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Lan XY, Li D, Cui Y, Nguyen TN, Li S, Chen HS. Proteomic analysis of jugular venous blood in acute large vessel occlusion stroke with futile recanalization. J Cereb Blood Flow Metab 2024; 44:702-711. [PMID: 38000017 PMCID: PMC11197136 DOI: 10.1177/0271678x231216767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 09/13/2023] [Accepted: 10/17/2023] [Indexed: 11/26/2023]
Abstract
Futile recanalization (FR) after endovascular treatment (EVT) remains a significant challenge for acute ischemic stroke (AIS) with large vessel occlusion (LVO). The pathogenesis of FR has not been well elucidated. We prospectively enrolled anterior circulation LVO-AIS patients who achieved successful recanalization after EVT. The jugular venous blood ipsilateral to stroke was collected before and immediately after recanalization. Plasma proteomic analysis based on liquid chromatography-mass spectrometry was performed using data-independent acquisition method. Differentially expressed proteins (DEPs) among patients with or without FR in the whole or propensity score matching (PSM) cohorts were screened according to the absolute value of fold change ≥1.5 and P value <0.05. We identified 104 and 34 DEPs between patients with or without FR in the whole cohort and PSM cohort, respectively. Bioinformatic analysis indicated that the identified proteins were primarily related to specific biological processes including immune response, complement activation, oxidative stress, lipid metabolism, protein ubiquitylation as well as autophagy, suggesting that these may be mechanisms in FR pathogenesis. Collectively, we discovered proteins that may be potential research targets for FR. The combination of proteomic and bioinformatic analysis could provide a better understanding of the pathogenesis of FR in a comprehensive manner.
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Affiliation(s)
- Xiao-Yan Lan
- Graduate School, Dalian Medical University, Dalian, China
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
- Department of Neurointervention, Dalian Municipal Central Hospital, Dalian, China
| | - Di Li
- Department of Neurointervention, Dalian Municipal Central Hospital, Dalian, China
| | - Yu Cui
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
| | - Thanh N Nguyen
- Department of Neurology, Radiology, Boston Medical Center, Boston, Massachusetts, USA
| | - Shen Li
- Department of Neurology and Psychiatry, Beijing Shijitan Hospital, Beijing, China
- Beijing Institute of Brain Disorders, Capital Medical University, Beijing, China
| | - Hui-Sheng Chen
- Graduate School, Dalian Medical University, Dalian, China
- Department of Neurology, General Hospital of Northern Theater Command, Shenyang, China
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Barba L, Vollmuth C, Abu-Rumeileh S, Halbgebauer S, Oeckl P, Steinacker P, Kollikowski AM, Schultz C, Wolf J, Pham M, Schuhmann MK, Heuschmann PU, Haeusler KG, Stoll G, Neugebauer H, Otto M. Serum β-synuclein, neurofilament light chain and glial fibrillary acidic protein as prognostic biomarkers in moderate-to-severe acute ischemic stroke. Sci Rep 2023; 13:20941. [PMID: 38017278 PMCID: PMC10684607 DOI: 10.1038/s41598-023-47765-7] [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: 08/22/2023] [Accepted: 11/17/2023] [Indexed: 11/30/2023] Open
Abstract
We aimed to assess the prognostic value of serum β-synuclein (β-syn), neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) in patients with moderate-to-severe acute ischemic stroke. We measured β-syn, GFAP and NfL in serum samples collected one day after admission in 30 adult patients with moderate-to-severe ischemic stroke due to middle cerebral artery (MCA) occlusion. We tested the associations between biomarker levels and clinical and radiological scores (National Institute of Health Stroke Scale scores, NIHSS, and Alberta Stroke Program Early CT Score, ASPECTS), as well as measures of functional outcome (modified Rankin Scale, mRS). Serum biomarkers were significantly associated with ASPECTS values (β-syn p = 0.0011, GFAP p = 0.0002) but not with NIHSS scores at admission. Patients who received mechanical thrombectomy and intravenous thrombolysis showed lower β-syn (p = 0.029) und NfL concentrations (p = 0.0024) compared to patients who received only mechanical thrombectomy. According to median biomarker levels, patients with high β-syn, NfL or GFAP levels showed, after therapy, lower clinical improvement (i.e., lower 24-h NIHSS change), higher NIHSS scores during hospitalization and higher mRS scores at 3-month follow-up. Elevated serum concentrations of β-syn (p = 0.016), NfL (p = 0.020) or GFAP (p = 0.010) were significantly associated with 3-month mRS of 3-6 vs. 0-2 even after accounting for age, sex and renal function. In patients with moderate-to-severe acute ischemic stroke, serum β-syn, NfL and GFAP levels associated with clinical and radiological scores at different timepoints and were able to predict short- and middle-term clinical outcomes.
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Affiliation(s)
- Lorenzo Barba
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany
| | | | - Samir Abu-Rumeileh
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany
| | | | - Patrick Oeckl
- Department of Neurology, University of Ulm, Ulm, Germany
- German Center for Neurodegenerative Diseases (DZNE E.V.), Ulm, Germany
| | - Petra Steinacker
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany
| | | | - Cara Schultz
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Judith Wolf
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | - Mirko Pham
- Department of Neuroradiology, University of Würzburg, Würzburg, Germany
| | | | - Peter U Heuschmann
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | | | - Guido Stoll
- Department of Neurology, University of Würzburg, Würzburg, Germany
| | | | - Markus Otto
- Department of Neurology, Martin-Luther-University of Halle-Wittenberg, Ernst-Grube Strasse 40, 06120, Halle (Saale), Germany.
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Rossi E, Bernabeu C. Novel vascular roles of human endoglin in pathophysiology. J Thromb Haemost 2023; 21:2327-2338. [PMID: 37315795 DOI: 10.1016/j.jtha.2023.06.007] [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: 03/16/2023] [Revised: 05/19/2023] [Accepted: 06/02/2023] [Indexed: 06/16/2023]
Abstract
Endoglin, alias CD105, is a human membrane glycoprotein highly expressed in vascular endothelial cells. It is involved in angiogenesis and angiogenesis-related diseases, including the rare vascular pathology known as hereditary hemorrhagic telangiectasia type 1. Although endoglin acts as an accessory receptor for members of the transforming growth factor-β family, in recent years, emerging evidence has shown a novel functional role for this protein beyond the transforming growth factor-β system. In fact, endoglin has been found to be an integrin counterreceptor involved in endothelial cell adhesion processes during pathological inflammatory conditions and primary hemostasis. Furthermore, a circulating form of endoglin, also named as soluble endoglin, whose levels are abnormally increased in different pathological conditions, such as preeclampsia, seems to act as an antagonist of membrane-bound endoglin and as a competitor of the fibrinogen-integrin interaction in platelet-dependent thrombus formation. These studies suggest that membrane-bound endoglin and circulating endoglin are important components involved in vascular homeostasis and hemostasis.
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Affiliation(s)
- Elisa Rossi
- Université Paris Cité, INSERM U1140, Innovative Therapies in Haemostasis, Paris, France.
| | - Carmelo Bernabeu
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas, Madrid, Spain
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Rossi E, Pericacho M, Kauskot A, Gamella-Pozuelo L, Reboul E, Leuci A, Egido-Turrion C, El Hamaoui D, Marchelli A, Fernández FJ, Margaill I, Vega MC, Gaussem P, Pasquali S, Smadja DM, Bachelot-Loza C, Bernabeu C. Soluble endoglin reduces thrombus formation and platelet aggregation via interaction with αIIbβ3 integrin. J Thromb Haemost 2023; 21:1943-1956. [PMID: 36990159 DOI: 10.1016/j.jtha.2023.03.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 03/17/2023] [Accepted: 03/21/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND The circulating form of human endoglin (sEng) is a cleavage product of membrane-bound endoglin present on endothelial cells. Because sEng encompasses an RGD motif involved in integrin binding, we hypothesized that sEng would be able to bind integrin αIIbβ3, thereby compromising platelet binding to fibrinogen and thrombus stability. METHODS In vitro human platelet aggregation, thrombus retraction, and secretion-competition assays were performed in the presence of sEng. Surface plasmon resonance (SPR) binding and computational (docking) analyses were carried out to evaluate protein-protein interactions. A transgenic mouse overexpressing human sEng (hsEng+) was used to measure bleeding/rebleeding, prothrombin time (PT), blood stream, and embolus formation after FeCl3-induced injury of the carotid artery. RESULTS Under flow conditions, supplementation of human whole blood with sEng led to a smaller thrombus size. sEng inhibited platelet aggregation and thrombus retraction, interfering with fibrinogen binding, but did not affect platelet activation. SPR binding studies demonstrated that the specific interaction between αIIbβ3 and sEng and molecular modeling showed a good fitting between αIIbβ3 and sEng structures involving the endoglin RGD motif, suggesting the possible formation of a highly stable αIIbβ3/sEng. hsEng+ mice showed increased bleeding time and number of rebleedings compared to wild-type mice. No differences in PT were denoted between genotypes. After FeCl3 injury, the number of released emboli in hsEng+ mice was higher and the occlusion was slower compared to controls. CONCLUSIONS Our results demonstrate that sEng interferes with thrombus formation and stabilization, likely via its binding to platelet αIIbβ3, suggesting its involvement in primary hemostasis control.
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Affiliation(s)
- Elisa Rossi
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France.
| | - Miguel Pericacho
- Department of Physiology and Pharmacology, Universidad de Salamanca, Salamanca, Spain
| | - Alexandre Kauskot
- HITh, INSERM UMR-S 1176, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - Luis Gamella-Pozuelo
- Department of Physiology and Pharmacology, Universidad de Salamanca, Salamanca, Spain; Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Etienne Reboul
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France
| | - Alexandre Leuci
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France
| | | | - Divina El Hamaoui
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France
| | - Aurore Marchelli
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France
| | - Francisco J Fernández
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Isabelle Margaill
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France
| | - M Cristina Vega
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
| | - Pascale Gaussem
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France; Service d'hématologie biologique, Hôpital Européen Georges Pompidou, AP-HP, Paris, France
| | - Samuela Pasquali
- Cibles Thérapeutiques et Conception de Médicaments (CiTCoM), UMR8038 CNRS, Paris, France
| | - David M Smadja
- Innovative Therapies in Hemostasis, INSERM U1140, Université Paris Cité, Paris, France; Service d'hématologie biologique, Hôpital Européen Georges Pompidou, AP-HP, Paris, France; Laboratory of Biosurgical Research, Carpentier Foundation, Paris, France
| | | | - Carmelo Bernabeu
- Centro de Investigaciones Biológicas Margarita Salas, Consejo Superior de Investigaciones Científicas (CSIC), Madrid, Spain
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