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Sun H, Sun K, Tian H, Chen X, Su S, Tu Y, Chen S, Wang J, Peng M, Zeng M, Li X, Luo Y, Xie Y, Feng X, Li Z, Zhang X, Li X, Liu Y, Ye W, Chen Z, Zhu Z, Li Y, Xia F, Zhou H, Duan C. Integrated metagenomic and metabolomic analysis reveals distinctive stage-specific gut-microbiome-derived metabolites in intracranial aneurysms. Gut 2024:gutjnl-2024-332245. [PMID: 38960582 DOI: 10.1136/gutjnl-2024-332245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 06/12/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE Our study aimed to explore the influence of gut microbiota and their metabolites on intracranial aneurysms (IA) progression and pinpoint-related metabolic biomarkers derived from the gut microbiome. DESIGN We recruited 358 patients with unruptured IA (UIA) and 161 with ruptured IA (RIA) from two distinct geographical regions for conducting an integrated analysis of plasma metabolomics and faecal metagenomics. Machine learning algorithms were employed to develop a classifier model, subsequently validated in an independent cohort. Mouse models of IA were established to verify the potential role of the specific metabolite identified. RESULTS Distinct shifts in taxonomic and functional profiles of gut microbiota and their related metabolites were observed in different IA stages. Notably, tryptophan metabolites, particularly indoxyl sulfate (IS), were significantly higher in plasma of RIA. Meanwhile, upregulated tryptophanase expression and indole-producing microbiota were observed in gut microbiome of RIA. A model harnessing gut-microbiome-derived tryptophan metabolites demonstrated remarkable efficacy in distinguishing RIA from UIA patients in the validation cohort (AUC=0.97). Gut microbiota depletion by antibiotics decreased plasma IS concentration, reduced IA formation and rupture in mice, and downregulated matrix metalloproteinase-9 expression in aneurysmal walls with elastin degradation reduction. Supplement of IS reversed the effect of gut microbiota depletion. CONCLUSION Our investigation highlights the potential of gut-microbiome-derived tryptophan metabolites as biomarkers for distinguishing RIA from UIA patients. The findings suggest a novel pathogenic role for gut-microbiome-derived IS in elastin degradation in the IA wall leading to the rupture of IA.
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Affiliation(s)
- Haitao Sun
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Mental Health of the Ministry of Education, Guangdong-Hong Kong-Macao Greater Bay Area Centre for Brain Science and Brain-Inspired Intelligence, Southern Medical University, Guangzhou, Guangdong, China
| | - Kaijian Sun
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hao Tian
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiheng Chen
- Beijing Neurosurgical Institute, Beijing Engineering Research Center for Interventional Neuroradiology, Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Shixing Su
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yi Tu
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Shilan Chen
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Jiaxuan Wang
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Meichang Peng
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Meiqin Zeng
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Li
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yunhao Luo
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yugu Xie
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Feng
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhuang Li
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xin Zhang
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Xifeng Li
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanchao Liu
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Wei Ye
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhengrui Chen
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhaohua Zhu
- Clinical Research Centre, Orthopedic Centre, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Youxiang Li
- Beijing Neurosurgical Institute, Beijing Engineering Research Center for Interventional Neuroradiology, Department of Neurosurgery, Beijing TianTan Hospital, Capital Medical University, Beijing, China
| | - Fangbo Xia
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Hongwei Zhou
- Microbiome Medicine Centre, Clinical Biobank Centre, Guangdong Provincial Clinical Research Centre for Laboratory Medicine, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Chuanzhi Duan
- Neurosurgery Centre, Department of Cerebrovascular Surgery, Engineering Technology Research Centre of Education Ministry of China on Diagnosis and Treatment of Cerebrovascular Disease, The National Key Clinical Specialty, Guangdong Provincial Key Laboratory on Brain Function Repair and Regeneration, The Neurosurgery Institute of Guangdong Province, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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Chen C, Tang F, Zhu M, Wang C, Zhou H, Zhang C, Feng Y. Role of inflammatory mediators in intracranial aneurysms: A review. Clin Neurol Neurosurg 2024; 242:108329. [PMID: 38781806 DOI: 10.1016/j.clineuro.2024.108329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 05/09/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024]
Abstract
The formation, growth, and rupture of intracranial aneurysms (IAs) involve hemodynamics, blood pressure, external stimuli, and a series of hormonal changes. In addition, inflammatory response causes the release of a series of inflammatory mediators, such as IL, TNF-α, MCP-1, and MMPs, which directly or indirectly promote the development process of IA. However, the specific role of these inflammatory mediators in the pathophysiological process of IA remains unclear. Recently, several anti-inflammatory, lipid-lowering, hormone-regulating drugs have been found to have a potentially protective effect on reducing IA formation and rupture in the population. These therapeutic mechanisms have not been fully elucidated, but we can look for potential therapeutic targets that may interfere with the formation and breakdown of IA by studying the relevant inflammatory response and the mechanism of IA formation and rupture involved in inflammatory mediators.
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Affiliation(s)
- Cheng Chen
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Fengjiao Tang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Meng Zhu
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Chao Wang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Han Zhou
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Chonghui Zhang
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China
| | - Yugong Feng
- Department of Neurosurgery, The Affiliated Hospital of Qingdao University, Qingdao city, China.
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Mirbagheri A, Rinkel GJE, Berneburg M, Etminan N. Association of Global Ultraviolet Radiation With the Incidence of Aneurysmal Subarachnoid Hemorrhage. Neurosurgery 2024:00006123-990000000-01261. [PMID: 38949385 DOI: 10.1227/neu.0000000000003091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 05/16/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Inflammation is a key pathomechanism for growth and rupture of intracranial aneurysms. Anti-inflammatory mechanisms may reduce rupture of intracranial aneurysms and the incidence of aneurysmal subarachnoid hemorrhage (SAH). Ultraviolet (UV) radiation from sunlight exposure induces systemic anti-inflammatory responses through immunosuppressive mechanisms. We studied whether SAH incidence is associated with UV radiation. METHODS Global SAH incidence, time trends, and regional differences from 32 countries were linked to UV radiation data from the Tropospheric Emission Monitoring Internet Service. Odds between low vs high UV exposure and SAH incidence were calculated. Correlation analysis was performed using R (R 4.1.2). RESULTS SAH incidences ranged from 1.3 to 27 per 100 000 patient-years (p-y) and UV index from 1.76 to 11.27. The correlation coefficient (rho) between SAH incidence and UV index was -0.48 (P = .012). SAH incidence was highest in Japan (13.7-27.9 p-y) with an UV index 6.28. UV index was highest in Chile 11.27 with a lower SAH incidence (3.8-4.8 p-y). The lowest UV index 1.76 was seen in Iceland with higher SAH incidence (9.8 p-y).Within Europe, regions with higher UV indices reported lower SAH incidences (Northwest Europe: SAH incidence p-y 8.61/UV index 2.85; Southeast Europe: SAH incidence p-y 7.37/UV index 4.65) with a significant inverse correlation (rho = -0.68, P = .004) and not a significant correlation between non-European countries (rho = -0.43, P = .19). Low exposure of UV radiation in global regions predicted higher than median incidences of SAH with an odds ratio 5.13 (95% CIs 1.02-31.5). CONCLUSION The incidence of SAH is inversely associated with UV radiation. Further studies should assess the actual UV exposure in relation to SAH incidence and potential biological explanations for the relation we found.
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Affiliation(s)
- Andia Mirbagheri
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Gabriel J E Rinkel
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Mark Berneburg
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Nima Etminan
- Department of Neurosurgery, University Hospital Mannheim, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Li R, Chen Y, Chen P, Ma L, Han H, Li Z, Zhou W, Chen X, Zhao Y. Lesion-Filling Index from Quantitative DSA Correlates with Hemorrhage of Cerebral AVM. AJNR Am J Neuroradiol 2024; 45:712-720. [PMID: 38697788 DOI: 10.3174/ajnr.a8218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/02/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND AND PURPOSE Rupture is the most life-threatening manifestation of cerebral AVMs. This study aimed to explore the hemodynamic mechanism of AVM rupture. We introduced a new quantitative DSA parameter that can reflect the degree of intranidal blood stasis, called the lesion-filling index. MATERIALS AND METHODS This study examined patients with AVMs who had undergone both DSA and MR imaging between 2013 and 2014. Clinical presentations, angioarchitecture, and hemodynamic parameters generated from quantitative DSA were analyzed using univariate and multivariable logistic regression. The lesion-filling index was defined as the arterial diagnostic window divided by the volume of the AVM. To assess the correlation between the lesion-filling index and rupture, we incorporated the lesion-filling index into 2 published prediction models widely recognized for predicting AVM rupture risk, R2eD and VALE. The DeLong test was used to examine whether the addition of the lesion-filling index improved predictive efficacy. RESULTS A total of 180 patients with AVMs were included. The mean lesion-filling index values in the ruptured group were higher compared with the unruptured group (390.27 [SD, 919.81] versus 49.40 [SD, 98.25]), P < .001). A higher lesion-filling index was significantly correlated with AVM rupture in 3 different multivariable logistic models, adjusting for angioarchitecture factors (OR = 1.004, P = .02); hemodynamic factors (OR = 1.005, P = .009); and combined factors (OR = 1.004, P = .03). Both R2eD (area under the curve, 0.601 versus 0.624; P = .15) and VALE (area under the curve, 0.603 versus 0.706; P < .001) predictive models showed improved predictive performance after incorporating the lesion-filling index and conducting 10-fold cross-validation. CONCLUSIONS The lesion-filling index showed a strong correlation with AVM rupture, suggesting that overperfusion is the hemodynamic mechanism leading to AVM rupture.
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Affiliation(s)
- Ruinan Li
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yu Chen
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.C., X.C., Y.Z.), Beijing, China
- Beijing Neurosurgical Institute (Y.C., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Pingting Chen
- College of Energy and Power Engineering (P.C.), Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Li Ma
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Department of Neurological Surgery (L.M.), University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Heze Han
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhipeng Li
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wanting Zhou
- Department of Artificial Intelligence (W.Z.), Beijing University of Posts and Telecommunications, Beijing, China
| | - Xiaolin Chen
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.C., X.C., Y.Z.), Beijing, China
- Beijing Neurosurgical Institute (Y.C., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yuanli Zhao
- From the Department of Neurosurgery (R.L., Y.C., L.M., H.H., Z.L., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases (Y.C., X.C., Y.Z.), Beijing, China
- Beijing Neurosurgical Institute (Y.C., X.C., Y.Z.), Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Suzuki T, Hasegawa H, Shibuya K, Fujiwara H, Oishi M. Clinical and Hemodynamic Features of Aneurysm Rupture in Coil Embolization of Intracranial Aneurysms. Diagnostics (Basel) 2024; 14:1203. [PMID: 38893729 PMCID: PMC11172232 DOI: 10.3390/diagnostics14111203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/30/2024] [Accepted: 06/04/2024] [Indexed: 06/21/2024] Open
Abstract
Intraprocedural rupture (IPR) during coil embolization (CE) of an intracranial aneurysm is a significant clinical concern that necessitates a comprehensive understanding of its clinical and hemodynamic predictors. Between January 2012 and December 2023, 435 saccular cerebral aneurysms were treated with CE at our institution. The inclusion criterion was extravasation or coil protrusion during CE. Postoperative data were used to confirm rupture points, and computational fluid dynamics (CFD) analysis was performed to assess hemodynamic characteristics, focusing on maximum pressure (Pmax) and wall shear stress (WSS). IPR occurred in six aneurysms (1.3%; three ruptured and three unruptured), with a dome size of 4.7 ± 1.8 mm and a D/N ratio of 1.5 ± 0.5. There were four aneurysms in the internal carotid artery (ICA), one in the anterior cerebral artery, and one in the middle cerebral artery. ICA aneurysms were treated using adjunctive techniques (three balloon-assisted, one stent-assisted). Two aneurysms (M1M2 and A1) were treated simply, yet had relatively small and misaligned domes. CFD analysis identified the rupture point as a flow impingement zone with Pmax in five aneurysms (83.3%). Time-averaged WSS was locally reduced around this area (1.3 ± 0.7 [Pa]), significantly lower than the aneurysmal dome (p < 0.01). Hemodynamically unstable areas have fragile, thin walls with rupture risk. A microcatheter was inserted along the inflow zone, directed towards the caution area. These findings underscore the importance of identifying hemodynamically unstable areas during CE. Adjunctive techniques should be applied with caution, especially in small aneurysms with axial misalignment, to minimize the rupture risk.
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Affiliation(s)
- Tomoaki Suzuki
- Department of Neurosurgery, Brain Research Institute, Niigata University, 1-757 Asahimachi-Dori, Niigata 951-8585, Japan
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Liu Z, Zhang M, Wang C, Wang Z, Liao X, Ou C, Si W. Flow diverters treatment planning of small- and medium-sized intracranial saccular aneurysms on the internal carotid artery via constraint-based virtual deployment. Int J Comput Assist Radiol Surg 2024; 19:1175-1183. [PMID: 38619792 DOI: 10.1007/s11548-024-03124-z] [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: 03/08/2024] [Accepted: 03/25/2024] [Indexed: 04/16/2024]
Abstract
PURPOSE The internal carotid artery (ICA) is a region with a high incidence for small- and medium-sized saccular aneurysms. However, the treatment relies heavily on the surgeon's experience to achieve optimal outcome. Although the finite element method (FEM) and computational fluid dynamics can predict the postoperative outcomes, due to the computational complexity of traditional methods, there is an urgent need for investigating the fast but versatile approaches related to numerical simulations of flow diverters (FDs) deployment coupled with the hemodynamic analysis to determine the treatment plan. METHODS We collected the preoperative and postoperative data from 34 patients (29 females, 5 males; mean age 55.74 ± 9.98 years) who were treated with a single flow diverter for small- to medium-sized intracranial saccular aneurysms on the ICA. The constraint-based virtual deployment (CVD) method is proposed to simulate the FDs expanding outward along the vessel centerline while be constrained by the inner wall of the vessel. RESULTS The results indicate that there were no significant differences in the reduction rates of wall shear stress and aneurysms neck velocity between the FEM and methods. However, the solution time of CVD was greatly reduced by 98%. CONCLUSION In the typical location of small- and medium-sized saccular aneurysms, namely the ICA, our virtual FDs deployment simulation effectively balances the computational accuracy and efficiency. Combined with hemodynamics analysis, our method can accurately represent the blood flow changes within the lesion region to assist surgeons in clinical decision-making.
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Affiliation(s)
- Zehua Liu
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China
| | - Meng Zhang
- Department of Neurosurgery, Shenzhen Second People's Hospital, Sungang West Road 3002, Futian District, Guangdong, 510000, China
| | - Chao Wang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, 100000, China
| | - Zhongxiao Wang
- Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tian Tan Hospital, Capital Medical University, TiantanXili 6, Dongcheng District, Beijing, 100000, China
| | - Xiangyun Liao
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China
| | - Chubin Ou
- Department of Radiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Zhongshan 2nd Road 106, Yuexiu District, Guangdong, 510000, China.
| | - Weixin Si
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Xueyuan street 1068, Shenzhen University Town, Nanshan District, Shenzhen, 518000, China.
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Boniforti MA, Vittucci G, Magini R. Endovascular Treatment of Intracranial Aneurysm: The Importance of the Rheological Model in Blood Flow Simulations. Bioengineering (Basel) 2024; 11:522. [PMID: 38927758 PMCID: PMC11200932 DOI: 10.3390/bioengineering11060522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 05/10/2024] [Accepted: 05/16/2024] [Indexed: 06/28/2024] Open
Abstract
Hemodynamics in intracranial aneurysm strongly depends on the non-Newtonian blood behavior due to the large number of suspended cells and the ability of red blood cells to deform and aggregate. However, most numerical investigations on intracranial hemodynamics adopt the Newtonian hypothesis to model blood flow and predict aneurysm occlusion. The aim of this study was to analyze the effect of the blood rheological model on the hemodynamics of intracranial aneurysms in the presence or absence of endovascular treatment. A numerical investigation was performed under pulsatile flow conditions in a patient-specific aneurysm with and without the insertion of an appropriately reconstructed flow diverter stent (FDS). The numerical simulations were performed using Newtonian and non-Newtonian assumptions for blood rheology. In all cases, FDS placement reduced the intra-aneurysmal velocity and increased the relative residence time (RRT) on the aneurysmal wall, indicating progressive thrombus formation and aneurysm occlusion. However, the Newtonian model largely overestimated RRT values and consequent aneurysm healing with respect to the non-Newtonian models. Due to the non-Newtonian blood properties and the large discrepancy between Newtonian and non-Newtonian simulations, the Newtonian hypothesis should not be used in the study of the hemodynamics of intracranial aneurysm, especially in the presence of endovascular treatment.
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Affiliation(s)
- Maria Antonietta Boniforti
- Department of Civil, Building, and Environmental Engineering, Sapienza University, 00184 Rome, Italy; (G.V.); (R.M.)
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Tang Y, Wei H, Zhang Z, Fu M, Feng J, Li Z, Liu X, Wu Y, Zhang J, You W, Xue R, Zhuo Y, Jiang Y, Li Y, Li R, Liu P. Transition of intracranial aneurysmal wall enhancement from high to low wall shear stress mediation with size increase: A hemodynamic study based on 7T magnetic resonance imaging. Heliyon 2024; 10:e30006. [PMID: 38694075 PMCID: PMC11061692 DOI: 10.1016/j.heliyon.2024.e30006] [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: 11/15/2023] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 05/03/2024] Open
Abstract
Background Wall shear stress (WSS) has been proved to be related to the formation, development and rupture of intracranial aneurysms. Aneurysm wall enhancement (AWE) on magnetic resonance imaging (MRI) can be caused by inflammation and have confirmed its relationship with low WSS. High WSS can also result in inflammation but the research of its correlation with AWE is lack because of the focus on large aneurysms limited by 3T MRI in most previous studies.This study aimed to assess the potential association between high or low WSS and AWE in different aneuryms. Especially the relationship between high WSS and AWE in small aneurysm. Methods Forty-three unruptured intracranial aneurysms in 42 patients were prospectively included for analysis. 7.0 T MRI was used for imaging. Aneurysm size was measured on three-dimensional time-of-flight (TOF) images. Aneurysm-to-pituitary stalk contrast ratio (CRstalk) was calculated on post-contrast black-blood T1-weighted fast spin echo sequence images. Hemodynamics were assessed by four-dimensional flow MRI. Results The small aneurysms group had more positive WSS-CRstalk correlation coefficient distribution (dome: 78.6 %, p = 0.009; body: 50.0 %, p = 0.025), and large group had more negative coefficient distribution (dome: 44.8 %, p = 0.001; body: 69.0 %, p = 0.002). Aneurysm size was positively correlated with the significant OSI-CRstalk correlation coefficient at the dome (p = 0.012) and body (p = 0.010) but negatively correlated with the significant WSS-CRstalk correlation coefficient at the dome (p < 0.001) and body (p = 0.017). Conclusion AWE can be mediated by both high and low WSS, and translate from high WSS- to low WSS-mediated pathways as size increase. Additionally, AWE may serve as an indicator of the stage of aneurysm development via different correlations with hemodynamic factors.
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Affiliation(s)
- Yudi Tang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Haining Wei
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Medical School, Tsinghua University, Beijing, China
| | - Zihao Zhang
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, China
| | - Mingzhu Fu
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Medical School, Tsinghua University, Beijing, China
| | - Junqiang Feng
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhixin Li
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Xinke Liu
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center, Beijing, China
| | - Yue Wu
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Jinyuan Zhang
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Wei You
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Rong Xue
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yan Zhuo
- State Key Laboratory of Brain and Cognitive Science, Beijing MR Center for Brain Research, Institute of Biophysics, Chinese Academy of Sciences, Beijing, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Yuhua Jiang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center, Beijing, China
| | - Youxiang Li
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center, Beijing, China
| | - Rui Li
- Center for Biomedical Imaging Research, Department of Biomedical Engineering, Medical School, Tsinghua University, Beijing, China
| | - Peng Liu
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Engineering Research Center, Beijing, China
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9
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Yang S, Hu Y, Wang X, Deng M, Ma J, Hao Y, Ran Z, Luo T, Han G, Xiang X, Liu J, Shi H, Tan Y. Machine learning and deep learning to identifying subarachnoid haemorrhage macrophage-associated biomarkers by bulk and single-cell sequencing. J Cell Mol Med 2024; 28:e18296. [PMID: 38702954 PMCID: PMC11069052 DOI: 10.1111/jcmm.18296] [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: 11/04/2023] [Revised: 02/29/2024] [Accepted: 03/25/2024] [Indexed: 05/06/2024] Open
Abstract
We investigated subarachnoid haemorrhage (SAH) macrophage subpopulations and identified relevant key genes for improving diagnostic and therapeutic strategies. SAH rat models were established, and brain tissue samples underwent single-cell transcriptome sequencing and bulk RNA-seq. Using single-cell data, distinct macrophage subpopulations, including a unique SAH subset, were identified. The hdWGCNA method revealed 160 key macrophage-related genes. Univariate analysis and lasso regression selected 10 genes for constructing a diagnostic model. Machine learning algorithms facilitated model development. Cellular infiltration was assessed using the MCPcounter algorithm, and a heatmap integrated cell abundance and gene expression. A 3 × 3 convolutional neural network created an additional diagnostic model, while molecular docking identified potential drugs. The diagnostic model based on the 10 selected genes achieved excellent performance, with an AUC of 1 in both training and validation datasets. The heatmap, combining cell abundance and gene expression, provided insights into SAH cellular composition. The convolutional neural network model exhibited a sensitivity and specificity of 1 in both datasets. Additionally, CD14, GPNMB, SPP1 and PRDX5 were specifically expressed in SAH-associated macrophages, highlighting its potential as a therapeutic target. Network pharmacology analysis identified some targeting drugs for SAH treatment. Our study characterised SAH macrophage subpopulations and identified key associated genes. We developed a robust diagnostic model and recognised CD14, GPNMB, SPP1 and PRDX5 as potential therapeutic targets. Further experiments and clinical investigations are needed to validate these findings and explore the clinical implications of targets in SAH treatment.
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Affiliation(s)
- Sha Yang
- Department of NeurosurgeryThe Affiliated Hospital of Guizhou Medical UniversityGuiyangChina
- Guizhou University Medical CollegeGuiyangChina
| | - Yunjia Hu
- Department of NeurosurgeryThe Affiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Xiang Wang
- Department of NeurosurgeryThe Affiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Mei Deng
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Jun Ma
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Yin Hao
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Zhongying Ran
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Tao Luo
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Guoqiang Han
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Xin Xiang
- Department of NeurosurgeryThe Affiliated Hospital of Guizhou Medical UniversityGuiyangChina
| | - Jian Liu
- Department of NeurosurgeryThe Affiliated Hospital of Guizhou Medical UniversityGuiyangChina
- Guizhou University Medical CollegeGuiyangChina
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
| | - Hui Shi
- Department of NeurosurgeryYongchuan Hospital affiliated to Chongqing Medical UniversityChongqingChina
| | - Ying Tan
- Department of NeurosurgeryGuizhou Provincial People's HospitalGuiyangChina
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10
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Wei H, Wang G, Tian Q, Liu C, Han W, Wang J, He P, Li M. Low shear stress induces macrophage infiltration and aggravates aneurysm wall inflammation via CCL7/CCR1/TAK1/ NF-κB axis. Cell Signal 2024; 117:111122. [PMID: 38417634 DOI: 10.1016/j.cellsig.2024.111122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Revised: 02/18/2024] [Accepted: 02/25/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND This study aimed to elucidate the mechanism by which wall shear stress (WSS) influences vascular walls, accounting for the susceptibility of intracranial aneurysms (IAs) to rupture. METHOD We collected blood samples from the sacs of 24 ruptured and 28 unruptured IAs and analyzed the expression of chemokine CCL7 using enzyme-linked immunosorbent assay (ELISA). Univariate and multivariate logistic regression analyses were employed to assess clinical data, aneurysm morphology, and hemodynamics in both groups. Pearson correlation analysis investigated the relationship between CCL7 expression in aneurysm sac blood and WSS. Additionally, we established a bionic cell parallel plate co-culture shear stress model and a mouse low shear stress (LSS) model. The model was modulated using CCL7 recombinant protein, CCR1 inhibitor, and TAK1 inhibitor. We further evaluated CCL7 expression in endothelial cells and the levels of TAK1, NF-κB, IL-1β, and TNF-α in macrophages. Subsequently, the intergroup differences in expression were calculated. RESULTS CCL7 expression was significantly higher in the ruptured group compared to the unruptured group. Hemodynamic analysis indicated that WSS was an independent predictor of the risk of aneurysm rupture. A negative linear correlation was observed between CCL7 expression and WSS. Upon addition of CCL7 recombinant protein, upregulation of CCR1 expression and increased levels of p-TAK1 and p-p65 were observed. Treatment with CCR1 and TAK1 inhibitors reduced inflammatory cytokine expression in macrophages under LSS conditions. Overexpression of TAK1 significantly alleviated the inhibitory effects of CCR1 inhibitors on p-p65 and inflammatory cytokines. CONCLUSION LSS prompts endothelial cells to secrete CCL7, which, upon binding to the macrophage surface receptor CCR1, stimulates the release of macrophage inflammatory factors via the TAK1/NF-κB signaling pathway. This process exacerbates aneurysm wall inflammation and increases the risk of aneurysm rupture.
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Affiliation(s)
- Heng Wei
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Guijun Wang
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Qi Tian
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Chengli Liu
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Wenrui Han
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Jianfeng Wang
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Peibang He
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China
| | - Mingchang Li
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan 430060, Hubei Province, China.
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11
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Tobe Y, Robertson AM, Ramezanpour M, Cebral JR, Watkins SC, Charbel FT, Amin-Hanjani S, Yu AK, Cheng BC, Woo HH. Comapping Cellular Content and Extracellular Matrix with Hemodynamics in Intact Arterial Tissues Using Scanning Immunofluorescent Multiphoton Microscopy. MICROSCOPY AND MICROANALYSIS : THE OFFICIAL JOURNAL OF MICROSCOPY SOCIETY OF AMERICA, MICROBEAM ANALYSIS SOCIETY, MICROSCOPICAL SOCIETY OF CANADA 2024; 30:342-358. [PMID: 38525887 PMCID: PMC11057816 DOI: 10.1093/mam/ozae025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 03/01/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024]
Abstract
Deviation of blood flow from an optimal range is known to be associated with the initiation and progression of vascular pathologies. Important open questions remain about how the abnormal flow drives specific wall changes in pathologies such as cerebral aneurysms where the flow is highly heterogeneous and complex. This knowledge gap precludes the clinical use of readily available flow data to predict outcomes and improve treatment of these diseases. As both flow and the pathological wall changes are spatially heterogeneous, a crucial requirement for progress in this area is a methodology for acquiring and comapping local vascular wall biology data with local hemodynamic data. Here, we developed an imaging pipeline to address this pressing need. A protocol that employs scanning multiphoton microscopy was developed to obtain three-dimensional (3D) datasets for smooth muscle actin, collagen, and elastin in intact vascular specimens. A cluster analysis was introduced to objectively categorize the smooth muscle cells (SMC) across the vascular specimen based on SMC actin density. Finally, direct quantitative comparison of local flow and wall biology in 3D intact specimens was achieved by comapping both heterogeneous SMC data and wall thickness to patient-specific hemodynamic results.
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Affiliation(s)
- Yasutaka Tobe
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Anne M Robertson
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Mehdi Ramezanpour
- Department of Mechanical Engineering and Materials Science, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Juan R Cebral
- Department of Bioengineering, George Mason University, Fairfax, VA 22030, USA
| | - Simon C Watkins
- Department of Cell Biology, University of Pittsburgh, PA 15261, USA
| | - Fady T Charbel
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Sepideh Amin-Hanjani
- Department of Neurological Surgery, University Hospital Cleveland Medical Center, Cleveland, OH 44106, USA
| | - Alexander K Yu
- Department of Neurological Surgery, Allegheny Health Network, Pittsburgh, PA 15212, USA
| | - Boyle C Cheng
- Neuroscience and Orthopedic Institutes, Allegheny Health Network, Pittsburgh, PA 15212, USA
| | - Henry H Woo
- Department of Neurosurgery, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, Manhasset, NY 11549, USA
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12
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Coccarelli A, Van Loon R, Chien A. A Computational Pipeline to Investigate Longitudinal Blood Flow Changes in the Circle of Willis of Patients with Stable and Growing Aneurysms. Ann Biomed Eng 2024:10.1007/s10439-024-03493-1. [PMID: 38616236 DOI: 10.1007/s10439-024-03493-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/10/2024] [Indexed: 04/16/2024]
Abstract
Changes in cerebral blood flow are often associated with the initiation and development of different life-threatening medical conditions including aneurysm rupture and ischemic stroke. Nevertheless, it is not fully clear how haemodynamic changes in time across the Circle of Willis (CoW) are related with intracranial aneurysm (IA) growth. In this work, we introduced a novel reduced-order modelling strategy for the systematic quantification of longitudinal blood flow changes across the whole CoW in patients with stable and unstable/growing aneurysm. Magnetic Resonance Angiography (MRA) images were converted into one-dimensional (1-D) vessel networks through a semi-automated procedure, with a level of geometric reconstruction accuracy controlled by user-dependent parameters. The proposed pipeline was used to systematically analyse longitudinal haemodynamic changes in seven different clinical cases. Our preliminary simulation results indicate that growing aneurysms are not necessarily associated with significant changes in mean flow over time. A concise sensitivity analysis also shed light on which modelling aspects need to be further characterized to have reliable patient-specific predictions. This study poses the basis for investigating how time-dependent changes in the vasculature affect the haemodynamics across the whole CoW in patients with stable and growing aneurysms.
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Affiliation(s)
- Alberto Coccarelli
- Zienkiewicz Institute for Modelling, Data and AI, Faculty of Science and Engineering, Swansea University, Swansea, UK.
- Department of Mechanical Engineering, Faculty of Science and Engineering, Swansea University, Swansea, UK.
| | - Raoul Van Loon
- Zienkiewicz Institute for Modelling, Data and AI, Faculty of Science and Engineering, Swansea University, Swansea, UK
- Biomedical Engineering Simulation and Testing Lab, Department of Biomedical Engineering, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Aichi Chien
- Radiological Sciences, School of Medicine, University of California Los Angeles (UCLA), Los Angeles, CA, USA
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13
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Rantasalo V, Gunn J, Pan E, Kiviniemi T, Hirvonen J, Rahi M, Fordell T, Rinne JK, Laukka D. Positive Correlation Between Thoracic Aortic Diameter and Intracranial Aneurysm Size-An Observational Cohort Study. World Neurosurg 2024; 184:e633-e646. [PMID: 38342167 DOI: 10.1016/j.wneu.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/02/2024] [Indexed: 02/13/2024]
Abstract
OBJECTIVE To investigate the association between intracranial aneurysms (IAs) and thoracic aortic diameter. METHODS This observational cohort study examined thoracic aortic diameters in patients with IA. Patients were categorized by IA size (<7 mm and ≥7 mm) and IA status (ruptured/unruptured) based on radiologic findings. We investigated the association between thoracic aortic diameter and IA size and status using binary and linear regression as univariate and multivariable analyses. RESULTS A total of 409 patients were included. Mean age was 60 (±11.7) years and 63% were women. Thoracic aortic diameters were greater among patients who had an IA ≥7 mm versus IA <7 mm (P < 0.05). In the univariate analysis, the diameter of the ascending aorta (odds ratio [OR], 1.07; 95% confidence interval [CI], 1.02-1.129 per 1 mm; P = 0.002), aortic arch (OR, 1.10; 95% CI, 1.04-1.15 per 1 mm; P < 0.001), and descending aorta (OR, 1.10; 95% CI, 1.03-1.16 per 1 mm; P = 0.003) were associated with IAs ≥7 mm. In the multivariable regression model, larger ascending aorta (OR, 1.09; 95% CI, 1.01-1.17 per 1 mm; P = 0.018), aortic arch (OR, 1.12; 95% CI, 1.02-1.22 per 1 mm; P = 0.013), and descending aorta (OR, 1.20; 95% CI, 1.08-1.33 per 1 mm; P < 0.001) were associated with ruptured IA. CONCLUSIONS Greater thoracic aortic diameters are associated with a higher risk of IA being larger than 7 mm and IA rupture. Exploring the concomitant growth tendency in IA and thoracic aorta provides a basis for future considerations regarding screening and risk management.
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Affiliation(s)
- Ville Rantasalo
- Department of Surgery, University of Turku, Turku, Finland; Heart Center, Turku University Hospital, University of Turku, Turku, Finland; Department of Surgery, Mikkeli Central Hospital, Mikkeli, Finland.
| | - Jarmo Gunn
- Department of Surgery, University of Turku, Turku, Finland; Heart Center, Turku University Hospital, University of Turku, Turku, Finland
| | - Emily Pan
- Department of Surgery, University of Turku, Turku, Finland; Heart Center, Turku University Hospital, University of Turku, Turku, Finland; Cardiovascular Medicine Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tuomas Kiviniemi
- Heart Center, Turku University Hospital, University of Turku, Turku, Finland
| | - Jussi Hirvonen
- Department of Radiology, University of Turku and Turku University Hospital, Turku, Finland; Department of Radiology, Faculty of Medicine and Health Technology and Tampere University Hospital, Tampere University, Tampere, Finland
| | - Melissa Rahi
- Clinical Neurosciences, University of Turku, Turku, Finland; Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland
| | - Terhi Fordell
- Department of Surgery, University of Turku, Turku, Finland; Heart Center, Turku University Hospital, University of Turku, Turku, Finland; Department of Surgery, Helsinki University Hospital, Hyvinkää Hospital, Hyvinkää, Finland
| | - Jaakko K Rinne
- Clinical Neurosciences, University of Turku, Turku, Finland; Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland
| | - Dan Laukka
- Clinical Neurosciences, University of Turku, Turku, Finland; Department of Neurosurgery, Neurocenter, Turku University Hospital, Turku, Finland
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14
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Tobe Y, Yagi T, Kawamura K, Suto K, Sawada Y, Hayashi Y, Yoshida H, Nishitani K, Okada Y, Kitahara S, Umezu M. Three-dimensional wall-thickness distributions of unruptured intracranial aneurysms characterized by micro-computed tomography. Biomech Model Mechanobiol 2024:10.1007/s10237-024-01835-5. [PMID: 38489080 DOI: 10.1007/s10237-024-01835-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/21/2024] [Indexed: 03/17/2024]
Abstract
Aneurysmal rupture is associated with wall thinning, but the mechanism is poorly understood. This study aimed to characterize the three-dimensional wall-thickness distributions of unruptured intracranial aneurysms. Five aneurysmal tissues were investigated using micro-computed tomography. First, the wall thickness was related to the aneurysmal wall appearances during surgery. The median wall thicknesses of the translucent and non-translucent walls were 50.56 and 155.93 µm, respectively (p < 0.05) with significant variation in the non-translucent wall thicknesses (p < 0.05). The three-dimensional observations characterized the spatial variation of wall thicknesses. Thin walls showed a uniform thickness profile ranging from 10 to 40 µm, whereas thick walls presented a peaked thickness profile ranging from 300 to 500 µm. In transition walls, the profile undulated due to the formation of focal thin/thick spots. Overall, the aneurysmal wall thicknesses were strongly site-dependent and spatially varied by 10 to 40 times within individual cases. Aneurysmal walls are exposed to wall stress driven by blood pressure. In theory, the magnitude of wall stress is inversely proportional to wall thickness. Thus, the observed spatial variation of wall thickness may increase the spatial variation of wall stress to a similar extent. The irregular wall thickness may yield stress concentration. The observed thin walls and focal thin spots may be caused by excessive wall stresses at the range of mechanical failure inducing wall injuries, such as microscopic tears, during aneurysmal enlargement. The present results suggested that blood pressure (wall stress) may have a potential of acting as a trigger of aneurysmal wall injury.
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Affiliation(s)
- Yasutaka Tobe
- Center for Advanced Biomedical Sciences, Waseda University, 2-2 Wakamatsucho Shinjukuku, Tokyo, 162-8480, Japan
| | - Takanobu Yagi
- Center for Advanced Biomedical Sciences, Waseda University, 2-2 Wakamatsucho Shinjukuku, Tokyo, 162-8480, Japan.
| | - Koichi Kawamura
- Second Department of Pathology, Akita University, Akita, Japan
| | - Kenta Suto
- Center for Advanced Biomedical Sciences, Waseda University, 2-2 Wakamatsucho Shinjukuku, Tokyo, 162-8480, Japan
| | - Yoichi Sawada
- Department of Health and Welfare Science, Okayama Prefectural University, Okayama, Japan
| | - Yoshifumi Hayashi
- Department of Neurosurgery, Kitahara International Hospital, Tokyo, Japan
| | - Hirotaka Yoshida
- Department of Neurosurgery, Tokyo General Hospital, Tokyo, Japan
| | | | - Yoshifumi Okada
- Department of Neurosurgery, Kitahara International Hospital, Tokyo, Japan
| | - Shigemi Kitahara
- Department of Neurosurgery, Kitahara International Hospital, Tokyo, Japan
| | - Mitsuo Umezu
- Center for Advanced Biomedical Sciences, Waseda University, 2-2 Wakamatsucho Shinjukuku, Tokyo, 162-8480, Japan
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15
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Tashiro R, Anzawa R, Inoue T, Mikagi A, Ozaki D, Tominaga K, Inoue T, Ishida T, Fujimura M, Usuki T, Endo H, Niizuma K, Tominaga T. The prognostic values of plasma desmosines, crosslinking molecules of elastic fibers, in the disease progression of Moyamoya disease. Bioorg Med Chem 2024; 100:117602. [PMID: 38324946 DOI: 10.1016/j.bmc.2024.117602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/09/2024] [Accepted: 01/11/2024] [Indexed: 02/09/2024]
Abstract
Moyamoya disease (MMD) is a cerebrovascular disease which is characterized by the chronic progression of steno-occlusive changes at the terminal portion of internal carotid arteries and the development of "moyamoya vessels." Dysregulation of the extracellular matrix is regarded as a key pathophysiology underlying unique vascular remodeling. Here, we measured the concentration of elastin crosslinkers desmosine and isodesmosine in the plasma of MMD patients. We aimed to reveal its diagnostic values of desmosines in the progression of steno-occlusive lesions. The concentrations of plasma desmosines were determined by liquid chromatography-tandem mass spectrometry. The temporal profiles of steno-occlusive lesions on magnetic resonance angiography were retrospectively evaluated, and the correlation between the progression of steno-occlusive changes in intracranial arteries and plasma desmosines concentrations was further analyzed. Plasma desmosines were significantly higher in MMD patients with disease progression compared to MMD patients without disease progression. Also, the incidence of disease progression was higher in MMD patients with plasma desmosines levels over limit of quantitation (LOQ) than those with plasma desmosines levels below LOQ. In conclusion, plasma desmosines could be potential biomarkers to predict the progression of steno-occlusive changes in MMD patients.
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Affiliation(s)
- Ryosuke Tashiro
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Riki Anzawa
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, Chiyoda-ku, Tokyo 102-8554, Japan
| | - Tomoo Inoue
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
| | - Ayame Mikagi
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, Chiyoda-ku, Tokyo 102-8554, Japan
| | - Dan Ozaki
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Keita Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Takashi Inoue
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Tomohisa Ishida
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Miki Fujimura
- Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo 060-0815, Japan
| | - Toyonobu Usuki
- Department of Materials and Life Sciences, Faculty of Science and Technology, Sophia University, Chiyoda-ku, Tokyo 102-8554, Japan.
| | - Hidenori Endo
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Kuniyasu Niizuma
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Biomedical Engineering, Sendai 980-8575, Japan; Department of Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan.
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
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16
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Ushio Y, Kataoka H, Akagawa H, Sato M, Manabe S, Kawachi K, Makabe S, Akihisa T, Seki M, Teraoka A, Iwasa N, Yoshida R, Tsuchiya K, Nitta K, Hoshino J, Mochizuki T. Factors associated with early-onset intracranial aneurysms in patients with autosomal dominant polycystic kidney disease. J Nephrol 2024:10.1007/s40620-023-01866-8. [PMID: 38315279 DOI: 10.1007/s40620-023-01866-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 12/14/2023] [Indexed: 02/07/2024]
Abstract
BACKGROUND Recently, the importance of attribute-based medicine has been emphasized. The effects of early-onset intracranial aneurysms on patients can be significant and long-lasting. Herein, we compared the factors associated with intracranial aneurysms in patients with autosomal dominant polycystic kidney disease (ADPKD) according to age categories (≥ 50 years, < 50 years). METHODS We included 519 ADPKD patients, with a median age of 44 years, estimated glomerular filtration rate of 54.5 mL/min/1.73 m2, and total follow-up duration of 3104 patient-years. Logistic regression analyses were performed to determine factors associated with intracranial aneurysms. RESULTS Regarding the presence of intracranial aneurysm, significant interactions were identified between the age category (age ≥ 50 years), female sex (P = 0.0027 for the interaction) and hypertension (P = 0.0074 for the interaction). Female sex and hypertension were associated with intracranial aneurysm risk factors only in patients aged ≥ 50 years. The presence of intracranial aneurysm was significantly associated with chronic kidney disease (CKD) stages 4-5 (odds ratio [OR] = 3.87, P = 0.0007) and family history of intracranial aneurysm or subarachnoid hemorrhage (OR = 2.30, P = 0.0217) in patients aged < 50 years. For patients aged ≥ 50 years, in addition to the abovementioned factors [OR = 2.38, P = 0.0355 for CKD stages 4-5; OR = 3.49, P = 0.0094 for family history of intracranial aneurysm or subarachnoid hemorrhage], female sex (OR = 4.51, P = 0.0005), and hypertension (OR = 5.89, P = 0.0012) were also associated with intracranial aneurysm. CONCLUSION Kidney dysfunction and family history of intracranial aneurysm or subarachnoid hemorrhage are risk factors for early-onset intracranial aneurysm. Patients aged < 50 years with a family history of intracranial aneurysm or subarachnoid hemorrhage or with CKD stages 4-5 may be at an increased risk of early-onset intracranial aneurysm.
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Affiliation(s)
- Yusuke Ushio
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Hiroshi Kataoka
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
| | - Hiroyuki Akagawa
- Tokyo Women's Medical University Institute for Integrated Medical Sciences (TIIMS), Tokyo, Japan
| | - Masayo Sato
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Shun Manabe
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Keiko Kawachi
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Shiho Makabe
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Taro Akihisa
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Momoko Seki
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Atsuko Teraoka
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Naomi Iwasa
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Rie Yoshida
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Ken Tsuchiya
- Department of Blood Purification, Tokyo Women's Medical University, Tokyo, Japan
| | - Kosaku Nitta
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Junichi Hoshino
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
| | - Toshio Mochizuki
- Department of Nephrology, Tokyo Women's Medical University, 8-1 Kawada-Cho, Shinjuku-ku, Tokyo, 162-8666, Japan
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Diagbouga MR, Lemeille S, Morel S, Kwak BR. Impact of disrupted cyclic stretch in intracranial aneurysms: Insights from endothelial cell transcriptomic dataset. Data Brief 2024; 52:110014. [PMID: 38235173 PMCID: PMC10792734 DOI: 10.1016/j.dib.2023.110014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/19/2024] Open
Abstract
Intracranial aneurysm (IA) rupture is a common cause of hemorrhagic stroke. The treatment of unruptured IAs is a challenging decision that requires delicate risk stratification. The rate of poor clinical outcomes after surgical intervention (aneurysm clipping) or endovascular coiling remains elevated (6.7% and 4.8%, respectively), and they do not provide an absolute guarantee to prevent IA growth and rupture. Currently, there is no pharmaceutical treatment to cure or stabilize IAs. Improving the current or developing new treatments for IA disease would require a better understanding of the cellular and molecular mechanisms occurring in the different stages of the disease. Hemodynamic forces play a critical role in IA disease. While the role of wall shear stress in IAs is well-established, the influence of cyclic circumferential stretch (CCS) still needs clarification. IAs are generally characterized by a lack of CCS. In this investigation, we sought to understand the effect of aneurysmal CCS on endothelial cell (EC) function and its potential significance in IA disease, hypothesizing that CCS can influence IA wall remodelling. RNA-seq data were generated from human umbilical vein ECs (HUVECs) exposed to physiological (6%) or aneurysmal CCS (static). We performed differential gene expression and pathway enrichment analysis. Additionally, we highlighted cell junction gene expression between static and 6% CCS to contribute to the debate about how cell junctions affect endothelium stability and integrity. Researchers in the vascular biology field may benefit from this transcriptomic profile to understand the effect of mechanical stretch on EC biology and its potential significance in vascular disease development.
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Affiliation(s)
- Mannekomba R. Diagbouga
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
| | - Sylvain Lemeille
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
| | - Sandrine Morel
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
- Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals and University of Geneva. Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland
| | - Brenda R. Kwak
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva. Rue Michel-Servet 1, 1211 Geneva, Switzerland
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Frączek MJ, Krzyżewski RM, Kliś KM, Kwinta BM, Popiela TJ, Stachura K. Unruptured intracranial aneurysms: Why should we focus on small aneurysms? A comprehensive update of recent findings. Pol J Radiol 2024; 89:e13-e23. [PMID: 38371893 PMCID: PMC10867953 DOI: 10.5114/pjr.2024.134424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/21/2023] [Indexed: 02/20/2024] Open
Abstract
Intracranial aneurysms (IAs) are a significant public health concern because they have the potential to cause deva-stating consequences, including death and disability. Despite advances in diagnostic and treatment modalities, the outcomes for patients with aneurysmal subarachnoid haemorrhage (aSAH) remain poor, with high rates of rebleeding, vasospasm, and cerebral ischaemia. IAs are a significant risk factor for aSAH, and it is estimated that up to 3% of the general population have IAs. Recent studies using novel imaging modalities have shown that the prevalence of IAs may be much higher, with 6.6% of adults aged 40-84 years having intradural saccular IAs ≥ 2 mm. The risk of rupture for IAs is difficult to predict, and the decision to treat them invasively is based on a balance between the estimated rupture risk and the procedural risks of the treatment. However, the mortality and morbidity rates among patients treated for IAs can be as high as 5%. There is a need for clear guidelines on the treatment of IAs, and this review aims to provide an update on recent findings in this area. To achieve this goal, the authors identified and summarized recent, high-impact studies on IAs. The review focuses on the diagnostic and treatment options for IAs, as well as the risks associated with these interventions. The authors also provide an overview of the natural history of IAs and discuss the challenges and uncertainties in managing these patients.
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Affiliation(s)
- Maciej Jakub Frączek
- Department of Neurosurgery and Neurotraumatology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
- Doctoral School of Medical and Health Sciences, Jagiellonian University Medical College, Krakow, Poland
| | - Roger Marek Krzyżewski
- Department of Neurosurgery and Neurotraumatology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Kornelia Maria Kliś
- Department of Neurosurgery and Neurotraumatology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Borys Maria Kwinta
- Department of Neurosurgery and Neurotraumatology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Tadeusz Jan Popiela
- Chair of Radiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Krzysztof Stachura
- Department of Neurosurgery and Neurotraumatology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
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19
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Zheng DX, Lv YY, Zhang XJ, Ye JS, Zhang JX, Chen C, Luo B, Yan D. Neutrophil-to-lymphocyte ratio associated with symptomatic saccular unruptured intracranial aneurysm. Eur J Med Res 2024; 29:40. [PMID: 38212838 PMCID: PMC10782625 DOI: 10.1186/s40001-023-01608-3] [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: 08/21/2023] [Accepted: 12/21/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND AND PURPOSE Whether symptomatic unruptured intracranial aneurysms (UIAs) lead to change in circulating inflammation remains unclear. This study aims to evaluate the role of hematological inflammatory indicators in predicting symptomatic UIA. METHODS Adult patients diagnosed with saccular intracranial aneurysm from March 2019 to September 2023 were recruited retrospectively. Clinical and laboratory data, including the white blood cells (WBC), neutral counts (NEUT), lymphocyte counts (LYM), and monocyte counts (MONO) of each patient, were collected. The neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR) were calculated as NLR = NEUT/LYM, LMR = LYM/MONO, SII = PLT*NEUT/LYM. The hematological inflammatory indicators were compared in symptomatic saccular and asymptomatic UIA patients. Multivariable logistic regression analyses were performed to explore the factors predicting symptomatic UIA. RESULTS One hundred and fifty UIA patients with a mean age of 58.5 ± 12.4 were included, of which 68% were females. The NLR and LMR were significantly associated with symptomatic UIA, and the association remained in small UIAs (< 7 mm). The multiple logistic regression analysis showed that NLR was independently associated with symptomatic UIA. On ROC curve analysis, the optimal cutoff value of NLR to differentiate symptomatic from asymptomatic was 2.38. In addition, LMR was significantly associated with symptomatic UIA smaller than 7 mm. CONCLUSION There was a significant correlation between NLR and symptomatic UIA. The NLR was independently associated with symptomatic UIA.
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Affiliation(s)
- De-Xiang Zheng
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yi-Yang Lv
- Department of Blood Transfusion, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiao-Jing Zhang
- Department of Epilepsy Center, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Jie-Shun Ye
- School of Civil Engineering and Transportation, South China University of Technology, Guangzhou, 510640, China
| | - Jian-Xing Zhang
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China
| | - Cha Chen
- Department of Clinical Laboratory, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China.
- The Second Clinical College of Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Bin Luo
- Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, China.
| | - Dan Yan
- Department of Ultrasound, The Second Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China.
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20
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Cayron AF, Bejuy O, Vargas MI, Colin DJ, Aoki T, Lövblad KO, Bijlenga P, Kwak BR, Allémann E, Morel S. Time-of-flight and black-blood MRI to study intracranial arteries in rats. Eur Radiol Exp 2024; 8:3. [PMID: 38191711 PMCID: PMC10774247 DOI: 10.1186/s41747-023-00407-z] [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: 09/28/2023] [Accepted: 11/07/2023] [Indexed: 01/10/2024] Open
Abstract
Intracranial aneurysms (IAs) are usually incidentally discovered by magnetic resonance imaging (MRI). Once discovered, the risk associated with their treatment must be balanced with the risk of an unexpected rupture. Although clinical observations suggest that the detection of contrast agent in the aneurysm wall using a double-inversion recovery black-blood (BB) sequence may point to IA wall instability, the exact meaning of this observation is not understood. Validation of reliable diagnostic markers of IA (in)stability is of utmost importance to deciding whether to treat or not an IA. To longitudinally investigate IA progression and enhance our understanding of this devastating disease, animal models are of great help. The aim of our study was to improve a three-dimensional (3D)-time-of-flight (TOF) sequence and to develop a BB sequence on a standard preclinical 3-T MRI unit to investigate intracranial arterial diseases in rats. We showed that our 3D-TOF sequence allows reliable measurements of intracranial artery diameters, inter-artery distances, and angles between arteries and that our BB sequence enables us to visualize intracranial arteries. We report the first BB-MRI sequence to visualize intracranial arteries in rats using a preclinical 3-T MRI unit. This sequence could be useful for a large community of researchers working on intracranial arterial diseases.Relevance statement We developed a black-blood MRI sequence to study vessel wall enhancement in rats with possible application to understanding IAs instability and finding reliable markers for clinical decision-making.Key points• Reliable markers of aneurysm stability are needed for clinical decision.• Detection of contrast enhancement in the aneurysm wall may be associated with instability.• We developed a black-blood MRI sequence in rats to be used to study vessel wall enhancement of IAs.
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Affiliation(s)
- Anne F Cayron
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, CMU, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
| | - Olivia Bejuy
- CIBM Center for BioMedical Imaging, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Small Animal Preclinical Imaging Platform, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maria Isabel Vargas
- Division of Neuroradiology, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Didier J Colin
- Small Animal Preclinical Imaging Platform, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Tomohiro Aoki
- Department of Pharmacology, Jikei University School of Medicine, Tokyo, Japan
| | - Karl-Olof Lövblad
- Division of Neuroradiology, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Philippe Bijlenga
- Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Brenda R Kwak
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, CMU, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Eric Allémann
- School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland
- Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, Geneva, Switzerland
- Small Animal Preclinical Imaging Platform, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sandrine Morel
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, CMU, Rue Michel-Servet 1, CH-1211, Geneva, Switzerland.
- Geneva Center for Inflammation Research, Faculty of Medicine, University of Geneva, Geneva, Switzerland.
- Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
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21
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Duan J, Zhao Q, He Z, Tang S, Duan J, Xing W. Current understanding of macrophages in intracranial aneurysm: relevant etiological manifestations, signaling modulation and therapeutic strategies. Front Immunol 2024; 14:1320098. [PMID: 38259443 PMCID: PMC10800944 DOI: 10.3389/fimmu.2023.1320098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 12/18/2023] [Indexed: 01/24/2024] Open
Abstract
Macrophages activation and inflammatory response play crucial roles in intracranial aneurysm (IA) formation and progression. The outcome of ruptured IA is considerably poor, and the mechanisms that trigger IA progression and rupture remain to be clarified, thereby developing effective therapy to prevent subarachnoid hemorrhage (SAH) become difficult. Recently, climbing evidences have been expanding our understanding of the macrophages relevant IA pathogenesis, such as immune cells population, inflammatory activation, intra-/inter-cellular signaling transductions and drug administration responses. Crosstalk between macrophages disorder, inflammation and cellular signaling transduction aggravates the devastating consequences of IA. Illustrating the pros and cons mechanisms of macrophages in IA progression are expected to achieve more efficient treatment interventions. In this review, we summarized the current advanced knowledge of macrophages activation, infiltration, polarization and inflammatory responses in IA occurrence and development, as well as the most relevant NF-κB, signal transducer and activator of transcription 1 (STAT1) and Toll-Like Receptor 4 (TLR4) regulatory signaling modulation. The understanding of macrophages regulatory mechanisms is important for IA patients' clinical outcomes. Gaining insight into the macrophages regulation potentially contributes to more precise IA interventions and will also greatly facilitate the development of novel medical therapy.
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Affiliation(s)
- Jian Duan
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, Sichuan, China
| | - Qijie Zhao
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, Sichuan, China
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Zeyuan He
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, Sichuan, China
| | - Shuang Tang
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, Sichuan, China
| | - Jia Duan
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, Sichuan, China
| | - Wenli Xing
- Department of Cerebrovascular Disease, Suining Central Hospital, Suining, Sichuan, China
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22
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Li Y, Zhu Y, Liu Y, Li G, Qu X. Comparative Study of the Diagnostic Value of Zero-Echo-Time Magnetic Resonance Angiography With Time-of-Flight Magnetic Resonance Angiography for Intracranial Aneurysm. J Comput Assist Tomogr 2024; 48:169-174. [PMID: 37531630 DOI: 10.1097/rct.0000000000001518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
OBJECTIVE Intracranial aneurysm (IAN) is a class of cerebrovascular diseases with a serious threat to patients, and an accurate diagnosis of IAN is very important for both selection of the appropriate therapy and prediction of the prognosis. This study aimed to evaluate the diagnostic values of zero-echo-time magnetic resonance angiography (ZTE-MRA) and time-of-flight magnetic resonance angiography (TOF-MRA) in patients with IAN. METHODS Digital subtraction angiography, ZTE-MRA, and TOF-MRA were performed in 18 patients diagnosed with IAN. The images of ZTE-MRA and TOF-MRA were compared for image quality, qualitative diagnosis, detailed diagnosis, number of thrombi, and residual aneurysm lumen, with digital subtraction angiography as the reference. RESULTS Zero-echo-time MRA and TOF-MRA did not show a significant difference in image quality or detailed information (including aneurysm size, growth direction, and angle with the aneurysm-carrying vessel) ( P > 0.05). However, ZTE-MRA showed advantages over TOF-MRA in terms of qualitative diagnosis (sensitivity and specificity), intra-aneurismal thrombus detection, and residual aneurysm lumen detection after embolization ( P < 0.05). CONCLUSIONS Compared with TOF-MRA, ZTE-MRA showed greater diagnostic value for IAN patients in terms of qualitative diagnosis, as well as the detection of intra-aneurysm thrombi and residual aneurysm lumen after embolization.
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Affiliation(s)
- Yushi Li
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
| | - Yifeng Zhu
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
| | - Yajie Liu
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
| | - Ge Li
- Department of Oncology, Yankuang New Journey General Hospital, Jining, China
| | - Xiaofeng Qu
- From the Department of Radiology, The Second Hospital, Dalian Medical University, Dalian
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23
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Wang H, Wang L, Liu Y, Men W, Hao W, Fang C, Li C, Zhang L. Plasma levels of CD36 and glutathione as biomarkers for ruptured intracranial aneurysm. Open Life Sci 2023; 18:20220757. [PMID: 38196515 PMCID: PMC10775171 DOI: 10.1515/biol-2022-0757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/18/2023] [Accepted: 09/24/2023] [Indexed: 01/11/2024] Open
Abstract
Evidence has proved that intracranial aneurysm (IA) formation and rupture might be closely related to inflammatory response and oxidative stress. Our objective was to evaluate the potential of CD36 and glutathione (GSH) as biomarkers for IA. In this study, the enzyme-linked immunosorbent assay was used to measure the plasma levels of CD36 and GSH in 30 IA patients and 30 healthy controls. Then, correlation analysis, receiver operating characteristic (ROC) curve, and logistic regression analysis were performed. The results showed that the plasma level of CD36 in IA patients was significantly higher than that in the control group (P < 0.0001), and plasma GSH was significantly lower compared with that in the control group (P < 0.0001). ROC analysis showed that CD36 and GSH had high sensitivity (90.0 and 96.6%) and specificity (96.6 and 86.6%) for IA diagnosis. The combined sensitivity and specificity achieved were 100 and 100%, respectively. The plasma levels of CD36 and GSH did not show a significant correlation with age, the Glasgow Coma Scale, Hunter-Hess score, aneurysm size, aneurysm height, aneurysm neck, and aspect ratio. The AUC of the logistic regression model based on CD36 and GSH was 0.505. Our results suggested that the combination of plasma CD36 and GSH could serve as potential biomarkers for IA rupture.
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Affiliation(s)
- Hanbin Wang
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Luxuan Wang
- Department of Neurological Function Examination, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Yunmei Liu
- Department of Reproductive Medicine, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Weidong Men
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Wanjiao Hao
- Department of Reproductive Medicine, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Chuan Fang
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
- Postdoctoral Research Station of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
- Key Laboratory of Precise Diagnosis and Treatment of Glioma in Hebei Province, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Chunhui Li
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
| | - Lijian Zhang
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
- Postdoctoral Research Station of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
- Key Laboratory of Precise Diagnosis and Treatment of Glioma in Hebei Province, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei Province, China
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24
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Jiang J, Gui S, Wei D, Chen X, Tang Y, Lv J, You W, Chen T, Yang S, Ge H, Li Y. Causal relationships between human blood metabolites and intracranial aneurysm and aneurysmal subarachnoid hemorrhage: a Mendelian randomization study. Front Neurol 2023; 14:1268138. [PMID: 38162442 PMCID: PMC10755882 DOI: 10.3389/fneur.2023.1268138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 11/27/2023] [Indexed: 01/03/2024] Open
Abstract
Objective The aim of this study was to assess the causal relationships between blood metabolites and intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm. Methods Our exposure sample consisted of 7,824 individuals from a genome-wide association study of human blood metabolites. Our outcome sample consisted of 79,429 individuals (7,495 cases and 71,934 controls) from the International Stroke Genetics Consortium, which conducted a genome-wide association study of intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm. We identified blood metabolites with a potential causal effect on intracranial aneurysms and conducted sensitivity analyses to validate our findings. Results After rigorous screening and Mendelian randomization tests, we found four, two, and three serum metabolites causally associated with intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm, respectively (all P < 0.05). Sensitivity analyses confirmed the robustness of these associations. Conclusions Our Mendelian randomization analysis demonstrated causal relationships between human blood metabolites and intracranial aneurysm, aneurysmal subarachnoid hemorrhage, and unruptured intracranial aneurysm. Further research is required to explore the potential of targeting these metabolites in the management of intracranial aneurysm.
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Affiliation(s)
- Jia Jiang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Siming Gui
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dachao Wei
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xiheng Chen
- Department of Neurosurgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
| | - Yudi Tang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jian Lv
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei You
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ting Chen
- School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Shu Yang
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huijian Ge
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Youxiang Li
- Department of Neurosurgery, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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25
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Yang H, Kim JJ, Kim YB, Cho KC, Oh JH. Investigation of paraclinoid aneurysm formation by comparing the combined influence of hemodynamic parameters between aneurysmal and non-aneurysmal arteries. J Cereb Blood Flow Metab 2023:271678X231218589. [PMID: 38051823 DOI: 10.1177/0271678x231218589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2023]
Abstract
Numerous studies have evaluated the effects of hemodynamic parameters on aneurysm formation. However, the reasons why aneurysms do not initiate in intracranial arteries are still unclear. This study aimed to investigate the influence of hemodynamic parameters, wall shear stress (WSS) and strain, on aneurysm formation by comparing between aneurysmal and non-aneurysmal arteries. Fifty-eight patients with paraclinoid aneurysms on one side were enrolled. Based on magnetic resonance angiography, each patient's left and right internal carotid arteries (ICAs) were reconstructed. For a patient having an aneurysm on one side, the ICA with the paraclinoid aneurysm was defined as the aneurysmal artery after eliminating the aneurysm, whereas the opposite ICA without aneurysm was defined as the non-aneurysmal artery. Computational fluid dynamics and fluid-structure interaction analyses were then performed for both aneurysmal and non-aneurysmal arteries. Finally, the relationship between high hemodynamic parameters and aneurysm location was investigated. For aneurysmal arteries, high WSS and strain locations were well-matched with the aneurysm formation site. Also, considerable correlations between high WSS and strain locations were observed. However, there was no significant relationship between high hemodynamic parameters and aneurysm formation for non-aneurysmal arteries. The findings are helpful for understanding aneurysm formation mechanism and encouraging further relevant research.
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Affiliation(s)
- Hyeondong Yang
- Department of Mechanical Engineering and BK21 FOUR ERICA-ACE Center, Hanyang University, Ansan, Korea
| | - Jung-Jae Kim
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Yong Bae Kim
- Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang-Chun Cho
- Department of Neurosurgery, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
| | - Je Hoon Oh
- Department of Mechanical Engineering and BK21 FOUR ERICA-ACE Center, Hanyang University, Ansan, Korea
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26
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Wang H, Wang L, Tan Y, Fang C, Li C, Zhang L. Identification of miRNAs Involved in Intracranial Aneurysm Rupture in Cigarette-Smoking Patients. Neurol Ther 2023; 12:2101-2119. [PMID: 37792217 PMCID: PMC10630182 DOI: 10.1007/s40120-023-00547-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/13/2023] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION Smoking is an independent risk factor for the formation and rupture of intracranial aneurysms (IA). However, the underlying mechanism remains unclear. METHODS In this study, we performed miRNA sequencing on plasma from 10 smoking patients with IA, 10 non-smoking patients with IA, and 10 healthy controls. The differentially expressed miRNAs (DE miRNAs) between smoking and non-smoking patients with IA were identified. Functional and pathway enrichment analysis is employed to investigate the potential functions of those DE miRNA target genes. The correlations with the clinical parameters were assessed using receiver operating characteristic curve (ROC) analysis. RESULTS In total, we identified 428 DE miRNAs. Functional enrichment analysis showed the target genes were significantly enriched in biological aspects related to cell characteristics, such as cell cycle, cell differentiation, and cell migration. Pathway analysis showed DE miRNAs mainly enriched in the PI3K-Akt signaling pathway, Focal adhesion, and JAK-STAT signaling pathway. The expressions of miR-574-5p, miR-151a-3p, and miR-652-3p correlated well with aneurysm parameters. The AUC of miR-574-5p, miR-151a-3p, and miR-652-3p were 97%, 92%, and 99%, respectively. CONCLUSION Our study indicated that smoking significantly altered the plasma miRNA profile in patients with IA. The expression of miR-574-5p, miR-151a-3p, and miR-652-3p correlated with aneurysm parameters, which may play a significant role in the formation and rupture of IA.
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Affiliation(s)
- Hanbin Wang
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China
| | - Luxuan Wang
- Department of Neurological Function Examination, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China
| | - Yanli Tan
- Department of Pathology, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China
| | - Chuan Fang
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China.
- Postdoctoral Research Station of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China.
- Hebei Key Laboratory of Precise Diagnosis and Treatment of Glioma, Baoding, China.
| | - Chunhui Li
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China.
| | - Lijian Zhang
- Department of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China.
- Postdoctoral Research Station of Neurosurgery, Affiliated Hospital of Hebei University, Hebei University, Baoding, 071000, Hebei, China.
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Valeti C, Gurusamy S, Krishnakumar K, Easwer HV, Kannath SK, Sudhir BJ, Patnaik BSV. Numerical investigation of unruptured middle cerebral artery bifurcation aneurysms: influence of aspect ratio. Comput Methods Biomech Biomed Engin 2023:1-16. [PMID: 37968912 DOI: 10.1080/10255842.2023.2279508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
An aneurysm is a disease condition, which is due to the pathological weakening of an arterial wall. These aneurysms are often found in various branch points and bifurcations of an artery in the cerebral circulation. Most aneurysms come to medical attention, either due to brain hemorrhages caused by rupture or found unruptured. To consider surgically invasive treatment modalities, clinicians need scientific methods such as, hemodynamic analysis to assess rupture risk. The arterial wall loses its structural integrity when wall shear stress (WSS) and other hemodynamic parameters exceed a certain threshold. In the present study, numerical simulations are carried out for unruptured middle cerebral artery (MCA) aneurysms. Three distinct representative sizes are chosen from a larger patient pool of 26 MCA aneurysms. Logically, these aneurysms represent three growth stages of any patient with similar anatomical structure. Simulations are performed to compare the three growth phases (with different aspect ratios) of an aneurysm and correlate their hemodynamic parameters. Simulations with patient specific boundary conditions reveal that, aneurysms with a higher aspect ratio (AR) correspond to an attendant decrease in both time-averaged wall shear stress (TAWSS) and spatial wall shear stress gradients (WSSG). Smaller MCAs were observed to have higher positive wall shear stress divergence (WSSD), exemplifying the tensile nature of arterial wall stretching. Present study identifies positive wall shear stress divergence (PWSSD) to be a potential biomarker for evaluating the growth of an aneurysm.
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Affiliation(s)
- Chanikya Valeti
- Department of Applied Mechanics and Biomedical Engineering, IIT Madras, Chennai, India
| | - Saravanan Gurusamy
- Department of Civil, Structural and Environmental Engineering, Trinity College, Dublin, Ireland
| | - K Krishnakumar
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Hariharan Venkat Easwer
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - Santhosh K Kannath
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - B J Sudhir
- Department of Applied Mechanics and Biomedical Engineering, IIT Madras, Chennai, India
- Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, India
| | - B S V Patnaik
- Department of Applied Mechanics and Biomedical Engineering, IIT Madras, Chennai, India
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Yuan X, Bao Q, Lu B, Xiang C, Hou X, Wei W. WTAP affects intracranial aneurysm progression by regulating m6A methylation modification. Open Med (Wars) 2023; 18:20230818. [PMID: 37854284 PMCID: PMC10579882 DOI: 10.1515/med-2023-0818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 08/06/2023] [Accepted: 09/13/2023] [Indexed: 10/20/2023] Open
Abstract
Intracranial aneurysm (IA) is a type of cerebrovascular disease that mainly occurs in the circle of Willis. Abnormalities in RNA methylation at the N6-methyladenosine (m6A) site have been associated with numerous types of human diseases. WTAP recruits the m6A methyltransferase complexes to the mRNA targets, and its expression is positively correlated with m6A methylation levels. This research aimed to explore the potential mechanisms of m6A methylation in IA. A selective arterial ligation method was used to establish an IA rat model; thereafter, the m6A methylation level and m6A methylation-related genes were determined in blood and circle of Willis samples using a commercial kit and real-time quantitative PCR, respectively. Subsequently, rat brain microvascular endothelial cells (rBMVECs) were treated with TNF-α, and the expression of m6A methylation-related genes within the cells were assessed. Lastly, the effects of WTAP on TNF-α-induced rBMVECs were further investigated through in vitro experiments. In result, the m6A RNA methylation level evidently declined in the blood and circle of Willis' samples of the IA rats, as compared to the corresponding samples from the control rats (P < 0.05). Compared to the results in the control rats/cells, WTAP expression was significantly downregulated, whereas ALKBH1 expression was evidently upregulated in the blood and circle of Willis samples of the TNF-α-induced rBMVECs of IA rats. Consequently, TNF-α-induced rBMVECs and rBMVECs with WTAP overexpression were successfully established. TNF-α inhibited the viability of the rBMVECs, promoted apoptosis, and significantly upregulated cleaved-caspase3 and downregulated WTAP expression. In contrast, WTAP overexpression significantly reversed these changes caused by TNF-α (P < 0.05). In conclusion, WTAP overexpression may modulate the growth of TNF-α-induced rBMVECs by enhancing WTAP expression and its m6A methylation.
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Affiliation(s)
- Xuesong Yuan
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Changzhou213002, China
| | - Qing Bao
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Changzhou213002, China
| | - Bin Lu
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Changzhou213002, China
| | - Chong Xiang
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Changzhou213002, China
| | - Xiaoshan Hou
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, Changzhou213002, China
| | - Wenfeng Wei
- Department of Neurosurgery, Wujin Hospital Affiliated to Jiangsu University, No. 2 Yongning North Road, Tianning District, Changzhou213002, China
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Chen B, Xie K, Zhang J, Yang L, Zhou H, Zhang L, Peng R. Comprehensive analysis of mitochondrial dysfunction and necroptosis in intracranial aneurysms from the perspective of predictive, preventative, and personalized medicine. Apoptosis 2023; 28:1452-1468. [PMID: 37410216 PMCID: PMC10425526 DOI: 10.1007/s10495-023-01865-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
Mitochondrial dysfunction and necroptosis are closely associated, and play vital roles in the medical strategy of multiple cardiovascular diseases. However, their implications in intracranial aneurysms (IAs) remain unclear. In this study, we aimed to explore whether mitochondrial dysfunction and necroptosis could be identified as valuable starting points for predictive, preventive, and personalized medicine for IAs. The transcriptional profiles of 75 IAs and 37 control samples were collected from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs), weighted gene co-expression network analysis, and least absolute shrinkage and selection operator (LASSO) regression were used to screen key genes. The ssGSEA algorithm was performed to establish phenotype scores. The correlation between mitochondrial dysfunction and necroptosis was evaluated using functional enrichment crossover, phenotype score correlation, immune infiltration, and interaction network construction. The IA diagnostic values of key genes were identified using machine learning. Finally, we performed the single-cell sequencing (scRNA-seq) analysis to explore mitochondrial dysfunction and necroptosis at the cellular level. In total, 42 IA-mitochondrial DEGs and 15 IA-necroptosis DEGs were identified. Screening revealed seven key genes invovled in mitochondrial dysfunction (KMO, HADH, BAX, AADAT, SDSL, PYCR1, and MAOA) and five genes involved in necroptosis (IL1B, CAMK2G, STAT1, NLRP3, and BAX). Machine learning confirmed the high diagnostic value of these key genes for IA. The IA samples showed higher expression of mitochondrial dysfunction and necroptosis. Mitochondrial dysfunction and necroptosis exhibited a close association. Furthermore, scRNA-seq indicated that mitochondrial dysfunction and necroptosis were preferentially up-regulated in monocytes/macrophages and vascular smooth muscle cells (VSMCs) within IA lesions. In conclusion, mitochondria-induced necroptosis was involved in IA formation, and was mainly up-regulated in monocytes/macrophages and VSMCs within IA lesions. Mitochondria-induced necroptosis may be a novel potential target for diagnosis, prevention, and treatment of IA.
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Affiliation(s)
- Bo Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, No. 87 Xiangya Rd., Changsha, 410008 Hunan People’s Republic of China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Surgery, LKS Faculty of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong, China
| | - Kang Xie
- Department of Neurosurgery, Xiangya Hospital, Central South University, No. 87 Xiangya Rd., Changsha, 410008 Hunan People’s Republic of China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Jianzhong Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University (Jiangxi Branch), Nanchang, 330000 Jiangxi China
| | - Liting Yang
- Department of Neurosurgery, Xiangya Hospital, Central South University, No. 87 Xiangya Rd., Changsha, 410008 Hunan People’s Republic of China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Hongshu Zhou
- Department of Neurosurgery, Xiangya Hospital, Central South University, No. 87 Xiangya Rd., Changsha, 410008 Hunan People’s Republic of China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
| | - Liyang Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, No. 87 Xiangya Rd., Changsha, 410008 Hunan People’s Republic of China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Neurosurgery, Xiangya Hospital, Central South University (Jiangxi Branch), Nanchang, 330000 Jiangxi China
| | - Renjun Peng
- Department of Neurosurgery, Xiangya Hospital, Central South University, No. 87 Xiangya Rd., Changsha, 410008 Hunan People’s Republic of China
- Hypothalamic-Pituitary Research Center, Xiangya Hospital, Central South University, Changsha, Hunan China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan China
- Department of Neurosurgery, Xiangya Hospital, Central South University (Jiangxi Branch), Nanchang, 330000 Jiangxi China
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Dinia L, Vert C, Gramegna LL, Arikan F, Hernández D, Coscojuela P, Martinez-Saez E, Ramón Y Cajal S, Luzi M, Sarria-Estrada S, Salerno A, De Barros A, Gandara D, Quintana M, Rovira A, Tomasello A. Wall enhancement as a biomarker of intracranial aneurysm instability: a histo-radiological study. Acta Neurochir (Wien) 2023; 165:2783-2791. [PMID: 37589724 DOI: 10.1007/s00701-023-05739-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/25/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND The aim of this is to explore the histological basis of vessel wall enhancement (WE) on magnetic resonance imaging (MRI), which is a strong radiological biomarker of aneurysmal prone to rupture compared to other classical risk predictors (e.g., PHASES score, size, morphology). METHODS A prospective observational study was performed including all consecutive patients presenting with a saccular intracranial aneurysm at Vall d'Hebron University Hospital between October 2017 and May 2019. The patients underwent high-resolution 3 T MRI, and their aneurysms were classified into asymptomatic, symptomatic, and ruptured. A histological and immunohistochemical study was performed in a subgroup of patients (n = 20, of which 15 presented with WE). Multiple regression analyses were performed to identify predictors of rupture and aneurysm symptoms. RESULTS A total of 132 patients were enrolled in the study. WE was present in 36.5% of aneurysms: 22.9% asymptomatic, 76.9% symptomatic, and 100% ruptured. Immunohistochemical markers associated with WE were CD3 T cell receptor (p = 0.05) and CD45 leukocyte common antigen (p = 0.05). Moreover, WE is an independent predictor of symptomatic and ruptured aneurysms (p < 0.001). CONCLUSIONS Aneurysms with WE present multiple histopathological changes that may contribute to wall disruption and represent the pathophysiological basis of radiological WE. Moreover, WE is an independent diagnostic predictor of aneurysm symptoms and rupture.
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Affiliation(s)
- Lavinia Dinia
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain
- Interventional Neuroradiology Section, Department of Radiology, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
| | - Carla Vert
- Section of Neuroradiology and Magnetic Resonance Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Laura Ludovica Gramegna
- Vall d'Hebron Institute of Research, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Servicio de Radiología, Unidad de Neurorradiología., Hospital del Mar, Barcelona, Spain
| | - Fuat Arikan
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain
- Neurotraumatology and Neurosurgery Research Unit, Department of Neurosurgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - David Hernández
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain
- Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | - Pilar Coscojuela
- Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain
| | | | | | - Michele Luzi
- Interventional Neuroradiology Section, Department of Radiology, Hospital de La Santa Creu I Sant Pau, Barcelona, Spain
- Torrette University Hospital, UNIVPM, Ancona, Italy
| | - Silvana Sarria-Estrada
- Section of Neuroradiology and Magnetic Resonance Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Annalaura Salerno
- Section of Neuroradiology and Magnetic Resonance Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Andrea De Barros
- Section of Neuroradiology and Magnetic Resonance Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Dario Gandara
- Neurotraumatology and Neurosurgery Research Unit, Department of Neurosurgery, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Manuel Quintana
- Department of Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Neurology Department, Epilepsy Unit, Vall d'Hebron Hospital, Barcelona, Spain
| | - Alex Rovira
- Section of Neuroradiology and Magnetic Resonance Unit, Vall d'Hebron University Hospital, Barcelona, Spain
| | - Alejandro Tomasello
- Vall d'Hebron Research Institute, Vall d'Hebron University Hospital, Barcelona, Spain.
- Interventional Neuroradiology Section, Department of Radiology, Vall d'Hebron University Hospital, Pg. Vall d'Hebron, 119-129, 08035, Barcelona, Spain.
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Zhou D, Zhu Y, Jiang P, Zhang T, Zhuang J, Li T, Qi L, Wang Y. Identifying pyroptosis- and inflammation-related genes in intracranial aneurysms based on bioinformatics analysis. Biol Res 2023; 56:50. [PMID: 37752552 PMCID: PMC10523789 DOI: 10.1186/s40659-023-00464-z] [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: 04/18/2023] [Accepted: 09/20/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Intracranial aneurysm (IA) is the most common cerebrovascular disease, and subarachnoid hemorrhage caused by its rupture can seriously impede nerve function. Pyroptosis is an inflammatory mode of cell death whose underlying mechanisms involving the occurrence and rupture of IAs remain unclear. In this study, using bioinformatics analysis, we identified the potential pyroptosis-related genes (PRGs) and performed their inflammatory response mechanisms in IAs. METHODS The mRNA expression matrix of the IA tissue was obtained from the Gene Expression Omnibus database, and 51 PRGs were obtained from previous articles collected from PubMed. The differentially expressed PRGs (DEPRGs) were performed using R software. Subsequently, we performed enrichment analysis, constructed a protein-protein interaction network, performed weighted gene coexpression network analysis (WGCNA) and external validation using another dataset, and identified a correlation between hub genes and immune cell infiltration. Finally, the expression and tissue distribution of these hub genes in IA tissues were detected using Western blotting and immunohistochemical (IHC) staining. RESULTS In total, 12 DEPRGs associated with IA were identified in our analysis, which included 11 up-regulated and one down-regulated genes. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses revealed that the DEPRGs were mostly enriched in the NOD-like receptor signaling pathway, interleukin-1 beta production, and the inflammasome complex. Three hub genes, NLRP3, IL1B and IL18, were identified using Cytoscape software and the WGCNA correlation module, and external validation revealed statistically significant differences between the expression of these hub genes in the ruptured and unruptured aneurysm groups (p < 0.05). Furthermore, all AUC values were > 0.75. Immune cell infiltration analysis suggested that the hub genes are related to CD8 T cell, macrophages and mast cells. Finally, IHC staining revealed that the protein levels of these hub genes were higher in ruptured and unruptured IA tissues than in normal tissues (p < 0.05). CONCLUSION The results of bioinformatics analysis showed that pyroptosis is closely related to the formation and rupture of IA, and identified three potential hub genes involved in the pyroptosis and infiltration ofcells. Our findings may improve the understanding of the mechanisms underlying pyroptosis in IA.
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Affiliation(s)
- Donglin Zhou
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, 107 Wenhua Western Road, Jinan, 250012, Shandong, China
| | - Yimin Zhu
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, China
| | - Peng Jiang
- Jiangsu Center for the Collaboration and Innovation of Cancer Biotherapy, Cancer Institute, Xuzhou Medical University, Xuzhou, China
| | - Tongfu Zhang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, 107 Wenhua Western Road, Jinan, 250012, Shandong, China
- Department of Neurosurgery, Yangxin County People's Hospital, Binzhou, China
| | - Jianfeng Zhuang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, 107 Wenhua Western Road, Jinan, 250012, Shandong, China
| | - Tao Li
- Department of Neurosurgery, The Third Affiliated Hospital of Shandong First Medical University, Jinan, China
| | - Linzeng Qi
- Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, China
| | - Yunyan Wang
- Department of Neurosurgery, Qilu Hospital of Shandong University, Cheeloo College of Medicine and Institute of Brain and Brain-Inspired Science, Shandong University, 107 Wenhua Western Road, Jinan, 250012, Shandong, China.
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Oliveira IL, Cardiff P, Baccin CE, Tatit RT, Gasche JL. On the major role played by the lumen curvature of intracranial aneurysms walls in determining their mechanical response, local hemodynamics, and rupture likelihood. Comput Biol Med 2023; 163:107178. [PMID: 37356290 DOI: 10.1016/j.compbiomed.2023.107178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 05/20/2023] [Accepted: 06/10/2023] [Indexed: 06/27/2023]
Abstract
The properties of intracranial aneurysms (IAs) walls are known to be driven by the underlying hemodynamics adjacent to the IA sac. Different pathways exist explaining the connections between hemodynamics and local tissue properties. The emergence of such theories is essential if one wishes to compute the mechanical response of a patient-specific IA wall and predict its rupture. Apart from the hemodynamics and tissue properties, one could assume that the mechanical response also depends on the local morphology, more specifically, the curvature of the luminal surface, with larger values at highly-curved wall portions. Nonetheless, this contradicts observations of IA rupture sites more often found at the dome, where the curvature is lower. This seeming contradiction indicates a complex interaction between the hemodynamics adjacent to the aneurysm wall, its morphology, and mechanical response, which warrants further investigation. This was the main goal of this work. We accomplished this by analyzing the stress and stretch fields in different regions of the wall for a sample of IAs, which have been classified based on particular hemodynamics conditions and lumen curvature. Pulsatile numerical simulations were performed using the one-way fluid-solid interaction strategy implemented in OpenFOAM (solids4foam toolbox). We found that the variable best correlated with regions of high stress and stretch was the lumen curvature. Additionally, our data suggest a connection between the local curvature and particular hemodynamics conditions adjacent to the wall, indicating that the lumen curvature is a property that could be used to assess both mechanical response and hemodynamic conditions, and, moreover, suggest new rupture indicators based on the curvature.
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Affiliation(s)
- I L Oliveira
- São Paulo State University (UNESP), School of Engineering, Bauru, Department of Mechanical Engineering, Av. Engenheiro Luiz Edmundo Carrijo Coube, 14-01, 17033-360, Bauru, SP, Brazil.
| | - P Cardiff
- University College Dublin (UCD), School of Mechanical and Materials Engineering, Dublin, Ireland.
| | - C E Baccin
- Interventional Neuroradiologist, Hospital Israelita Albert Einstein, São Paulo, Brazil.
| | - R T Tatit
- Albert Einstein Israeli Faculty of Health Sciences, São Paulo, Brazil.
| | - J L Gasche
- São Paulo State University (UNESP), School of Engineering, Ilha Solteira, Mechanical Engineering Department, Brazil.
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Lorga T, Pizzuto S, Coskun O, Sgreccia A, Cavazza M, Rahman MH, Rodesch G, Di Maria F, Consoli A. Reconstruction of the sphenoid sinus erosion or dehiscence after treatment of unruptured intracavernous aneurysms with flow diverter stents. J Neurointerv Surg 2023:jnis-2023-020734. [PMID: 37586819 DOI: 10.1136/jnis-2023-020734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Intracavernous carotid aneurysms (ICCAs) are rare, frequently asymptomatic, with a low rupture risk, which, however, can lead to life-threatening epistaxis. The aim of this study was to assess the effect of the treatment of asymptomatic ICCAs with flow diverters (FD) on sphenoid bone erosion or dehiscence in a selected cohort of patients. METHODS We retrospectively reviewed all asymptomatic ICCAs with sphenoid bone erosion or dehiscence detected on cone beam CT (CBCT) and treated with FD between December 2018 and December 2022. Patients were followed-up with CBCT and bone reconstruction was blindly evaluated by two interventional neuroradiologists and classified as unchanged, partial, or complete. RESULTS A total of 10 patients (women: 90%, mean age 58 years) treated with an FD for an asymptomatic ICCA with associated sphenoid bone erosion or dehiscence were included in this cohort. Sphenoid bone erosion was present in seven patients and dehiscence was observed in the remaining three. After treatment with FD, complete reconstruction of the sphenoid sinus wall occurred in seven cases, and partial reconstruction in two cases. Sphenoid bone erosion remained unchanged after treatment in only one patient. CONCLUSIONS The decision to treat asymptomatic and unruptured ICCAs remains challenging due to their benign natural history and low hemorrhagic risk. The presence of sphenoid sinus erosion or dehiscence should not be overlooked since it could be considered as an indication for prophylactic treatment of life-threatening epistaxis. The mechanisms of bone erosion by the aneurysm and of reconstruction after treatment are still to be fully elucidated.
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Affiliation(s)
- Tiago Lorga
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
- Neuroradiology, Centro Hospitalar Universitário de Lisboa Central EPE, Lisboa, Portugal
| | - Silvia Pizzuto
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
| | - Oguzhan Coskun
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
| | - Alessandro Sgreccia
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
| | - Martino Cavazza
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
- Diagnostic and Interventional Radiology, University Hospital Arcispedale Sant'Anna of Ferrara, Cona, Italy
| | - Mohammad Habibur Rahman
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
- Interventional Neurology, National Institute of Neurosciences and Hospital, Sher-E-Bangla Nagar, Bangladesh
| | - Georges Rodesch
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
| | - Federico Di Maria
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
| | - Arturo Consoli
- Diagnostic and Interventional Neuroradiology, Hôpital Foch, Suresnes, France
- Versailles Saint-Quentin-en-Yvelines University, Versailles, France
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Lin M, Xia N, Lin R, Xu L, Chen Y, Zhou J, Lin B, Zheng K, Wang H, Jia X, Liu J, Zhu D, Chen C, Yang Y, Su N. Machine learning prediction model for the rupture status of middle cerebral artery aneurysm in patients with hypertension: a Chinese multicenter study. Quant Imaging Med Surg 2023; 13:4867-4878. [PMID: 37581038 PMCID: PMC10423353 DOI: 10.21037/qims-22-918] [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: 09/02/2022] [Accepted: 05/19/2023] [Indexed: 08/16/2023]
Abstract
Background Hypertension is a common comorbidity in patients with unruptured intracranial aneurysms and is closely associated with the rupture of aneurysms. However, only a few studies have focused on the rupture risk of aneurysms comorbid with hypertension. This retrospective study aimed to construct prediction models for the rupture of middle cerebral artery (MCA) aneurysm associated with hypertension using machine learning (ML) algorithms, and the constructed models were externally validated with multicenter datasets. Methods We included 322 MCA aneurysm patients comorbid with hypertension who were being treated in four hospitals. All participants underwent computed tomography angiography (CTA), and aneurysm morphological features were measured. Clinical characteristics included sex, age, smoking, and hypertension history. Based on the clinical and morphological characteristics, the training datasets (n=277) were used to fit the ML algorithms to construct prediction models, which were externally validated with the testing datasets (n=45). The prediction performances of the models were assessed by receiver operating characteristic (ROC) curves. Results The areas under the ROC curve (AUCs) of the k-nearest-neighbor (KNN), neural network (NNet), support vector machine (SVM) and logistic regression (LR) models in the training datasets were 0.83 [95% confidence interval (CI): 0.78-0.88], 0.87 (95% CI: 0.82-0.92), 0.91 (95% CI: 0.88-0.95), and 0.83 (95% CI: 0.77-0.88), respectively, and in the testing datasets were 0.74 (95% CI: 0.59-0.89), 0.82 (95% CI: 0.69-0.94), 0.73 (95% CI: 0.58-0.88), and 0.76 (95% CI: 0.61-0.90), respectively. The aspect ratio (AR) was ranked as the most important variable in the ML models except for NNet. Further analysis showed that the AR had good diagnostic performance, with AUC values of 0.75 in the training datasets and 0.77 in the testing datasets. Conclusions The ML models performed reasonably accurately in predicting MCA aneurysm rupture comorbid with hypertension. AR was demonstrated as the leading predictor for the rupture of MCA aneurysm with hypertension.
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Affiliation(s)
- Mengqi Lin
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Nengzhi Xia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ru Lin
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Liuhui Xu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yongchun Chen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jiafeng Zhou
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Boli Lin
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Kuikui Zheng
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hao Wang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xiufen Jia
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jinjin Liu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Dongqin Zhu
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Chao Chen
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Yunjun Yang
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Na Su
- Department of Radiology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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Hadad S, Karnam Y, Mut F, Lohner R, Robertson AM, Kaneko N, Cebral JR. Computational fluid dynamics-based virtual angiograms for the detection of flow stagnation in intracranial aneurysms. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2023; 39:e3740. [PMID: 37288602 PMCID: PMC10524728 DOI: 10.1002/cnm.3740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 05/15/2023] [Accepted: 05/21/2023] [Indexed: 06/09/2023]
Abstract
The goal of this study was to test if CFD-based virtual angiograms could be used to automatically discriminate between intracranial aneurysms (IAs) with and without flow stagnation. Time density curves (TDC) were extracted from patient digital subtraction angiography (DSA) image sequences by computing the average gray level intensity inside the aneurysm region and used to define injection profiles for each subject. Subject-specific 3D models were reconstructed from 3D rotational angiography (3DRA) and computational fluid dynamics (CFD) simulations were performed to simulate the blood flow inside IAs. Transport equations were solved numerically to simulate the dynamics of contrast injection into the parent arteries and IAs and then the contrast retention time (RET) was calculated. The importance of gravitational pooling of contrast agent within the aneurysm was evaluated by modeling contrast agent and blood as a mixture of two fluids with different densities and viscosities. Virtual angiograms can reproduce DSA sequences if the correct injection profile is used. RET can identify aneurysms with significant flow stagnation even when the injection profile is not known. Using a small sample of 14 IAs of which seven were previously classified as having flow stagnation, it was found that a threshold RET value of 0.46 s can successfully identify flow stagnation. CFD-based prediction of stagnation was in more than 90% agreement with independent visual DSA assessment of stagnation in a second sample of 34 IAs. While gravitational pooling prolonged contrast retention time it did not affect the predictive capabilities of RET. CFD-based virtual angiograms can detect flow stagnation in IAs and can be used to automatically identify aneurysms with flow stagnation even without including gravitational effects on contrast agents.
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Affiliation(s)
- Sara Hadad
- Department of Bioengineering George Mason University, Fairfax, VA, USA
| | - Yogesh Karnam
- Department of Bioengineering George Mason University, Fairfax, VA, USA
| | - Fernando Mut
- Department of Bioengineering George Mason University, Fairfax, VA, USA
| | - Rainald Lohner
- Center for Computational Fluid Dynamics, College of Science, George Mason University, VA, Fairfax, USA
| | - Anne M Robertson
- Department of Mechanical Engineering and Material Science, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Naoki Kaneko
- Department of Interventional Neuroradiology, University of California Los Angeles, Los Angeles, California, USA
| | - Juan R Cebral
- Department of Bioengineering George Mason University, Fairfax, VA, USA
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Shima Y, Sasagawa S, Ota N, Oyama R, Tanaka M, Kubota-Sakashita M, Kawakami H, Kobayashi M, Takubo N, Ozeki AN, Sun X, Kim YJ, Kamatani Y, Matsuda K, Maejima K, Fujita M, Noda K, Kamiyama H, Tanikawa R, Nagane M, Shibahara J, Tanaka T, Rikitake Y, Mataga N, Takahashi S, Kosaki K, Okano H, Furihata T, Nakaki R, Akimitsu N, Wada Y, Ohtsuka T, Kurihara H, Kamiguchi H, Okabe S, Nakafuku M, Kato T, Nakagawa H, Saito N, Nakatomi H. Increased PDGFRB and NF-κB signaling caused by highly prevalent somatic mutations in intracranial aneurysms. Sci Transl Med 2023; 15:eabq7721. [PMID: 37315111 DOI: 10.1126/scitranslmed.abq7721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/23/2023] [Indexed: 06/16/2023]
Abstract
Intracranial aneurysms (IAs) are a high-risk factor for life-threatening subarachnoid hemorrhage. Their etiology, however, remains mostly unknown at present. We conducted screening for sporadic somatic mutations in 65 IA tissues (54 saccular and 11 fusiform aneurysms) and paired blood samples by whole-exome and targeted deep sequencing. We identified sporadic mutations in multiple signaling genes and examined their impact on downstream signaling pathways and gene expression in vitro and an arterial dilatation model in mice in vivo. We identified 16 genes that were mutated in at least one IA case and found that these mutations were highly prevalent (92%: 60 of 65 IAs) among all IA cases examined. In particular, mutations in six genes (PDGFRB, AHNAK, OBSCN, RBM10, CACNA1E, and OR5P3), many of which are linked to NF-κB signaling, were found in both fusiform and saccular IAs at a high prevalence (43% of all IA cases examined). We found that mutant PDGFRBs constitutively activated ERK and NF-κB signaling, enhanced cell motility, and induced inflammation-related gene expression in vitro. Spatial transcriptomics also detected similar changes in vessels from patients with IA. Furthermore, virus-mediated overexpression of a mutant PDGFRB induced a fusiform-like dilatation of the basilar artery in mice, which was blocked by systemic administration of the tyrosine kinase inhibitor sunitinib. Collectively, this study reveals a high prevalence of somatic mutations in NF-κB signaling pathway-related genes in both fusiform and saccular IAs and opens a new avenue of research for developing pharmacological interventions.
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Affiliation(s)
- Yasuyuki Shima
- Biomedical Neural Dynamics Collaboration Laboratory, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
- Neurodegenerative Disorders Collaboration Laboratory, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Shota Sasagawa
- Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Nakao Ota
- Biomedical Neural Dynamics Collaboration Laboratory, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
- Department of Neurosurgery, Sapporo Teishinkai Hospital, Sapporo, Hokkaido 065-0033, Japan
| | - Rieko Oyama
- Biomedical Neural Dynamics Collaboration Laboratory, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Minoru Tanaka
- Biomedical Neural Dynamics Collaboration Laboratory, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
- Division of Innovative Cancer Therapy and Department of Surgical Neuro-Oncology, Institute of Medical Science, University of Tokyo, Tokyo 108-8639, Japan
| | - Mie Kubota-Sakashita
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Hirochika Kawakami
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Mika Kobayashi
- Isotope Science Center, University of Tokyo, Tokyo 113-0032, Japan
| | - Naoko Takubo
- Isotope Science Center, University of Tokyo, Tokyo 113-0032, Japan
| | | | - Xiaoning Sun
- Isotope Science Center, University of Tokyo, Tokyo 113-0032, Japan
| | - Yeon-Jeong Kim
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo 108-8639, Japan
| | - Koichi Matsuda
- Laboratory of Clinical Genome Sequencing, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo 108-8639, Japan
| | - Kazuhiro Maejima
- Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Masashi Fujita
- Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Kosumo Noda
- Department of Neurosurgery, Sapporo Teishinkai Hospital, Sapporo, Hokkaido 065-0033, Japan
| | - Hiroyasu Kamiyama
- Department of Neurosurgery, Sapporo Teishinkai Hospital, Sapporo, Hokkaido 065-0033, Japan
| | - Rokuya Tanikawa
- Department of Neurosurgery, Sapporo Teishinkai Hospital, Sapporo, Hokkaido 065-0033, Japan
| | - Motoo Nagane
- Department of Neurosurgery, Faculty of Medicine, Kyorin University, Mitaka, Tokyo 181-8611, Japan
| | - Junji Shibahara
- Department of Pathology, Faculty of Medicine, Kyorin University, Mitaka, Tokyo 181-8611, Japan
| | - Toru Tanaka
- Laboratory of Medical Pharmaceutics, Kobe Pharmaceutical University, Kobe, Hyogo 658-8558, Japan
| | - Yoshiyuki Rikitake
- Laboratory of Medical Pharmaceutics, Kobe Pharmaceutical University, Kobe, Hyogo 658-8558, Japan
| | - Nobuko Mataga
- Support Unit for Bio-Material Analysis, Research Resources Division, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Satoru Takahashi
- Department of Anatomy and Embryology, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki 305-0005, Japan
| | - Kenjiro Kosaki
- Center for Medical Genetics, Keio University Faculty of Medicine, Tokyo 160-0016, Japan
| | - Hideyuki Okano
- Department of Physiology, Keio University School of Medicine, Tokyo 160-0016, Japan
- Laboratory for Marmoset Neural Architecture, Center for Brain Science, RIKEN, Wako, Saitama 351-0198, Japan
- International Center for Brain Science, Fujita Health University, Toyoake, Aichi 470-1192, Japan
| | - Tomomi Furihata
- Laboratory of Clinical Pharmacy and Experimental Therapeutics, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences, Hachioji, Tokyo 192-0392, Japan
| | | | | | - Youichiro Wada
- Isotope Science Center, University of Tokyo, Tokyo 113-0032, Japan
| | - Toshihisa Ohtsuka
- Department of Biochemistry, Faculty of Medicine and Graduate School of Medicine, University of Yamanashi, Chuo, Yamanashi 409-3898, Japan
| | - Hiroki Kurihara
- Department of Molecular Cell Biology, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo 113-8654, Japan
| | - Hiroyuki Kamiguchi
- Laboratory for Neural Cell Dynamics, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Shigeo Okabe
- Department of Cellular Neurobiology, Graduate School of Medicine and Faculty of Medicine, University of Tokyo, Tokyo 113-8654, Japan
- Brain Medical Science Collaboration Division, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
| | - Masato Nakafuku
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
| | - Hidewaki Nakagawa
- Laboratory for Cancer Genomics, RIKEN Center for Integrative Medical Sciences, Yokohama, Kanagawa 230-0045, Japan
| | - Nobuhito Saito
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo 113-8654, Japan
| | - Hirofumi Nakatomi
- Biomedical Neural Dynamics Collaboration Laboratory, RIKEN Center for Brain Science, Wako, Saitama 351-0198, Japan
- Department of Neurosurgery, Faculty of Medicine, Kyorin University, Mitaka, Tokyo 181-8611, Japan
- Department of Neurosurgery, Graduate School of Medicine, University of Tokyo, Tokyo 113-8654, Japan
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Bao J, Gan X, Feng W, Li Y, Qiu Y, Zhou M, Guo J, He L. Abnormal flow pattern of low wall shear stress and high oscillatory shear index in spontaneous vertebral artery dissection with vertebral artery hypoplasia. Front Neurosci 2023; 17:1179963. [PMID: 37389359 PMCID: PMC10303804 DOI: 10.3389/fnins.2023.1179963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 05/26/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Spontaneous vertebral artery dissection (sVAD) might tend to develop in vertebral artery hypoplasia (VAH) with hemodynamic dysfunction and it is crucial to assess hemodynamics in sVAD with VAH to investigate this hypothesis. This retrospective study aimed to quantify hemodynamic parameters in patients with sVAD with VAH. Methods Patients who had suffered ischemic stroke due to an sVAD of VAH were enrolled in this retrospective study. The geometries of 14 patients (28 vessels) were reconstructed using Mimics and Geomagic Studio software from CT angiography (CTA). ANSYS ICEM and ANSYS FLUENT were utilized for mesh generation, set boundary conditions, solve governing equations, and perform numerical simulations. Slices were obtained at the upstream area, dissection or midstream area and downstream area of each VA. The blood flow patterns were visualized through instantaneous streamline and pressure at peak systole and late diastole. The hemodynamic parameters included pressure, velocity, time-averaged blood flow, time-averaged wall shear stress (TAWSS), oscillatory shear index (OSI), endothelial cell action potential (ECAP), relative residence time (RRT) and time-averaged nitric oxide production rate (TARNO). Results Significant focal increased velocity was present in the dissection area of steno-occlusive sVAD with VAH compared to other nondissected areas (0.910 m/s vs. 0.449 vs. 0.566, p < 0.001), while focal slow flow velocity was observed in the dissection area of aneurysmal dilatative sVAD with VAH according to velocity streamlines. Steno-occlusive sVAD with VAH arteries had a lower time-averaged blood flow (0.499 cm3/s vs. 2.268, p < 0.001), lower TAWSS (1.115 Pa vs. 2.437, p = 0.001), higher OSI (0.248 vs. 0.173, p = 0.006), higher ECAP (0.328 Pa-1 vs. 0.094, p = 0.002), higher RRT (3.519 Pa-1 vs. 1.044, p = 0.001) and deceased TARNO (104.014 nM/s vs. 158.195, p < 0.001) than the contralateral VAs. Conclusion Steno-occlusive sVAD with VAH patients had abnormal blood flow patterns of focal increased velocity, low time-averaged blood flow, low TAWSS, high OSI, high ECAP, high RRT and decreased TARNO. These results provide a good basis for further investigation of sVAD hemodynamics and support the applicability of the CFD method in testing the hemodynamic hypothesis of sVAD. More detailed hemodynamic conditions with different stages of sVAD are warranted in the future.
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Affiliation(s)
- Jiajia Bao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xinling Gan
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Wentao Feng
- Key Laboratory of Biomechanics and Mechanobiology (Beihang University) Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Yanbo Li
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yue Qiu
- Department of Applied Mechanics, Sichuan University, Chengdu, China
| | - Muke Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jian Guo
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Li He
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
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Wang Z, Ma J, Yue H, Zhang Z, Fang F, Wang G, Liu X, Shen Y. Vascular smooth muscle cells in intracranial aneurysms. Microvasc Res 2023:104554. [PMID: 37236346 DOI: 10.1016/j.mvr.2023.104554] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/17/2023] [Accepted: 05/19/2023] [Indexed: 05/28/2023]
Abstract
Intracranial aneurysm (IA) is a severe cerebrovascular disease characterized by abnormal bulging of cerebral vessels that may rupture and cause a stroke. The expansion of the aneurysm accompanies by the remodeling of vascular matrix. It is well-known that vascular remodeling is a process of synthesis and degradation of extracellular matrix (ECM), which is highly dependent on the phenotype of vascular smooth muscle cells (VSMCs). The phenotypic switching of VSMC is considered to be bidirectional, including the physiological contractile phenotype and alternative synthetic phenotype in response to injury. There is increasing evidence indicating that VSMCs have the ability to switch to various phenotypes, including pro-inflammatory, macrophagic, osteogenic, foamy and mesenchymal phenotypes. Although the mechanisms of VSMC phenotype switching are still being explored, it is becoming clear that phenotype switching of VSMCs plays an essential role in IA formation, progression, and rupture. This review summarized the various phenotypes and functions of VSMCs associated with IA pathology. The possible influencing factors and potential molecular mechanisms of the VSMC phenotype switching were further discussed. Understanding how phenotype switching of VSMC contributed to the pathogenesis of unruptured IAs can bring new preventative and therapeutic strategies for IA.
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Affiliation(s)
- Zhenye Wang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Jia Ma
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Hongyan Yue
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Zhewei Zhang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China
| | - Fei Fang
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China; Jinfeng Laboratory, Chongqing 401329, China
| | - Guixue Wang
- Jinfeng Laboratory, Chongqing 401329, China; Key Laboratory of Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, College of Bioengineering, Chongqing University, Chongqing 400030, China
| | - Xiaoheng Liu
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China; Jinfeng Laboratory, Chongqing 401329, China
| | - Yang Shen
- Institute of Biomedical Engineering, West China School of Basic Medical Sciences & Forensic Medicine, Sichuan University, Chengdu 610041, China; Jinfeng Laboratory, Chongqing 401329, China.
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He W, Hu Z, Zhong Y, Wu C, Li J. The Potential of NLRP3 Inflammasome as a Therapeutic Target in Neurological Diseases. Mol Neurobiol 2023; 60:2520-2538. [PMID: 36680735 DOI: 10.1007/s12035-023-03229-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 01/10/2023] [Indexed: 01/22/2023]
Abstract
NLRP3 (NLRP3: NOD-, LRR-, and pyrin domain-containing protein 3) inflammasome is the best-described inflammasome that plays a crucial role in the innate immune system and a wide range of diseases. The intimate association of NLRP3 with neurological disorders, including neurodegenerative diseases and strokes, further emphasizes its prominence as a clinical target for pharmacological intervention. However, after decades of exploration, the mechanism of NLRP3 activation remains indefinite. This review highlights recent advances and gaps in our insights into the regulation of NLRP3 inflammasome. Furthermore, we present several emerging pharmacological approaches of clinical translational potential targeting the NLRP3 inflammasome in neurological diseases. More importantly, despite small-molecule inhibitors of the NLRP3 inflammasome, we have focused explicitly on Chinese herbal medicine and botanical ingredients, which may be splendid therapeutics by inhibiting NLRP3 inflammasome for central nervous system disorders. We expect that we can contribute new perspectives to the treatment of neurological diseases.
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Affiliation(s)
- Wenfang He
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhiping Hu
- Department of Neurology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yanjun Zhong
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Chenfang Wu
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Jinxiu Li
- Department of Critical Care Medicine, The Second Xiangya Hospital, Central South University, Changsha, China.
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Tang M, Zhou D, He J, Bai H, Li Q, Xu H. Chitinase-3 like-protein-1, matrix metalloproteinase -9 and positive intracranial arterial remodelling. Front Aging Neurosci 2023; 15:1154116. [PMID: 37091521 PMCID: PMC10119585 DOI: 10.3389/fnagi.2023.1154116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/20/2023] [Indexed: 04/08/2023] Open
Abstract
IntroductionPositive intracranial arterial remodelling is a dilated lesion of the large intracranial vessels; however, its pathogenesis is currently unknown. Some studies have identified chitinase-3 like-protein-1 (YKL-40) and matrix metalloproteinase (MMP)-9 as circulating inflammatory factors involved in positive vascular remodelling. Herein, we aimed to investigate the relationship between changes in serum YKL-40 and MMP-9 levels and positive intracranial arterial remodelling in patients with cerebral small vessel disease (CSVD).MethodsA total of 110 patients with CSVD were selected. Patients with brain arterial remodelling (BAR) scores >1 times the standard deviation were defined as the positive intracranial artery remodelling group (n = 21 cases), and those with BAR scores ≤1 times the standard deviation were defined as the non-positive intracranial artery remodelling group (n = 89 cases). Serum YKL-40 and MMP-9 levels were measured using an enzyme-linked immunosorbent assay kit. Factors influencing positive intracranial artery remodelling using binary logistic regression analysis and predictive value of YKL-40 and MMP-9 for positive intracranial arterial remodelling in patients with CSVD were assessed by a subject receiver operating characteristic curve.ResultsStatistically significant differences in serum YKL-40 and MMP-9 levels were observed between the positive and non-positive remodelling groups (p < 0.05). The integrated indicator (OR = 9.410, 95% CI: 3.156 ~ 28.054, P<0.01) of YKL-40 and MMP-9 levels were independent risk factors for positive intracranial arterial remodelling. The integrated indicator (OR = 3.763, 95% CI: 1.884 ~ 7.517, p < 0.01) of YKL-40 and MMP-9 were independent risk factors for positive arterial remodelling in posterior circulation, but were not significantly associated with positive arterial remodelling in anterior circulation (p > 0.05). The area under the curve for YKL-40 and MMP-9 diagnostic positive remodelling was 0.778 (95% CI: 0.692–0.865, p < 0.01) and 0.736 (95% CI: 0.636–0.837, p < 0.01), respectively.DiscussionElevated serum YKL-40 and MMP-9 levels are independent risk factors for positive intracranial arterial remodelling in patients with CSVD and may predict the presence of positive intracranial arterial remodelling, providing new ideas for the mechanism of its occurrence and development and the direction of treatment.
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Affiliation(s)
- Ming Tang
- Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Dongyang Zhou
- Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junhui He
- Department of Cardiology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongying Bai
- Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- Hongying Bai,
| | - Qianqian Li
- Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- *Correspondence: Qianqian Li,
| | - Hui Xu
- Department of Neurology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Boster KAS, Cai S, Ladrón-de-Guevara A, Sun J, Zheng X, Du T, Thomas JH, Nedergaard M, Karniadakis GE, Kelley DH. Artificial intelligence velocimetry reveals in vivo flow rates, pressure gradients, and shear stresses in murine perivascular flows. Proc Natl Acad Sci U S A 2023; 120:e2217744120. [PMID: 36989300 PMCID: PMC10083563 DOI: 10.1073/pnas.2217744120] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 02/15/2023] [Indexed: 03/30/2023] Open
Abstract
Quantifying the flow of cerebrospinal fluid (CSF) is crucial for understanding brain waste clearance and nutrient delivery, as well as edema in pathological conditions such as stroke. However, existing in vivo techniques are limited to sparse velocity measurements in pial perivascular spaces (PVSs) or low-resolution measurements from brain-wide imaging. Additionally, volume flow rate, pressure, and shear stress variation in PVSs are essentially impossible to measure in vivo. Here, we show that artificial intelligence velocimetry (AIV) can integrate sparse velocity measurements with physics-informed neural networks to quantify CSF flow in PVSs. With AIV, we infer three-dimensional (3D), high-resolution velocity, pressure, and shear stress. Validation comes from training with 70% of PTV measurements and demonstrating close agreement with the remaining 30%. A sensitivity analysis on the AIV inputs shows that the uncertainty in AIV inferred quantities due to uncertainties in the PVS boundary locations inherent to in vivo imaging is less than 30%, and the uncertainty from the neural net initialization is less than 1%. In PVSs of N = 4 wild-type mice we find mean flow speed 16.33 ± 11.09 µm/s, volume flow rate 2.22 ± 1.983 × 103 µm3/s, axial pressure gradient ( - 2.75 ± 2.01)×10-4 Pa/µm (-2.07 ± 1.51 mmHg/m), and wall shear stress (3.00 ± 1.45)×10-3 Pa (all mean ± SE). Pressure gradients, flow rates, and resistances agree with prior predictions. AIV infers in vivo PVS flows in remarkable detail, which will improve fluid dynamic models and potentially clarify how CSF flow changes with aging, Alzheimer's disease, and small vessel disease.
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Affiliation(s)
| | - Shengze Cai
- Institute of Cyber-Systems and Control, College of Control Science and Engineering, Zhejiang University, Hangzhou310027, Zhejiang, China
| | - Antonio Ladrón-de-Guevara
- Center for Translational Neuromedicine and Department of Neuroscience, University of Rochester Medical Center, Rochester, NY14627
| | - Jiatong Sun
- Department of Mechanical Engineering, University of Rochester, Rochester, NY14627
| | - Xiaoning Zheng
- Department of Mathematics, College of Information Science and Technology, Jinan University, Guangzhou510632, China
| | - Ting Du
- Center for Translational Neuromedicine and Department of Neuroscience, University of Rochester Medical Center, Rochester, NY14627
- School of Pharmacy, China Medical University, Shenyang, Liaoning110122, China
| | - John H. Thomas
- Department of Mechanical Engineering, University of Rochester, Rochester, NY14627
| | - Maiken Nedergaard
- Center for Translational Neuromedicine and Department of Neuroscience, University of Rochester Medical Center, Rochester, NY14627
| | - George Em Karniadakis
- Division of Applied Mathematics, Brown University, Providence, RI02912
- School of Engineering, Brown University, Providence, RI02912
| | - Douglas H. Kelley
- Department of Mechanical Engineering, University of Rochester, Rochester, NY14627
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Li S, Zhang Q, Huang Z, Chen F. Integrative analysis of multi-omics data to identify three immune-related genes in the formation and progression of intracranial aneurysms. Inflamm Res 2023; 72:1001-1019. [PMID: 37014439 DOI: 10.1007/s00011-023-01725-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/01/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
OBJECTIVE AND DESIGN The prevalence of intracranial aneurysms (IAs) has increased globally. We performed bioinformatics analysis to identify key biomarkers associated with IA formation. METHODS AND RESULTS We conducted a comprehensive analysis combined with multi-omics data and methods to identify immune-related genes (IRGs) and immunocytes involved in IAs. Functional enrichment analyses showed enhanced immune responses and suppressed organizations of extracellular matrix (ECM) during aneurysm progression. xCell analyses showed that the abundance of B cells, macrophages, mast cells, and monocytes significantly increased from levels in control to unruptured aneurysms and to ruptured aneurysms. Of 21 IRGs identified by overlapping, a three-gene (CXCR4, S100B, and OSM) model was constructed through LASSO logistic regression. The diagnostic ability of the three biomarkers in discriminating aneurysms from the control samples demonstrated a favorable diagnostic value. Among the three genes, OSM and CXCR4 were up-regulated and hypomethylated in IAs, while S100B was down-regulated and hypermethylated. The expression of the three IRGs was further validated by qRT-PCR and immunohistochemistry and mouse IA model using scRNA-seq analysis. CONCLUSION The present study demonstrated heightened immune response and suppressed ECM organization in aneurysm formation and rupture. The three-gene immune-related signature (CCR4, S100B, and OSM) model may facilitate IA diagnosis and prevention.
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Affiliation(s)
- Shifu Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China
| | - Qian Zhang
- Department of Neurosurgery, Xiangya Hospital, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China
| | - Zheng Huang
- Department of Neurosurgery, Xiangya Hospital, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China
| | - Fenghua Chen
- Department of Neurosurgery, Xiangya Hospital, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Central South University, 87 Xiangya Street, Changsha, 410008, Hunan, China.
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Ono I, Kayahara T, Kawashima A, Okada A, Miyamoto S, Kataoka H, Kurita H, Ishii A, Aoki T. Hypoxic microenvironment as a crucial factor triggering events leading to rupture of intracranial aneurysm. Sci Rep 2023; 13:5545. [PMID: 37015954 PMCID: PMC10073088 DOI: 10.1038/s41598-023-32001-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 03/21/2023] [Indexed: 04/06/2023] Open
Abstract
Subarachnoid hemorrhage being the rupture of intracranial aneurysm (IA) as a major cause has quite poor prognosis, despite the modern technical advances. Thereby, the mechanisms underlying the rupture of lesions should be clarified. Recently, we and others have clarified the formation of vasa vasorum in IA lesions presumably for inflammatory cells to infiltrate in lesions as the potential histopathological alternation leading to rupture. In the present study, we clarified the origin of vasa vasorum as arteries located at the brain surface using 3D-immunohistochemistry with tissue transparency. Using Hypoxyprobe, we then found the presence of hypoxic microenvironment mainly at the adventitia of intracranial arteries where IA is formed. In addition, the production of vascular endothelial growth factor (VEGF) from cultured macrophages in such a hypoxic condition was identified. Furthermore, we found the accumulation of VEGF both in rupture-prone IA lesions induced in a rat model and human unruptured IA lesions. Finally, the VEGF-dependent induction of neovessels from arteries on brain surface was confirmed. The findings from the present study have revealed the potential role of hypoxic microenvironment and hypoxia-induced VEGF production as a machinery triggering rupture of IAs via providing root for inflammatory cells in lesions to exacerbate inflammation.
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Affiliation(s)
- Isao Ono
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomomichi Kayahara
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akitsugu Kawashima
- Department of Neurosurgery, Tokyo Women's Medical University Yachiyo Medical Center, Chiba, Japan
| | - Akihiro Okada
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Hiroharu Kataoka
- Department of Neurosurgery, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Hiroki Kurita
- Department of Cerebrovascular Surgery, Saitama Medical University International Medical Center, Saitama, Japan
| | - Akira Ishii
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Tomohiro Aoki
- Department of Molecular Pharmacology, Research Institute, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, 564-8565, Japan.
- Core Research for Evolutional Science and Technology (CREST) from Japan Agency for Medical Research and Development (AMED), National Cerebral and Cardiovascular Center, Osaka, Japan.
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Khadivar P, Alipour M. Synergic effect of bone marrow derived mesenchymal stem cells and differentiated keratinocytes-like cells with a novel cellulose and collagen nanoscaffold on wound healing in rats. Biomed Pharmacother 2023. [DOI: 10.1016/j.biopha.2023.114404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
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Haemmerli J, Morel S, Georges M, Haidar F, Chebib FT, Morita A, Nozaki K, Tominaga T, Bervitskiy AV, Rzaev J, Schaller K, Bijlenga P. Characteristics and Distribution of Intracranial Aneurysms in Patients with Autosomal Dominant Polycystic Kidney Disease Compared with the General Population: A Meta-Analysis. KIDNEY360 2023; 4:e466-e475. [PMID: 36961086 PMCID: PMC10278849 DOI: 10.34067/kid.0000000000000092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 01/30/2023] [Indexed: 03/25/2023]
Abstract
Key Points IAs location distribution in patients with ADPKD differ from the ones in non-ADPKD patients IAs in patients with ADPKD are more commonly located in the anterior circulation and in large caliber arteries Because of IA multiplicity and singular IA distribution, patients with ADPKD represent a special population who need to be closely followed Background Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic condition associated with intracranial aneurysms (IAs). The associated pathophysiology remains unknown, but an association with wall shear stress is suspected. Cerebral arterial location is the principal factor influencing IA natural history. This study aims to compare IA location-specific distribution between ADPKD and non-ADPKD patients. Methods The ADPKD group comprised data from a systematic review of the literature (2016–2020, N =7) and three cohorts: integrated biomedical informatics for the management of cerebral aneurysms, Novosibirsk, and Unruptured Cerebral Aneurysms Study. The non-ADPKD group was formed from the integrated biomedical informatics for the management of cerebral aneurysms, Unruptured Cerebral Aneurysms Study, International Stroke Genetics Consortium, and the Finnish cohort from the literature. Patients and IAs characteristics were compared between ADPKD and non-ADPKD groups, and a meta-analysis for IA locations was performed. Results A total of 1184 IAs from patients with ADPKD were compared with 21,040 IAs from non-ADPKD patients. In total, 78.6% of patients with ADPKD had hypertension versus 39.2% of non-ADPKD patients. A total of 32.4% of patients with ADPKD were smokers versus 31.5% of non-ADPKD patients. In total, 30.1% of patients with ADPKD had a positive family history for IA versus 15.8% of the non-ADPKD patients. Patients with ADPKD showed a higher rate of IA multiplicity (33.2% versus 23.1%). IAs from patients with ADPKD showed a significant predominance across the internal carotid and middle cerebral arteries. Posterior communicating IAs were more frequently found in the non-ADPKD group. The meta-analysis confirmed a predominance of IAs in the patients with ADPKD across large caliber arteries (odds ratio [95% confidence interval]: internal carotid artery: 1.90 [1.10 to 3.29]; middle cerebral artery: 1.18 [1.02–1.36]). Small diameter arteries, such as the posterior communicating, were observed more in non-ADPKD patients (0.21 [0.11–0.88]). Conclusion This analysis shows that IAs diagnosed in patients with ADPKD are more often localized in large caliber arteries from the anterior circulation in comparison with IAs in non-ADPKD patients. It shows that primary cilia driven wall shear stress vessel remodeling to be more critical in cerebral anterior circulation large caliber arteries.
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Affiliation(s)
- Julien Haemmerli
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Sandrine Morel
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Pathology and Immunology, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marc Georges
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Fadi Haidar
- Division of Nephrology, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Division of Transplantation, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Fouad T. Chebib
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Akio Morita
- Department of Neurological Surgery, Nippon Medical School, Tokyo, Japan
| | - Kazuhiko Nozaki
- Department of Neurosurgery, Shiga University of Medical Science, Otsu, Japan
| | - Teiji Tominaga
- Department of Neurosurgery, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Anatoliy V. Bervitskiy
- The “Federal Centre of Neurosurgery” of the Ministry of Health of the Russian Federation Novosibirsk, Novosibirsk Region, Novosibirsk, Russia
| | - Jamil Rzaev
- The “Federal Centre of Neurosurgery” of the Ministry of Health of the Russian Federation Novosibirsk, Novosibirsk Region, Novosibirsk, Russia
| | - Karl Schaller
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Philippe Bijlenga
- Division of Neurosurgery, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Lapraz P, Pinsard Q, Coudert R, Cortese J, Rouchaud A. Association between flow patterns of the posterior cerebral arterial circle and basilar-tip aneurysms. Surg Radiol Anat 2023; 45:505-511. [PMID: 36894789 DOI: 10.1007/s00276-023-03121-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE The Cerebral arterial circle presents multiple individual anatomical configurations which are of the highest importance regarding the pathological processes for intracranial aneurysms development. Previous studies highlighted the importance of geometry and especially arterial bifurcations leading to aneurysms development. The primary objective of this study was to determine whether a flow pattern asymmetry of the P1 segments of the posterior cerebral arteries was associated with a higher risk of basilar tip aneurysm. MATERIAL AND METHODS Two different populations were retrospectively reviewed. The first population, without aneurysm, for which TOF MRI sequences were reviewed. The second population with patients harboring basilar tip aneurysms for whom cerebral angiograms were reviewed. We retrospectively analyzed the flow contribution and symmetry of the two right and left P1 segments of the posterior cerebral arteries and the two posterior communicating arteries (Pcomm). We analyzed the association and risk factors for basilar tip aneurysm. RESULTS The anatomical and flow configurations of P1 and Pcomm have been reviewed in 467 patients without aneurysms and 35 patients with aneurysms. We identified a significant association between the flow pattern asymmetry of the P1 segments and the presence of a basilar tip aneurysm (OR = 2.12; IC95% = [1.01-4.36]; p = 0.04). We also confirmed that the male gender was protective against aneurysm (OR = 0.45; IC95% = [0.194-0.961]; p = 0.04). CONCLUSION Non-modal basilar tip bifurcation and flow asymmetry of P1 segments are associated with an increased risk of basilar tip aneurysm. These findings highlight the importance of analyzing MRI-TOF of the posterior configuration of the Cerebral arterial circle to potentially refine the aneurysms risk prediction.
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Affiliation(s)
- Pierre Lapraz
- Department of Human Anatomy, Laboratoire d'Anatomie, Faculty of Medicine, University of Limoges, 2, rue du Docteur Marcland, 87025, Limoges, France
| | - Quentin Pinsard
- Department of Human Anatomy, Laboratoire d'Anatomie, Faculty of Medicine, University of Limoges, 2, rue du Docteur Marcland, 87025, Limoges, France
| | - Romain Coudert
- Department of Radiology, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France
| | - Jonathan Cortese
- Department of Interventional Neuroradiology-NEURI Brain Vascular Center, Bicêtre Hospital, Le Kremlin-Bicêtre, France
| | - Aymeric Rouchaud
- Department of Radiology, Limoges University Hospital, CHU Dupuytren, 2, Avenue Martin-Luther-King, 87000, Limoges, France. .,UMR 7252, University of Limoges, XLIM CNRS, 87000, Limoges, France.
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Matur AV, Yamani AS, Robinson MW, Smith MS, Shirani P, Grossman AW, Prestigiacomo CJ. Association between underlying autoimmune disease and small aneurysm size at rupture. J Neurosurg 2023; 138:701-708. [PMID: 35901690 DOI: 10.3171/2022.5.jns22750] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/24/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Although the role of inflammation in the development of aneurysms is established, less is known about the development of intracranial aneurysms in the setting of underlying autoimmune disease. The underlying systemic inflammatory characteristics of disorders such as systemic lupus erythematosus, rheumatoid arthritis, and Sjögren's syndrome may influence the development of intracranial aneurysms through common inflammatory pathways. The authors hypothesized that there is an association between underlying autoimmune disease and aneurysm growth and rupture. METHODS Medical records of patients who underwent cerebral angiography between August 2018 and August 2021 were manually reviewed. Autoimmune diseases as defined for this study are those known to have systemic inflammatory effects on the central nervous system or multiple other organ systems. Statistical analysis, including construction of multivariable linear and logistic regression models, was performed using R version 4.1.0. RESULTS Chart review identified 190 patients with 469 ruptured and unruptured saccular intracranial aneurysms. There were 31 patients with 44 aneurysms identified as having an autoimmune disease. The mean size of a ruptured aneurysm was significantly smaller among patients with autoimmune disease compared with patients without autoimmune disease (4.14 mm vs 5.34 mm, p = 0.03). The multivariate logistic regression model did not identify any significant association between rupture and autoimmune disease when controlling for other variables (p = 0.49). In the multivariate linear regression model, autoimmune disease was still significantly associated with a smaller size at rupture (p = 0.04), and smoking was associated with a larger size at rupture (p = 0.03) when controlling for other variables. A second multivariate logistic regression model found autoimmune disease to be independently associated with rupture at a size smaller than 7 mm (p = 0.02), while smoking was independently associated with rupture at a size larger than 7 mm (p = 0.01). CONCLUSIONS Autoimmune disease is associated with a smaller aneurysm size at rupture, although it is not associated with rupture itself. This association may be due to inflammatory pathways that are common to autoimmune diseases as well as aneurysm wall development. Although the authors were unable to identify any association between rupture status and the presence of autoimmune disease, the association between smaller size at rupture and autoimmune disease warrants further studies, as autoimmune disease may influence the trajectory of aneurysm development and the decision to treat.
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Affiliation(s)
- Abhijith V Matur
- 1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati; and
| | - Ali S Yamani
- 1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati; and
| | - Michael W Robinson
- 1Department of Neurosurgery, University of Cincinnati College of Medicine, Cincinnati; and
| | - Matthew S Smith
- 2Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Peyman Shirani
- 2Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Aaron W Grossman
- 2Department of Neurology, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Zhao J, Xiang X, Zhang H, Ye Y, He Z. A Study of the Association Between Carotid Artery Curvature and Intracranial Aneurysms. Neurologist 2023; 28:99-103. [PMID: 35697041 PMCID: PMC9977412 DOI: 10.1097/nrl.0000000000000449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Carotid artery curvature is considered a sign of a weak vessel wall, and we hypothesize that a weak vascular wall under the effect of hemodynamics may cause intracranial aneurysms. MATERIALS AND METHODS The general data of 534 patients with aneurysms and 473 control patients were retrospectively analyzed in a case-control study. Carotid artery curvature was characterized as none, tortuosity, kinking, and coiling by computed tomography angiography images. Univariate analysis was performed to determine the degree of carotid artery tortuosity and to analyze the general data between the aneurysm group and the control group, and then, multivariate statistical logistic regression analysis was used to analyze the statistical significance of the univariate analysis. Finally, the correlation between aneurysm-related features and carotid artery curvature was analyzed. RESULTS Univariate analysis showed that kinking was significantly related to the occurrence of intracranial aneurysms ( P =0.009). The results of multivariate regression analysis showed that kinking was an independent risk factor for the occurrence of aneurysms (odds ratio: 1.942; 95% confidence interval: 1.387-2.720 for model 1; odds ratio: 1.995; 95% confidence interval: 1.419-2.805 for model 2). In the analysis of the correlation between the characteristics of intracranial aneurysms and the curvature of the internal carotid artery, there was no correlation between the curvature of the internal carotid artery and the size, location or number of aneurysms, or whether the intracranial aneurysm was ruptured. CONCLUSION Intracranial aneurysms are associated with carotid artery curvature. Kinking of the internal carotid artery may indicate a higher risk for aneurysm formation.
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Affiliation(s)
- Jun Zhao
- Department of Neurosurgery, Dazhou integrated TCM&Western Medicine Hospital
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Xiang Xiang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hongxia Zhang
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Ye
- School of Health caring Industry, Sichuan University of Arts and Science, Dazhou
| | - Zhaohui He
- Department of Neurosurgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Raghuram A, Galloy A, Nino M, Sanchez S, Hasan D, Raghavan S, Samaniego EA. Comprehensive morphomechanical analysis of brain aneurysms. Acta Neurochir (Wien) 2023; 165:461-470. [PMID: 36595056 DOI: 10.1007/s00701-022-05476-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 12/21/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVE Brain aneurysms comprise different compartments that undergo unique biological processes. A detailed multimodal analysis incorporating 3D aneurysm wall enhancement (AWE), computational fluid dynamics (CFD), and finite element analysis (FEA) data can provide insights into the aneurysm wall biology. METHODS Unruptured aneurysms were prospectively imaged with 7 T high-resolution MRI (HR-MRI). 3D AWE color maps of the entire aneurysm wall were generated and co-registered with contour plots of morphomechanical parameters derived from CFD and FEA. A multimodal analysis of the entire aneurysm was performed using 3D circumferential AWE (3D-CAWE), wall tension (WT), time-averaged wall shear stress (TAWSS), wall shear stress gradient (WSSG), and oscillatory shear index (OSI). A detailed compartmental analysis of each aneurysm's dome, bleb, and neck was also performed. RESULTS Twenty-six aneurysms were analyzed. 3D-CAWE + aneurysms had higher WT (p = 0.03) and higher TAWSS (p = 0.045) than 3D-CAWE- aneurysms. WT, TAWSS, and WSSG were lower in areas of focal AWE in the aneurysm dome compared to the neck (p = 0.009, p = 0.049, and p = 0.040, respectively), whereas OSI was higher in areas of focal AWE compared to the neck (p = 0.020). When compared to areas of no AWE of the aneurysm sac (AWE = 0.92 vs. 0.49, p = 0.001), blebs exhibited lower WT (1.6 vs. 2.45, p = 0.010), lower TAWSS (2.6 vs. 6.34), lower OSI (0.0007 vs. 0.0010), and lower WSSG (2900 vs. 5306). Fusiform aneurysms had a higher 3D-CAWE and WT than saccular aneurysms (p = 0.046 and p = 0.003, respectively). CONCLUSIONS Areas of focal high AWE in the sac and blebs are associated with low wall tension, low wall shear stress, and low flow conditions (TAWSS and WSSG). Conversely, the neck had average AWE, high wall tension, high wall shear stress, and high flow conditions. The aneurysm dome and the aneurysm neck have different morphomechanical environments, with increased mechanical load at the neck.
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Affiliation(s)
| | - Adam Galloy
- Roy J Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Marco Nino
- Roy J Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | | | - David Hasan
- Department of Neurosurgery, Duke University, Durham, NC, USA
| | - Suresh Raghavan
- Roy J Carver Department of Biomedical Engineering, University of Iowa, Iowa City, IA, USA
| | - Edgar A Samaniego
- Department of Neurology, University of Iowa, Iowa City, IA, USA. .,Department of Neurosurgery, University of Iowa, Iowa City, IA, USA. .,Department of Radiology, University of Iowa, Iowa City, IA, USA. .,Current Institution, The University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA, 52246, USA.
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50
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Sunderland K, Jia W, He W, Jiang J, Zhao F. Impact of spatial and temporal stability of flow vortices on vascular endothelial cells. Biomech Model Mechanobiol 2023; 22:71-83. [PMID: 36271263 PMCID: PMC9975038 DOI: 10.1007/s10237-022-01632-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 08/23/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Intracranial aneurysms (IAs) are pathological dilations of cerebrovascular vessels due to degeneration of the mechanical strength of the arterial wall, precluded by altered cellular functionality. The presence of swirling hemodynamic flow (vortices) is known to alter vascular endothelial cell (EC) morphology and protein expression indicative of IAs. Unfortunately, less is known if vortices with varied spatial and temporal stability lead to differing levels of EC change. The aim of this work is to investigate vortices of varying spatial and temporal stability impact on ECs. METHODS Vortex and EC interplay was investigated by a novel combination of parallel plate flow chamber (PPFC) design and computational analysis. ECs were exposed to laminar (7.5 dynes/[Formula: see text] wall shear stress) or low (<1 dynes/[Formula: see text]) stress vortical flow using PPFCs. Immunofluorescent imaging analyzed EC morphology, while ELISA tests quantified VE-cadherin (cell-cell adhesion), VCAM-1 (macrophage-EC adhesion), and cleaved caspase-3 (apoptotic signal) expression. PPFC flow was simulated, and vortex stability was calculated via the temporally averaged degree of (volume) overlap (TA-DVO) of vortices within a given area. RESULTS EC morphological changes were independent of vortex stability. Increased stability promoted VE-cadherin degradation (correlation coefficient r = [Formula: see text]0.84) and 5-fold increased cleaved caspase-3 post 24 h in stable (TA-DVO 0.736 ± 0.05) vs unstable (TA-DVO 0.606 [Formula: see text]0.2) vortices. ECs in stable vortices displayed a 4.5-fold VCAM-1 increase than unstable counterparts after 12 h. CONCLUSION This work demonstrates highly stable disturbed flow imparts increased inflammatory signaling, degraded cell-cell adhesion, and increased cellular apoptosis than unstable vortices. Such knowledge offers novel insight toward understanding IA development and rupture.
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Affiliation(s)
- Kevin Sunderland
- Biomedical Engineering, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA
| | - Wenkai Jia
- Biomedical Engineering, Texas A &M University, 400 Bizzell St, College Station, TX, 77843, USA
| | - Weilue He
- Biomedical Engineering, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA
| | - Jingfeng Jiang
- Biomedical Engineering, Michigan Technological University, 1400 Townsend Drive, Houghton, MI, 49931, USA.
| | - Feng Zhao
- Biomedical Engineering, Texas A &M University, 400 Bizzell St, College Station, TX, 77843, USA.
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