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Sun F, Zhou J, Chen X, Yang T, Wang G, Ge J, Zhang Z, Mei Z. No-reflow after recanalization in ischemic stroke: From pathomechanisms to therapeutic strategies. J Cereb Blood Flow Metab 2024; 44:857-880. [PMID: 38420850 DOI: 10.1177/0271678x241237159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Endovascular reperfusion therapy is the primary strategy for acute ischemic stroke. No-reflow is a common phenomenon, which is defined as the failure of microcirculatory reperfusion despite clot removal by thrombolysis or mechanical embolization. It has been reported that up to 25% of ischemic strokes suffer from no-reflow, which strongly contributes to an increased risk of poor clinical outcomes. No-reflow is associated with functional and structural alterations of cerebrovascular microcirculation, and the injury to the microcirculation seriously hinders the neural functional recovery following macrovascular reperfusion. Accumulated evidence indicates that pathology of no-reflow is linked to adhesion, aggregation, and rolling of blood components along the endothelium, capillary stagnation with neutrophils, astrocytes end-feet, and endothelial cell edema, pericyte contraction, and vasoconstriction. Prevention or treatment strategies aim to alleviate or reverse these pathological changes, including targeted therapies such as cilostazol, adhesion molecule blocking antibodies, peroxisome proliferator-activated receptors (PPARs) activator, adenosine, pericyte regulators, as well as adjunctive therapies, such as extracorporeal counterpulsation, ischemic preconditioning, and alternative or complementary therapies. Herein, we provide an overview of pathomechanisms, predictive factors, diagnosis, and intervention strategies for no-reflow, and attempt to convey a new perspective on the clinical management of no-reflow post-ischemic stroke.
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Affiliation(s)
- Feiyue Sun
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jing Zhou
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Xiangyu Chen
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Tong Yang
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Guozuo Wang
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Jinwen Ge
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Hunan Academy of Chinese Medicine, Changsha, Hunan, China
| | - Zhanwei Zhang
- The First Affiliated Hospital of Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Zhigang Mei
- Key Laboratory of Hunan Province for Integrated Traditional Chinese and Western Medicine on Prevention and Treatment of Cardio-Cerebral Diseases, College of Integrated Traditional Chinese Medicine and Western Medicine, Hunan University of Chinese Medicine, Changsha, Hunan, China
- Third-Grade Pharmacological Laboratory on Chinese Medicine Approved by State Administration of Traditional Chinese Medicine, College of Medicine and Health Sciences, China Three Gorges University, Yichang, Hubei, China
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2
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Yang Q, Ye W, Luo D, Xing J, Xiao Q, Wu H, Yao Y, Wang G, Yang L, Guo D, Wang K, He Y, Ye X, Zhang J, Jin Z, Fan Z, Wen X, Mao J, Chen X, Zhao Q. Neuroprotective effects of anti-TRAIL-ICG nanoagent and its multimodal imaging evaluation in cerebral ischemia-reperfusion injury. Mater Today Bio 2024; 26:101094. [PMID: 38854952 PMCID: PMC11157279 DOI: 10.1016/j.mtbio.2024.101094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 05/08/2024] [Accepted: 05/19/2024] [Indexed: 06/11/2024] Open
Abstract
Cerebral ischemia-reperfusion injury (CIRI) is a major challenge to neuronal survival in acute ischemic stroke (AIS). However, effective neuroprotective agents remain to be developed for the treatment of CIRI. In this work, we have developed an Anti-TRAIL protein-modified and indocyanine green (ICG)-responsive nanoagent (Anti-TRAIL-ICG) to target ischemic areas and then reduce CIRI and rescue the ischemic penumbra. In vitro and in vivo experiments have demonstrated that the carrier-free nanoagent can enhance drug transport across the blood-brain barrier (BBB) in stroke mice, exhibiting high targeting ability and good biocompatibility. Anti-TRAIL-ICG nanoagent played a better neuroprotective role by reducing apoptosis and ferroptosis, and significantly improved ischemia-reperfusion injury. Moreover, the multimodal imaging platform enables the dynamic in vivo examination of multiple morphofunctional information, so that the dynamic molecular events of nanoagent can be detected continuously and in real time for early treatment in transient middle cerebral artery occlusion (tMCAO) models. Furthermore, it has been found that Anti-TRAIL-ICG has great potential in the functional reconstruction of neurovascular networks through optical coherence tomography angiography (OCTA). Taken together, our work effectively alleviates CIRI after stoke by blocking multiple cell death pathways, which offers an innovative strategy for harnessing the apoptosis and ferroptosis against CIRI.
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Affiliation(s)
- Qiong Yang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Wenxuan Ye
- The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Doudou Luo
- The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361102, China
| | - Jiwei Xing
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Qingqing Xiao
- Department of Vascular Intervention, Guilin Medical College Affiliated Hospital, Guilin Medical College, Guilin, 541000, China
| | - Huiling Wu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Youliang Yao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Guangxing Wang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Luyao Yang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Dongbei Guo
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Kun Wang
- Key Laboratory of Optoelectronic Science and Technology for Medicine of Ministry of Education, Fujian Normal University, Fuzhou, 350117, China
| | - Yaqin He
- Department of Oncology Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Xiaofeng Ye
- Department of Oncology Surgery, General Hospital of Ningxia Medical University, Yinchuan, 750004, China
| | - Jinde Zhang
- Institute of Advanced Science Facilities, Shenzhen, Guangdong, 518107, China
| | - Zhaokui Jin
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, 511436, China
| | - Zhongxiong Fan
- School of Pharmaceutical Sciences and Institute of Materia Medica, Xinjiang University, Urumqi, 830017, China
| | - Xiaofei Wen
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
| | - Jingsong Mao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
- Department of Vascular Intervention, Guilin Medical College Affiliated Hospital, Guilin Medical College, Guilin, 541000, China
| | - Xiaoyuan Chen
- Yong Loo Lin School of Medicine and Faculty of Engineering, National University of Singapore, Singapore, 117597, Singapore
| | - Qingliang Zhao
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, Center for Molecular Imaging and Translational Medicine, Department of Vascular & Tumor Interventional Radiology, The First Affiliated Hospital of Xiamen University, School of Medicine, School of Public Health, Xiamen University, Xiamen, 361102, China
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Quan X, Liang X, Ding Y, Han Y, Li J, Yuan M, Li Y, Yuan Z, Wang R, Zhao Y. Cryo-Shocked Platelet Coupled with ROS-Responsive Nanomedicine for Targeted Treatment of Thromboembolic Disease. ACS NANO 2023; 17:6519-6533. [PMID: 36971410 DOI: 10.1021/acsnano.2c11865] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Thrombolysis with tissue plasminogen activator (tPA) provides the most common therapy for ischemic stroke onset within the past 4.5 h. However, enhanced neutrophil infiltration and secondary blood-brain barrier injury caused by tPA administration have limited its therapeutic application, and tPA treatment is often accompanied by hemorrhagic transformation. To overcome the limitations of thrombolysis by tPA, maximize the therapeutic efficacy, and improve the safety, herein, we report a cryo-shocked platelet-based cell-hitchhiking drug delivery system, which consists of cryo-shocked platelet (CsPLT) and reactive oxygen species (ROS)-responsive liposomes loaded with thrombolytic tPA and anti-inflammation drug aspirin (ASA). CsPLT and liposomes were facilely conjugated via host-guest interactions. Under the guidance of CsPLT, it selectively accumulated in the thrombus site and quickly released the therapeutic payloads in response to the high ROS. tPA subsequently exhibited localized thrombolytic activity to suppress the expansion of thrombus, while ASA assisted in the inactivation of reactive astrogliosis, microglial/macrophage, and obstruction of neutrophil infiltration. This cryo-shocked platelet-hitchhiking tPA/ASA delivery system not only improves the thrombus-targeting efficiency of the two drugs for highly localized thrombolytic effects and anti-inflammation actions and platelets inactivation but also provides insights to the development of targeted drug delivery systems for thromboembolic disease treatment.
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Affiliation(s)
- Xingping Quan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Xiao Liang
- Cancer Center, Faculty of Health Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Yuanfu Ding
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Yan Han
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Junyan Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Mengchen Yuan
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Yiyang Li
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Zhen Yuan
- Cancer Center, Faculty of Health Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Ruibing Wang
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
- Department of Pharmaceutical Sciences, Faculty of Health Sciences, University of Macau, Taipa, Macau, SAR 999078, China
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macau, SAR 999078, China
- Department of Pharmaceutical Sciences, Faculty of Health Sciences, University of Macau, Taipa, Macau, SAR 999078, China
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Bice AR, Xiao Q, Kong J, Yan P, Rosenthal ZP, Kraft AW, Smith KP, Wieloch T, Lee JM, Culver JP, Bauer AQ. Homotopic contralesional excitation suppresses spontaneous circuit repair and global network reconnections following ischemic stroke. eLife 2022; 11:e68852. [PMID: 35723585 PMCID: PMC9333991 DOI: 10.7554/elife.68852] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Understanding circuit-level manipulations that affect the brain's capacity for plasticity will inform the design of targeted interventions that enhance recovery after stroke. Following stroke, increased contralesional activity (e.g. use of the unaffected limb) can negatively influence recovery, but it is unknown which specific neural connections exert this influence, and to what extent increased contralesional activity affects systems- and molecular-level biomarkers of recovery. Here, we combine optogenetic photostimulation with optical intrinsic signal imaging to examine how contralesional excitatory activity affects cortical remodeling after stroke in mice. Following photothrombosis of left primary somatosensory forepaw (S1FP) cortex, mice either recovered spontaneously or received chronic optogenetic excitation of right S1FP over the course of 4 weeks. Contralesional excitation suppressed perilesional S1FP remapping and was associated with abnormal patterns of stimulus-evoked activity in the unaffected limb. This maneuver also prevented the restoration of resting-state functional connectivity (RSFC) within the S1FP network, RSFC in several networks functionally distinct from somatomotor regions, and resulted in persistent limb-use asymmetry. In stimulated mice, perilesional tissue exhibited transcriptional changes in several genes relevant for recovery. Our results suggest that contralesional excitation impedes local and global circuit reconnection through suppression of cortical activity and several neuroplasticity-related genes after stroke, and highlight the importance of site selection for targeted therapeutic interventions after focal ischemia.
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Affiliation(s)
- Annie R Bice
- Department of Radiology, Washington University in St. LouisSaint LouisUnited States
| | - Qingli Xiao
- Department of Neurology, Washington University in St. LouisSaint LouisUnited States
| | - Justin Kong
- Department of Biology, Washington University in St. LouisSaint LouisUnited States
| | - Ping Yan
- Department of Neurology, Washington University in St. LouisSaint LouisUnited States
| | | | - Andrew W Kraft
- Department of Neurology, Washington University in St. LouisSaint LouisUnited States
| | - Karen P Smith
- Department of Neurology, Washington University in St. LouisSaint LouisUnited States
| | | | - Jin-Moo Lee
- Department of Neurology, Washington University in St. LouisSaint LouisUnited States
| | - Joseph P Culver
- Department of Radiology, Washington University in St. LouisSt. LouisUnited States
| | - Adam Q Bauer
- Department of Radiology, Washington University in St. LouisSaint LouisUnited States
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5
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Chen X, Wang J, Ge L, Lu G, Wan H, Jiang Y, Yao Z, Deng G, Zhang X. A fibrin targeted molecular imaging evaluation of microvascular no-reflow in acute ischemic stroke. Brain Behav 2022; 12:e2474. [PMID: 35025138 PMCID: PMC8865146 DOI: 10.1002/brb3.2474] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 11/21/2021] [Accepted: 12/13/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE To investigate the relationship between fibrin deposition and "no-reflow" within microcirculation after thrombolysis in acute ischemic stroke (AIS). MATERIALS AND METHODS Experiments were approved by the institutional animal care and use committee. An experimental AIS model was induced in C57BL/6 mice by middle cerebral artery occlusion (MCAO) via the photothrombotic method. Mice were randomly assigned to non-thrombolytic or thrombolytic treated groups (n = 12 per group). The modified Neurological Severity Score and Fast Beam Balance Test were performed by a researcher blinded to the treatment method. MRI was utilized to evaluate all of the mice. An FXIIIa-targeted probe was applied to detect fibrin deposition in acute ischemic brain regions by fluorescence imaging. Necrosis and pathological changes of brain tissue were estimated via Hematoxylin and eosin staining while fibrin deposition was observed by immunohistochemistry. RESULTS Thrombolytic therapy improved AIS clinical symptoms. The infarct area of non-thrombolytic treated mice was significantly greater than that of the thrombolytic treated mice (p < .0001). Fluorescent imaging indicated fibrin deposition in ischemic brain tissue in both groups, with less fibrin in non-thrombolytic treated mice than thrombolytic treated mice, though the difference was not significant. Brain cells with abnormal morphology, necrosis, and liquefication were observed in the infarcted area for both groups. Clotted red blood cells (RBCs) and fibrin build-up in capillaries were found near the ischemic area in both non-thrombolytic and thrombolytic treated groups of mice. CONCLUSION Fibrin deposition and stacked RBCs contribute to microcirculation no-reflow in AIS after thrombolytic therapy.
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Affiliation(s)
- Xi Chen
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Liang Ge
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Gang Lu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Hailin Wan
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yeqing Jiang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenwei Yao
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Gang Deng
- Department of Intervention and Vascular Surgery, Zhongda Hospital, Southeast University, Nanjing, China
| | - Xiaolong Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
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Stefan S, Lee J. Deep learning toolbox for automated enhancement, segmentation, and graphing of cortical optical coherence tomography microangiograms. BIOMEDICAL OPTICS EXPRESS 2020; 11:7325-7342. [PMID: 33409000 PMCID: PMC7747889 DOI: 10.1364/boe.405763] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/17/2020] [Accepted: 11/17/2020] [Indexed: 05/03/2023]
Abstract
Optical coherence tomography angiography (OCTA) is becoming increasingly popular for neuroscientific study, but it remains challenging to objectively quantify angioarchitectural properties from 3D OCTA images. This is mainly due to projection artifacts or "tails" underneath vessels caused by multiple-scattering, as well as the relatively low signal-to-noise ratio compared to fluorescence-based imaging modalities. Here, we propose a set of deep learning approaches based on convolutional neural networks (CNNs) to automated enhancement, segmentation and gap-correction of OCTA images, especially of those obtained from the rodent cortex. Additionally, we present a strategy for skeletonizing the segmented OCTA and extracting the underlying vascular graph, which enables the quantitative assessment of various angioarchitectural properties, including individual vessel lengths and tortuosity. These tools, including the trained CNNs, are made publicly available as a user-friendly toolbox for researchers to input their OCTA images and subsequently receive the underlying vascular network graph with the associated angioarchitectural properties.
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Affiliation(s)
- Sabina Stefan
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI 02912, USA
| | - Jonghwan Lee
- Center for Biomedical Engineering, School of Engineering, Brown University, Providence, RI 02912, USA
- Carney Institute for Brain Science, Brown University, Providence, RI 02912, USA
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7
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Li Y, Rakymzhan A, Tang P, Wang RK. Procedure and protocols for optical imaging of cerebral blood flow and hemodynamics in awake mice. BIOMEDICAL OPTICS EXPRESS 2020; 11:3288-3300. [PMID: 32637255 PMCID: PMC7316002 DOI: 10.1364/boe.394649] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/09/2020] [Accepted: 05/19/2020] [Indexed: 05/10/2023]
Abstract
We describe a method and procedure that allows for the optical coherence tomography angiography (OCTA) and intrinsic optical signal imaging (IOSI) of cerebral blood flow and hemodynamics in fully awake mice. We detail the procedure of chronic cranial window preparation, the use of an air-lift mobile homecage to achieve stable optical recording in the head-restrained awake mouse, and the imaging methods to achieve multiparametric hemodynamic measurements. The results show that by using a collection of OCTA algorithms, the high-resolution cerebral vasculature can be reliably mapped at a fully awake state, including flow velocity measurements in penetrating arterioles and capillary bed. Lastly, we demonstrate how the awake imaging paradigm is used to study cortical hemodynamics in the mouse barrel cortex during whisker stimulation. The method presented here will facilitate optical recording in the awake, active mice and open the door to many projects that can bridge the hemodynamics in neurovascular units to naturalistic behavior.
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Affiliation(s)
- Turgay Dalkara
- From the Department of Neurology, Faculty of Medicine and Institute of Neurological Sciences and Psychiatry, Hacettepe University, Ankara, Turkey; and Department of Radiology, Massachusetts General Hospital, Harvard University, Boston
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Alarcon-Martinez L, Yilmaz-Ozcan S, Yemisci M, Schallek J, Kılıç K, Villafranca-Baughman D, Can A, Di Polo A, Dalkara T. Retinal ischemia induces α-SMA-mediated capillary pericyte contraction coincident with perivascular glycogen depletion. Acta Neuropathol Commun 2019; 7:134. [PMID: 31429795 PMCID: PMC6701129 DOI: 10.1186/s40478-019-0761-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 06/26/2019] [Indexed: 12/21/2022] Open
Abstract
Increasing evidence indicates that pericytes are vulnerable cells, playing pathophysiological roles in various neurodegenerative processes. Microvascular pericytes contract during cerebral and coronary ischemia and do not relax after re-opening of the occluded artery, causing incomplete reperfusion. However, the cellular mechanisms underlying ischemia-induced pericyte contraction, its delayed emergence, and whether it is pharmacologically reversible are unclear. Here, we investigate i) whether ischemia-induced pericyte contractions are mediated by alpha-smooth muscle actin (α-SMA), ii) the sources of calcium rise in ischemic pericytes, and iii) if peri-microvascular glycogen can support pericyte metabolism during ischemia. Thus, we examined pericyte contractility in response to retinal ischemia both in vivo, using adaptive optics scanning light ophthalmoscopy and, ex vivo, using an unbiased stereological approach. We found that microvascular constrictions were associated with increased calcium in pericytes as detected by a genetically encoded calcium indicator (NG2-GCaMP6) or a fluoroprobe (Fluo-4). Knocking down α-SMA expression with RNA interference or fixing F-actin with phalloidin or calcium antagonist amlodipine prevented constrictions, suggesting that constrictions resulted from calcium- and α-SMA-mediated pericyte contractions. Carbenoxolone or a Cx43-selective peptide blocker also reduced calcium rise, consistent with involvement of gap junction-mediated mechanisms in addition to voltage-gated calcium channels. Pericyte calcium increase and capillary constrictions became significant after 1 h of ischemia and were coincident with depletion of peri-microvascular glycogen, suggesting that glucose derived from glycogen granules could support pericyte metabolism and delay ischemia-induced microvascular dysfunction. Indeed, capillary constrictions emerged earlier when glycogen breakdown was pharmacologically inhibited. Constrictions persisted despite recanalization but were reversible with pericyte-relaxant adenosine administered during recanalization. Our study demonstrates that retinal ischemia, a common cause of blindness, induces α-SMA- and calcium-mediated persistent pericyte contraction, which can be delayed by glucose driven from peri-microvascular glycogen. These findings clarify the contractile nature of capillary pericytes and identify a novel metabolic collaboration between peri-microvascular end-feet and pericytes.
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Affiliation(s)
- Luis Alarcon-Martinez
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
- Department of Neuroscience and Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Sinem Yilmaz-Ozcan
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Muge Yemisci
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
| | - Jesse Schallek
- Flaum Eye Institute and Center for Visual Science, University of Rochester, Rochester, New York, USA
| | - Kıvılcım Kılıç
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey
| | - Deborah Villafranca-Baughman
- Department of Neuroscience and Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Alp Can
- Department of Histology and Embryology, School of Medicine, Ankara University, Ankara, Turkey
| | - Adriana Di Polo
- Department of Neuroscience and Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Université de Montréal, Montréal, Québec, Canada
| | - Turgay Dalkara
- Institute of Neurological Sciences and Psychiatry, Hacettepe University, Sihhiye, 06100, Ankara, Turkey.
- Department of Neurology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
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10
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Choi WJ, Li Y, Wang RK. Monitoring Acute Stroke Progression: Multi-Parametric OCT Imaging of Cortical Perfusion, Flow, and Tissue Scattering in a Mouse Model of Permanent Focal Ischemia. IEEE TRANSACTIONS ON MEDICAL IMAGING 2019; 38:1427-1437. [PMID: 30714910 PMCID: PMC6660833 DOI: 10.1109/tmi.2019.2895779] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Cerebral ischemic stroke causes injury to brain tissue characterized by a complex cascade of neuronal and vascular events. Imaging during the early stages of its development allows prediction of tissue infarction and penumbra so that optimal intervention can be determined in order to salvage brain function impairment. Therefore, there is a critical need for novel imaging techniques that can characterize brain injury in the earliest phases of the ischemic stroke. This paper examined optical coherence tomography (OCT) for imaging acute injury in experimental ischemic stroke in vivo. Based on endogenous optical scattering signals provided by OCT imaging, we have developed a single, integrated imaging platform enabling the measurement of changes in blood perfusion, blood flow, erythrocyte velocity, and light attenuation within a cortical tissue, during focal cerebral ischemia in a mouse model. During the acute phase (from 5 min to the first few hours following the blood occlusion), the multi-parametric OCT imaging revealed multiple hemodynamic and tissue scattering responses in vivo, including cerebral blood flow deficits, capillary non-perfusion, displacement of penetrating vessels, and increased light attenuation in the cortical tissue at risk that are spatially correlated with the infarct core, as determined by postmortem staining with triphenyltetrazolium chloride. The use of multi-parametric OCT imaging may aid in the comprehensive evaluation of ischemic lesions during the early stages of stroke, thereby providing essential knowledge for guiding treatment decisions.
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Affiliation(s)
- Woo June Choi
- School of Electrical and Electronics Engineering, College of ICT Engineering, Chung-Ang University, Seoul, 06974, Korea
| | - Yuandong Li
- Department of Bioengineering, University of Washington, Seattle WA 98195, USA
| | - Ruikang K. Wang
- Corresponding author, phone: 206-616-5025; fax: 206-616-5025;
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Guo Z, Li Z, Deng Y, Chen SL. Photoacoustic microscopy for evaluating a lipopolysaccharide-induced inflammation model in mice. JOURNAL OF BIOPHOTONICS 2019; 12:e201800251. [PMID: 30515990 DOI: 10.1002/jbio.201800251] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2018] [Revised: 12/03/2018] [Accepted: 12/03/2018] [Indexed: 06/09/2023]
Abstract
Photoacoustic microscopy (PAM) is a noninvasive imaging technique and is excellent to study structural and functional changes in the microcirculation. In this work, a lipopolysaccharide (LPS)-induced inflammation model in mice is noninvasively evaluated by PAM. PAM is used to image the microvascular structural changes in mice for 8 hours after the LPS with different concentrations is applied. Quantitative analysis of five vessel parameters is conducted, which shows that the rate of reduction in microvasculature is highly dependent on the applied LPS concentrations. For low-concentration LPS, changes in the microvasculature are not obvious over the observation period, whereas for high-concentration LPS, quick and marked reduction in the microvasculature is observed. In addition, changes in capillaries are more significant than those in relatively large vessels. The results show that PAM is able to evaluate the inflammation mouse model by studying structural (and potentially functional) changes in the microcirculation. Furthermore, PAM may have potential for early intervention and treatment plan optimization of sepsis by monitoring the microcirculation and inflammatory response.
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Affiliation(s)
- Zhendong Guo
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Zhe Li
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuxiao Deng
- Department of Critical Care Medicine, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Sung-Liang Chen
- University of Michigan-Shanghai Jiao Tong University Joint Institute, Shanghai Jiao Tong University, Shanghai, China
- State Key Laboratory of Advanced Optical Communication Systems and Networks, Shanghai Jiao Tong University, Shanghai, China
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12
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Ma Z, Ding N, Yu Y, Ma Y, Yuan X, Wang Y, Zhao Y, Luan J, Liu J. Quantification of cerebral vascular perfusion density via optical coherence tomography based on locally adaptive regional growth. APPLIED OPTICS 2018; 57:10117-10124. [PMID: 30645216 DOI: 10.1364/ao.57.010117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 11/07/2018] [Indexed: 06/09/2023]
Abstract
Optical coherence tomography (OCT) angiography is a noninvasive imaging modality that produces volumetric views of blood flow perfusion in vivo with resolution at capillary level, which has been widely adopted to monitor cerebral perfusion status after stroke in experimental settings. Accurate quantification of cerebral perfusion from OCT angiograms is important for understanding the cerebral vascular pathophysiology and assessing the treatment of ischemic stroke. Quantification of blood vessels from OCT angiography faces some problems; one is uneven backscatter (which causes some blood vessels to be very bright, some very dark), and the other is that the brightness in the same blood vessel also changes due to the difference in diameter or depth. In this paper, we proposed a locally adaptive region growing algorithm to solve this problem. The algorithm, which confines the region growing process to a local region, is used to segment blood vessels in different images to cope well with the intensity changes in blood vessels. During segmentation, the initial seed pixels were selected with the aid of the Otsu algorithm, the growth criterion considered both global and local information, and the thresholds were also adjusted adaptively as local regions varied. After these processes are completed, we can calculate the percentage of segmented blood vessels across field of view of the images, named cerebral vascular perfusion density, and use it as an indicator to evaluate the cerebral blood perfusion of middle cerebral artery occlusion in mice. This paper demonstrates that the algorithm can produce satisfactory vascular segmentation results, and CVPD can be used as an effective indicator for evaluating post-ischemic injury.
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13
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Engedal TS, Hjort N, Hougaard KD, Simonsen CZ, Andersen G, Mikkelsen IK, Boldsen JK, Eskildsen SF, Hansen MB, Angleys H, Jespersen SN, Pedraza S, Cho TH, Serena J, Siemonsen S, Thomalla G, Nighoghossian N, Fiehler J, Mouridsen K, Østergaard L. Transit time homogenization in ischemic stroke - A novel biomarker of penumbral microvascular failure? J Cereb Blood Flow Metab 2018; 38:2006-2020. [PMID: 28758524 PMCID: PMC6259320 DOI: 10.1177/0271678x17721666] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Cerebral ischemia causes widespread capillary no-flow in animal studies. The extent of microvascular impairment in human stroke, however, is unclear. We examined how acute intra-voxel transit time characteristics and subsequent recanalization affect tissue outcome on follow-up MRI in a historic cohort of 126 acute ischemic stroke patients. Based on perfusion-weighted MRI data, we characterized voxel-wise transit times in terms of their mean transit time (MTT), standard deviation (capillary transit time heterogeneity - CTH), and the CTH:MTT ratio (relative transit time heterogeneity), which is expected to remain constant during changes in perfusion pressure in a microvasculature consisting of passive, compliant vessels. To aid data interpretation, we also developed a computational model that relates graded microvascular failure to changes in these parameters. In perfusion-diffusion mismatch tissue, prolonged mean transit time (>5 seconds) and very low cerebral blood flow (≤6 mL/100 mL/min) was associated with high risk of infarction, largely independent of recanalization status. In the remaining mismatch region, low relative transit time heterogeneity predicted subsequent infarction if recanalization was not achieved. Our model suggested that transit time homogenization represents capillary no-flow. Consistent with this notion, low relative transit time heterogeneity values were associated with lower cerebral blood volume. We speculate that low RTH may represent a novel biomarker of penumbral microvascular failure.
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Affiliation(s)
- Thorbjørn S Engedal
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark.,2 Department of Neuroradiology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
| | - Niels Hjort
- 3 Department of Neurology Aarhus University Hospital, Aarhus C, Denmark
| | | | - Claus Z Simonsen
- 3 Department of Neurology Aarhus University Hospital, Aarhus C, Denmark
| | - Grethe Andersen
- 3 Department of Neurology Aarhus University Hospital, Aarhus C, Denmark
| | - Irene Klærke Mikkelsen
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark
| | - Jens K Boldsen
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark
| | - Simon F Eskildsen
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark
| | - Mikkel B Hansen
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark
| | - Hugo Angleys
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark
| | - Sune N Jespersen
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark.,4 Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
| | | | - Tae H Cho
- 6 Hospices Civils de Lyon, Lyon, France
| | | | | | - Götz Thomalla
- 7 University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | | | - Jens Fiehler
- 7 University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Kim Mouridsen
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark
| | - Leif Østergaard
- 1 Center of Functionally Integrative Neuroscience and MINDLab, Aarhus University, Aarhus University Hospital, Aarhus C, Denmark.,2 Department of Neuroradiology, Aarhus University Hospital, Nørrebrogade 44, 8000 Aarhus C, Denmark
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14
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Cao S, Zhang J, Ma L, Hsia CJC, Koehler RC. Transfusion of Polynitroxylated Pegylated Hemoglobin Stabilizes Pial Arterial Dilation and Decreases Infarct Volume After Transient Middle Cerebral Artery Occlusion. J Am Heart Assoc 2017; 6:JAHA.117.006505. [PMID: 28899897 PMCID: PMC5634295 DOI: 10.1161/jaha.117.006505] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Polynitroxylation of hemoglobin confers superoxide dismutase–mimetic and peroxidase activity and may protect from reperfusion injury in addition to facilitating oxygen transport. We determined whether transfusion of polynitroxylated PEGylated hemoglobin (PNPH) is protective in the rat filament model of 2 hours of middle cerebral artery occlusion (MCAO). Methods and Results Transfusion of 10 mL/kg of PNPH at 20 minutes of MCAO reduced infarct volume by over 70% (n=10). To determine whether PNPH might act by promoting vasodilation, pial arteriolar diameter in the distal MCA border region was measured in closed cranial windows. With no transfusion, MCAO induced an initial dilation (36±2% ±SE) that subsided by 2 hours (5±4%; n=8). With PNPH transfusion at 20 minutes of MCAO, the initial dilation (31±3%) was better maintained at 2 hours (21±4%; n=7; P<0.02). Delaying PNPH transfusion until 90 minutes of MCAO increased perfusion in the border region from 48±6% of the preischemic baseline to 67±8% (n=8; P<0.005). The effect of PNPH transfusion after reperfusion was also tested. Compared with the control median hemispheric infarct volume of 22% (13% to 34% interquartiles; n=15), infarct volume was reduced to 7% (3% to 13%; n=14 P<0.05) when PNPH was transfused at 4 hours after MCAO (2 hours of reperfusion) but not significantly when transfused at 6 hours (8%; 3% to 35%; n=14) or at 8 hours (12%; 10% to 25%; n=14) after MCAO. Conclusions PNPH transfusion has a significant therapeutic window for protection during and after transient MCAO and may act, in part, by stabilizing vascular function and improving collateral blood flow.
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Affiliation(s)
- Suyi Cao
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Jian Zhang
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
| | - Li Ma
- Department of Physics, Georgia Southern University, Statesboro, GA
| | | | - Raymond C Koehler
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, Baltimore, MD
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