Acute Ischemic Stroke

Petty, Kate; Lemkuil, Brian P.; Gierl, B

doi:10.1016/j.anclin.2020.11.002

Cited by 18 publications

(18 citation statements)

References 28 publications

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“…Acute ischemic stroke (AIS) is a cerebrovascular disorder caused by arterial stenosis or occlusion, which is one of the major causes of neurological deaths globally 1,2 . Currently, great progress has been made in treatments of AIS (including thrombolytic treatment, revascularization therapy, and neuroprotective treatment), while there exist a proportion of AIS patients facing long‐term adverse outcomes 3–5 .…”

Section: Introductionmentioning

confidence: 99%

“…Acute ischemic stroke (AIS) is a cerebrovascular disorder caused by arterial stenosis or occlusion, which is one of the major causes of neurological deaths globally. 1,2 Currently, great progress has been made in treatments of AIS (including thrombolytic treatment, revascularization therapy, and neuroprotective treatment), while there exist a proportion of AIS patients facing long-term adverse outcomes. [3][4][5] Cognitive impairment is a common undesirable outcome of AIS patients that is correlated with permanent disability and even death, which results in a huge economical and humanistic burden.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal change of Th1, Th2, and Th17 cells and their relationship between cognitive impairment, stroke recurrence, and mortality among acute ischemic stroke patients

Cui

Han

et al. 2022

Clinical Laboratory Analysis

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Background T‐helper (Th) cells regulate immunity and inflammation, and modulate cognitive impairment in both cardio‐cerebrovascular and neurological diseases. This study aimed to explore the correlation of longitudinal change of Th1/2/17 cells with cognitive impairment and prognosis in acute ischemic stroke (AIS). Methods Th1/2/17 cells were detected by flow cytometry in peripheral blood samples from 150 AIS patients at admission (baseline), Day (D)1, D3, and D7 after admission, and from 30 controls. Mini‐Mental State Examination (MMSE) score among AIS patients at discharge was assessed. Stroke recurrence and mortality were evaluated. Results Th1 (p = 0.013) and Th17 cells (p < 0.001) but not Th2 cells (p = 0.105) were elevated in AIS patients versus controls. Th1 cells (p = 0.027) and Th17 cells (p < 0.001) but not Th2 cells (p = 0.227) were positively correlated with NIHSS score in AIS patients. Furthermore, Th1 and Th17 cells elevated from baseline to D3 and then decreased on D7 after AIS onset, while Th2 cells illustrated an opposite trend (all p < 0.001). Th17 cells on D1 (p = 0.011), D3 (p = 0.014), and D7 (p < 0.001) were correlated with lower MMSE score, and their levels on D3 (p = 0.033) and D7 (p = 0.004) were related to elevated cognitive impairment. Th1 and Th2 cells were not related to cognitive function (all p > 0.05). Additionally, Th17 cells at baseline, D1, D3, and D7 (all p < 0.05) were increased in recurrent patients versus non‐recurrent patients, and in survived patients versus dead patients, but Th1 or Th2 cells did not vary (all p > 0.05). Conclusion Th17 cells correlate with increased cognitive impairment, stroke recurrence, and mortality among AIS patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Longitudinal change of Th1, Th2, and Th17 cells and their relationship between cognitive impairment, stroke recurrence, and mortality among acute ischemic stroke patients

Cui

Han

et al. 2022

Clinical Laboratory Analysis

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“… 1 , 2 In China, stroke is the third highest cause of death with mortality of approximately 1.5 million in 2018, 3 which AIS may result in permanent disability, both functionally and cognitively; meanwhile, the morbidity of AIS is continuous increasing, which causes a huge economical and humanistic burden. 4 , 5 Over the decades, great advances have made in the strategies for AIS management such as neuroprotective treatment, intravenous thrombolysis, and anticoagulation treatment, while AIS patients still suffer from elevating recurrence and increasing mortality. 6 , 7 , 8 In view of that there still exists several challenges in the management of AIS, the identification of reliable biomarker to monitor disease risk, severity, and prognosis is crucial.…”

Section: Introductionmentioning

confidence: 99%

“…Acute ischemic stroke (AIS) is viewed as one of main causes of neurologic death worldwide 1,2 . In China, stroke is the third highest cause of death with mortality of approximately 1.5 million in 2018, 3 which AIS may result in permanent disability, both functionally and cognitively; meanwhile, the morbidity of AIS is continuous increasing, which causes a huge economical and humanistic burden 4,5 . Over the decades, great advances have made in the strategies for AIS management such as neuroprotective treatment, intravenous thrombolysis, and anticoagulation treatment, while AIS patients still suffer from elevating recurrence and increasing mortality 6–8 .…”

Section: Introductionmentioning

confidence: 99%

Clinical role of serum histone deacetylase 4 measurement in acute ischemic stroke: Relation to disease risk, severity, and prognosis

Wang

Pang

et al. 2022

Clinical Laboratory Analysis

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Objective Histone deacetylase 4 (HDAC4) is engaged in the pathophysiology of acute ischemic stroke (AIS) through modulating atherosclerosis, inflammation and neurocyte death. This study aimed to investigate the clinical role of HDAC4 in AIS. Methods Serum samples were collected from 176 AIS patients and 80 controls for HDAC4 detection by enzyme‐linked immunosorbent assay (ELISA). In AIS patients, disease severity was assessed by National Institute of Health Stroke Scale (NIHSS) score and their recurrence‐free survival (RFS) and overall survival (OS) were calculated, inflammatory cytokines and adhesion molecules were detected by ELISA. Results HDAC4 was declined in AIS patients vs. controls (p < 0.001), it also had certain ability of distinguishing AIS patients from controls with an area under curve of 0.748 (95% confidence interval: 0.689–0.806). Among AIS patients, HDAC4 was negatively linked with NIHSS score (p < 0.001) but no other clinical features (all p > 0.05). Moreover, HDAC4 was negatively related to interleukin (IL)‐17 (p = 0.010) and tumor necrosis factor alpha (p = 0.001), while it was not correlated with IL‐1β (p = 0.081) or IL‐6 (p = 0.074). Furthermore, HDAC4 was negatively associated with intercellular cell adhesion molecule‐1 (p < 0.001) and vascular cell adhesion molecule‐1 (p = 0.003). During a median follow‐up of 19.0 months, 17 (9.7%) patients had recurrence and 10 (5.7%) patients died. Additionally, high HDAC4 was linked with prolonged RFS (p = 0.044) but not OS (p = 0.079). Conclusion HDAC4 possesses the potential to monitor disease risk, inflammation and estimate recurrence of AIS, while further study with larger scale is needed to verify our findings.

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“…Ischemic stroke accounts for 80% of stroke cases and still lacks therapeutic choices for effective treatment strategies for the majority of stroke patients (Lalu et al 2020). Intravenous alteplase and endovascular thrombectomy are effective rescue treatments for stroke patients (Petty et al 2021) but unfortunately only a limited number of patients benefit from this reperfusion therapy because of the narrow therapeutic window and contraindications (Bhaskar et al 2018). Currently there are clinical trials employing neuroprotectants that target early pathogenic mechanisms in stroke (Shafie and Yu 2021).…”

Section: Introductionmentioning

confidence: 99%

Intranasal Salvinorin A Improves Long-term Neurological Function via Immunomodulation in a Mouse Ischemic Stroke Model

Misilimu

Chen

et al. 2021

J Neuroimmune Pharmacol

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Salvinorin A (SA), a highly selective kappa opioid receptor agonist, has been shown to reduce brain infarct volume and improve neurological function after ischemic stroke. However, the underlying mechanisms have not been fully understood yet. Therefore, we explored whether SA provides neuroprotective effects by regulating the immune response after ischemic stroke both in the central nervous system (CNS) and peripheral circulation. In this study, adult male mice were subjected to transient Middle Cerebral Artery Occlusion (tMCAO) and then were treated intranasally with SA (50 μg/kg) or with the vehicle dimethyl sulfoxide (DMSO). Multiple behavioral tests were used to evaluate neurofunction. Flow cytometry and immunofluorescence staining were used to evaluate the infiltration of peripheral immune cells into the brain. The tracer cadaverine and endogenous immunoglobulin G (IgG) extravasation were used to detect blood brain barrier leakage. We observed that SA intranasal administration after ischemic stroke decreased the expression of pro-inflammatory factors in the brain. SA promoted the polarization of microglia/macrophages into a transitional phenotype and decreased the pro-inflammatory phenotype in the brain after tMCAO. Interestingly, SA treatment scarcely altered the number of peripheral immune cells but decreased the macrophage and neutrophil infiltration into the brain at 24 h after tMCAO. Furthermore, SA treatment also preserved BBB integrity, reduced long-term brain atrophy and white matter injury, as well as improved the long-term neurofunctional outcome in mice. In this study, intranasal administration of SA improved long-term neurological function via immuno-modulation and by preserving blood–brain barrier integrity in a mouse ischemic stroke model, suggesting that SA could potentially serve as an alternative treatment strategy for ischemic stroke. Graphic Abstract

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Acute Ischemic Stroke

Cited by 18 publications

References 28 publications

Longitudinal change of Th1, Th2, and Th17 cells and their relationship between cognitive impairment, stroke recurrence, and mortality among acute ischemic stroke patients

Longitudinal change of Th1, Th2, and Th17 cells and their relationship between cognitive impairment, stroke recurrence, and mortality among acute ischemic stroke patients

Clinical role of serum histone deacetylase 4 measurement in acute ischemic stroke: Relation to disease risk, severity, and prognosis

Intranasal Salvinorin A Improves Long-term Neurological Function via Immunomodulation in a Mouse Ischemic Stroke Model

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