchymal cells may be used as drug carriers for the aged post-stroke brains. CONCLUSION While the middle aged brain does not seem to impair drug and cell therapies, in a real clinical practice involving older post-stroke patients, successful regenerative therapies would have to be carried out for a much longer time.
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Affiliation(s)
- Raluca Elena Sandu
- University of Medicine and Pharmacy of Craiova, Chair of Biochemistry, Neurobiology of Aging Group, Romania
| | - Adrian Tudor Balseanu
- University of Medicine and Pharmacy of Craiova, Chair of Biochemistry, Neurobiology of Aging Group, Romania
| | - Catalin Bogdan
- University of Medicine and Pharmacy of Craiova, Chair of Biochemistry, Neurobiology of Aging Group, Romania
| | - Mark Slevin
- Department of Healthcare Science, Manchester Metropolitan University, Manchester, UK
| | - Eugen Petcu
- Griffith University School of Medicine, Gold Coast Campus, QLD 4222, Australia
| | - Aurel Popa-Wagner
- Department of Psychiatry, University Hospital Rostock, Germany; University of Medicine and Pharmacy of Craiova, Chair of Biochemistry, Neurobiology of Aging Group, Romania.
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10
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Chan HH, Wathen CA, Ni M, Zhuo S. Stem cell therapies for ischemic stroke: current animal models, clinical trials and biomaterials. RSC Adv 2017. [DOI: 10.1039/c7ra00336f] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
We report the facilitation of stem cell therapy in stroke by tissue engineering and applications of biomaterials.
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Affiliation(s)
- Hugh H. Chan
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology
- Fujian Normal University
- Fuzhou 350007
- P. R. China
- Department of Neuroscience
| | | | - Ming Ni
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology
- Fujian Normal University
- Fuzhou 350007
- P. R. China
| | - Shuangmu Zhuo
- Key Laboratory of OptoElectronic Science and Technology for Medicine of Ministry of Education & Fujian Provincial Key Laboratory of Photonics Technology
- Fujian Normal University
- Fuzhou 350007
- P. R. China
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11
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Sandu RE, Uzoni A, Ciobanu O, Moldovan M, Anghel A, Radu E, Coogan AN, Popa-Wagner A. Post-stroke gaseous hypothermia increases vascular density but not neurogenesis in the ischemic penumbra of aged rats. Restor Neurol Neurosci 2016; 34:401-14. [DOI: 10.3233/rnn-150600] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Adriana Uzoni
- Molecular Psychiatry, Department of Psychiatry, University of Medicine Rostock, Rostock, Germany
| | - Ovidiu Ciobanu
- University of Medicine and Pharmacy, Craiova, Romania
- Department of Psychiatry, University Medicine of Saarland, Homburg/Saar, Germany
| | - Mihai Moldovan
- Neuroscience and Pharmacology, Panum, University of Copenhagen, Copenhagen, Denmark
| | - Andrei Anghel
- Department of Biochemistry, University of Medicine and Pharmacy “Victor Babes”, Timisoara, Romania
| | - Eugen Radu
- University of Medicine and Pharmacy Carol Davila, Bucharest, Romania
| | - Andrew N. Coogan
- Department of Psychology, Maynooth University, National University of Ireland, Maynooth, Ireland
| | - Aurel Popa-Wagner
- Molecular Psychiatry, Department of Psychiatry, University of Medicine Rostock, Rostock, Germany
- University of Medicine and Pharmacy, Craiova, Romania
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12
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Mawet J, Eikermann-Haerter K, Park KY, Helenius J, Daneshmand A, Pearlman L, Avery R, Negro A, Velioglu M, Arsava EM, Ay H, Ayata C. Sensitivity to acute cerebral ischemic injury in migraineurs: A retrospective case-control study. Neurology 2015; 85:1945-9. [PMID: 26537055 DOI: 10.1212/wnl.0000000000002166] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 07/08/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Migraine, particularly with aura, is a risk factor for ischemic stroke. Recent data in migraine mutant mice suggest that cerebral hyperexcitability associated with migraine accelerates recruitment of ischemic penumbra into the core, resulting in faster infarct growth compared with wild type. We hypothesized that individuals with a history of migraine are more likely to exhibit increased recruitment of ischemic tissue into the infarct in acute stroke. METHODS In this retrospective case-control study, we identified participants with reliably documented migraine history, measured lesion volumes on diffusion-weighted and perfusion-weighted MRI obtained within 72 hours of symptom onset, calculated the proportion of ischemic tissue on perfusion-weighted imaging (PWI) hyperintense on diffusion-weighted imaging (DWI), and compared the proportion of patients with no-mismatch pattern defined as DWI lesion >83% of PWI lesion. RESULTS Migraineurs (n = 45) were younger, more often female, less likely to have vascular risk factors, and more often had cervical artery dissection, but otherwise did not differ from controls (n = 27). A significantly larger proportion of migraineurs had no-mismatch pattern, indicating that the entire perfusion defect was recruited into the infarct by the time of MRI (22% vs 4% of migraineurs and controls, respectively; p = 0.044). The difference was even more prominent in migraineurs with aura (36% vs 4%, p = 0.019). The association between migraine and no-mismatch pattern persisted after adjustment for time to MRI (p = 0.041). CONCLUSIONS This case-control study supports the hypothesis that a history of migraine, particularly with aura, is associated with a no-mismatch pattern during acute ischemic stroke, consistent with data obtained in migraine mutant mice.
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Affiliation(s)
- Jerome Mawet
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Katharina Eikermann-Haerter
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Kwang-Yeol Park
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Johanna Helenius
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Ali Daneshmand
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Lea Pearlman
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Ross Avery
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Andrea Negro
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Murat Velioglu
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Ethem Murat Arsava
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France
| | - Hakan Ay
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France.
| | - Cenk Ayata
- From the Neurovascular Research Laboratory, Department of Radiology (J.M., K.E.-H., A.D., L.P., A.N., C.A.), Martinos Center for Biomedical Imaging and Stroke Service (K.-Y.P., J.H., R.A., M.V., E.M.A., H.A.), and Stroke Service and Neuroscience Intensive Care Unit, Department of Neurology (C.A.), Massachusetts General Hospital, Harvard Medical School, Charlestown; and Emergency Headache Center (J.M.), Lariboisière Hospital, APHP, DHU Neurovasc Sorbonne Paris-Cité, Paris, France.
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13
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Popa-Wagner A, Buga AM, Doeppner TR, Hermann DM. Stem cell therapies in preclinical models of stroke associated with aging. Front Cell Neurosci 2014; 8:347. [PMID: 25404892 PMCID: PMC4217499 DOI: 10.3389/fncel.2014.00347] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2014] [Accepted: 10/06/2014] [Indexed: 01/01/2023] Open
Abstract
Stroke has limited treatment options, demanding a vigorous search for new therapeutic strategies. Initial enthusiasm to stimulate restorative processes in the ischemic brain by means of cell-based therapies has meanwhile converted into a more balanced view recognizing impediments related to unfavorable environments that are in part related to aging processes. Since stroke afflicts mostly the elderly, it is highly desirable and clinically important to test the efficacy of cell therapies in aged brain microenvironments. Although widely believed to be refractory to regeneration, recent studies using both neural precursor cells and bone marrow-derived mesenchymal stem cells for stroke therapy suggest that the aged rat brain is not refractory to cell-based therapy, and that it also supports plasticity and remodeling. Yet, important differences exist in the aged compared with young brain, i.e., the accelerated progression of ischemic injury to brain infarction, the reduced rate of endogenous neurogenesis and the delayed initiation of neurological recovery. Pitfalls in the development of cell-based therapies may also be related to age-associated comorbidities, e.g., diabetes or hyperlipidemia, which may result in maladaptive or compromised brain remodeling, respectively. These age-related aspects should be carefully considered in the clinical translation of restorative therapies.
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Affiliation(s)
- Aurel Popa-Wagner
- Department of Psychiatry, Aging and Brain Disorders, University of Medicine Rostock Rostock, Germany ; Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova Craiova, Romania
| | - Ana-Maria Buga
- Department of Psychiatry, Aging and Brain Disorders, University of Medicine Rostock Rostock, Germany ; Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova Craiova, Romania
| | | | - Dirk M Hermann
- Department of Neurology, University Hospital Essen Essen, Germany
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Coelho BP, Giraldi-Guimarães A. Effect of age and gender on recovery after stroke in rats treated with bone marrow mononuclear cells. Neurosci Res 2014; 88:67-73. [PMID: 25176441 DOI: 10.1016/j.neures.2014.08.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/26/2014] [Accepted: 08/11/2014] [Indexed: 11/19/2022]
Abstract
Stroke is a disease of the elderly. However, most of the preclinical studies about the treatment of stroke with bone marrow-derived cells have used young animals. Here, it was assessed whether the sensorimotor recovery promoted by the treatment of the brain ischemia with the bone marrow mononuclear cells (BMMCs) is influenced by age and/or gender. Unilateral cortical ischemia by thermocoagulation was made in the primary motor and sensorimotor cortices in young and middle-aged rats of both genders. Twenty four hours after ischemia, animals received intravenous injection of BMMCs or vehicle. Each combination of age and gender received BMMCs from donor with the same combination. Survival rate and ischemic lesion size were quantified. Sensorimotor recovery was evaluated by the cylinder and adhesive tests. The results showed that the treatment with BMMCs resulted in sensorimotor recovery of both young and middle-aged ischemic rats. No important effect of gender was found, but age was a significant factor. Middle-aged animals had increased mortality and lesion sizes. In the adhesive test, middle-aged animals had lower BMMCs-induced sensorimotor recovery. The results suggest that the treatment of stroke with the BMMCs should be beneficial for males and females in the elderly.
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Affiliation(s)
- Bárbara Paula Coelho
- Laboratório de Biologia Celular e Tecidual, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy Ribeiro (UENF), Campos dos Goytacazes, RJ, Brazil
| | - Arthur Giraldi-Guimarães
- Laboratório de Biologia Celular e Tecidual, Centro de Biociências e Biotecnologia, Universidade Estadual do Norte Fluminense Darcy Ribeiro (UENF), Campos dos Goytacazes, RJ, Brazil.
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15
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Balseanu AT, Buga AM, Catalin B, Wagner DC, Boltze J, Zagrean AM, Reymann K, Schaebitz W, Popa-Wagner A. Multimodal Approaches for Regenerative Stroke Therapies: Combination of Granulocyte Colony-Stimulating Factor with Bone Marrow Mesenchymal Stem Cells is Not Superior to G-CSF Alone. Front Aging Neurosci 2014; 6:130. [PMID: 25002846 PMCID: PMC4066299 DOI: 10.3389/fnagi.2014.00130] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2014] [Accepted: 06/03/2014] [Indexed: 01/01/2023] Open
Abstract
Attractive therapeutic strategies to enhance post-stroke recovery of aged brains include methods of cellular therapy that can enhance the endogenous restorative mechanisms of the injured brain. Since stroke afflicts mostly the elderly, it is highly desirable to test the efficacy of cell therapy in the microenvironment of aged brains that is generally refractory to regeneration. In particular, stem cells from the bone marrow allow an autologous transplantation approach that can be translated in the near future to the clinical practice. Such a bone marrow-derived therapy includes the grafting of stem cells as well as the delayed induction of endogenous stem cell mobilization and homing by the stem cell mobilizer granulocyte colony-stimulating factor (G-CSF). We tested the hypothesis that grafting of bone marrow-derived pre-differentiated mesenchymal cells (BM-MSCs) in G-CSF-treated animals improves the long-term functional outcome in aged rodents. To this end, G-CSF alone (50 μg/kg) or in combination with a single dose (106 cells) of rat BM MSCs was administered intravenously to Sprague-Dawley rats at 6 h after transient occlusion (90 min) of the middle cerebral artery. Infarct volume was measured by magnetic resonance imaging at 3 and 48 days post-stroke and additionally by immunhistochemistry at day 56. Functional recovery was tested during the entire post-stroke survival period of 56 days. Daily treatment for post-stroke aged rats with G-CSF led to a robust and consistent improvement of neurological function after 28 days. The combination therapy also led to robust angiogenesis in the formerly infarct core and beyond in the “islet of regeneration.” However, G-CSF + BM MSCs may not impact at all on the spatial reference-memory task or infarct volume and therefore did not further improve the post-stroke recovery. We suggest that in a real clinical practice involving older post-stroke patients, successful regenerative therapies would have to be carried out for a much longer time.
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Affiliation(s)
- Adrian Tudor Balseanu
- Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova , Craiova , Romania
| | - Ana-Maria Buga
- Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova , Craiova , Romania ; Department of Psychiatry, University Medicine of Rostock , Rostock , Germany
| | - Bogdan Catalin
- Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova , Craiova , Romania
| | | | - Johannes Boltze
- Fraunhofer Institute for Cell Therapy and Immunology , Leipzig , Germany ; Translational Center for Regenerative Medicine, University of Leipzig , Leipzig , Germany ; Stroke and Neurovascular Regulation Laboratory, Massachusetts General Hospital and Harvard Medical School , Charlestown, MA , USA
| | - Ana-Maria Zagrean
- Carol Davila University of Medicine and Pharmacy , Bucharest , Romania
| | - Klaus Reymann
- German Center for Neurodegenerative Diseases (DZNE) Magdeburg in collobaration with Leibniz Institute for Neurobiology , Magdeburg , Germany
| | - Wolf Schaebitz
- Evangelisches Krankenhaus Bielefeld gGmbH Akademisches Lehrkrankenhaus der Universität Münster , Münster , Germany
| | - Aurel Popa-Wagner
- Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy of Craiova , Craiova , Romania ; Department of Psychiatry, University Medicine of Rostock , Rostock , Germany
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16
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Sztriha LK, Cusack U, Kandasamy N, Jarosz J, Kalra L. Determinants of mismatch in acute ischaemic stroke. J Neurol Sci 2013; 334:10-3. [DOI: 10.1016/j.jns.2013.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2013] [Revised: 07/03/2013] [Accepted: 07/08/2013] [Indexed: 11/26/2022]
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17
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Buga AM, Di Napoli M, Popa-Wagner A. Preclinical models of stroke in aged animals with or without comorbidities: role of neuroinflammation. Biogerontology 2013; 14:651-62. [PMID: 24057280 DOI: 10.1007/s10522-013-9465-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Accepted: 09/10/2013] [Indexed: 12/31/2022]
Abstract
Age is the principal nonmodifiable risk factor for stroke. Over the past 10 years, suitable models for stroke in aged rats have been established. At genetic and cellular level there are significant differences in behavioral, cytological and genomics responses to injury in old animals as compared with the young ones. Behaviorally, the aged rats have the capacity to recover after cortical infarcts albeit to a lower extent than the younger counterparts. Similarly, the increased vulnerability of the aged brain to stroke, together with a decreased interhemisphere synchrony after stroke, assessed by different experimental methods (MRI, fMRI, in vivo microscopy, EEG) leads to unfavorable recovery of physical and cognitive functions in aged people and may have a prognostic value for the recovery of stroke patients. Furthermore, in elderly, comorbidities like diabetes or arterial hypertension are associated with higher risk of stroke, increased mortality and disability, and poorer functional status and quality of life. Aging brain reacts strongly to ischemia-reperfusion injury with an early inflammatory response. The process of cellular senescence can be an important additional contributor to chronic post-stroke by creating a "primed" inflammatory environment in the brain. Overall, these pro-inflammatory reactions promote early scar formation associated with tissue fibrosis and reduce functional recovery. A better understanding of molecular factors and signaling pathways underlying the contribution of comorbidities to stroke-induced pathological sequelae, may be translated into successful treatment or prevention therapies for age-associated diseases which would improve lifespan and quality of life.
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Affiliation(s)
- A-M Buga
- Department of Functional Sciences, Center of Clinical and Experimental Medicine, University of Medicine and Pharmacy, Craiova, Craiova, Romania
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Castañeda-Delgado J, Miranda-Castro N, González-Amaro R, González-Curiel I, Montoya-Rosales A, Rivas-Calderon B, Rivas-Santiago B. Production of antimicrobial peptides is preserved in aging. Clin Immunol 2013; 148:198-205. [DOI: 10.1016/j.clim.2013.05.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Revised: 05/16/2013] [Accepted: 05/22/2013] [Indexed: 01/08/2023]
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Henninger N, Lin E, Haussen DC, Lehman LL, Takhtani D, Selim M, Moonis M. Leukoaraiosis and sex predict the hyperacute ischemic core volume. Stroke 2012; 44:61-7. [PMID: 23233384 DOI: 10.1161/strokeaha.112.679084] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Leukoaraiosis (LA) and male sex have been associated with decreased cerebrovascular reactivity, which potentially adversely affects tissue viability in acute stroke. Therefore, we aimed to elucidate the contribution of LA-severity and sex to the extent of the hyperacute ischemic core volume after intracranial large artery occlusion. METHODS We analyzed data from 87 patients with acute intracranial large artery occlusion who had acute multimodal computed tomography-imaging. LA-severity was assessed using the van Swieten scale on noncontrast computed tomography. Computed tomography perfusion data were analyzed using automatic calculation of the mean transit time and hyperacute cerebral blood volume defects. Multivariate linear and logistic regression analyses were used to identify independent predictors of the hyperacute infarct-volume. RESULTS Severe LA (van Swieten Scale, 3-4; odds ratio, 43.22; 95% CI, 6.26-298.42; P<0.001) and male sex (odds ratio, 7.52; 95% CI, 1.38-40.86; P=0.020) were independently associated with a hyperacute cerebral blood volume-lesion >25 mL on multivariate logistic regression analysis. Multivariate linear regression analysis confirmed the association between severe LA (P<0.001) and male sex (P=0.01) with larger cerebral blood volume-lesions. There was no significant difference in the absolute or relative mean transit time-lesion volumes when stratified by LA-severity or sex. Women had significantly smaller cerebral blood volume-lesion volumes compared with men (P=0.036). CONCLUSIONS Severe LA and male sex are associated with larger infarct cores, which adds to the notion that sex and LA alter the brain's intrinsic susceptibility to acute cerebral ischemia. Future, larger studies are needed to confirm our observation that women have smaller core volumes and its significance.
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Affiliation(s)
- Nils Henninger
- Department of Neurology, University of Massachusetts Medical School, 55 Lake Ave, N Worcester, MA 01655, USA.
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