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Szepanowski RD, Haupeltshofer S, Vonhof SE, Frank B, Kleinschnitz C, Casas AI. Thromboinflammatory challenges in stroke pathophysiology. Semin Immunopathol 2023:10.1007/s00281-023-00994-4. [PMID: 37273022 DOI: 10.1007/s00281-023-00994-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/27/2023] [Indexed: 06/06/2023]
Abstract
Despite years of encouraging translational research, ischemic stroke still remains as one of the highest unmet medical needs nowadays, causing a tremendous burden to health care systems worldwide. Following an ischemic insult, a complex signaling pathway emerges leading to highly interconnected thrombotic as well as neuroinflammatory signatures, the so-called thromboinflammatory cascade. Here, we thoroughly review the cell-specific and time-dependent role of different immune cell types, i.e., neutrophils, macrophages, T and B cells, as key thromboinflammatory mediators modulating the neuroinflammatory response upon stroke. Similarly, the relevance of platelets and their tight crosstalk with a variety of immune cells highlights the relevance of this cell-cell interaction during microvascular dysfunction, neovascularization, and cellular adhesion. Ultimately, we provide an up-to-date overview of therapeutic approaches mechanistically targeting thromboinflammation currently under clinical translation, especially focusing on phase I to III clinical trials.
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Affiliation(s)
- R D Szepanowski
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - S Haupeltshofer
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - S E Vonhof
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - B Frank
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
| | - C Kleinschnitz
- Department of Neurology, University Hospital Essen, Essen, Germany.
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany.
| | - A I Casas
- Department of Neurology, University Hospital Essen, Essen, Germany
- Center for Translational Neuro- and Behavioral Sciences (C-TNBS), Essen, Germany
- Department of Pharmacology and Personalised Medicine, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Gillespie S, Holloway PM, Becker F, Rauzi F, Vital SA, Taylor KA, Stokes KY, Emerson M, Gavins FNE. The isothiocyanate sulforaphane modulates platelet function and protects against cerebral thrombotic dysfunction. Br J Pharmacol 2018; 175:3333-3346. [PMID: 29797311 DOI: 10.1111/bph.14368] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 04/30/2018] [Accepted: 05/04/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND AND PURPOSE Platelet activation provides a critical link between inflammation and thrombosis. Sulforaphane (SFN), a naturally occurring isothiocyanate, has been shown to display both anti-inflammatory and anti-thrombotic actions in the systemic microvasculature. As inflammation promotes thrombosis and vice versa, in this study we investigated whether SFN is able to reduce inflammatory potentiation of thrombotic events, suppress platelet activation and thrombus formation in the cerebral microvasculature. EXPERIMENTAL APPROACH Thrombosis was induced in the murine brain using the light/dye-injury model, in conjunction with LPS treatment, with and without SFN treatment. In vitro and in vivo platelet assays (aggregation, flow and other functional tests) were also employed, using both human and murine platelets. KEY RESULTS SFN was found to reduce LPS-mediated enhancement of thrombus formation in the cerebral microcirculation. In tail-bleed experiments, LPS treatment prolonged bleeding time, and SFN treatment was found to protect against this LPS-induced derangement of platelet function. SFN inhibited collagen-mediated platelet aggregation in vitro and in vivo and the associated adhesion and impaired calcium signalling. Furthermore, glycoprotein VI was shown to be involved in the protective effects observed with SFN treatment. CONCLUSIONS AND IMPLICATIONS The data presented here provide evidence for the use of SFN in preventing stroke in selected high-risk patient cohorts.
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Affiliation(s)
| | - Paul M Holloway
- Division of Brain Sciences, Imperial College London, London, UK.,Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Felix Becker
- Department of General, Visceral and Transplant Surgery, University Hospital Muenster, Muenster, Germany
| | - Francesca Rauzi
- Platelet Biology Group, National Heart and Lung Institute, Imperial College London, London, UK
| | - Shantel A Vital
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Kirk A Taylor
- Platelet Biology Group, National Heart and Lung Institute, Imperial College London, London, UK
| | - Karen Y Stokes
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
| | - Michael Emerson
- Platelet Biology Group, National Heart and Lung Institute, Imperial College London, London, UK
| | - Felicity N E Gavins
- Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA.,Department of Neurology, Louisiana State University Health Sciences Center - Shreveport, Shreveport, LA, USA
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Sun YY, Li Y, Wali B, Li Y, Lee J, Heinmiller A, Abe K, Stein DG, Mao H, Sayeed I, Kuan CY. Prophylactic Edaravone Prevents Transient Hypoxic-Ischemic Brain Injury: Implications for Perioperative Neuroprotection. Stroke 2015; 46:1947-55. [PMID: 26060244 DOI: 10.1161/strokeaha.115.009162] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 05/11/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND PURPOSE Hypoperfusion-induced thrombosis is an important mechanism for postsurgery stroke and cognitive decline, but there are no perioperative neuroprotectants to date. This study investigated whether prophylactic application of Edaravone, a free radical scavenger already used in treating ischemic stroke in Japan, can prevent infarct and cognitive deficits in a murine model of transient cerebral hypoxia-ischemia. METHODS Adult male C57BL/6 mice were subjected to transient hypoxic-ischemic (tHI) insult that consists of 30-minute occlusion of the unilateral common carotid artery and exposure to 7.5% oxygen. Edaravone or saline was prophylactically applied to compare their effects on cortical oxygen saturation, blood flow, coagulation, oxidative stress, metabolites, and learning-memory using methods that include photoacoustic imaging, laser speckle contrast imaging, solid-state NMR, and Morris water maze. The effects on infarct size by Edaravone application at different time points after tHI were also compared. RESULTS Prophylactic administration of Edaravone (4.5 mg/kg×2, IP, 1 hour before and 1 hour after tHI) improved vascular reperfusion, oxygen saturation, and the maintenance of brain metabolites, reducing oxidative stress, thrombosis, white-matter injury, and learning impairment after tHI insult. Delayed Edaravone treatment after 3 h post-tHI became unable to reduce infarct size. CONCLUSIONS Acute application of Edaravone may be a useful strategy to prevent postsurgery stroke and cognitive impairment, especially in patients with severe carotid stenosis.
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Affiliation(s)
- Yu-Yo Sun
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Yikun Li
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Bushra Wali
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Yuancheng Li
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Jolly Lee
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Andrew Heinmiller
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Koji Abe
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Donald G Stein
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Hui Mao
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Iqbal Sayeed
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.)
| | - Chia-Yi Kuan
- From the Department of Pediatrics and Center for Neurodegenerative Diseases, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA (Y.-Y.S., Y.L., J.L., C.-Y.K.); Department of Emergency Medicine, Brain Research Laboratory, Emory University School of Medicine, Atlanta, GA (B.W., D.G.S., I.S.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA (Y.L., H.M.); VisualSonics Inc. Toronto, ON, Canada (A.H.); and Department of Neurology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan (K.A.).
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