1
|
Planas AM. Role of microglia in stroke. Glia 2024; 72:1016-1053. [PMID: 38173414 DOI: 10.1002/glia.24501] [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: 08/29/2023] [Revised: 12/07/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
Microglia play key roles in the post-ischemic inflammatory response and damaged tissue removal reacting rapidly to the disturbances caused by ischemia and working to restore the lost homeostasis. However, the modified environment, encompassing ionic imbalances, disruption of crucial neuron-microglia interactions, spreading depolarization, and generation of danger signals from necrotic neurons, induce morphological and phenotypic shifts in microglia. This leads them to adopt a proinflammatory profile and heighten their phagocytic activity. From day three post-ischemia, macrophages infiltrate the necrotic core while microglia amass at the periphery. Further, inflammation prompts a metabolic shift favoring glycolysis, the pentose-phosphate shunt, and lipid synthesis. These shifts, combined with phagocytic lipid intake, drive lipid droplet biogenesis, fuel anabolism, and enable microglia proliferation. Proliferating microglia release trophic factors contributing to protection and repair. However, some microglia accumulate lipids persistently and transform into dysfunctional and potentially harmful foam cells. Studies also showed microglia that either display impaired apoptotic cell clearance, or eliminate synapses, viable neurons, or endothelial cells. Yet, it will be essential to elucidate the viability of engulfed cells, the features of the local environment, the extent of tissue damage, and the temporal sequence. Ischemia provides a rich variety of region- and injury-dependent stimuli for microglia, evolving with time and generating distinct microglia phenotypes including those exhibiting proinflammatory or dysfunctional traits and others showing pro-repair features. Accurate profiling of microglia phenotypes, alongside with a more precise understanding of the associated post-ischemic tissue conditions, is a necessary step to serve as the potential foundation for focused interventions in human stroke.
Collapse
Affiliation(s)
- Anna M Planas
- Cerebrovascular Research Laboratory, Department of Neuroscience and Experimental Therapeutics, Instituto de Investigaciones Biomédicas de Barcelona (IIBB), Consejo Superior de Investigaciones Científicas (CSIC), Barcelona, Spain
- Cerebrovascular Diseases, Area of Clinical and Experimental Neuroscience, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS)-Hospital Clínic, Barcelona, Spain
| |
Collapse
|
2
|
DeCock CA, Giordano J, Donovan GK, Tornatore CS. Reader Response: Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline: Report of the AAN Guidelines Subcommittee, AAP, CNS, and SCCM. Neurology 2024; 102:e209369. [PMID: 38648606 DOI: 10.1212/wnl.0000000000209369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024] Open
|
3
|
Hasseldam H, Rasmussen RS, El Ali HH, Johansen FF. N-acetyl aspartate levels early after ischemic stroke accurately reflect long-term brain damage. Heliyon 2024; 10:e24233. [PMID: 38293500 PMCID: PMC10825333 DOI: 10.1016/j.heliyon.2024.e24233] [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: 04/25/2023] [Revised: 11/24/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024] Open
Abstract
Background Estimation of brain damage following an ischemic stroke is most often performed within the first few days after the insult, where large amounts of oedematous fluid have accumulated. This can potentially hamper correct measurement of infarcted area, since oedema formation poorly reflects infarct size. This study presents a non-invasive, easily applicable and reliable method to accurately predict long-term evolution and late-stage infarction. Objective We performed a longitudinal analysis of brain infarct evolution after MCAO in mice, in order to determine whether water-compensated N-Acetylaspartate (NAA) levels in the infarct area, measured 24 h after the insult, is a suitable marker for late-stage infarction and thereby prognosis. Methods Twenty mice were divided into 4 groups and scanned longitudinally at different time-points after MCAO, followed by euthanisation for histology: Group 1) MRI/MRS at day 1 after MCAO (n = 4), Group 2) MRI/MRS at days 1 and 7 after MCAO (n = 5), Group 3) MRI/MRS at days 1, 7, and 14 after MCAO (n = 3), and Group 4) MRI/MRS at days 1, 7, 14, and 28 after MCAO (n = 4). At days 1, 7, 14, and 28, NAA levels were correlated with histological determination of neuronal death based on Nissl and H&E stainings. Results Twenty-four hours after the insult, NAA levels in the infarcted area decreased by 35 %, but steadily returned to normal after 28 days. In the acute phases, NAA levels strongly correlated with loss of Nissl substance (r2 = -0.874, p = 0.002), whereas NAA levels in later stages reflect glial metabolism and tissue reorganisation. Most importantly, NAA levels 24 h after MCAO was highly correlated with late stage infarction at days 14 and 28 (r2 = 0.73, p = 0.01), in contrast to T2 (r2 = 0.06, p = 0.59). Conclusions By using a fixed voxel, which is easily positioned in the affected area, it is possible to obtain reliable measures of the extent of neuronal loss at early time points independent of oedema and brain deformation. Importantly, NAA levels 24 h after MCAO accurately reflects late-stage infarction, suggesting that NAA is a useful prognostic biomarker early after an ischemic stroke.
Collapse
Affiliation(s)
| | | | - Henrik Hussein El Ali
- University of Copenhagen, Department of Biomedical Sciences, 2200 Copenhagen, Denmark
| | | |
Collapse
|
4
|
Didwischus N, Guduru A, Badylak SF, Modo M. In vitro dose-dependent effects of matrix metalloproteinases on ECM hydrogel biodegradation. Acta Biomater 2024; 174:104-115. [PMID: 38081445 PMCID: PMC10775082 DOI: 10.1016/j.actbio.2023.12.003] [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: 07/17/2023] [Revised: 11/17/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023]
Abstract
Matrix metalloproteinases (MMPs) cause proteolysis of extracellular matrix (ECM) in tissues affected by stroke. However, little is known about how MMPs degrade ECM hydrogels implanted into stroke cavities to regenerate lost tissue. To establish a structure-function relationship between different doses of individual MMPs and isolate their effects in a controlled setting, an in vitro degradation assay quantified retained urinary bladder matrix (UBM) hydrogel mass as a measure of degradation across time. A rheological characterization indicated that lower ECM concentrations (<4 mg/mL) did not cure completely at 37 °C and had a high fraction of mobile proteins that were easily washed-out. Hydrolysis by dH2O caused a steady 2 % daily decrease in hydrogel mass over 14 days. An acceleration of degradation to 6 % occurred with phosphate buffered saline and artificial cerebrospinal fluid. MMPs induced a dose-dependent increase and within 14 days almost completely (>95 %) degraded the hydrogel. MMP-9 exerted the most significant biodegradation, compared to MMP-3 and -2. To model the in vivo exposure of hydrogel to MMPs, mixtures of MMP-2, -3, and -9, present in the cavity at 14-, 28-, or 90-days post-stroke, revealed that 14- and 28-days mixtures achieved an equivalent biodegradation, but a 90-days mixture exhibited a slower degradation. These results revealed that hydrolysis, in addition to proteolysis, exerts a major influence on the degradation of hydrogels. Understanding the mechanisms of ECM hydrogel biodegradation is essential to determine the therapeutic window for bioscaffold implantation after a stroke, and they are also key to determine optimal degradation kinetics to support tissue regeneration. STATEMENT OF SIGNIFICANCE: After implantation into a stroke cavity, extracellular matrix (ECM) hydrogel promotes tissue regeneration through the degradation of the bioscaffold. However, the process of degradation of an ECM hydrogel remains poorly understood. We here demonstrated in vitro under highly controlled conditions that hydrogel degradation is very dependent on its protein concentration. Lower protein concentration hydrogels were weaker in rheological measurements and particularly susceptible to hydrolysis. The proteolytic degradation of tissue ECM after a stroke is caused by matrix metalloproteinases (MMPs). A dose-dependent MMP-driven biodegradation of ECM hydrogel exceeded the effects of hydrolysis. These results highlight the importance of in vitro testing of putative causes of degradation to gain a better understanding of how these factors affect in vivo biodegradation.
Collapse
Affiliation(s)
- Nadine Didwischus
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Arun Guduru
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen F Badylak
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA; Department of Surgery, University of Pittsburgh, Pittsburgh, PA, USA
| | - Michel Modo
- Department of Radiology, University of Pittsburgh, Pittsburgh, PA, USA; McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA.
| |
Collapse
|
5
|
Loppi SH, Tavera-Garcia MA, Becktel DA, Maiyo BK, Johnson KE, Nguyen TVV, Schnellmann RG, Doyle KP. Increased fatty acid metabolism and decreased glycolysis are hallmarks of metabolic reprogramming within microglia in degenerating white matter during recovery from experimental stroke. J Cereb Blood Flow Metab 2023; 43:1099-1114. [PMID: 36772984 PMCID: PMC10291449 DOI: 10.1177/0271678x231157298] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/22/2022] [Accepted: 01/20/2023] [Indexed: 02/12/2023]
Abstract
The goal of this study was to evaluate changes in metabolic homeostasis during the first 12 weeks of recovery in a distal middle cerebral artery occlusion mouse model of stroke. To achieve this goal, we compared the brain metabolomes of ipsilateral and contralateral hemispheres from aged male mice up to 12 weeks after stroke to that of age-matched naïve and sham mice. There were 707 biochemicals detected in each sample by liquid chromatography-mass spectroscopy (LC-MS). Mitochondrial fatty acid β-oxidation, indicated by acyl carnitine levels, was increased in stroked tissue at 1 day and 4 weeks following stroke. Glucose and several glycolytic intermediates were elevated in the ipsilateral hemisphere for 12 weeks compared to the aged naïve controls, but pyruvate was decreased. Additionally, itaconate, a glycolysis inhibitor associated with activation of anti-inflammatory mechanisms in myeloid cells, was higher in the same comparisons. Spatial transcriptomics and RNA in situ hybridization localized these alterations to microglia within the area of axonal degeneration. These results indicate that chronic metabolic differences exist between stroked and control brains, including alterations in fatty acid metabolism and glycolysis within microglia in areas of degenerating white matter for at least 12 weeks after stroke.
Collapse
Affiliation(s)
- Sanna H Loppi
- Department of Immunobiology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Marco A Tavera-Garcia
- Department of Immunobiology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Danielle A Becktel
- Department of Immunobiology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Boaz K Maiyo
- Department of Immunobiology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Kristos E Johnson
- Department of Immunobiology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Thuy-Vi V Nguyen
- Department of Neurology, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Rick G Schnellmann
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, Arizona, USA
- BIO5 Institute, College of Medicine, University of Arizona, Tucson, Arizona, USA
| | - Kristian P Doyle
- Department of Immunobiology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Neurology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- BIO5 Institute, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Arizona Center on Aging, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Psychology, College of Medicine, University of Arizona, Tucson, Arizona, USA
- Department of Neurosurgery, College of Medicine, University of Arizona, Tucson, Arizona, USA
| |
Collapse
|
6
|
Zbesko JC, Stokes J, Becktel DA, Doyle KP. Targeting foam cell formation to improve recovery from ischemic stroke. Neurobiol Dis 2023; 181:106130. [PMID: 37068641 PMCID: PMC10993857 DOI: 10.1016/j.nbd.2023.106130] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 04/19/2023] Open
Abstract
Inflammation is a crucial part of the healing process after an ischemic stroke and is required to restore tissue homeostasis. However, the inflammatory response to stroke also worsens neurodegeneration and creates a tissue environment that is unfavorable to regeneration for several months, thereby postponing recovery. In animal models, inflammation can also contribute to the development of delayed cognitive deficits. Myeloid cells that take on a foamy appearance are one of the most prominent immune cell types within chronic stroke infarcts. Emerging evidence indicates that they form as a result of mechanisms of myelin lipid clearance becoming overwhelmed, and that they are a key driver of the chronic inflammatory response to stroke. Therefore, targeting lipid accumulation in foam cells may be a promising strategy for improving recovery. The aim of this review is to provide an overview of current knowledge regarding inflammation and foam cell formation in the brain in the weeks and months following ischemic stroke and identify targets that may be amenable to therapeutic intervention.
Collapse
Affiliation(s)
- Jacob C Zbesko
- Department of Immunobiology, University of Arizona, United States
| | - Jessica Stokes
- Department of Pediatrics, University of Arizona, United States
| | | | - Kristian P Doyle
- Department of Immunobiology, University of Arizona, United States; Departments of Neurology, Neurosurgery, Psychology, Arizona Center on Aging, and the BIO5 Institute, University of Arizona, United States.
| |
Collapse
|
7
|
Dialog beyond the Grave: Necrosis in the Tumor Microenvironment and Its Contribution to Tumor Growth. Int J Mol Sci 2023; 24:ijms24065278. [PMID: 36982351 PMCID: PMC10049335 DOI: 10.3390/ijms24065278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Revised: 02/27/2023] [Accepted: 03/07/2023] [Indexed: 03/12/2023] Open
Abstract
Damage-associated molecular patterns (DAMPs) are endogenous molecules released from the necrotic cells dying after exposure to various stressors. After binding to their receptors, they can stimulate various signaling pathways in target cells. DAMPs are especially abundant in the microenvironment of malignant tumors and are suspected to influence the behavior of malignant and stromal cells in multiple ways often resulting in promotion of cell proliferation, migration, invasion, and metastasis, as well as increased immune evasion. This review will start with a reminder of the main features of cell necrosis, which will be compared to other forms of cell death. Then we will summarize the various methods used to assess tumor necrosis in clinical practice including medical imaging, histopathological examination, and/or biological assays. We will also consider the importance of necrosis as a prognostic factor. Then the focus will be on the DAMPs and their role in the tumor microenvironment (TME). We will address not only their interactions with the malignant cells, frequently leading to cancer progression, but also with the immune cells and their contribution to immunosuppression. Finally, we will emphasize the role of DAMPs released by necrotic cells in the activation of Toll-like receptors (TLRs) and the possible contributions of TLRs to tumor development. This last point is very important for the future of cancer therapeutics since there are attempts to use TLR artificial ligands for cancer therapeutics.
Collapse
|
8
|
Morrison HW, White MM, Rothers JL, Taylor-Piliae RE. Examining the Associations between Post-Stroke Cognitive Function and Common Comorbid Conditions among Stroke Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13445. [PMID: 36294026 PMCID: PMC9603222 DOI: 10.3390/ijerph192013445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/03/2022] [Accepted: 10/15/2022] [Indexed: 06/16/2023]
Abstract
A considerable complication for stroke survivors is the subsequent development of cognitive decline or dementia. In this study, the relationship between the inflammation-centered comorbidity burden on post-stroke cognitive function among community-dwelling stroke survivors capable of independent living was examined. Data for this secondary analysis were collected from stroke survivors (n = 97) participating in a randomized clinical trial. Participants provided baseline responses, regarding cognitive function (mini-mental status exam, MMSE; Montreal cognitive assessment, MoCA), history of stroke comorbid conditions, and the Stroke Prognosis Instrument-II (SPI-II), an index of stroke comorbidity and recurrent stroke risk within the next two years. Relationships and differences between groups were tested for significance using Spearman's correlation, Kruskal-Wallis, or Mann-Whitney U tests. Most stroke survivors (69%) had multiple comorbidities. Total SPI-II scores were negatively correlated to both MoCA and MMSE scores (r = -0.25, p = 0.01; r = -0.22, p = 0.03, respectively), and differences in MoCA scores among SPI-II risk groups (low, medium, high) were evident (p = 0.05). In contrast, there were no differences in MoCA or MMSE scores when comorbid conditions were examined individually. Lastly, no gender differences were evident in cognitive assessments. Our data support the premise that comorbidity's burden impacts post-stroke cognitive decline, more than a single comorbid condition. Inflammation may be an important component of this comorbidity burden. Future studies that operationalize this concept will better illuminate the complex phenomenon of post-stroke cognitive decline for improved clinical rehabilitation modalities.
Collapse
Affiliation(s)
| | - Melissa M. White
- El Paso Veteran’s Administration Healthcare System, El Paso, TX 79930, USA
| | - Janet L. Rothers
- BIO5 Institute Statistics Consulting Lab, The University of Arizona, Tucson, AZ 85721, USA
| | | |
Collapse
|
9
|
Hammel G, Zivkovic S, Ayazi M, Ren Y. Consequences and mechanisms of myelin debris uptake and processing by cells in the central nervous system. Cell Immunol 2022; 380:104591. [PMID: 36030093 DOI: 10.1016/j.cellimm.2022.104591] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 07/29/2022] [Accepted: 08/15/2022] [Indexed: 11/28/2022]
Abstract
Central nervous system (CNS) disorders and trauma involving changes to the neuronal myelin sheath have long been a topic of great interest. One common pathological change in these diseases is the generation of myelin debris resulting from the breakdown of the myelin sheath. Myelin debris contains many inflammatory and neurotoxic factors that inhibit remyelination and make its clearance a prerequisite for healing in CNS disorders. Many professional and semiprofessional phagocytes participate in the clearance of myelin debris in the CNS. These cells use various mechanisms for the uptake of myelin debris, and each cell type produces its own unique set of pathologic consequences resulting from the debris uptake. Examining these cells' phagocytosis of myelin debris will contribute to a more complete understanding of CNS disease pathogenesis and help us conceptualize how the necessary clearance of myelin debris must be balanced with the detrimental consequences brought about by its clearance.
Collapse
Affiliation(s)
- Grace Hammel
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, United States.
| | - Sandra Zivkovic
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, United States.
| | - Maryam Ayazi
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, United States.
| | - Yi Ren
- Department of Biomedical Sciences, Florida State University College of Medicine, Tallahassee, FL, United States.
| |
Collapse
|
10
|
Mechtouff L, Sigovan M, Douek P, Costes N, Le Bars D, Mansuy A, Haesebaert J, Bani-Sadr A, Tordo J, Feugier P, Millon A, Luong S, Si-Mohamed S, Collet-Benzaquen D, Canet-Soulas E, Bochaton T, Crola Da Silva C, Paccalet A, Magne D, Berthezene Y, Nighoghossian N. Simultaneous assessment of microcalcifications and morphological criteria of vulnerability in carotid artery plaque using hybrid 18F-NaF PET/MRI. J Nucl Cardiol 2022; 29:1064-1074. [PMID: 33145738 DOI: 10.1007/s12350-020-02400-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 08/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Previous studies have suggested the role of microcalcifications in plaque vulnerability. This exploratory study sought to assess the potential of hybrid positron-emission tomography (PET)/magnetic resonance imaging (MRI) using 18F-sodium fluoride (18F-NaF) to check simultaneously 18F-NaF uptake, a marker of microcalcifications, and morphological criteria of vulnerability. METHODS AND RESULTS We included 12 patients with either recently symptomatic or asymptomatic carotid stenosis. All patients underwent 18F-NaF PET/MRI. 18F-NaF target-to-background ratio (TBR) was measured in culprit and nonculprit (including contralateral plaques of symptomatic patients) plaques as well as in other arterial walls. Morphological criteria of vulnerability were assessed on MRI. Mineral metabolism markers were also collected. 18F-NaF uptake was higher in culprit compared to nonculprit plaques (median TBR 2.6 [2.2-2.8] vs 1.7 [1.3-2.2]; P = 0.03) but was not associated with morphological criteria of vulnerability on MRI. We found a positive correlation between 18F-NaF uptake and calcium plaque volume and ratio but not with circulating tissue-nonspecific alkaline phosphatase (TNAP) activity and inorganic pyrophosphate (PPi) levels. 18F-NaF uptake in the other arterial walls did not differ between symptomatic and asymptomatic patients. CONCLUSIONS 18F-NaF PET/MRI may be a promising tool for providing additional insights into the plaque vulnerability.
Collapse
Affiliation(s)
- Laura Mechtouff
- Stroke Department, Pierre Wertheimer Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron, France.
- INSERM U1060, CarMeN Laboratory, University Lyon 1, Lyon, France.
| | - Monica Sigovan
- CNRS, UMR 5220, CREATIS, University of Lyon, Lyon, France
- INSA-Lyon UCBL, Inserm U1206, UJM-Saint Etienne, Lyon, France
| | - Philippe Douek
- CNRS, UMR 5220, CREATIS, University of Lyon, Lyon, France
- INSA-Lyon UCBL, Inserm U1206, UJM-Saint Etienne, Lyon, France
- Department of Radiology, Louis Pradel University Hospital, Bron, France
| | | | - Didier Le Bars
- CERMEP - Imagerie du vivant, Lyon, France
- ICBMS, University C. Bernard Lyon 1 & Hospices Civils de Lyon, Lyon, France
| | - Adeline Mansuy
- Cellule Recherche Imagerie, Louis Pradel University Hospital, Bron, France
| | - Julie Haesebaert
- Clinical Research and Epidemiology Unit, Public Health Department Hospices Civils de Lyon & Université de Lyon, Université Claude Bernard Lyon 1, Université Saint-Étienne, HESPER EA 7425, F-69008 Lyon, 42023, Saint-Etienne, France
| | - Alexandre Bani-Sadr
- Department of Nuclear Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | - Jérémie Tordo
- Department of Nuclear Medicine, Lyon Sud Hospital, Hospices Civils de Lyon, Lyon, France
| | - Patrick Feugier
- Vascular Surgery Department, Edouard Herriot University Hospital & Claude Bernard Lyon 1 University, Lyon, France
| | - Antoine Millon
- Vascular Surgery Department, Edouard Herriot University Hospital & Claude Bernard Lyon 1 University, Lyon, France
| | - Stéphane Luong
- Department of Radiology, Louis Pradel University Hospital, Bron, France
| | - Salim Si-Mohamed
- Department of Radiology, Louis Pradel University Hospital, Bron, France
| | | | | | - Thomas Bochaton
- INSERM U1060, CarMeN Laboratory, University Lyon 1, Lyon, France
| | | | | | - David Magne
- ICBMS, CNRS, UMR 5246, University Lyon 1, Lyon, France
| | - Yves Berthezene
- CNRS, UMR 5220, CREATIS, University of Lyon, Lyon, France
- Neuroradiology Department, Pierre Wertheimer Hospital, Bron, France
| | - Norbert Nighoghossian
- Stroke Department, Pierre Wertheimer Hospital, Hospices Civils de Lyon, 59 Boulevard Pinel, 69677, Bron, France
- INSERM U1060, CarMeN Laboratory, University Lyon 1, Lyon, France
| |
Collapse
|
11
|
Nguyen TVV, Crumpacker RH, Calderon KE, Garcia FG, Zbesko JC, Frye JB, Gonzalez S, Becktel DA, Yang T, Tavera-Garcia MA, Morrison HW, Schnellmann RG, Longo FM, Doyle KP. Post-Stroke Administration of the p75 Neurotrophin Receptor Modulator, LM11A-31, Attenuates Chronic Changes in Brain Metabolism, Increases Neurotransmitter Levels, and Improves Recovery. J Pharmacol Exp Ther 2022; 380:126-141. [PMID: 34893553 PMCID: PMC11048261 DOI: 10.1124/jpet.121.000711] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 11/29/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to test whether poststroke oral administration of a small molecule p75 neurotrophin receptor (p75NTR) modulator (LM11A-31) can augment neuronal survival and improve recovery in a mouse model of stroke. Mice were administered LM11A-31 for up to 12 weeks, beginning 1 week after stroke. Metabolomic analysis revealed that after 2 weeks of daily treatment, mice that received LM11A-31 were distinct from vehicle-treated mice by principal component analysis and had higher levels of serotonin, acetylcholine, and dopamine in their ipsilateral hemisphere. LM11A-31 treatment also improved redox homeostasis by restoring reduced glutathione. It also offset a stroke-induced reduction in glycolysis by increasing acetyl-CoA. There was no effect on cytokine levels in the infarct. At 13 weeks after stroke, adaptive immune cell infiltration in the infarct was unchanged in LM11A-31-treated mice, indicating that LM11A-31 does not alter the chronic inflammatory response to stroke at the site of the infarct. However, LM11A-31-treated mice had less brain atrophy, neurodegeneration, tau pathology, and microglial activation in other regions of the ipsilateral hemisphere. These findings correlated with improved recovery of motor function on a ladder test, improved sensorimotor and cognitive abilities on a nest construction test, and less impulsivity in an open field test. These data support small molecule modulation of the p75NTR for preserving neuronal health and function during stroke recovery. SIGNIFICANCE STATEMENT: The findings from this study introduce the p75 neurotrophin receptor as a novel small molecule target for promotion of stroke recovery. Given that LM11A-31 is in clinical trials as a potential therapy for Alzheimer's disease, it could be considered as a candidate for assessment in stroke or vascular dementia studies.
Collapse
Affiliation(s)
- Thuy-Vi V Nguyen
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Rachel H Crumpacker
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Kylie E Calderon
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Frankie G Garcia
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Jacob C Zbesko
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Jennifer B Frye
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Selena Gonzalez
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Danielle A Becktel
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Tao Yang
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Marco A Tavera-Garcia
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Helena W Morrison
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Rick G Schnellmann
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Frank M Longo
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| | - Kristian P Doyle
- Department of Immunobiology (T.-V.V.N., K.P.D., R.H.C., K.E.C., F.G.G., J.C.Z., J.B.F., D.A.B., M.A.T.-G.), Department of Neurology (T.-V.V.N., K.P.D., S.G.), College of Nursing (H.W.M.), Department of Pharmacology and Toxicology (R.G.S.), and Arizona Center on Aging (K.P.D.), University of Arizona, Tucson, Arizona; Department of Neurology and Neurologic Sciences, Stanford University, Stanford, California (T.Y., F.M.L.); and Southern Arizona Department of Veterans Affairs Health Care System, Tucson, Arizona (R.G.S.)
| |
Collapse
|
12
|
Chovsepian A, Berchtold D, Winek K, Mamrak U, Ramírez Álvarez I, Dening Y, Golubczyk D, Weitbrecht L, Dames C, Aillery M, Fernandez‐Sanz C, Gajewski Z, Dieterich M, Janowski M, Falkai P, Walczak P, Plesnila N, Meisel A, Pan‐Montojo F. A Primeval Mechanism of Tolerance to Desiccation Based on Glycolic Acid Saves Neurons in Mammals from Ischemia by Reducing Intracellular Calcium-Mediated Excitotoxicity. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2103265. [PMID: 34904402 PMCID: PMC8811841 DOI: 10.1002/advs.202103265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 11/02/2021] [Indexed: 06/09/2023]
Abstract
Stroke is the second leading cause of death and disability worldwide. Current treatments, such as pharmacological thrombolysis or mechanical thrombectomy, reopen occluded arteries but do not protect against ischemia-induced damage that occurs before reperfusion or neuronal damage induced by ischemia/reperfusion. It has been shown that disrupting the conversion of glyoxal to glycolic acid (GA) results in a decreased tolerance to anhydrobiosis in Caenorhabditis elegans dauer larva and that GA itself can rescue this phenotype. During the process of desiccation/rehydration, a metabolic stop/start similar to the one observed during ischemia/reperfusion occurs. In this study, the protective effect of GA is tested in different ischemia models, i.e., in commonly used stroke models in mice and swine. The results show that GA, given during reperfusion, strongly protects against ischemic damage and improves functional outcome. Evidence that GA exerts its effect by counteracting the glutamate-dependent increase in intracellular calcium during excitotoxicity is provided. These results suggest that GA treatment has the potential to reduce mortality and disability in stroke patients.
Collapse
Affiliation(s)
- Alexandra Chovsepian
- Department of Psychiatry and PsychotherapyLudwig‐Maximilian University HospitalNussbaumstrasse. 780336MunichGermany
| | - Daniel Berchtold
- Department of NeurologyNeuroCure Clinical Research CenterCenter for Stroke ResearchCharité University MedicineCharitéplatz 110117BerlinGermany
| | - Katarzyna Winek
- Department of NeurologyNeuroCure Clinical Research CenterCenter for Stroke ResearchCharité University MedicineCharitéplatz 110117BerlinGermany
- Present address:
Present address: Edmond and Lily Safra Center for Brain SciencesHebrew University of JerusalemJerusalem9190401Israel
| | - Uta Mamrak
- Laboratory of Experimental Stroke ResearchInstitute for Stroke and Dementia Research (ISD)University of Munich Medical CenterFeodor‐Lynen‐Strasse 1781377MunichGermany
| | - Inés Ramírez Álvarez
- Department of NeurologyLudwig‐Maximilian University HospitalMarchioninstrasse. 1581377MunichGermany
- Munich Cluster for Systems Neurology (SyNergy)Ludwig‐Maximilian University Munich81377MunichGermany
| | - Yanina Dening
- Department of Psychiatry and PsychotherapyLudwig‐Maximilian University HospitalNussbaumstrasse. 780336MunichGermany
- Department of NeurologyLudwig‐Maximilian University HospitalMarchioninstrasse. 1581377MunichGermany
| | | | - Luis Weitbrecht
- Department of NeurologyNeuroCure Clinical Research CenterCenter for Stroke ResearchCharité University MedicineCharitéplatz 110117BerlinGermany
| | - Claudia Dames
- Department of NeurologyNeuroCure Clinical Research CenterCenter for Stroke ResearchCharité University MedicineCharitéplatz 110117BerlinGermany
| | - Marine Aillery
- Department of NeurologyNeuroCure Clinical Research CenterCenter for Stroke ResearchCharité University MedicineCharitéplatz 110117BerlinGermany
- Present address:
Present address: SeppicÎle‐de‐FranceLa Garenne‐Colombes92250France
| | - Celia Fernandez‐Sanz
- Department of NeurologyLudwig‐Maximilian University HospitalMarchioninstrasse. 1581377MunichGermany
- Munich Cluster for Systems Neurology (SyNergy)Ludwig‐Maximilian University Munich81377MunichGermany
- Present address:
Present address: Center for Translational MedicineDepartment of MedicineThomas Jefferson UniversityPhiladelphiaPA19107USA
| | - Zdzislaw Gajewski
- Center for Translational MedicineWarsaw University of Life SciencesWarsaw02‐787Poland
| | - Marianne Dieterich
- Department of NeurologyLudwig‐Maximilian University HospitalMarchioninstrasse. 1581377MunichGermany
- Munich Cluster for Systems Neurology (SyNergy)Ludwig‐Maximilian University Munich81377MunichGermany
| | - Miroslaw Janowski
- Program in Image Guided NeurointerventionsDepartment of Diagnostic Radiology and Nuclear MedicineUniversity of MarylandBaltimoreMD21201USA
| | - Peter Falkai
- Department of Psychiatry and PsychotherapyLudwig‐Maximilian University HospitalNussbaumstrasse. 780336MunichGermany
| | - Piotr Walczak
- Program in Image Guided NeurointerventionsDepartment of Diagnostic Radiology and Nuclear MedicineUniversity of MarylandBaltimoreMD21201USA
| | - Nikolaus Plesnila
- Laboratory of Experimental Stroke ResearchInstitute for Stroke and Dementia Research (ISD)University of Munich Medical CenterFeodor‐Lynen‐Strasse 1781377MunichGermany
- Munich Cluster for Systems Neurology (SyNergy)Ludwig‐Maximilian University Munich81377MunichGermany
| | - Andreas Meisel
- Department of NeurologyNeuroCure Clinical Research CenterCenter for Stroke ResearchCharité University MedicineCharitéplatz 110117BerlinGermany
| | - Francisco Pan‐Montojo
- Department of Psychiatry and PsychotherapyLudwig‐Maximilian University HospitalNussbaumstrasse. 780336MunichGermany
- Department of NeurologyLudwig‐Maximilian University HospitalMarchioninstrasse. 1581377MunichGermany
- Munich Cluster for Systems Neurology (SyNergy)Ludwig‐Maximilian University Munich81377MunichGermany
| |
Collapse
|
13
|
Becktel DA, Zbesko JC, Frye JB, Chung AG, Hayes M, Calderon K, Grover JW, Li A, Garcia FG, Tavera-Garcia MA, Schnellmann RG, Wu HJJ, Nguyen TVV, Doyle KP. Repeated Administration of 2-Hydroxypropyl-β-Cyclodextrin (HPβCD) Attenuates the Chronic Inflammatory Response to Experimental Stroke. J Neurosci 2022; 42:325-348. [PMID: 34819339 PMCID: PMC8802936 DOI: 10.1523/jneurosci.0933-21.2021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/24/2021] [Accepted: 11/16/2021] [Indexed: 11/30/2022] Open
Abstract
Globally, more than 67 million people are living with the effects of ischemic stroke. Importantly, many stroke survivors develop a chronic inflammatory response that may contribute to cognitive impairment, a common and debilitating sequela of stroke that is insufficiently studied and currently untreatable. 2-Hydroxypropyl-β-cyclodextrin (HPβCD) is an FDA-approved cyclic oligosaccharide that can solubilize and entrap lipophilic substances. The goal of the present study was to determine whether the repeated administration of HPβCD curtails the chronic inflammatory response to stroke by reducing lipid accumulation within stroke infarcts in a distal middle cerebral artery occlusion mouse model of stroke. To achieve this goal, we subcutaneously injected young adult and aged male mice with vehicle or HPβCD 3 times per week, with treatment beginning 1 week after stroke. We evaluated mice at 7 weeks following stroke using immunostaining, RNA sequencing, lipidomic, and behavioral analyses. Chronic stroke infarct and peri-infarct regions of HPβCD-treated mice were characterized by an upregulation of genes involved in lipid metabolism and a downregulation of genes involved in innate and adaptive immunity, reactive astrogliosis, and chemotaxis. Correspondingly, HPβCD reduced the accumulation of lipid droplets, T lymphocytes, B lymphocytes, and plasma cells in stroke infarcts. Repeated administration of HPβCD also preserved NeuN immunoreactivity in the striatum and thalamus and c-Fos immunoreactivity in hippocampal regions. Additionally, HPβCD improved recovery through the protection of hippocampal-dependent spatial working memory and reduction of impulsivity. These results indicate that systemic HPβCD treatment following stroke attenuates chronic inflammation and secondary neurodegeneration and prevents poststroke cognitive decline.SIGNIFICANCE STATEMENT Dementia is a common and debilitating sequela of stroke. Currently, there are no available treatments for poststroke dementia. Our study shows that lipid metabolism is disrupted in chronic stroke infarcts, which causes an accumulation of uncleared lipid debris and correlates with a chronic inflammatory response. To our knowledge, these substantial changes in lipid homeostasis have not been previously recognized or investigated in the context of ischemic stroke. We also provide a proof of principle that solubilizing and entrapping lipophilic substances using HPβCD could be an effective strategy for treating chronic inflammation after stroke and other CNS injuries. We propose that using HPβCD for the prevention of poststroke dementia could improve recovery and increase long-term quality of life in stroke sufferers.
Collapse
Affiliation(s)
- Danielle A Becktel
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | - Jacob C Zbesko
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | - Jennifer B Frye
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | - Amanda G Chung
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | - Megan Hayes
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | - Kylie Calderon
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | - Jeffrey W Grover
- Department of Molecular and Cellular Biology, University of Arizona, Tucson, Arizona 85719
| | - Anna Li
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
- Arizona Arthritis Center, University of Arizona, Tucson, Arizona 85719
| | - Frankie G Garcia
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
| | | | - Rick G Schnellmann
- Department of Pharmacology and Toxicology, University of Arizona, Tucson, Arizona 85719
| | - Hsin-Jung Joyce Wu
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
- Arizona Arthritis Center, University of Arizona, Tucson, Arizona 85719
| | - Thuy-Vi V Nguyen
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
- Department of Neurology, University of Arizona, Tucson, Arizona 85719
| | - Kristian P Doyle
- Department of Immunobiology, University of Arizona, Tucson, Arizona 85719
- Department of Neurology, University of Arizona, Tucson, Arizona 85719
- BIO5 Institute, University of Arizona, Tucson, Arizona 85719
- Arizona Center on Aging, University of Arizona, Tucson, Arizona 85719
- Department of Psychology, University of Arizona, Tucson, Arizona 85719
- Department of Neurosurgery, University of Arizona, Tucson, Arizona 85719
| |
Collapse
|
14
|
Brown GC. Neuronal Loss after Stroke Due to Microglial Phagocytosis of Stressed Neurons. Int J Mol Sci 2021; 22:13442. [PMID: 34948237 PMCID: PMC8707068 DOI: 10.3390/ijms222413442] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/09/2021] [Accepted: 12/10/2021] [Indexed: 11/17/2022] Open
Abstract
After stroke, there is a rapid necrosis of all cells in the infarct, followed by a delayed loss of neurons both in brain areas surrounding the infarct, known as 'selective neuronal loss', and in brain areas remote from, but connected to, the infarct, known as 'secondary neurodegeneration'. Here we review evidence indicating that this delayed loss of neurons after stroke is mediated by the microglial phagocytosis of stressed neurons. After a stroke, neurons are stressed by ongoing ischemia, excitotoxicity and/or inflammation and are known to: (i) release "find-me" signals such as ATP, (ii) expose "eat-me" signals such as phosphatidylserine, and (iii) bind to opsonins, such as complement components C1q and C3b, inducing microglia to phagocytose such neurons. Blocking these factors on neurons, or their phagocytic receptors on microglia, can prevent delayed neuronal loss and behavioral deficits in rodent models of ischemic stroke. Phagocytic receptors on microglia may be attractive treatment targets to prevent delayed neuronal loss after stroke due to the microglial phagocytosis of stressed neurons.
Collapse
Affiliation(s)
- Guy C Brown
- Department of Biochemistry, University of Cambridge, Cambridge CB2 1QW, UK
| |
Collapse
|
15
|
The Feasibility of Tai Chi Exercise as a Beneficial Mind-Body Intervention in a Group of Community-Dwelling Stroke Survivors with Symptoms of Depression. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8600443. [PMID: 34765010 PMCID: PMC8577891 DOI: 10.1155/2021/8600443] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/08/2021] [Accepted: 10/15/2021] [Indexed: 11/18/2022]
Abstract
Depression is prevalent among one-third to two-thirds of acute and chronic stroke survivors. Despite the availability of pharmacotherapies and/or psychotherapies, depression persists, even for 5–10 years after stroke, reflecting limited treatment responses and/or adherence to this conventional care. Mind-body interventions are commonly used among adults to ameliorate depressive symptoms. Thus, the feasibility of Tai Chi, alongside conventional care, to manage poststroke depression was investigated using a single-group pre-post intervention design. Recruitment and retention, intervention adherence, safety, acceptability, and fidelity were assessed. Symptoms of depression, anxiety, and stress were assessed using standardized questionnaires, objective sleep was assessed via a research-grade triaxial accelerometer, and blood samples were taken to measure oxidative stress, inflammatory markers, and a neurotrophic growth factor using commercially available kits per manufacturer's protocol. Pre-post intervention changes were assessed using paired t-tests. We enrolled stroke survivors (N = 11, mean age = 69.7 ± 9.3) reporting depression symptoms. After the intervention, we observed significant reductions in symptoms of depression (−5.3 ± 5.9, p=0.01), anxiety (−2.2 ± 2.4, p=0.01), and stress (−4.6 ± 4.8, p=0.01), along with better sleep efficiency (+1.8 ± 1.8, p=0.01), less wakefulness after sleep onset (−9.3 ± 11.6, p=0.04), and less time awake (−9.3 ± 11.6, p=0.04). There was a 36% decrease in oxidative stress (p=0.02), though no significant changes in the other biomarkers were found (all p values >0.05). Tai Chi exercise is a feasible intervention that can be used alongside conventional care to manage poststroke depression, aid in reducing symptoms of anxiety and stress, and improve sleep.
Collapse
|
16
|
Isho B, Florescu A, Wang AA, Gommerman JL. Fantastic IgA plasma cells and where to find them. Immunol Rev 2021; 303:119-137. [PMID: 34046908 DOI: 10.1111/imr.12980] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 05/04/2021] [Indexed: 12/12/2022]
Abstract
IgA is produced in large quantities at mucosal surfaces by IgA+ plasma cells (PC), protecting the host from pathogens, and restricting commensal access to the subepithelium. It is becoming increasingly appreciated that IgA+ PC are not constrained to mucosal barrier sites. Rather, IgA+ PC may leave these sites where they provide both host defense and immunoregulatory function. In this review, we will outline how IgA+ PC are generated within the mucosae and how they subsequently migrate to their "classical" effector site, the gut lamina propria. From there we provide examples of IgA+ PC displacement from the gut to other parts of the body, referencing examples during homeostasis and inflammation. Lastly, we will speculate on mechanisms of IgA+ PC displacement to other tissues. Our aim is to provide a new perspective on how IgA+ PC are truly fantastic beasts of the immune system and identify new places to find them.
Collapse
Affiliation(s)
- Baweleta Isho
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | | | - Angela A Wang
- Department of Immunology, University of Toronto, Toronto, ON, Canada
| | | |
Collapse
|
17
|
D'Souza A, Dave KM, Stetler RA, S. Manickam D. Targeting the blood-brain barrier for the delivery of stroke therapies. Adv Drug Deliv Rev 2021; 171:332-351. [PMID: 33497734 DOI: 10.1016/j.addr.2021.01.015] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 02/06/2023]
Abstract
A variety of neuroprotectants have shown promise in treating ischemic stroke, yet their delivery to the brain remains a challenge. The endothelial cells lining the blood-brain barrier (BBB) are emerging as a dynamic factor in the response to neurological injury and disease, and the endothelial-neuronal matrix coupling is fundamentally neuroprotective. In this review, we discuss approaches that target the endothelium for drug delivery both across the BBB and to the BBB as a viable strategy to facilitate neuroprotective effects, using the example of brain-derived neurotrophic factor (BDNF). We highlight the advances in cell-derived extracellular vesicles (EVs) used for CNS targeting and drug delivery. We also discuss the potential of engineered EVs as a potent strategy to deliver BDNF or other drug candidates to the ischemic brain, particularly when coupled with internal components like mitochondria that may increase cellular energetics in injured endothelial cells.
Collapse
|
18
|
Krinock MJ, Singhal NS. Diabetes, stroke, and neuroresilience: looking beyond hyperglycemia. Ann N Y Acad Sci 2021; 1495:78-98. [PMID: 33638222 DOI: 10.1111/nyas.14583] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 12/14/2022]
Abstract
Ischemic stroke is a leading cause of morbidity and mortality among type 2 diabetic patients. Preclinical and translational studies have identified critical pathophysiological mediators of stroke risk, recurrence, and poor outcome in diabetic patients, including endothelial dysfunction and inflammation. Most clinical trials of diabetes and stroke have focused on treating hyperglycemia alone. Pioglitazone has shown promise in secondary stroke prevention for insulin-resistant patients; however, its use is not yet widespread. Additional research into clinical therapies directed at diabetic pathophysiological processes to prevent stroke and improve outcome for diabetic stroke survivors is necessary. Resilience is the process of active adaptation to a stressor. In patients with diabetes, stroke recovery is impaired by insulin resistance, endothelial dysfunction, and inflammation, which impair key neuroresilience pathways maintaining cerebrovascular integrity, resolving poststroke inflammation, stimulating neural plasticity, and preventing neurodegeneration. Our review summarizes the underpinnings of stroke risk in diabetes, the clinical consequences of stroke in diabetic patients, and proposes hypotheses and new avenues of research for therapeutics to stimulate neuroresilience pathways and improve stroke outcome in diabetic patients.
Collapse
Affiliation(s)
- Matthew J Krinock
- Department of Neurology, University of California - San Francisco, San Francisco, California
| | - Neel S Singhal
- Department of Neurology, University of California - San Francisco, San Francisco, California
| |
Collapse
|
19
|
Young KF, Gardner R, Sariana V, Whitman SA, Bartlett MJ, Falk T, Morrison HW. Can quantifying morphology and TMEM119 expression distinguish between microglia and infiltrating macrophages after ischemic stroke and reperfusion in male and female mice? J Neuroinflammation 2021; 18:58. [PMID: 33618737 PMCID: PMC7901206 DOI: 10.1186/s12974-021-02105-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/05/2021] [Indexed: 12/30/2022] Open
Abstract
Background Ischemic stroke is an acquired brain injury with gender-dependent outcomes. A persistent obstacle in understanding the sex-specific neuroinflammatory contributions to ischemic brain injury is distinguishing between resident microglia and infiltrating macrophages—both phagocytes—and determining cell population-specific contributions to injury evolution and recovery processes. Our purpose was to identify microglial and macrophage populations regulated by ischemic stroke using morphology analysis and the presence of microglia transmembrane protein 119 (TMEM119). Second, we examined sex and menopause differences in microglia/macrophage cell populations after an ischemic stroke. Methods Male and female, premenopausal and postmenopausal, mice underwent either 60 min of middle cerebral artery occlusion and 24 h of reperfusion or sham surgery. The accelerated ovarian failure model was used to model postmenopause. Brain tissue was collected to quantify the infarct area and for immunohistochemistry and western blot methods. Ionized calcium-binding adapter molecule, TMEM119, and confocal microscopy were used to analyze the microglia morphology and TMEM119 area in the ipsilateral brain regions. Western blot was used to quantify protein quantity. Results Post-stroke injury is increased in male and postmenopause female mice vs. premenopause female mice (p < 0.05) with differences primarily occurring in the caudal sections. After stroke, the microglia underwent a region, but not sex group, dependent transformation into less ramified cells (p < 0.0001). However, the number of phagocytic microglia was increased in distal ipsilateral regions of postmenopausal mice vs. the other sex groups (p < 0.05). The number of TMEM119-positive cells was decreased in proximity to the infarct (p < 0.0001) but without a sex group effect. Two key findings prevented distinguishing microglia from systemic macrophages. First, morphological data were not congruent with TMEM119 immunofluorescence data. Cells with severely decreased TMEM119 immunofluorescence were ramified, a distinguishing microglia characteristic. Second, whereas the TMEM119 immunofluorescence area decreased in proximity to the infarcted area, the TMEM119 protein quantity was unchanged in the ipsilateral hemisphere regions using western blot methods. Conclusions Our findings suggest that TMEM119 is not a stable microglia marker in male and female mice in the context of ischemic stroke. Until TMEM119 function in the brain is elucidated, its use to distinguish between cell populations following brain injury with cell infiltration is cautioned. Supplementary Information The online version contains supplementary material available at 10.1186/s12974-021-02105-2.
Collapse
Affiliation(s)
- Kimberly F Young
- College of Nursing, University of Arizona, 1305 N. Martin Ave., Tucson, AZ, 85721, USA.,Current affiliation: Department of Psychology, University of Arizona, 1503 E University Blvd., Tucson, AZ, USA.,University of Arizona Evelyn F. McKnight Brain Institute, 1333 N. Martin Ave., Tucson, AZ, USA
| | - Rebeca Gardner
- College of Science, University of Arizona, 1040 4th St., Tucson, AZ, USA
| | - Victoria Sariana
- College of Nursing, University of Arizona, 1305 N. Martin Ave., Tucson, AZ, 85721, USA
| | - Susan A Whitman
- College of Nursing, University of Arizona, 1305 N. Martin Ave., Tucson, AZ, 85721, USA
| | - Mitchell J Bartlett
- College of Medicine, Department of Neurology, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ, USA
| | - Torsten Falk
- College of Medicine, Department of Neurology, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ, USA.,College of Medicine, Department of Pharmacology, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ, USA
| | - Helena W Morrison
- College of Nursing, University of Arizona, 1305 N. Martin Ave., Tucson, AZ, 85721, USA.
| |
Collapse
|
20
|
Abstract
PURPOSE OF REVIEW To review new evidence on links between poststroke dementia and inflammation. RECENT FINDINGS Although there are still no treatments for poststroke dementia, recent evidence has improved our understanding that stroke increases the risk of incident dementia and worsens cognitive trajectory for at least a decade afterwards. Within approximately the first year dementia onset is associated with stroke severity and location, whereas later absolute risk is associated with more traditional dementia risk factors, such as age and imaging findings. The molecular mechanisms that underlie increased risk of incident dementia in stroke survivors remain unproven; however new data in both human and animal studies suggests links between cognitive decline and inflammation. These point to a model where chronic brain inflammation, provoked by inefficient clearance of myelin debris and a prolonged innate and adaptive immune response, causes poststroke dementia. These localized immune events in the brain may themselves be influenced by the peripheral immune state at key times after stroke. SUMMARY This review recaps clinical evidence on poststroke dementia, new mechanistic links between the chronic inflammatory response to stroke and poststroke dementia, and proposes a model of immune-mediated neurodegeneration after stroke.
Collapse
|
21
|
Zbesko JC, Frye JB, Becktel DA, Gerardo DK, Stokes J, Calderon K, Nguyen TVV, Bhattacharya D, Doyle KP. IgA natural antibodies are produced following T-cell independent B-cell activation following stroke. Brain Behav Immun 2021; 91:578-586. [PMID: 32956832 PMCID: PMC8279117 DOI: 10.1016/j.bbi.2020.09.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/08/2020] [Accepted: 09/15/2020] [Indexed: 12/22/2022] Open
Abstract
Up to 30% of stroke patients experience cognitive decline within one year of their stroke. There are currently no FDA-approved drugs that can prevent post-stroke cognitive decline, in part due to a poor understanding of the mechanisms involved. We have previously demonstrated that a B-lymphocyte response to stroke, marked by IgA + cells, can cause delayed cognitive dysfunction in mice and that a similar adaptive immune response occurs in the brains of some human stroke patients that suffer from vascular dementia. The stimuli which trigger B-lymphocyte activation following stroke, and their target antigens, are still unknown. Therefore, to learn more about the mechanisms by which B-lymphocytes become activated following stroke we first characterized the temporal kinetics of the B-lymphocyte, T-lymphocyte, and plasma cell (PC) response to stroke in the brain by immunohistochemistry (IHC). We discovered that B-lymphocyte, T-lymphocyte, and plasma cell infiltration within the infarct progressively increases between 2 and 7 weeks after stroke. We then compared the B-lymphocyte response to stroke in WT, MHCII-/-, CD4-/-, and MyD88-/- mice to determine if B-lymphocytes mature into IgA + PCs through a T-lymphocyte and MyD88 dependent mechanism. Our data from a combination of IHC and flow cytometry indicate that following stroke, a population of IgA + PCs develops independently of CD4 + helper T-lymphocytes and MyD88 signaling. Subsequent sequencing of immunoglobulin genes of individual IgA + PCs present within the infarct identified a novel population of natural antibodies with few somatic mutations in complementarity-determining regions. These findings indicate that a population of IgA + PCs develops in the infarct following stroke by B-lymphocytes interacting with one or more thymus independent type 2 (TI-2) antigens, and that they produce IgA natural antibodies.
Collapse
Affiliation(s)
- Jacob C. Zbesko
- Department of Immunobiology, University of Arizona, Tucson, AZ 85719, USA
| | | | | | - Diana K. Gerardo
- Department of Immunobiology, University of Arizona, Tucson, AZ 85719, USA
| | - Jessica Stokes
- Department of Pediatrics, University of Arizona, Tucson, AZ 85719, USA
| | - Kylie Calderon
- Department of Immunobiology, University of Arizona, Tucson, AZ 85719, USA
| | - Thuy-Vi V. Nguyen
- Department of Immunobiology, University of Arizona, Tucson, AZ 85719, USA,Department of Neurology, University of Arizona, Tucson, AZ 85719, USA
| | | | - Kristian P. Doyle
- Department of Immunobiology, University of Arizona, Tucson, AZ 85719, USA,Department of Neurology, University of Arizona, Tucson, AZ 85719, USA,Arizona Center on Aging, University of Arizona, Tucson, AZ 85719, USA,Corresponding author at: Department of Immunobiology, University of Arizona, Tucson, 1656 E. Mabel Street, Tucson, Arizona 85719, USA. (K.P. Doyle)
| |
Collapse
|
22
|
He JQ, Sussman ES, Steinberg GK. Revisiting Stem Cell-Based Clinical Trials for Ischemic Stroke. Front Aging Neurosci 2020; 12:575990. [PMID: 33381020 PMCID: PMC7767918 DOI: 10.3389/fnagi.2020.575990] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 11/23/2020] [Indexed: 12/12/2022] Open
Abstract
Stroke is the leading cause of serious long-term disability, significantly reducing mobility in almost half of the affected patients aged 65 years and older. There are currently no proven neurorestorative treatments for chronic stroke. To address the complex problem of restoring function in ischemic brain tissue, stem cell transplantation-based therapies have emerged as potential restorative therapies. Aligning with the major cell types found within the ischemic brain, stem-cell-based clinical trials for ischemic stroke have fallen under three broad cell lineages: hematopoietic, mesenchymal, and neural. In this review article, we will discuss the scientific rationale for transplanting cells from each of these lineages and provide an overview of published and ongoing trials using this framework.
Collapse
Affiliation(s)
- Joy Q He
- Institute for Stem Cell Biology and Regenerative Medicine, Stanford University School of Medicine, Stanford, CA, United States
| | - Eric S Sussman
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University School of Medicine, Stanford, CA, United States.,Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States.,Stanford Stroke Center, Stanford Health Care, Stanford, CA, United States
| |
Collapse
|
23
|
Elkind MSV, Boehme AK, Smith CJ, Meisel A, Buckwalter MS. Infection as a Stroke Risk Factor and Determinant of Outcome After Stroke. Stroke 2020; 51:3156-3168. [PMID: 32897811 DOI: 10.1161/strokeaha.120.030429] [Citation(s) in RCA: 124] [Impact Index Per Article: 31.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Understanding the relationship between infection and stroke has taken on new urgency in the era of the coronavirus disease 2019 (COVID-19) pandemic. This association is not a new concept, as several infections have long been recognized to contribute to stroke risk. The association of infection and stroke is also bidirectional. Although infection can lead to stroke, stroke also induces immune suppression which increases risk of infection. Apart from their short-term effects, emerging evidence suggests that poststroke immune changes may also adversely affect long-term cognitive outcomes in patients with stroke, increasing the risk of poststroke neurodegeneration and dementia. Infections at the time of stroke may also increase immune dysregulation after the stroke, further exacerbating the risk of cognitive decline. This review will cover the role of acute infections, including respiratory infections such as COVID-19, as a trigger for stroke; the role of infectious burden, or the cumulative number of infections throughout life, as a contributor to long-term risk of atherosclerotic disease and stroke; immune dysregulation after stroke and its effect on the risk of stroke-associated infection; and the impact of infection at the time of a stroke on the immune reaction to brain injury and subsequent long-term cognitive and functional outcomes. Finally, we will present a model to conceptualize the many relationships among chronic and acute infections and their short- and long-term neurological consequences. This model will suggest several directions for future research.
Collapse
Affiliation(s)
- Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. (M.S.V.E., A.K.B.).,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. (M.S.V.E., A.K.B.)
| | - Amelia K Boehme
- Department of Neurology, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY. (M.S.V.E., A.K.B.).,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. (M.S.V.E., A.K.B.)
| | - Craig J Smith
- Division of Cardiovascular Sciences, Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester Centre for Clinical Neurosciences, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Manchester, United Kingdom (C.J.S.)
| | - Andreas Meisel
- Center for Stroke Research Berlin, Department for Experimental Neurology, Department of Neurology, NeuroCure Clinical Research Center, Charité Universitätsmedizin Berlin, Germany (A.M.)
| | - Marion S Buckwalter
- Department of Neurology and Neurological Sciences, Stanford University Medical Center, CA (M.S.B.)
| |
Collapse
|
24
|
Zhou Y, Yao Y, Sheng L, Zhang J, Zhang JH, Shao A. Osteopontin as a candidate of therapeutic application for the acute brain injury. J Cell Mol Med 2020; 24:8918-8929. [PMID: 32657030 PMCID: PMC7417697 DOI: 10.1111/jcmm.15641] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Revised: 06/05/2020] [Accepted: 06/25/2020] [Indexed: 01/07/2023] Open
Abstract
Acute brain injury is the leading cause of human death and disability worldwide, which includes intracerebral haemorrhage, subarachnoid haemorrhage, cerebral ischaemia, traumatic brain injury and hypoxia‐ischaemia brain injury. Currently, clinical treatments for neurological dysfunction of acute brain injury have not been satisfactory. Osteopontin (OPN) is a complex adhesion protein and cytokine that interacts with multiple receptors including integrins and CD44 variants, exhibiting mostly neuroprotective roles and showing therapeutic potential for acute brain injury. OPN‐induced tissue remodelling and functional repair mainly rely on its positive roles in the coordination of pro‐inflammatory and anti‐inflammatory responses, blood‐brain barrier maintenance and anti‐apoptotic actions, as well as other mechanisms such as affecting the chemotaxis and proliferation of nerve cells. The blood OPN strongly parallel with the OPN induced in the brain and can be used as a novel biomarker of the susceptibility, severity and outcome of acute brain injury. In the present review, we summarized the molecular signalling mechanisms of OPN as well as its overall role in different kinds of acute brain injury.
Collapse
Affiliation(s)
- Yunxiang Zhou
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yihan Yao
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lesang Sheng
- Department of Surgical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianmin Zhang
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Brain Research Institute, Zhejiang University, Hangzhou, China.,Collaborative Innovation Center for Brain Science, Zhejiang University, Hangzhou, China
| | - John H Zhang
- Department of Physiology and Pharmacology, Basic Sciences, School of Medicine, Loma Linda University, Loma Linda, CA, USA.,Department of Anesthesiology, Neurosurgery and Neurology, Loma Linda University School of Medicine, Loma Linda, CA, USA
| | - Anwen Shao
- Department of Neurosurgery, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
25
|
Solt SA, Smith RL, Pirzadeh A, Belhorn T, Zwemer E. Is It Just Water Under the Bridge? An Eight-Day-Old With Late-Onset Group B Streptococcal Infection After Water Birth. Cureus 2020; 12:e8614. [PMID: 32676250 PMCID: PMC7362660 DOI: 10.7759/cureus.8614] [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] [Indexed: 11/06/2022] Open
Abstract
Group B Streptococcus (Streptococcus agalactiae or GBS) infections are known as a leading cause of morbidity and mortality in the neonatal population. The role of water birth in colonizing and transmitting GBS between mother and infant is unclear. We present a case of an exclusively breastfed full-term infant, born via water birth, to a GBS-negative woman who developed GBS mastitis. The infant presented with severe, late-onset GBS meningitis/septic shock and subsequently developed fatal necrotizing enterocolitis. Literature regarding the potential role of water birth in GBS transmission is reviewed.
Collapse
Affiliation(s)
- Shannon A Solt
- Pediatric Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Rebecca L Smith
- Pediatric Critical Care Medicine, UNC Hospitals, Chapel Hill, USA
| | - Afsaneh Pirzadeh
- Pediatric Critical Care Medicine, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Tom Belhorn
- Pediatric Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, USA
| | - Eric Zwemer
- Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, USA
| |
Collapse
|
26
|
Iadecola C, Buckwalter MS, Anrather J. Immune responses to stroke: mechanisms, modulation, and therapeutic potential. J Clin Invest 2020; 130:2777-2788. [PMID: 32391806 PMCID: PMC7260029 DOI: 10.1172/jci135530] [Citation(s) in RCA: 348] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Stroke is the second leading cause of death worldwide and a leading cause of disability. Most strokes are caused by occlusion of a major cerebral artery, and substantial advances have been made in elucidating how ischemia damages the brain. In particular, increasing evidence points to a double-edged role of the immune system in stroke pathophysiology. In the acute phase, innate immune cells invade brain and meninges and contribute to ischemic damage, but may also be protective. At the same time, danger signals released into the circulation by damaged brain cells lead to activation of systemic immunity, followed by profound immunodepression that promotes life-threatening infections. In the chronic phase, antigen presentation initiates an adaptive immune response targeted to the brain, which may underlie neuropsychiatric sequelae, a considerable cause of poststroke morbidity. Here, we briefly review these pathogenic processes and assess the potential therapeutic value of targeting immunity in human stroke.
Collapse
Affiliation(s)
- Costantino Iadecola
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
| | - Marion S. Buckwalter
- Department of Neurology and Neurological Sciences, Stanford University Medical Center, Stanford, California, USA
| | - Josef Anrather
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York, USA
| |
Collapse
|
27
|
Zera KA, Buckwalter MS. The Local and Peripheral Immune Responses to Stroke: Implications for Therapeutic Development. Neurotherapeutics 2020; 17:414-435. [PMID: 32193840 PMCID: PMC7283378 DOI: 10.1007/s13311-020-00844-3] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The immune response to stroke is an exciting target for future stroke therapies. Stroke is a leading cause of morbidity and mortality worldwide, and clot removal (mechanical or pharmacological) to achieve tissue reperfusion is the only therapy currently approved for patient use. Due to a short therapeutic window and incomplete effectiveness, however, many patients are left with infarcted tissue that stimulates inflammation. Although this is critical to promote repair, it can also damage surrounding healthy brain tissue. In addition, acute immunodepression and subsequent infections are common and are associated with worse patient outcomes. Thus, the acute immune response is a major focus of researchers attempting to identify ways to amplify its benefits and suppress its negative effects to improve short-term recovery of patients. Here we review what is known about this powerful process. This includes the role of brain resident cells such as microglia, peripherally activated cells such as macrophages and neutrophils, and activated endothelium. The role of systemic immune activation and subsequent immunodepression in the days after stroke is also discussed, as is the chronic immune responses and its effects on cognitive function. The biphasic role of inflammation, as well as complex timelines of cell production, differentiation, and trafficking, suggests that the relationship between the acute and chronic phases of stroke recovery is complex. Gaining a more complete understanding of this intricate process by which inflammation is initiated, propagated, and terminated may potentially lead to therapeutics that can treat a larger population of stroke patients than what is currently available. The immune response plays a critical role in patient recovery in both the acute and chronic phases after stroke. In patients, the immune response can be beneficial by promoting repair and recovery, and also detrimental by propagating a pro-inflammatory microenvironment. Thus, it is critical to understand the mechanisms of immune activation following stroke in order to successfully design therapeutics.
Collapse
Affiliation(s)
- Kristy A Zera
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | - Marion S Buckwalter
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, USA.
- Wu Tsai Neurosciences Institute, Stanford University, Stanford, CA, USA.
- Department of Neurosurgery, Stanford Univeristy School of Medicine, Stanford, CA, USA.
| |
Collapse
|
28
|
Abstract
Brain tissue lost after a stroke is not regenerated, although a repair response associated with neurogenesis does occur. A failure to regenerate functional brain tissue is not caused by the lack of available neural cells, but rather the absence of structural support to permit a repopulation of the lesion cavity. Inductive bioscaffolds can provide this support and promote the invasion of host cells into the tissue void. The putative mechanisms of bioscaffold degradation and its pivotal role to permit invasion of neural cells are reviewed and discussed in comparison to peripheral wound healing. Key differences between regenerating and non-regenerating tissues are contrasted in an evolutionary context, with a special focus on the neurogenic response as a conditio sine qua non for brain regeneration. The pivotal role of the immune system in biodegradation and the formation of a neovasculature are contextualized with regeneration of peripheral soft tissues. The application of rehabilitation to integrate newly forming brain tissue is suggested as necessary to develop functional tissue that can alleviate behavioral impairments. Pertinent aspects of brain tissue development are considered to provide guidance to produce a metabolically and functionally integrated de novo tissue. Although little is currently known about mechanisms involved in brain tissue regeneration, this review outlines the various components and their interplay to provide a framework for ongoing and future studies. It is envisaged that a better understanding of the mechanisms involved in brain tissue regeneration will improve the design of biomaterials and the methods used for implantation, as well as rehabilitation strategies that support the restoration of behavioral functions.
Collapse
Affiliation(s)
- Michel Modo
- McGowan Institute for Regenerative Medicine, University of Pittsburgh, Pittsburgh, PA, United States,Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, United States,Department of Radiology, University of Pittsburgh, Pittsburgh, PA, United States,*Correspondence: Michel Modo,
| |
Collapse
|
29
|
Riew TR, Kim S, Jin X, Kim HL, Lee JH, Lee MY. Osteopontin and its spatiotemporal relationship with glial cells in the striatum of rats treated with mitochondrial toxin 3-nitropropionic acid: possible involvement in phagocytosis. J Neuroinflammation 2019; 16:99. [PMID: 31088570 PMCID: PMC6518780 DOI: 10.1186/s12974-019-1489-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 04/25/2019] [Indexed: 12/16/2022] Open
Abstract
Background Osteopontin (OPN, SPP1) is upregulated in response to acute brain injury, and based on its immunoreactivity, two distinct forms have been identified: intracellular OPN within brain macrophages and small granular OPN, identified as OPN-coated degenerated neurites. This study investigates the spatiotemporal relationship between punctate OPN deposition and astroglial and microglial reactions elicited by 3-nitropropionic acid (3-NP). Methods Male Sprague-Dawley rats were intraperitoneally injected with mitochondrial toxin 3-NP and euthanized at 3, 7, 14, and 28 days. Quantitative and qualitative light and electron microscopic techniques were used to assess the relationship between OPN and glial cells. Statistical significance was determined by Student’s t test or a one-way analysis of variance followed by Tukey’s multiple comparisons test. Results Punctate OPN-immunoreactive profiles were synthesized and secreted by amoeboid-like brain macrophages in the lesion core, but not by reactive astrocytes and activated microglia with a stellate shape in the peri-lesional area. Punctate OPN accumulation was detected only in the lesion core away from reactive astrocytes in the peri-lesional area at day 3, but had direct contact with, and even overlapped with astroglial processes at day 7. The distance between the OPN-positive area and the astrocytic scar significantly decreased from days 3 to 7. By days 14 and 28 post-lesion, when the glial scar was fully formed, punctate OPN distribution mostly overlapped with the astrocytic scar. Three-dimensional reconstructions and quantitative image analysis revealed numerous granular OPN puncta inside the cytoplasm of reactive astrocytes and brain macrophages. Reactive astrocytes showed prominent expression of the lysosomal marker lysosomal-associated membrane protein 1, and ultrastructural analysis confirmed OPN-coated degenerating neurites inside astrocytes, suggesting the phagocytosis of OPN puncta by reactive astrocytes after injury. Conclusions Punctate OPN-immunoreactive profiles corresponded to OPN-coated degenerated neurites, which were closely associated with, or completely engulfed by, the reactive astrocytes forming the astroglial scar in 3-NP lesioned striatum, suggesting that OPN may cause astrocytes to migrate towards these degenerated neurites in the lesion core to establish physical contact with, and possibly, to phagocytose them. Our results provide novel insights essential to understanding the recovery and repair of the central nervous system tissue. Electronic supplementary material The online version of this article (10.1186/s12974-019-1489-1) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Tae-Ryong Riew
- Department of Anatomy, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul, 06591, Republic of Korea
| | - Soojin Kim
- Department of Anatomy, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul, 06591, Republic of Korea
| | - Xuyan Jin
- Department of Anatomy, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul, 06591, Republic of Korea.,Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Hong Lim Kim
- Integrative Research Support Center, Laboratory of Electron Microscope, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Jeong-Hwa Lee
- Department of Biochemistry, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.,The Institute for Aging and Metabolic Diseases, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea
| | - Mun-Yong Lee
- Department of Anatomy, Catholic Neuroscience Institute, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seoul, 06591, Republic of Korea. .,Department of Biomedicine and Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
| |
Collapse
|
30
|
Schöniger S, Schütze E, Michalski D, Puchta J, Kaiser M, Härtig W. Neuropathological findings suggestive for a stroke in an alpaca (Vicugna pacos). Acta Vet Scand 2019; 61:1. [PMID: 30602394 PMCID: PMC6317207 DOI: 10.1186/s13028-018-0438-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 12/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This case report describes a focal brain lesion in an alpaca (Vicugna pacos). Although this is a restricted study based on a single animal, neuropathological features are reported that are most likely attributed to a vascular event with either ischemic or hemorrhagic pathology. Concerning translational issues, these findings extend neurovascular unit concept to the alpacas' brain and qualify a larger panel of stroke tissue markers for further exploration of ischemic or hemorrhagic consequences beyond the usually used small animal models in stroke research. CASE PRESENTATION A brain lesion indicative of a stroke was diagnosed in a 3-year-old female alpaca as an incidental finding during a post mortem examination. The rostral portion of the right frontal lobe contained a 1.0 × 1.5 × 1.7 cm lesion that extended immediately to the overlying leptomeninges. Microscopically, it was composed of liquefactive necrosis with cholesterol crystal deposition and associated granulomatous inflammation as well as vascularized fibrous connective tissue rimmed by proliferated astrocytes. Multiple fluorescence labeling of the affected brain regions revealed strong microgliosis as shown by immunostaining of the ionized calcium binding adapter molecule 1 and astrogliosis as demonstrated by enhanced immunoreactivity for glial fibrillary acidic protein. In parallel, a drastic neuronal loss was detected by considerably diminished immunolabeling of neuronal nuclei. Concomitantly, up-regulated immunoreactivities for collagen IV and neurofilament light chains were found in the affected tissues, indicating vascular and cytoskeletal reactions. CONCLUSIONS Driven by these neuropathological features, the incidental brain lesion found in this alpaca strongly suggests an ischemic or hemorrhagic etiology. However, since typical hallmarks became verifiable as previously described for other species affected by focal cerebral ischemia, the lesion is more likely related to an ischemic event. Nevertheless, as such cellular alterations might be difficult to distinguish from other brain lesions as for instance caused by inflammatory processes, adjuvant observations and species-related features need to be considered for etiological interpretations. Indeed, the lack of neurological deficits is likely attributed to the location of the lesion within the rostral aspect of the right frontal lobe of the alpacas' brain. Further, fibroblast migration from the meninges likely caused the intralesional scar formation.
Collapse
|
31
|
Hong A, Aguilar MI, Del Borgo MP, Sobey CG, Broughton BRS, Forsythe JS. Self-assembling injectable peptide hydrogels for emerging treatment of ischemic stroke. J Mater Chem B 2019. [DOI: 10.1039/c9tb00257j] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Ischaemic stroke remains one of the leading causes of death and disability worldwide, without any long-term effective treatments targeted at regeneration. This has led to developments of novel, biomaterial-based strategies using self-assembling peptide hydrogels.
Collapse
Affiliation(s)
- Andrew Hong
- Department of Materials Science and Engineering
- Monash Institute of Medical Engineering
- Monash University
- Clayton
- Australia
| | - Marie-Isabel Aguilar
- Department of Biochemistry & Molecular Biology
- Monash Biomedicine Discovery Institute
- Monash University
- Clayton
- Australia
| | - Mark P. Del Borgo
- Department of Biochemistry & Molecular Biology
- Monash Biomedicine Discovery Institute
- Monash University
- Clayton
- Australia
| | - Christopher G. Sobey
- Vascular Biology and Immunopharmacology Group
- Department of Physiology
- Anatomy and Microbiology
- La Trobe University
- Bundoora
| | - Brad R. S. Broughton
- Cardiovascular & Pulmonary Pharmacology Group
- Biomedicine Discovery Institute and Department of Pharmacology
- Monash University
- Clayton
- Australia
| | - John S. Forsythe
- Department of Materials Science and Engineering
- Monash Institute of Medical Engineering
- Monash University
- Clayton
- Australia
| |
Collapse
|