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Chen Y, Gu M, Patterson J, Zhang R, Statz JK, Reed E, Abutarboush R, Ahlers ST, Kawoos U. Temporal Alterations in Cerebrovascular Glycocalyx and Cerebral Blood Flow after Exposure to a High-Intensity Blast in Rats. Int J Mol Sci 2024; 25:3580. [PMID: 38612392 PMCID: PMC11011510 DOI: 10.3390/ijms25073580] [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: 01/05/2024] [Revised: 03/09/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
The glycocalyx is a proteoglycan-glycoprotein structure lining the luminal surface of the vascular endothelium and is susceptible to damage due to blast overpressure (BOP) exposure. The glycocalyx is essential in maintaining the structural and functional integrity of the vasculature and regulation of cerebral blood flow (CBF). Assessment of alterations in the density of the glycocalyx; its components (heparan sulphate proteoglycan (HSPG/syndecan-2), heparan sulphate (HS), and chondroitin sulphate (CS)); CBF; and the effect of hypercapnia on CBF was conducted at 2-3 h, 1, 3, 14, and 28 days after a high-intensity (18.9 PSI/131 kPa peak pressure, 10.95 ms duration, and 70.26 PSI·ms/484.42 kPa·ms impulse) BOP exposure in rats. A significant reduction in the density of the glycocalyx was observed 2-3 h, 1-, and 3 days after the blast exposure. The glycocalyx recovered by 28 days after exposure and was associated with an increase in HS (14 and 28 days) and in HSPG/syndecan-2 and CS (28 days) in the frontal cortex. In separate experiments, we observed significant decreases in CBF and a diminished response to hypercapnia at all time points with some recovery at 3 days. Given the role of the glycocalyx in regulating physiological function of the cerebral vasculature, damage to the glycocalyx after BOP exposure may result in the onset of pathogenesis and progression of cerebrovascular dysfunction leading to neuropathology.
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Affiliation(s)
- Ye Chen
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Ming Gu
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Jacob Patterson
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- Parsons Corporation, Columbia, MD 21046, USA
| | - Ruixuan Zhang
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Jonathan K. Statz
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Eileen Reed
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- Parsons Corporation, Columbia, MD 21046, USA
| | - Rania Abutarboush
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
| | - Stephen T. Ahlers
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
| | - Usmah Kawoos
- Naval Medical Research Command, Silver Spring, MD 20910, USA; (Y.C.); (M.G.)
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD 20817, USA
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Kirby C, Barrington J, Sondag L, Loan JJ, Schreuder FH, McColl BW, Klijn CJ, Al-Shahi Salman R, Samarasekera N. Association between circulating inflammatory biomarkers and functional outcome or perihaematomal oedema after ICH: a systematic review & meta-analysis. Wellcome Open Res 2023; 8:239. [PMID: 38037559 PMCID: PMC10687391 DOI: 10.12688/wellcomeopenres.19187.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2023] [Indexed: 12/02/2023] Open
Abstract
Background Currently, there are no specific medical treatments for intracerebral haemorrhage (ICH), but the inflammatory response may provide a potential route to treatment. Given the known effects of acute brain injury on peripheral immunity, we hypothesised that inflammatory biomarkers in peripheral blood may be associated with clinical outcome following ICH, as well as perihaematomal oedema (PHO), which is an imaging marker of the neuroinflammatory response. Methods We searched OVID Medline and EMBASE on 07 April 2021 for studies of humans with ICH measuring an inflammatory biomarker in peripheral blood and PHO or clinical outcome. Risk of bias was assessed both by using a scale comprising features of the Newcastle-Ottawa Assessment Scale, STROBE-ME and REMARK guidelines, and for studies included in meta-analysis, also by the QUIPS tool.We used random effects meta-analysis to pool standardised mean differences (SMD) if ≥1 study quantified the association between identical biomarkers and measures of PHO or functional outcome. Results Of 8,615 publications, 16 examined associations between 21 inflammatory biomarkers and PHO (n=1,299 participants), and 93 studies examined associations between ≥1 biomarker and clinical outcome (n=17,702 participants). Overall, 20 studies of nine biomarkers (n=3,199) met criteria for meta-analysis of associations between inflammatory biomarkers and clinical outcome. Death or dependency (modified Rankin Scale (mRS) 3‒6) 90 days after ICH was associated with higher levels of fibrinogen (SMD 0.32; 95%CI [0.04, 0.61]; p=0.025), and high mobility group box protein 1 (HMGB1) (SMD 1.67; 95%CI [0.05, 3.30]; p=0.04). Higher WBC was associated with death or dependency at 90 days (pooled SMD 0.27; 95% CI [0.11, 0.44]; p=0.001; but the association was no longer significant when the analysis was restricted to studies with a low risk of bias (pooled SMD 0.22; 95% CI -0.04-0.48). Higher CRP seemed to be associated with death or dependency at 90 days (pooled SMD 0.80; 95% CI [0.44, 1.17]; p<0.0001) but this association was no longer significant when adjusted OR were pooled (OR 0.99 (95% CI 0.98-1.01)). Conclusions Higher circulating levels of, fibrinogen and HMGB1 are associated with poorer outcomes after ICH. This study highlights the clinical importance of the inflammatory response to ICH and identifies additional research needs in determining if these associations are mediated via PHO and are potential therapeutic targets. Registration PROSPERO ( CRD42019132628; 28/05/2019).
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Affiliation(s)
- Caoimhe Kirby
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Jack Barrington
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Lotte Sondag
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - James J.M. Loan
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Floris H.B.M. Schreuder
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Barry W. McColl
- Centre for Discovery Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- UK Dementia Research Institute, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Catharina J.M. Klijn
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud Universiteit, Nijmegen, Gelderland, The Netherlands
| | - Rustam Al-Shahi Salman
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
| | - Neshika Samarasekera
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
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Liang D, Zeng X, Yao M, Li F, Lin J, Zhang L, Liu J, Huang L. Dynamic changes in the glycocalyx and clinical outcomes in patients undergoing endovascular treatments for large vessel occlusion. Front Neurol 2023; 14:1046915. [PMID: 36779062 PMCID: PMC9909103 DOI: 10.3389/fneur.2023.1046915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 01/09/2023] [Indexed: 01/27/2023] Open
Abstract
Purpose We aimed to verify the prognostic value of the glycocalyx as a marker of blood-brain barrier damage in patients with acute ischemic stroke undergoing endovascular therapy. Methods We recruited patients with large vessel occlusion who were undergoing recanalization and tested their glycocalyx at multiple time points. On the basis of the 90-day follow-up data, the patients were divided into a survivor group and a nonsurvivor group. In addition, neurological function was tracked, and patients were divided into a neurological deterioration group and a group without neurological deterioration. Associations between outcomes and dynamic changes in the glycocalyx were determined using a linear mixed model, and significant factors were used as covariates. Results Nonsurvivors and patients with neurological deterioration had significantly higher syndecan-1 concentrations than survivors and patients without neurological deterioration, and syndecan-1 tended to decline after endovascular therapy (p < 0.05). The increased level of syndecan-1 at 36 h after endovascular treatment was positively correlated with the National Institute of Health Stroke Scale score for neurological deterioration (r = 0.702, p = 0.005). However, there was no significant difference in the level of hyaluronic acid or heparan sulfate in the plasma of patients with different clinical outcomes. Conclusion Pre-reperfusion syndecan-1 levels in patients with large vessel occlusion stroke are associated with 90-day mortality and the re-degradation of syndecan-1 is positively associated with neurological deterioration.
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Affiliation(s)
- Dan Liang
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China,Department of Neurology, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
| | - Xiuli Zeng
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Mingzheng Yao
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Fei Li
- Department of Neurology, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, China
| | - Jiaxing Lin
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Liang Zhang
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China
| | - Jialin Liu
- Department of Neurology, Meizhou People's Hospital, Meizhou, China
| | - Li'an Huang
- Department of Neurology, The First Affiliated Hospital, Jinan University, Guangzhou, China,*Correspondence: Li'an Huang ✉
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Matsuyama T, Yoshinaga SK, Shibue K, Mak TW. Comorbidity-associated glutamine deficiency is a predisposition to severe COVID-19. Cell Death Differ 2021; 28:3199-3213. [PMID: 34663907 PMCID: PMC8522258 DOI: 10.1038/s41418-021-00892-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 09/30/2021] [Accepted: 10/04/2021] [Indexed: 12/15/2022] Open
Abstract
SARS-CoV-2 vaccinations have greatly reduced COVID-19 cases, but we must continue to develop our understanding of the nature of the disease and its effects on human immunity. Previously, we suggested that a dysregulated STAT3 pathway following SARS-Co-2 infection ultimately leads to PAI-1 activation and cascades of pathologies. The major COVID-19-associated metabolic risks (old age, hypertension, cardiovascular diseases, diabetes, and obesity) share high PAI-1 levels and could predispose certain groups to severe COVID-19 complications. In this review article, we describe the common metabolic profile that is shared between all of these high-risk groups and COVID-19. This profile not only involves high levels of PAI-1 and STAT3 as previously described, but also includes low levels of glutamine and NAD+, coupled with overproduction of hyaluronan (HA). SARS-CoV-2 infection exacerbates this metabolic imbalance and predisposes these patients to the severe pathophysiologies of COVID-19, including the involvement of NETs (neutrophil extracellular traps) and HA overproduction in the lung. While hyperinflammation due to proinflammatory cytokine overproduction has been frequently documented, it is recently recognized that the immune response is markedly suppressed in some cases by the expansion and activity of MDSCs (myeloid-derived suppressor cells) and FoxP3+ Tregs (regulatory T cells). The metabolomics profiles of severe COVID-19 patients and patients with advanced cancer are similar, and in high-risk patients, SARS-CoV-2 infection leads to aberrant STAT3 activation, which promotes a cancer-like metabolism. We propose that glutamine deficiency and overproduced HA is the central metabolic characteristic of COVID-19 and its high-risk groups. We suggest the usage of glutamine supplementation and the repurposing of cancer drugs to prevent the development of severe COVID-19 pneumonia.
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Affiliation(s)
- Toshifumi Matsuyama
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan.
| | | | - Kimitaka Shibue
- Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan
| | - Tak W Mak
- Princess Margaret Cancer Centre, University Health Network, 610 University Avenue, Toronto, ON, M5G 2M9, Canada
- Department of Medical Biophysics, University of Toronto, 101 College Street, Toronto, ON, M5G 1L7, Canada
- Department of Immunology, University of Toronto, 101 College Street, Toronto, ON, M5G 1L7, Canada
- Department of Pathology, University of Hong Kong, Hong Kong, Pok Fu Lam, 999077, Hong Kong
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Brain Immune Interactions-Novel Emerging Options to Treat Acute Ischemic Brain Injury. Cells 2021; 10:cells10092429. [PMID: 34572077 PMCID: PMC8472028 DOI: 10.3390/cells10092429] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 12/25/2022] Open
Abstract
Ischemic stroke is still among the leading causes of mortality and morbidity worldwide. Despite intensive advancements in medical sciences, the clinical options to treat ischemic stroke are limited to thrombectomy and thrombolysis using tissue plasminogen activator within a narrow time window after stroke. Current state of the art knowledge reveals the critical role of local and systemic inflammation after stroke that can be triggered by interactions taking place at the brain and immune system interface. Here, we discuss different cellular and molecular mechanisms through which brain–immune interactions can take place. Moreover, we discuss the evidence how the brain influence immune system through the release of brain derived antigens, damage-associated molecular patterns (DAMPs), cytokines, chemokines, upregulated adhesion molecules, through infiltration, activation and polarization of immune cells in the CNS. Furthermore, the emerging concept of stemness-induced cellular immunity in the context of neurodevelopment and brain disease, focusing on ischemic implications, is discussed. Finally, we discuss current evidence on brain–immune system interaction through the autonomic nervous system after ischemic stroke. All of these mechanisms represent potential pharmacological targets and promising future research directions for clinically relevant discoveries.
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Alex Matos Ribeiro J, Fernanda García-Salazar L, Regina Saade-Pacheco C, Shirley Moreira Silva É, Garcia Oliveira S, Flávia Silveira A, Sanches Garcia-Araújo A, Luiz Russo T. Prognostic molecular markers for motor recovery in acute hemorrhagic stroke: A systematic review. Clin Chim Acta 2021; 522:45-60. [PMID: 34389283 DOI: 10.1016/j.cca.2021.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/06/2021] [Accepted: 08/07/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Molecular biomarkers are associated with poor prognosis in ischemic stroke individuals. However, it might not be generalizable to post-acute hemorrhagic stroke since the underlying mechanisms of this brain damage differ from those found in ischemic stroke. The main purpose of this review was to synthesize the potential predictive molecular biomarkers for motor recovery following acute hemorrhagic stroke. MATERIALS AND METHODS An electronic search was conducted by 2 independent reviewers in the following databases: PubMed (Medline), EMBASE, Web of Science, and CINAHL. We included studies that addressed the following: collected blood, urine, or cerebrospinal fluid samples within 72 h after hemorrhagic stroke and that reported the prognostic association with functional motor recovery for each molecular biomarker. Screening of titles, abstracts, and full texts and data extraction were undertaken independently by pairs of reviewers. RESULTS Twelve thousand, five hundred and sixty-four studies were identified and 218 were considered eligible. Finally, we included 70 studies, with 96 biomarkers analyzed, of which 61 were considered as independent prognostic biomarkers, and 10 presented controversial results. CONCLUSION This systematic review shows that motor functional recovery can be predicted by 61 independent prognostic molecular biomarkers assessed in the acute phase after a hemorrhagic stroke.
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Affiliation(s)
| | - Luisa Fernanda García-Salazar
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, Brazil; Universidad del Rosario, School of Medicine and Health Sciences, Rehabilitation Science Research Group, Bogotá, Colombia.
| | - Cássia Regina Saade-Pacheco
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, Brazil; Educational Foundation of the Municipality of Assis, Municipal Institute of Higher Education of Assis, Assis, Brazil.
| | | | | | - Ana Flávia Silveira
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, Brazil.
| | | | - Thiago Luiz Russo
- Federal University of São Carlos, Department of Physical Therapy, São Carlos, Brazil.
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Lv Y, Sun Q, Li J, Zhang W, He Y, Zhou Y. Disability Status and Its Influencing Factors Among Stroke Patients in Northeast China: A 3-Year Follow-Up Study. Neuropsychiatr Dis Treat 2021; 17:2567-2573. [PMID: 34393485 PMCID: PMC8357400 DOI: 10.2147/ndt.s320785] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 07/12/2021] [Indexed: 12/21/2022] Open
Abstract
PURPOSE To explore the rate of post-stroke disability and its associated factors in the third year following discharge from inpatient rehabilitation in Northeast China. DESIGN A prospective cohort study. METHODS A total of 522 persons who were hospitalized with a diagnosis of stroke were recruited consecutively between April 2015 and December 2015 and followed for 3 years. The primary outcome was disability, which was assessed using the Modified Barthel Index (MBI), a cutoff score of ≤95 indicates disability. Plausible risk factors of disability were selected from available variables to perform multivariate logistic regression analysis. FINDINGS The proportion of post-stroke patients with disability decreased from 63.8% to 46.7% at 3-year follow-up. The factors associated with post-stroke disability were age, neurological deficits, cognitive function, depression, and social support. CONCLUSIONS/CLINICAL RELEVANCE Disability continues to be a significant issue for individuals after a stroke, and community health workers should perform targeted assessments and interventions to decrease disability, and pay special attention to individuals who are at greatest risk of post-stroke disability.
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Affiliation(s)
- Yumei Lv
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
| | - Qiuxue Sun
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
| | - Juan Li
- Department of Pneumology, Qingdao Hospital of Traditional Chinese Medicine, Qingdao, Shangdong Province, People’s Republic of China
| | - Wenyue Zhang
- Department of Rehabilitation, People’s Hospital of Daqing, Daqing, Heilongjiang Province, People’s Republic of China
| | - Yudi He
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
| | - Yuqiu Zhou
- School of Nursing, Harbin Medical University (Daqing), Daqing, Heilongjiang Province, People’s Republic of China
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Ding HY, Xie YN, Dong Q, Kimata K, Nishida Y, Ishiguro N, Zhuo LS. Roles of hyaluronan in cardiovascular and nervous system disorders. J Zhejiang Univ Sci B 2019; 20:428-436. [PMID: 31090268 DOI: 10.1631/jzus.b1900155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Hyaluronan is a widely occurring extracellular matrix molecule, which is not only a supporting structural component, but also an active regulator of cellular functions. The chemophysical and biological properties of hyaluronan are greatly affected by its molecular size and several hyaluronan-binding proteins, making hyaluronan a fascinating molecule with great functional diversity. This review summarizes our current understanding of the roles of hyaluronan in cardiovascular and nervous system disorders, such as atherosclerosis, myocardial infarction, and stroke, with the aim to provide a foundation for future research and clinical trials.
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Affiliation(s)
- Hong-Yan Ding
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Ya-Nan Xie
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Qiang Dong
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China
| | - Koji Kimata
- Multidisciplinary Pain Center, Aichi Medical University, Nagakute, Aichi 480-1195, Japan
| | - Yoshihiro Nishida
- Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Naoki Ishiguro
- Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
| | - Li-Sheng Zhuo
- Nagoya University Graduate School of Medicine, Nagoya, Aichi 466-8550, Japan
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9
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Dysregulation of Hyaluronan Homeostasis During White Matter Injury. Neurochem Res 2019; 45:672-683. [PMID: 31542857 DOI: 10.1007/s11064-019-02879-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/16/2019] [Accepted: 09/16/2019] [Indexed: 12/13/2022]
Abstract
Although the extra cellular matrix (ECM) comprises a major proportion of the CNS parenchyma, new roles for the ECM in regeneration and repair responses to CNS injury have only recently been appreciated. The ECM undergoes extensive remodeling following injury to the developing or mature CNS in disorders that -include perinatal hypoxic-ischemic cerebral injury, multiple sclerosis and age-related vascular dementia. Here we focus on recently described mechanisms involving hyaluronan (HA), which negatively impact myelin repair after cerebral white matter injury. Injury induced depolymerization of hyaluronan (HA)-a component of the neural ECM-can inhibit myelin repair through the actions of specific sizes of HA fragments. These bioactive fragments selectively block the maturation of late oligodendrocyte progenitors via an immune tolerance-like pathway that suppresses pro-myelination signaling. We highlight emerging new pathophysiological roles of the neural ECM, particularly of those played by HA fragments (HAf) after injury and discuss strategies to promoter repair and regeneration of chronic myelination failure.
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Al-Ahmad AJ, Patel R, Palecek SP, Shusta EV. Hyaluronan impairs the barrier integrity of brain microvascular endothelial cells through a CD44-dependent pathway. J Cereb Blood Flow Metab 2019; 39:1759-1775. [PMID: 29589805 PMCID: PMC6727144 DOI: 10.1177/0271678x18767748] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Hyaluronan (HA) constitutes the most abundant extracellular matrix component during brain development, only to become a minor component rapidly after birth and in adulthood to remain in specified regions. HA signaling has been associated with several neurological disorders, yet the impact of HA signaling at the blood-brain barrier (BBB) function remains undocumented. In this study, we investigated the impact of HA on BBB properties using human-induced pluripotent stem cell (iPSC) -derived and primary human and rat BMECs. The impact of HA signaling on developmental and mature BMECs was assessed by measuring changes in TEER, permeability, BMECs markers (GLUT1, tight junction proteins, P-gp) expression and localization, CD44 expression and hyaluronan levels. In general, HA treatment decreased barrier function and reduced P-gp activity with effects being more prominent upon treatment with oligomeric forms of HA (oHA). Such effects were exacerbated when applied during BMEC differentiation phase (considered as developmental BBB). We noted a hyaluronidase activity as well as an increase in CD44 expression during prolonged oxygen-glucose deprivation stress. Inhibition of HA signaling by antibody blockade of CD44 abrogated the detrimental effects of HA treatment. These results suggest the importance of HA signaling through CD44 on BBB properties.
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Affiliation(s)
- Abraham J Al-Ahmad
- 1 Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, WI, USA.,2 Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX, USA
| | - Ronak Patel
- 2 Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX, USA
| | - Sean P Palecek
- 1 Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, WI, USA
| | - Eric V Shusta
- 1 Department of Chemical and Biological Engineering, University of Wisconsin-Madison, Madison, WI, USA
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Gülke E, Gelderblom M, Magnus T. Danger signals in stroke and their role on microglia activation after ischemia. Ther Adv Neurol Disord 2018; 11:1756286418774254. [PMID: 29854002 PMCID: PMC5968660 DOI: 10.1177/1756286418774254] [Citation(s) in RCA: 146] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Accepted: 04/10/2018] [Indexed: 12/26/2022] Open
Abstract
Ischemic stroke is a major cause of death. Besides the direct damage resulting from oxygen and glucose deprivation, sterile inflammation plays a pivotal role in increasing cellular death. Damaged-associated molecular patterns (DAMPs) are passively released from dying cells and activate the innate immune system. Thus, they take part in the direct and rapid activation of the inflammatory response after stroke onset. In this review the role of the most important DAMPs, high mobility group box 1, heat and cold shock proteins, purines, and peroxiredoxins, are addressed. Moreover, intracellular pathways activated by DAMPs in microglia are illuminated.
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Affiliation(s)
- Eileen Gülke
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Mathias Gelderblom
- Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246 Hamburg, Germany
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Wang KC, Tang SC, Lee JE, Li YI, Huang YS, Yang WS, Jeng JS, Arumugam TV, Tu YK. Cerebrospinal fluid high mobility group box 1 is associated with neuronal death in subarachnoid hemorrhage. J Cereb Blood Flow Metab 2017; 37:435-443. [PMID: 26823474 PMCID: PMC5381442 DOI: 10.1177/0271678x16629484] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We aim to determine the cerebrospinal fluid levels of high mobility group box 1 in subarachnoid hemorrhage patients and to investigate the involvement of the receptor for advanced glycation end products and high mobility group box 1 in the pathogenesis of post-subarachnoid hemorrhage neuronal death. The study included 40 patients (mean age, 59 ± 19 years) with Fisher's grade ≥ III aneurysmal subarachnoid hemorrhage. Cerebrospinal fluid was collected on the seventh day post-hemorrhage. Receptor for advanced glycation end products expression was examined in rat brain tissue following subarachnoid hemorrhage and in cultured neurons exposed to post-subarachnoid hemorrhage cerebrospinal fluid. Therapeutic effects of the recombinant soluble form of RAGE on subarachnoid hemorrhage models were also investigated. The results indicated that a higher level of cerebrospinal fluid high mobility group box 1 was independently associated with unfavorable outcome at three months post-subarachnoid hemorrhage (OR = 1.061, 95% CI: 1.005-1.121). Expression of RAGE increased in post-subarachnoid hemorrhage rat brain cells and in cultured neuron with stimulation of post-subarachnoid hemorrhage cerebrospinal fluid. Administration of recombinant soluble form of RAGE significantly reduced the number of positive TUNEL staining cells in subarachnoid hemorrhage rat and improved cell viability in post-subarachnoid hemorrhage cerebrospinal fluid-treated cultured neurons. Thus, the level of cerebrospinal fluid high mobility group box 1 can be a prognostic indicator for patients with Fisher's grade ≥ III aneurysmal subarachnoid hemorrhage and that treatment with soluble form of RAGE is a novel approach for subarachnoid hemorrhage.
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Affiliation(s)
- Kuo-Chuan Wang
- 1 Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Chun Tang
- 2 Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jing-Er Lee
- 3 Department of Neurology, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan
| | - Yu-I Li
- 4 Department and Graduate Institute of Forensic Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yi-Shuian Huang
- 5 Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Wei-Shiung Yang
- 6 Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,7 Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University Taipei, Taiwan
| | - Jiann-Shing Jeng
- 2 Department of Neurology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Thiruma V Arumugam
- 8 Department of Physiology, Yong Loo Lin School Medicine, National University of Singapore, Singapore
| | - Yong-Kwang Tu
- 1 Division of Neurosurgery, Department of Surgery, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Tang SC, Yeh SJ, Tsai LK, Hu CJ, Lien LM, Peng GS, Yang WS, Chiou HY, Jeng JS. Cleaved but not endogenous secretory RAGE is associated with outcome in acute ischemic stroke. Neurology 2015; 86:270-6. [PMID: 26683643 DOI: 10.1212/wnl.0000000000002287] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 09/18/2015] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the expression patterns of 2 soluble isoforms of receptor for advanced glycation end-product (RAGE), including endogenous secretory RAGE (esRAGE) and cleaved RAGE (cRAGE), and their associations with outcome in acute ischemic stroke (IS). METHODS Acute IS patients (n = 106) and age- and sex-matched controls (n = 150) were recruited. Plasma levels of total soluble RAGE (sRAGE) and esRAGE in patients at <48 hours and 48-72 hours after IS and in controls were measured by ELISA. The level of cRAGE was calculated by subtracting the level of sRAGE from that of esRAGE. Poor outcome was defined as modified Rankin Scale score >2 at 3 months after stroke. RESULTS The plasma levels of cRAGE were significantly higher and correlated to those of esRAGE (p < 0.001). The plasma levels of esRAGE and cRAGE were both significantly higher in IS patients <48 hours and 48-72 hours after onset than in controls, but only level of cRAGE at <48 hours was independently associated with poor outcome after adjusting for clinical variables (odds ratio 2.44; 95% confidence interval 1.16-5.16; p = 0.019). CONCLUSION The plasma level of cRAGE at <48 hours after IS, rather than esRAGE, is a significant predictor of acute IS outcome.
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Affiliation(s)
- Sung-Chun Tang
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Shin-Joe Yeh
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Li-Kai Tsai
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Chaur-Jong Hu
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Li-Ming Lien
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Giia-Sheun Peng
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Wei-Shiung Yang
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Hung-Yi Chiou
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan
| | - Jiann-Shing Jeng
- From the Stroke Center and Department of Neurology (S.-C.T., S.-J.Y., L.-K.T., J.-S.J.), Department of Internal Medicine (W.-S.Y.), National Taiwan University Hospital; the Department of Neurology (C.-J.H.), Taipei Medical University Hospital and Shuang Ho Hospital; the Department of Neurology (L.-M.L.), Shin Kong Wu Ho-Su Memorial Hospital; the Department of Neurology (G.-S.P.), Tri-Service General Hospital; and the School of Public Health (H.-Y.C.), Taipei Medical University, Taipei, Taiwan.
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Hyaluronan Synthesis, Catabolism, and Signaling in Neurodegenerative Diseases. Int J Cell Biol 2015; 2015:368584. [PMID: 26448752 PMCID: PMC4581574 DOI: 10.1155/2015/368584] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Accepted: 04/11/2015] [Indexed: 11/18/2022] Open
Abstract
The glycosaminoglycan hyaluronan (HA), a component of the extracellular matrix, has been implicated in regulating neural differentiation, survival, proliferation, migration, and cell signaling in the mammalian central nervous system (CNS). HA is found throughout the CNS as a constituent of proteoglycans, especially within perineuronal nets that have been implicated in regulating neuronal activity. HA is also found in the white matter where it is diffusely distributed around astrocytes and oligodendrocytes. Insults to the CNS lead to long-term elevation of HA within damaged tissues, which is linked at least in part to increased transcription of HA synthases. HA accumulation is often accompanied by elevated expression of at least some transmembrane HA receptors including CD44. Hyaluronidases that digest high molecular weight HA into smaller fragments are also elevated following CNS insults and can generate HA digestion products that have unique biological activities. A number of studies, for example, suggest that both the removal of high molecular weight HA and the accumulation of hyaluronidase-generated HA digestion products can impact CNS injuries through mechanisms that include the regulation of progenitor cell differentiation and proliferation. These studies, reviewed here, suggest that targeting HA synthesis, catabolism, and signaling are all potential strategies to promote CNS repair.
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