2
|
Zhao YH, Liang Y, Wang KJ, Jin SN, Yu XM, Zhang Q, Wei JY, Liu H, Fang WG, Zhao WD, Li Y, Chen YH. Endothelial lincRNA-p21 alleviates cerebral ischemia/reperfusion injury by maintaining blood-brain barrier integrity. J Cereb Blood Flow Metab 2024:271678X241248907. [PMID: 38661094 DOI: 10.1177/0271678x241248907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Abstract
Blood-brain barrier (BBB) disruption is increasingly recognized as an early contributor to the pathophysiology of cerebral ischemia/reperfusion (I/R) injury, and is also a key event in triggering secondary damage to the central nervous system. Recently, long non-coding RNA (lncRNA) have been found to be associated with ischemic stroke. However, the roles of lncRNA in BBB homeostasis remain largely unknown. Here, we report that long intergenic non-coding RNA-p21 (lincRNA-p21) was the most significantly down-regulated lncRNA in human brain microvascular endothelial cells (HBMECs) after oxygen and glucose deprivation/reoxygenation (OGD/R) treatment among candidate lncRNA, which were both sensitive to hypoxia and involved in atherosclerosis. Exogenous brain-endothelium-specific overexpression of lincRNA-p21 could alleviate BBB disruption, diminish infarction volume and attenuate motor function deficits in middle cerebral artery occlusion/reperfusion (MCAO/R) mice. Further results showed that lincRNA-p21 was critical to maintain BBB integrity by inhibiting the degradation of junction proteins under MCAO/R and OGD/R conditions. Specifically, lincRNA-p21 could inhibit autophagy-dependent degradation of occludin by activating PI3K/AKT/mTOR signaling pathway. Besides, lincRNA-p21 could inhibit VE-cadherin degradation by binding with miR-101-3p. Together, we identify that lincRNA-p21 is critical for BBB integrity maintenance, and endothelial lincRNA-p21 overexpression could alleviate cerebral I/R injury in mice, pointing to a potential strategy to treat cerebral I/R injury.
Collapse
Affiliation(s)
- Yun-Hua Zhao
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
- Guangdong Key Laboratory of Age-Related Cardiac and Cerebral Diseases, Institute of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- Department of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Yu Liang
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Kang-Ji Wang
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Sheng-Nan Jin
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Xiao-Meng Yu
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Qian Zhang
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Jia-Yi Wei
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Hui Liu
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Wen-Gang Fang
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Wei-Dong Zhao
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Yuan Li
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| | - Yu-Hua Chen
- Department of Developmental Cell Biology, Key Laboratory of Cell Biology, Ministry of Public Health, China Medical University, Shenyang, China
- Department of Developmental Cell Biology, Key Laboratory of Medical Cell Biology, Ministry of Education, China Medical University, Shenyang, China
| |
Collapse
|
3
|
Kim DJ, Singh N, Catanese L, Yu AYX, Demchuk AM, Lloret-Villas MI, Deschaintre Y, Coutts SB, Khosravani H, Appireddy R, Moreau F, Gubitz G, Tkach A, Dowlatshahi D, Medvedev G, Mandzia J, Pikula A, Shankar J, Williams H, Manosalva H, Siddiqui M, Zafar A, Imoukhuede O, Hunter G, Phillips S, Hill MD, Poppe AY, Ademola A, Shamy M, Bala F, Sajobi TT, Swartz RH, Almekhlafi MA, Menon BK, Field TS. Sex-Based Analysis of Workflow and Outcomes in Acute Ischemic Stroke Patients Treated With Alteplase Versus Tenecteplase. Stroke 2024; 55:288-295. [PMID: 38174568 DOI: 10.1161/strokeaha.123.045320] [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: 08/14/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND Understanding sex differences in stroke care is important in reducing potential disparities. Our objective was to explore sex differences in workflow efficiency, treatment efficacy, and safety in the AcT trial (Alteplase Compared to Tenecteplase). METHODS AcT was a multicenter, registry-linked randomized noninferiority trial comparing tenecteplase (0.25 mg/kg) with alteplase (0.9 mg/kg) in acute ischemic stroke within 4.5 hours of onset. In this post hoc analysis, baseline characteristics, workflow times, successful reperfusion (extended Thrombolysis in Cerebral Infarction score ≥2b), symptomatic intracerebral hemorrhage, 90-day functional independence (modified Rankin Scale score, 0-1), and 90-day mortality were compared by sex. Mixed-effects regression analysis was used adjusting for age, stroke severity, and occlusion site for outcomes. RESULTS Of 1577 patients treated with intravenous thrombolysis (2019-2022), 755 (47.9%) were women. Women were older (median, 77 [68-86] years in women versus 70 [59-79] years in men) and had a higher proportion of severe strokes (National Institutes of Health Stroke Scale score >15; 32.4% versus 24.9%) and large vessel occlusions (28.7% versus 21.5%) compared with men. All workflow times were comparable between sexes. Women were less likely to achieve functional independence (31.7% versus 39.8%; unadjusted relative risk, 0.80 [95% CI, 0.70-0.91]) and had higher mortality (17.7% versus 13.3%; unadjusted relative risk, 1.33 [95% CI, 1.06-1.69]). Adjusted analysis showed no difference in outcomes between sexes. CONCLUSIONS Differences in prognostic factors of age, stroke severity, and occlusion site largely accounted for higher functional dependence and mortality in women. No sex disparities were apparent in workflow quality indicators. Given the integration of the AcT trial into clinical practice, these results provide reassurance that no major sex biases are apparent in acute stroke management throughout participating Canadian centers. REGISTRATION URL: https://www.clinicaltrials.gov; Unique identifier: NCT03889249.
Collapse
Affiliation(s)
- Diana J Kim
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Nishita Singh
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada (N.S., J.S.)
| | - Luciana Catanese
- Hamilton Health Sciences Centre, McMaster University, Hamilton, ON, Canada (L.C.)
| | - Amy Y X Yu
- Division of Neurology, Sunnybrook Health Sciences Centre (A.Y.X.Y., H.K., R.H.S.), University of Toronto, ON, Canada
| | - Andrew M Demchuk
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Radiology, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | | | - Yan Deschaintre
- Department of Neurosciences, Université de Montréal, QC, Canada (Y.D.)
| | - Shelagh B Coutts
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Radiology, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Houman Khosravani
- Division of Neurology, Sunnybrook Health Sciences Centre (A.Y.X.Y., H.K., R.H.S.), University of Toronto, ON, Canada
| | - Ramana Appireddy
- Division of Neurology, Queen's University, Kingston, ON, Canada (R.A.)
| | | | - Gord Gubitz
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada (G.G., S.P.)
| | | | - Dar Dowlatshahi
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, ON, Canada (D.D., M. Shamy)
| | - George Medvedev
- Royal Columbian Hospital, New Westminster, BC, Canada (G.M.)
| | - Jennifer Mandzia
- London Health Sciences Centre, Western University, London, ON, Canada (J.M.)
| | | | - Jai Shankar
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada (N.S., J.S.)
| | | | | | | | - Atif Zafar
- St Michael's Hospital, Toronto, ON, Canada (A.Z.)
| | | | - Gary Hunter
- University of Saskatchewan, Saskatoon, Canada (G.H.)
| | - Stephen Phillips
- Queen Elizabeth II Health Sciences Centre, Halifax, NS, Canada (G.G., S.P.)
| | - Michael D Hill
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Radiology, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | | | - Ayoola Ademola
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Michel Shamy
- Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, ON, Canada (D.D., M. Shamy)
| | - Fouzi Bala
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Tolulope T Sajobi
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Richard H Swartz
- Division of Neurology, Sunnybrook Health Sciences Centre (A.Y.X.Y., H.K., R.H.S.), University of Toronto, ON, Canada
| | - Mohammed A Almekhlafi
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Radiology, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Bijoy K Menon
- Department of Clinical Neurosciences, Cumming School of Medicine (D.J.K., A.M.D., S.B.C., M.D.H., A.A., F.B., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Radiology, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., M.A.A., B.K.M.), University of Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine (A.M.D., S.B.C., M.D.H., A.A., T.T.S., M.A.A., B.K.M.), University of Calgary, AB, Canada
| | - Thalia S Field
- Vancouver Stroke Program, Division of Neurology, The University of British Columbia, Vancouver, Canada (T.S.F.)
| |
Collapse
|