The role of leukocytes in acute ischemic stroke-related thrombosis: a notable but neglected topic

Bi, Rentang; Chen, Shengcai; Chen, Shaolin; Peng, Qiwei; Jin, Huijuan; Hu, Bo

doi:10.1007/s00018-021-03897-5

Cited by 13 publications

(12 citation statements)

References 173 publications

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“…The role of WBCs in thrombosis is being expanded upon in recent research, playing a part in releasing proinflammatory and procoagulant mediators [ 31 , 81 ], but also thrombus resolution by modulating fibrinolysis pathways to restore patency of flow [ 81 ]. Higher WBC proportions correspond with worse recanalization outcomes [ 42 ], and with cardioembolic origin [ 34 , 35 , 36 , 42 , 82 ].…”

Section: Clot Componentsmentioning

confidence: 99%

“…Higher WBC proportions correspond with worse recanalization outcomes [ 42 ], and with cardioembolic origin [ 34 , 35 , 36 , 42 , 82 ]. These thrombi are associated with higher NIHSS scores [ 31 ]. Higher neutrophil and lymphocyte content also corresponds to a higher incidence of clot fragmentation [ 36 , 70 ].…”

Section: Clot Componentsmentioning

confidence: 99%

“…Better outcomes have been associated with greater clot perviousness, shorter thrombi, and a shorter procedural time [ 97 ]. More severe strokes are associated with higher polyhedrocytes, platelets, fibrin, VWF, WBC, and NET content, as well as the cardioembolic cause [ 31 , 34 , 60 , 77 ]. Clot fragmentation is a frequent complication; however, whether RBC-rich or PF-rich clots are more prone to embolization remains unclear.…”

Section: Clot Composition and Clinical Outcomesmentioning

confidence: 99%

“…Given the small number of patients who can benefit from rt-PA thrombolysis, there is a compelling need for novel thrombolytic agents targeting non-fibrin clot components. Studies have shown that ADAMTS13 or DNAse-1 which cleave VWF and DNA, respectively, are more successful at dissolving rt-PA-resistant clots than rt-PA alone [ 22 , 31 , 82 ]. Thrombolytic drugs could also aim to target PAI-1 and thrombin-activatable fibrinolysis inhibitors (TAFI) [ 22 ].…”

Section: Future Directionsmentioning

confidence: 99%

“…Targeting the process of immuno-thrombosis with Cl-amidine, which inhibits protein arginine deiminase 4 (an enzyme promoting NET formation), has also been shown to improve stroke outcomes in an animal study [ 85 ]. Furthermore, anti-inflammatory drugs (e.g., roflumilast) can suppress platelet, neutrophil, and NET activation [ 31 ], and immunotherapy can target interactions between immune and coagulation pathways [ 107 ].…”

Section: Future Directionsmentioning

confidence: 99%

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Clot Morphology in Acute Ischemic Stroke Decision Making

Huang

Bhaskar

2022

IJMS

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Stroke is a leading cause of death and disability in the world, and the provision of reperfusion therapy and endovascular therapy, in particular, have revolutionized the treatment of patients with stroke and opened opportunities to look at brain clots retrieved after the procedure. The use of histopathology and molecular profiling of clots is of growing research and clinical interest. However, its clinical implications and incorporation within stroke workflows remain suboptimal. Recent studies have indicated that the study of brain clots may inform the mechanism of stroke and hence guide treatment decision-making in select groups of patients, especially patients without a defined cause or known mechanism. This article provides a comprehensive overview of various clot histopathological examinations in acute stroke-care settings, their clinical utility, and existing gaps and opportunities for further research. We also provide targeted recommendations to improve clot analysis workflow, hence standardizing its incorporation into clinical practice.

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Section: Clot Componentsmentioning

confidence: 99%

Section: Clot Componentsmentioning

confidence: 99%

Section: Clot Composition and Clinical Outcomesmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

Section: Future Directionsmentioning

confidence: 99%

See 3 more Smart Citations

Clot Morphology in Acute Ischemic Stroke Decision Making

Huang

Bhaskar

2022

IJMS

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The protective role of endothelial GLUT1 in ischemic stroke

Peng,

Zeng

2024

Brain and Behavior

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ObjectiveTo provide thorough insight on the protective role of endothelial glucose transporter 1 (GLUT1) in ischemic stroke.MethodsWe comprehensively review the role of endothelial GLUT1 in ischemic stroke by narrating the findings concerning biological characteristics of GLUT1 in brain in depth, summarizing the changes of endothelial GLUT1 expression and activity during ischemic stroke, discussing how GLUT1 achieves its neuroprotective effect via maintaining endothelial function, and identifying some outstanding blind spots in current studies.ResultsEndothelial GLUT1 maintains persistent high glucose and energy requirements of the brain by transporting glucose through the blood–brain barrier, which preserves endothelial function and is beneficial to stroke prognosis.ConclusionThis review underscores the potential involvement of GLUT1 trafficking, activity modulation, and degradation, and we look forward to more clinical and animal studies to illuminate these mechanisms.

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