Sphenopalatine Ganglion Stimulation to Augment Cerebral Blood Flow

Background and Purpose—

Many patients with acute ischemic stroke are not eligible for thrombolysis or mechanical reperfusion therapies due to contraindications, inaccessible vascular occlusions, late presentation, or large infarct core. Sphenopalatine ganglion (SPG) stimulation to enhance collateral flow and stabilize the blood-brain barrier offers an alternative, potentially more widely deliverable, therapy.

Methods—

In a randomized, sham-controlled, double-masked trial at 41 centers in 7 countries, patients with anterior circulation ischemic stroke not treated with reperfusion therapies within 24 hours of onset were randomly allocated to active SPG stimulation or sham control. The primary efficacy outcome was improvement beyond expectations on the modified Rankin Scale of global disability at 90 days (sliding dichotomy), assessed in the modified intention-to-treat population. The initial planned sample size was 660 patients, but the trial was stopped early when technical improvements in device placement occurred, so that analysis of accumulated experience could be conducted to inform a successor trial.

Results—

Among 303 enrolled patients, 253 received at least one active SPG or sham stimulation, constituting the modified intention-to-treat population (153 SPG stimulation and 100 sham control). Age was median 73 years (interquartile range, 64–79), 52.6% were female, deficit severity on the National Institutes of Health Stroke Scale was median 11 (interquartile range, 9–15), and time from last known well median 18.6 hours (interquartile range, 14.5–22.5). For the primary outcome, improved 3-month disability beyond expectations, rates in the SPG versus sham treatment groups were 49.7% versus 40.0%; odds ratio, 1.48 (95% CI, 0.89–2.47); P =0.13. A significant treatment interaction with stroke location (cortical versus noncortical) was noted, P =0.04. In the 87 patients with confirmed cortical involvement, rates of improvement beyond expectations were 50.0% versus 27.0%; odds ratio, 2.70 (95% CI, 1.08–6.73); P =0.03. Similar response patterns were observed for all prespecified secondary efficacy outcomes. No differences in mortality or serious adverse event safety end points were observed.

Conclusions—

SPG stimulation within 24 hours of onset is safe in acute ischemic stroke. SPG stimulation was not shown to statistically significantly improve 3-month disability above expectations, though favorable outcomes were nominally higher with SPG stimulation. Beneficial effects may distinctively be conferred in patients with confirmed cortical involvement. The results of this study need to be confirmed in a larger pivotal study.

Clinical Trial Registration—

URL: https://www.clinicaltrials.gov . Unique identifier: NCT03767192.

Intracellular distribution of phototropin 1 protein in the short-day plant Ipomoea nil

Phototropin 1 (phot1) is a blue-light Ser/Thr receptor kinase that contains two LOV domains. It is a plasma membrane-associated protein that mediates phototropism, blue-light induced chloroplast movement, and stomatal opening. The aim of the present work was to analyze the intracellular localization of phot1 protein in Ipomoea nil seedlings. In cotyledon and hypocotyl cells of etiolated seedlings, phot1 was specifically localized in the plasma membrane regions, whereas in light-treated seedlings, it was homogeneously distributed throughout the whole cytoplasm, excluding cell nuclei and vacuoles. Phot1 was also localized in cotyledon epidermal and guard cells. Such a localization pattern suggests a light-dependent intracellular distribution of phot1 in Ipomoea nil. On the basis of the spatial distribution, the possible role of phot1 is also discussed.

Transformation of 1-O-(indole-3-acetyl)-beta-D-glucose into di-O-(indole-3-acetyl)-D-glucose catalysed by enzyme preparations from corn seedlings

A new enzymatic activity, which catalyses formation in vitro of di-O-(indole-3-acetyl)-D-glucose from 1-O-(indole-3-acetyl)-beta-D-glucose has been found in extracts of Zea mays seedlings. The structure of di-O-(indole-3-acetyl)-D-glucose, not as yet described, has been assigned by GC-MS, 1H NMR and ammonolysis.

Transformation of 1-O-(indole-3-acetyl)-beta-D-glucose into di-O-(indole-3-acetyl)-D-glucose catalysed by enzyme preparations from corn seedlings

A new enzymatic activity, which catalyses formation in vitro of di-O-(indole-3-acetyl)-D-glucose from 1-O-(indole-3-acetyl)-beta-D-glucose has been found in extracts of Zea mays seedlings. The structure of di-O-(indole-3-acetyl)-D-glucose, not as yet described, has been assigned by GC-MS, 1H NMR and ammonolysis.

Calcium localization in oat aleurone cells using chlorotetracycline and X-ray microanalysis

Calcium distribution was studied in oat caryopses. Using the chlorotetracycline method it was found that membrane-associated Ca(2+) was present in the aleurone layer. X-ray microanalysis confirmed the presence of calcium in aleurone cells; it also demonstrated the presence of considerable amounts of calcium in the cell wall surrounding these cells.

Enzymatic Esterification of Indole-3-acetic Acid to myo-Inositol and Glucose

Incubation of mature sweet corn kernels of Zea mays in dilute solutions of (14)C-labeled indole-3-acetic acid leads to the formation of (14)C-labeled esters of myo-inositol, glucose, and glucans. Utilizing this knowledge it was found that an enzyme preparation from immature sweet corn kernels of Zea mays catalyzed the CoA- and ATP-dependent esterification of indole-3-acetic acid to myo-inositol and glucose. The esters formed were 2-O-(indole-3-acetyl)-myo-inositol, 1-dl-1-O-(indole-3-acetyl)-myo-inositol, di-O-(indole-3-acetyl)-myo-inositol, tri-O-(indole-3-acetyl)-myo-inositol, 2-O-(indole-3-acetyl)-d-glucopyranose, 4-O-(indole-3-acetyl)-d-glucopyranose and 6-O-(indole-3-acetyl)-d-glycopyranose. An assay system was developed for measuring esterification of (14)C-labeled indole-3-acetic acid by ammonolysis of the esters followed by isolation and counting the radioactive indole-3-acetamide.