Monocyte-related cytokines/chemokines in cerebral ischemic stroke

Molecularly imprinted nanoparticles hitchhiking on neutrophils for precise treatment of ischemic stroke

Ischemic stroke (IS), the most prevalent type of stroke worldwide, is associated with a variety of complex processes, including oxidative stress, apoptosis, and ferroptosis. Recent findings indicate that inhibiting iron overload as a key regulatory mechanism of ferroptosis profoundly influences the pathogenesis and treatment of IS. In addition, enhanced blood-brain barrier (BBB) penetration and precise targeting of the ischaemic site contribute to improved therapeutic outcomes in IS. In this study, we developed FeSO4 templated-molecularly imprinted nanoparticles (MINPs) with high-affinity recognition of ferrous ions (Fe2+). MINPs exhibited physicochemical properties that perfectly match the polarity and condensed structure of Fe2+, resulting in the effective and specific clearance of Fe2+ through efficient and selective adsorption both in vivo and in vitro. Moreover, MINPs hitchhiked circulating neutrophils, thereby facilitating their penetration through BBB and enhancing targeted delivery to the ischemic brain. Our results, supported by transcriptomic analysis, further elucidated the molecular mechanisms by which MINPs significantly inhibit ferroptosis while concurrently regulating apoptosis and inflammation, thereby conferring marked neuroprotection against IS.

Remote Organ Damage Induced by Stroke: Molecular Mechanisms and Comprehensive Interventions

Significance: Damage after stroke is not only limited to the brain but also often occurs in remote organs, including the heart, lung, liver, kidney, digestive tract, and spleen, which are frequently affected by complex pathophysiological changes. The organs in the human body are closely connected, and signals transmitted through various molecular substances could regulate the pathophysiological changes of remote organs. Recent Advances: The latest studies have shown that inflammatory response plays an important role in remote organ damage after stroke, and can aggravate remote organ damage by activating oxidative stress, sympathetic axis, and hypothalamic axis, and disturbing immunological homeostasis. Remote organ damage can also cause damage to the brain, aggravating inflammatory response and oxidative damage. Critical Issues: Therefore, an in-depth exploration of inflammatory and oxidative mechanisms and adopting corresponding comprehensive intervention strategies have become necessary to reduce damage to remote organs and promote brain protection. Future Directions: The comprehensive intervention strategy involves multifaceted treatment methods such as inflammation regulation, antioxidants, and neural stem cell differentiation. It provides a promising treatment alternative for the comprehensive recovery of stroke patients and an inspiration for future research and treatment. The various organs of the human body are interconnected at the molecular level. Only through comprehensive intervention at the molecular and organ levels can we save remote organ damage and protect the brain after stroke to the greatest extent. Antioxid. Redox Signal. 42, 885-904.

Loss of Epitranscriptomic Modification N6-Methyladenosine (m6A) Reader YTHDF1 Exacerbates Ischemic Brain Injury in a Sexually Dimorphic Manner

N6-Methyladenosine (m6A) is a neuronal-enriched, reversible post-transcriptional modification that regulates RNA metabolism. The m6A-modified RNAs recruit various m6A-binding proteins that act as readers. Differential m6A methylation patterns are implicated in ischemic brain damage, yet the precise role of m6A readers in propagating post-stroke m6A signaling remains unclear. We presently evaluated the functional significance of the brain-enriched m6A reader YTHDF1, in post-stroke pathophysiology. Focal cerebral ischemia significantly increased YTHDF1 mRNA and protein expression in adult mice of both sexes. YTHDF1-/- male, but not female, mice subjected to transient middle cerebral artery occlusion (MCAO) showed worsened motor function recovery and increased infarction compared to sex-matched YTHDF1+/+ mice. YTHDF1-/- male, but not female, mice subjected to transient MCAO also showed significantly perturbed expression of genes related to inflammation, and increased infiltration of peripheral immune cells into the peri-infarct cortex, compared with sex-matched YTHDF1+/+ mice. Thus, this study demonstrates a sexual dimorphism of YTHDF1 in regulating post-ischemic inflammation and pathophysiology. Hence, post-stroke epitranscriptomic regulation might be sex-dependent.

Influential factors related to feeding disorders in preterm infants and the construction of predictive models

Objective

To investigate the influencing factors associated with feeding disorders in preterm infants and to construct a prediction model.

Methods

314 cases of preterm infants admitted to our hospital from January 2019 to December 2022 were retrospectively analyzed and divided into feeding disorder group and non-feeding disorder group according to the presence of feeding disorder at 37 weeks of corrected gestational age. Statistical analysis of children's general information, hospitalization measures, laboratory tests, feeding time, etc. Multifactorial Logistic regression analysis of the occurrence of feeding disorders related to the influence of factors, and the use of subjects to make a work characteristic curve to analyze the predictive value of the relevant factors on feeding disorders.

Results

Multifactorial logistic regression analysis suggested that lower birth gestational age, birth weight, white blood cell count, absolute value of monocytes, blood calcium value, Apgar score at 1 min after birth, and longer duration of noninvasive ventilation were risk factors for feeding disorders in preterm infants. ROC curve analysis suggested that the area under the curve of the feeding disorders was predicted by the combination of the above seven indexes to construct the feeding disorders prediction model The AUC was 0.866 (P < 0.001, 95% CI 0.801-0.932), and it had a maximum Yoden index of 0.699, an optimal cutoff value of 0.169, a sensitivity of 85.4%, a specificity of 84.5%, and a prediction accuracy of 91.4%.

Conclusions

Lower birth gestational age, birth weight, white blood cell count, absolute monocyte value, blood calcium value, low Apgar score at 1 min after birth, and prolonged noninvasive ventilation are risk factors for feeding disorders in preterm infants, and the present prediction model is a good predictor of the occurrence of feeding disorders in preterm infants.

Advancements in research on the thrombo-inflammation mechanisms mediated by factor XII in ischemic stroke

Ischemic stroke (IS) is a major cause of mortality and disability, with thrombo-inflammation constituting a core pathophysiological mechanism. This process is closely linked to coagulation cascade activation, endothelial injury, immune cell infiltration, and neuronal damage. Coagulation factor XII (FXII), a key mediator of the contact activation pathway, has emerged as a promising therapeutic target due to its dual role in pathological thrombosis and immune regulation, without compromising physiological hemostasis. However, the clinical translation of FXII-targeted therapies is hindered by paradoxical observations. Recent studies highlight that FXII's functional complexity stems from its structural and spatial heterogeneity: full-length FXII derived from the liver and short FXII mRNA isoforms expressed in neurons mediate distinct biological effects. While FXII contributes to neuroinflammation and vascular injury via endothelial-platelet-neutrophil interactions, neuron-derived FXII exhibits neuroprotective effects through HGF-mediated signaling pathways. Additionally, circulating FXIIa promotes vascular remodeling by enhancing endothelial growth factor (VEGF) release. This review summarizes the multifaceted regulatory mechanisms of FXII in IS, focusing on its structure, distribution, preclinical-clinical paradox, and current therapeutic strategies. Special emphasis is placed on its domain-specific functions and the neuroprotective effects of FXII.

Type I collagen secreted in white matter lesions inhibits remyelination and functional recovery

White matter injury is caused by cerebral blood flow disturbances associated with stroke and demyelinating diseases such as multiple sclerosis. Remyelination is induced spontaneously after white matter injury, but progressive multiple sclerosis and white matter stroke are usually characterised by remyelination failure. However, the mechanisms underlying impaired remyelination in lesions caused by demyelination and stroke remain unclear. In the current study, we demonstrated that collagen fibres accumulated in the demyelinated lesions of multiple sclerosis patients (age range 23-80 years) and white matter lesions of stroke patients (age range 80-87 years), suggesting that the accumulation of collagen fibres correlates with remyelination failure in these lesions. To investigate the function of collagen fibres in the white matter lesions, we generated two types of white matter injury in mice. We induced focal demyelination by lysolecithin (LPC) injection and ischemic stroke by endothelin 1 (ET1) injection into the internal capsule. We found that type I collagen fibres were secreted in ET1-induced lesions with impaired white matter regeneration in the chronic phase of disease. We also showed that monocyte-derived macrophages that infiltrated into lesions from the peripheral blood produced type I collagen after white matter injury, and that type I collagen also exacerbated microglial activation, astrogliosis, and axonal injury. Finally, we demonstrated that oligodendrocyte differentiation and remyelination were inhibited in the presence of type I collagen after LPC-induced demyelination. These results suggest that type I collagen secreted by monocyte-derived macrophages inhibited white matter regeneration, and therefore, the modulation of type I collagen metabolism might be a novel therapeutic target for white matter injury.

Salivary chemokines and growth factors in patients with ischemic stroke

Stroke is a serious health problem that affects an increasing number of people. As a result of the blockage of blood flow, tissue necrosis occurs in areas of the brain supplied by the damaged vessel, and leads to the development of inflammation. Changes that occur in the brain allow molecules to enter the blood, and it has been suggested that some can also penetrate the saliva. This study is the first to assess the profile of 25 chemokines and growth factors in the saliva of stroke survivors compared to a control group. 22 stroke survivors and 22 individuals matched by age and gender were enrolled in the study. Salivary chemokines and growth factors were assessed using the multiplex ELISA method. In the unstimulated saliva of stroke patients, we demonstrated significantly higher levels of chemotactic factors (CTACK/CCL27, IL-8/CXCL8, MIG/CXCL9, MIF) and growth factors (basic FGF, G-CSF, HGF, LIF, VEGF) compared to controls. The levels of MCP-3/CCL7, eotaxin/CCL11, IP-10/CXCL10, IL-3/MCGF, and PDGF-BB were lower in the saliva of the study group. The concentration of basic FGF negatively correlated with cognitive function as measured by the Addenbrooke's Cognitive Examination (ACE) scale (p = 0.007 r = - 0.56), while salivary IL-3 and LIF levels positively correlated with scores on the Functional Independence Measure (FIM) scale (p = 0.019 r = 0.53; p  = 0.033 r = 0.47, respectively). Receiver Operating Characteristic (ROC) analysis showed that salivary basic FGF, HGF, IL-3 and LIF can distinguish ischemic stroke patients from the control group with high sensitivity and specificity. In conclusion, disruptions in chemokine and growth factor levels in saliva may suggest an inflammatory etiology of ischemic stroke. Salivary basic FGF, HGF, IL-3 and LIF could serve as potential biomarkers for stroke. Further research is needed to illuminate the differences in salivary inflammatory mediator profiles in stroke and to evaluate the diagnostic utility of chemokines and growth factors in clinical practice.

Integrating machine learning and multi-omics analysis to reveal nucleotide metabolism-related immune genes and their functional validation in ischemic stroke

Background

Ischemic stroke (IS) is a major global cause of death and disability, linked to nucleotide metabolism imbalances. This study aimed to identify nucleotide metabolism-related genes associated with IS and explore their roles in disease mechanisms for new diagnostic and therapeutic strategies.

Methods

IS gene expression data were sourced from the GEO database. Differential expression analysis and weighted gene co-expression network analysis (WGCNA) were conducted in R, intersecting results with nucleotide metabolism-related genes. Functional enrichment and connectivity map (cMAP) analyses identified key genes and potential therapeutic agents. Core immune-related genes were determined using LASSO regression, SVM-RFE, and Random Forest algorithms. Immune cell infiltration levels and correlations were analyzed via CIBERSORT. Single-cell RNA sequencing (scRNA-seq) data and molecular docking assessed gene expression, localization, and gene-drug binding. In vivo experiments validated core gene expression.

Results

Thirty-three candidate genes were identified, mainly involved in immune and inflammatory responses. CFL1, HMCES, and GIMAP1 emerged as key immune-related genes, linked to immune cell infiltration and showing high diagnostic potential. cMAP analysis indicated these genes as drug targets. scRNA-seq clarified their expression and localization, and molecular docking confirmed strong drug binding. In vivo experiments validated their significant expression in IS.

Conclusion

This study underscores the role of nucleotide metabolism in IS, identifying CFL1, HMCES, and GIMAP1 as potential biomarkers and therapeutic targets, providing insights for IS diagnosis and therapy development.

Decoding the immune Response: Analyzing PBMCs in ischemic stroke and Evaluating the effects of Rivaroxaban on gene expression

BACKGROUND

Ischemic stroke (IS) is primarily caused by intricate inflammatory pathways and is a major global reason for mortality and disability. Patients with atrial fibrillation are treated with Rivaroxaban, a direct factor Xa inhibitor, to avoid stroke. This study looks at how certain genes are expressed in individuals with IS and how Rivaroxaban affects these genes and proteins.

METHODS

Using gene expression data from the GEO database, dysregulated genes in IS patients were found. Peripheral blood mononuclear cells from 50 IS patients were used to measure the expression of CXCL8, CXCL2, and G0S2 90 days before and after Rivaroxaban therapy using RT-PCR and ELISA. The Enrichr online tool was used to perform a functional enrichment analysis.

RESULTS

GEO2R analysis revealed that CXCL8, CXCL2, and G0S2 were significantly upregulated in IS samples compared to controls. Following Rivaroxaban therapy, the mRNA and protein levels of these genes showed a marked reduction, indicating a potential anti-inflammatory effect.

CONCLUSION

Rivaroxaban may control inflammatory responses in patients with IS, according to the study, which also reveals important genes implicated in IS. These results demonstrate the possibility of focused treatment approaches to reduce inflammation brought on by stroke.

Intranasal delivery of hMSC-derived supernatant for treatment of ischemic stroke by inhibiting the pro-inflammatory polarization of neutrophils

BACKGROUND

Stem cells utilized for ischemic stroke treatment often display unstable homing capabilities and diminished activity in vivo, limiting their neuroprotective efficacy. Furthermore, the optimal delivery route for stem cells remains undetermined. While the cytokines secreted by stem cells show promise in modulating post-stroke inflammation, the direct application of these supernatants in ischemic stroke treatment and the underlying mechanisms are still unclear.

METHODS

Secretory supernatants (hMSC-L) and cell lysate products (hMSC-M) from primary human umbilical cord mesenchymal stem cells-cultured medium were administered intranasally to mice with cerebral ischemia. The neuroprotective effects of hMSC-L and hMSC-M were assessed with TTC staining, behavioral tests and pathological staining. Flow cytometry and qPCR evaluated the expression of immune cells and cytokines in the CNS and peripheral immune organs. In vitro, flow cytometry and ELISA measured the effects of hMSC-L and hMSC-M on N2 polarization and inflammatory cytokines expression in primary murine neutrophils. Western blot analysis determined the impact of hMSC-L and hMSC-M on the PPAR-γ/STAT6/SOCS1 pathway, which is crucial for N2 neutrophil polarization.

RESULTS

TTC staining, behavioral experiments, and pathological assessments reveal intranasal delivery of hMSC-L and hMSC-M significantly reduces the infarct volume of mice with cerebral ischemia, improves neurological function scores, and promotes motor function recovery. Higher concentrations of hMSC-M contributed a more pronounced effect on neuropathological improvements in ischemic mice. Intranasal delivery of hMSC-L and hMSC-M significantly reduces neutrophil infiltration in the brain post-stroke and increases the proportion of anti-inflammatory N2-subtype neutrophils, boosting the expression levels of IL-10 and TGF-β. In vitro experiments demonstrate that hMSC-L and hMSC-M promote nuclear translocation of PPAR-γ in neutrophils stimulated with PMA, activating the downstream STAT6/SOCS1 signaling pathway to encourage N2-subtype neutrophil polarization.

CONCLUSIONS

Intranasal delivery of hMSC-L and hMSC-M effectively ameliorates cerebral ischemic injury in mice, comparable to traditional administration routes like intravenous delivery. Treatment with hMSC-L and hMSC-M enhances the PPAR-γ/STAT6/SOCS1 pathway and improves the neuroinflammatory response post-stroke by increasing N2 neutrophil infiltration. These results provide a theoretical basis for a deeper understanding of the mechanisms of stem cell therapy and for exploring suitable delivery pathways of stem cell treatment.

CCL17/CCR4 Axis Promotes Hematoma Clearance via ERK/AP1/SRA-Mediated Microglial Polarization After Intracerebral Hemorrhage

BACKGROUND

Our previous studies demonstrated that CCL17 and its receptor CCR4 play crucial roles in neuroinflammation and microglial activation following intracerebral hemorrhage (ICH). However, the specific mechanisms by which the CCL17/CCR4 axis regulates microglial polarization and hematoma clearance remain unclear.

AIMS

This study investigates how the CCL17/CCR4 signaling pathway modulates microglial phenotype transition and enhances hematoma resolution after ICH, building upon our earlier findings showing CCR4's involvement in neuroinflammatory responses.

METHODS

Using CRISPR-mediated CCR4 disruption and CCR4 overexpression approaches in a mouse ICH model, we examined neurological outcomes, inflammatory responses, and hematoma volumes. We further evaluated the therapeutic potential of recombinant CCL17 administration. The downstream ERK signaling pathway's role in CCL17/CCR4-mediated microglial function was investigated through pharmacological inhibition.

RESULTS

CCR4 knockout exacerbated neurological deficits, increased neuroinflammation, and enlarged hematomas. In contrast, enhancing CCR4 expression or administering recombinant CCL17 improved functional recovery and provided neuroprotection. Mechanistically, CCL17/CCR4 signaling activated the ERK/AP1/SRA pathway, promoting anti-inflammatory, phagocytic microglial polarization, evidenced by increased CD206 and SRA expression. ERK inhibition reversed these protective effects.

CONCLUSION

Our findings extend previous work by revealing that the CCL17/CCR4 axis enhances hematoma clearance through the ERK/AP1/SRA pathway-mediated microglial polarization. This mechanism represents a promising therapeutic target for ICH treatment.

Caloric Restriction Preserves BBB Integrity After Transient Focal Cerebral Ischemia Through Reducing Neutrophil Infiltration

AIMS

Caloric restriction is a health-promoting lifestyle that has been reported to protect both white and gray matter in cases of ischemic stroke. This study will explore the underlying mechanism of restricted feeding (RF) and provide a theoretical basis for precise clinical treatment of stroke.

METHODS

In this study, we pretreated C57BL/6J mice with 70% RF for a continuous 28-day period prior to 60 min of transient focal cerebral ischemia (tFCI). Histological staining, diffusion tensor imaging (DTI), and behavioral assessments were used to assess RF's neuroprotection following tFCI. Immunofluorescence staining, quantitative real-time PCR, and flow cytometry were conducted to evaluate brain inflammation post-tFCI. Western blot, immunofluorescence staining, tracers, and electric microscopy were used to assess the blood-brain barrier (BBB) integrity. Peripheral neutrophils were cleared by administrating an anti-Ly6G antibody.

RESULTS

Initially, DTI, NeuN staining, and a batch of behavioral tests verified that RF significantly mitigated both gray/white matter injury and neurological deficits in the short- and long-term following tFCI. RF mice showed more anti-inflammatory microglia in their brains, along with reduced inflammatory cytokines, and chemokines. Interestingly, RF significantly reduced the neutrophils and macrophage infiltration. Subsequently, we observed that RF mice exhibited better BBB integrity following tFCI, with reduced neutrophil infiltration and matrix metalloprotein-9 release. Furthermore, the clearance of neutrophils with anti-Ly6G antibody in ad libitum feeding mice (LF-Ly6G) elicited comparable neuroprotective effects to those observed in RF, including improvements in neurological deficits, reductions in infarct volume, and mitigation of BBB damage.

CONCLUSIONS

In summary, our findings suggest that RF maintains the BBB integrity following ischemic stroke at least partially by reducing neutrophil infiltration, thereby alleviating both neurological and histological impairments.

Exploring and validating associations between six systemic inflammatory indices and ischemic stroke in a middle-aged and old Chinese population

BACKGROUND

Inflammation and maladaptive immune mechanisms have been substantiated as integral components in the critical pathological processes of the injury cascade in ischemic stroke (IS). This study aimed to explore the associations between six systemic inflammatory indices and IS in a Chinese population.

METHODS

This was a case-control study based on the retrospective review of electronic medical records from two hospitals in Shandong Province, China. Systemic inflammatory indices, including the systemic inflammation response index (SIRI), systemic immune inflammation index (SII), pan-immune-inflammation value (PIV), neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and lymphocyte monocyte ratio (LMR), were calculated. Logistic regression models and classification analyses were employed to evaluate associations and discriminatory abilities.

RESULTS

In total, 9392 participants aged 40-83 years old were included in the discovery (3620 pairs of IS-present cases and healthy controls) and validation (1076 pairs of IS-present cases and IS-absent controls with IS mimics) datasets. After adjusting for potential confounding factors, IS was found to be associated with all six systemic indices in the discovery dataset, including SIRI (odd ratio [OR] 8.77, 95% confidence interval [CI] 7.48-10.33), SII (1.03, 1.01-1.04), PIV (1.01, 1.01-1.01), NLR (2.23, 2.08-2.39), PLR (1.01, 1.01-1.01), and LMR (0.77, 0.75-0.78). Notably, only LMR exhibited significant associations with IS in both discovery and validation datasets (0.88, 0.83-0.93), suggesting an independent protective role of this index. SIRI, SII, PIV, NLR, and LMR showed good discriminative ability between IS patients and healthy controls in the discovery dataset (AUCs > 0.70). However, they performed poorly in distinguishing IS patients from IS mimics in the validation dataset (AUCs < 0.60).

CONCLUSION

This study provides valuable insights into the associations between systemic inflammatory indices and IS, offering potential implications for risk stratification. While these inflammatory indices are potential indicators for distinguishing IS from healthy conditions, additional biomarkers may be needed when differentiating IS from other chronic inflammatory conditions in clinical practice.

Exploring the Role of Chemokine-Related Gene Deregulation and Immune Infiltration in Ischemic Stroke: Insights into CXCL16 and SEMA3E as Potential Biomarkers

Ischemic stroke is a leading cause of mortality and disability globally. Understanding the role of chemokine-related differently expressed genes (CDGs) in ischemic stroke pathophysiology is essential for advancing diagnostic and therapeutic strategies. We conducted comprehensive analyses using the GSE16561 dataset: chemokine pathway enrichment via GSVA, differential expression of 12 CDGs, Pearson correlation, and functional enrichment analyses (GO and KEGG). Machine learning algorithms were employed to develop diagnostic models, evaluated using ROC curve analysis. A nomogram was constructed and validated with independent datasets (GSE58294). Gene set enrichment analysis (GSEA) and immuno-infiltration analysis were also performed. Chemokine pathway scores were significantly elevated in ischemic stroke, indicating their potential involvement. Logistic regression emerged as the most effective diagnostic model, with CXCL16 and SEMA3E as significant biomarkers. The nomogram exhibited high discriminatory ability (AUC = 0.964), well-calibrated predictions, and clinical utility across datasets. GSEA highlighted key biological pathways associated with CXCL16 and SEMA3E. Immuno-infiltration analysis revealed significant differences in immune cell infiltration between control and ischemic stroke groups, with distinct correlations between CXCL16 and SEMA3E expression and immune cell populations. This study highlights the deregulation of CDGs in ischemic stroke and their implications in critical biological processes. CXCL16 and SEMA3E are identified as key biomarkers with potential diagnostic utility. Insights from gene set enrichment and immuno-infiltration analyses provide mechanistic understanding, suggesting novel therapeutic targets and enhancing clinical decision-making in ischemic stroke management.

Pathophysiology of Angiotensin II-Mediated Hypertension, Cardiac Hypertrophy, and Failure: A Perspective from Macrophages

Heart failure is a complex syndrome characterized by cardiac hypertrophy, fibrosis, and diastolic/systolic dysfunction. These changes share many pathological features with significant inflammatory responses in the myocardium. Among the various regulatory systems that impact on these heterogeneous pathological processes, angiotensin II (Ang II)-activated macrophages play a pivotal role in the induction of subcellular defects and cardiac adverse remodeling during the progression of heart failure. Ang II stimulates macrophages via its AT1 receptor to release oxygen-free radicals, cytokines, chemokines, and other inflammatory mediators in the myocardium, and upregulates the expression of integrin adhesion molecules on both monocytes and endothelial cells, leading to monocyte-endothelial cell-cell interactions. The transendothelial migration of monocyte-derived macrophages exerts significant biological effects on the proliferation of fibroblasts, deposition of extracellular matrix proteins, induction of perivascular/interstitial fibrosis, and development of hypertension, cardiac hypertrophy and heart failure. Inhibition of macrophage activation using Ang II AT1 receptor antagonist or depletion of macrophages from the peripheral circulation has shown significant inhibitory effects on Ang II-induced vascular and myocardial injury. The purpose of this review is to discuss the current understanding in Ang II-induced maladaptive cardiac remodeling and dysfunction, particularly focusing on molecular signaling pathways involved in macrophages-mediated hypertension, cardiac hypertrophy, fibrosis, and failure. In addition, the challenges remained in translating these findings to the treatment of heart failure patients are also addressed.

Macrophages suppress cardiac reprogramming of fibroblasts in vivo via IFN-mediated intercellular self-stimulating circuit

Direct conversion of cardiac fibroblasts (CFs) to cardiomyocytes (CMs) in vivo to regenerate heart tissue is an attractive approach. After myocardial infarction (MI), heart repair proceeds with an inflammation stage initiated by monocytes infiltration of the infarct zone establishing an immune microenvironment. However, whether and how the MI microenvironment influences the reprogramming of CFs remains unclear. Here, we found that in comparison with cardiac fibroblasts (CFs) cultured in vitro, CFs that transplanted into infarct region of MI mouse models resisted to cardiac reprogramming. RNA-seq analysis revealed upregulation of interferon (IFN) response genes in transplanted CFs, and subsequent inhibition of the IFN receptors increased reprogramming efficiency in vivo. Macrophage-secreted IFN-β was identified as the dominant upstream signaling factor after MI. CFs treated with macrophage-conditioned medium containing IFN-β displayed reduced reprogramming efficiency, while macrophage depletion or blocking the IFN signaling pathway after MI increased reprogramming efficiency in vivo. Co-IP, BiFC and Cut-tag assays showed that phosphorylated STAT1 downstream of IFN signaling in CFs could interact with the reprogramming factor GATA4 and inhibit the GATA4 chromatin occupancy in cardiac genes. Furthermore, upregulation of IFN-IFNAR-p-STAT1 signaling could stimulate CFs secretion of CCL2/7/12 chemokines, subsequently recruiting IFN-β-secreting macrophages. Together, these immune cells further activate STAT1 phosphorylation, enhancing CCL2/7/12 secretion and immune cell recruitment, ultimately forming a self-reinforcing positive feedback loop between CFs and macrophages via IFN-IFNAR-p-STAT1 that inhibits cardiac reprogramming in vivo. Cumulatively, our findings uncover an intercellular self-stimulating inflammatory circuit as a microenvironmental molecular barrier of in situ cardiac reprogramming that needs to be overcome for regenerative medicine applications.

CX3CL1 (Fractalkine): An important cytokine in physiological and pathological pregnancies

C-X3-C motif chemokine ligand 1 (CX3CL1), commonly known as Fractalkine, is an important chemokine with dual functions of chemotaxis and adhesion. It plays a pivotal role in a variety of physiological processes and pathological conditions, particularly in conjunction with its receptor, C-X3-C motif chemokine receptor 1 (CX3CR1). This review focuses on the expression and intricate regulatory mechanisms of CX3CL1 at the maternal-fetal interface, emphasizing its multifaceted role during pregnancy. CX3CL1 was detected in the trophoblast and decidua tissues, playing a crucial role in recruitment of immune cells, enhancing endometrial receptivity, and modulating trophoblast cell activities. Abnormal expression of CX3CL1 has been correlated with adverse pregnancy outcomes such as spontaneous abortion, gestational diabetes, preeclampsia, and preterm births. By elucidating the complex interplay of CX3CL1 at the maternal-fetal interface, this review aims to shed light on its potential roles in pregnancy-related complications.

Enhanced T-cell activation and chemokine-associated function in CD14-positive cells from venous sinus blood in sub-acute cerebral venous sinus thrombosis

Background

Patients with sub-acute cerebral venous sinus thrombosis experience (SA.CVST) severe symptoms compared to two other venous sinus-related diseases, including chronic cerebral venous sinus thrombosis (C.CVST) and idiopathic intracranial hypertension (IIH).

Objective

This study aimed to determine whether the different immune reactions in different venous sinuses are related.

Methods

Stagnant blood in the cerebral venous sinuses was extracted by passing a microcatheter and CD14-positive cells were sorted by magnetic beads and subjected to RNA-seq sequencing.

Results

Compared to patients with IIH, 128 genes were significantly down-regulated and 373 genes were significantly up-regulated in the sub-acute CVST samples. The functions of these genes were mainly focused on "immune response", "T cell activation" and "plasma membrane". Gene Set Enrichment Analysis (GSEA) showed T cell survival and activation-related function significantly unregulated in sub-acute CVST. On the other hand, there were 366 genes down-regulated in chronic CVST and 75 genes up-regulated in chronic CVST. In functional annotation, these differently expressed genes were enriched in the "extracellular region", "chemokine-mediated signaling pathway" and "immune response". GSEA analysis confirmed that chemokine-related functions were all up-regulated in sub-acute CVST and monocyte-macrophage adhesion functions were also significantly up-regulated.

Conclusion

This study suggested the CD14-positive created an activated immune response in sub-acute CVST.

The interplay between ferroptosis and inflammation: therapeutic implications for cerebral ischemia-reperfusion

Stroke ranks as the second most significant contributor to mortality worldwide and is a major factor in disability. Ischemic strokes account for 71% of all stroke incidences globally. The foremost approach to treating ischemic stroke prioritizes quick reperfusion, involving methods such as intravenous thrombolysis and endovascular thrombectomy. These techniques can reduce disability but necessitate immediate intervention. After cerebral ischemia, inflammation rapidly arises in the vascular system, producing pro-inflammatory signals that activate immune cells, which in turn worsen neuronal injury. Following reperfusion, an overload of intracellular iron triggers the Fenton reaction, resulting in an excess of free radicals that cause lipid peroxidation and damage to cellular membranes, ultimately leading to ferroptosis. The relationship between inflammation and ferroptosis is increasingly recognized as vital in the process of cerebral ischemia-reperfusion (I/R). Inflammatory processes disturb iron balance and encourage lipid peroxidation (LPO) through neuroglial cells, while also reducing the activity of antioxidant systems, contributing to ferroptosis. Furthermore, the lipid peroxidation products generated during ferroptosis, along with damage-associated molecular patterns (DAMPs) released from ruptured cell membranes, can incite inflammation. Given the complex relationship between ferroptosis and inflammation, investigating their interaction in brain I/R is crucial for understanding disease development and creating innovative therapeutic options. Consequently, this article will provide a comprehensive introduction of the mechanisms linking ferroptosis and neuroinflammation, as well as evaluate potential treatment modalities, with the goal of presenting various insights for alleviating brain I/R injury and exploring new therapeutic avenues.

Deciphering the mechanistic impact of acupuncture on the neurovascular unit in acute ischemic stroke: Insights from basic research in a narrative review

Ischemic stroke(IS), a severe acute cerebrovascular disease, not only imposes a heavy economic burden on society but also presents numerous challenges in treatment. During the acute phase, while thrombolysis and thrombectomy serve as primary treatments, these approaches are restricted by a narrow therapeutic window. During rehabilitation, commonly used neuroprotective agents struggle with their low drug delivery efficiency and inadequate preclinical testing, and the long-term pharmacological and toxicity effects of nanomedicines remain undefined. Meanwhile, acupuncture as a therapeutic approach is widely acknowledged for its effectiveness in treating IS and has been recommended by the World Health Organization (WHO) as an alternative and complementary therapy, even though its exact mechanisms remain unclear. This review aims to summarize the known mechanisms of acupuncture and electroacupuncture (EA) in the treatment of IS. Research shows that acupuncture treatment mainly protects the neurovascular unit through five mechanisms: 1) reducing neuronal apoptosis and promoting neuronal repair and proliferation; 2) maintaining the integrity of the blood-brain barrier (BBB); 3) inhibiting the overactivation and polarization imbalance of microglia; 4) regulating the movement of vascular smooth muscle (VSM) cells; 5) promoting the proliferation of oligodendrocyte precursors. Through an in-depth analysis, this review reveals the multi-level, multi-dimensional impact of acupuncture treatment on the neurovascular unit (NVU) following IS, providing stronger evidence and a theoretical basis for its clinical application.

Crosstalk Among Glial Cells in the Blood-Brain Barrier Injury After Ischemic Stroke

Blood-brain barrier (BBB) is comprised of brain microvascular endothelial cells (ECs), astrocytes, perivascular microglia, pericytes, neuronal processes, and the basal lamina. As a complex and dynamic interface between the blood and the central nervous system (CNS), BBB is responsible for transporting nutrients essential for the normal metabolism of brain cells and hinders many toxic compounds entering into the CNS. The loss of BBB integrity following stroke induces tissue damage, inflammation, edema, and neural dysfunction. Thus, BBB disruption is an important pathophysiological process of acute ischemic stroke. Understanding the mechanism underlying BBB disruption can uncover more promising biological targets for developing treatments for ischemic stroke. Ischemic stroke-induced activation of microglia and astrocytes leads to increased production of inflammatory mediators, containing chemokines, cytokines, matrix metalloproteinases (MMPs), etc., which are important factors in the pathological process of BBB breakdown. In this review, we discussed the current knowledges about the vital and dual roles of astrocytes and microglia on the BBB breakdown during ischemic stroke. Specifically, we provided an updated overview of phenotypic transformation of microglia and astrocytes, as well as uncovered the crosstalk among astrocyte, microglia, and oligodendrocyte in the BBB disruption following ischemic stroke.

Exploration of the mechanism of Taohong Siwu Decoction for the treatment of ischemic stroke based on CCL2/CCR2 axis

Background and aims

Taohong Siwu Decoction (THSWD) is a traditional Chinese herbal prescription that is effective for ischemic stroke, Whether THSWD regulates the CCL2/CCR2 axis and thus reduces the inflammatory response induced by ischemic stroke is not known. The aim of this study was to elucidate the mechanism of action of THSWD in the treatment of ischemic stroke using bioinformatics combined with in vitro and in vivo experiments.

Methods

R language was used to analyze middle cerebral artery occlusion/reperfusion (MCAO/R) rat transcriptome data and to identify differential gene expression following THSWD treatment. Gene set enrichment analysis (GSEA) was used to analyze the gene set enrichment pathway of MCAO/R rats treated with THSWD. PPI networks screened key targets. The Human Brain Microvascular Endothelial Cells (HBMEC) Oxygen Glucose Deprivation/Reoxygenation (OGD/R) model and SD rat models of MCAO/R were established. FITC-dextran, immunofluorescence, flow cytometry, ELISA, immunohistochemistry, Western blotting, and RT-qPCR were performed to identify potential treatment targets.

Results

A total of 515 differentially expressed genes of THSWD in MCAO/R rats were screened and 92 differentially expressed genes of THSWD potentially involved in stroke intervention were identified, including Cd68, Ccl2, and other key genes. In vitro, THSWD reversed the increase in permeability of HBMEC cells and M1/M2 polarization of macrophages induced by CCL2/CCR2 axis agonists. In vivo, THSWD improved nerve function injury and blood-brain barrier injury in MCAO/R rats. Further, THSWD inhibited the infiltration and polarization of macrophages, reduced the expression of IL-6, TNF-α, and MMP-9, and increased the expression of IL-4, while reducing the gene and protein expression of CCL2 and CCR2.

Conclusion

THSWD may play a protective role in ischemic stroke by inhibiting the CCL2/CCR2 axis, reducing the infiltration of macrophages, and promoting the polarization of M2 macrophages, thereby reducing inflammatory damage, and protecting injury to the blood-brain barrier.

Vascular Aging in Ischemic Stroke

Cellular senescence, a permanent halt in cell division due to stress, spurs functional and structural changes, contributing to vascular aging characterized by endothelial dysfunction and vascular remodeling. This process raises the risk of ischemic stroke (IS) in older individuals, with its mechanisms still not completely understood despite ongoing research efforts. In this review, we have analyzed the impact of vascular aging on increasing susceptibility and exacerbating the pathology of IS. We have emphasized the detrimental effects of endothelial dysfunction and vascular remodeling influenced by oxidative stress and inflammatory response on vascular aging and IS. Our goal is to aid the understanding of vascular aging and IS pathogenesis, particularly benefiting older adults with high risk of IS.

Endothelial and macrophage interactions in the angiogenic niche

The interactions between vascular cells, especially endothelial cells, and macrophages play a pivotal role in maintaining the subtle balance of vascular biology, which is crucial for angiogenesis in both healthy and diseased states. These cells are central to ensuring a harmonious balance between tissue repair and preventing excessive angiogenic activity, which could lead to pathological conditions. Recent advances in sophisticated genetic engineering vivo models and novel sequencing approaches, such as single-cell RNA-sequencing, in immunobiology have significantly enhanced our understanding of the gene expression and behavior of macrophages. These insights offer new perspectives on the role macrophages play not only in development but also across various health conditions. In this review, we explore the complex interactions between multiple types of macrophages and endothelium, focusing on their impact on new blood vessel formation. By understanding these intricate interactions, we aim to provide insights into new methods for managing angiogenesis in various diseases, thereby offering hope for the development of novel therapeutic approaches.

Identification of metabolic components of carotid plaque in high-risk patients utilizing liquid chromatography-tandem mass spectrometry

OBJECTIVE

Carotid atherosclerosis is a chronic progressive vascular disease that can be complicated by stroke in severe cases. Prompt diagnosis and treatment of high-risk patients are quite difficult due to the lack of reliable clinical biomarkers. This study aimed to explore potential plaque metabolic markers of stroke-prone risk and relevant targets for pharmacological intervention.

METHOD

Carotid intima and plaque sample tissues were obtained from 20 patients with cerebrovascular symptoms of carotid origin. An untargeted metabolomics approach based on liquid chromatography-tandem mass spectrometry was utilized to characterize the metabolic profiles of the tissues. Multivariate and univariate analysis tools were used.

RESULTS

A total of 154 metabolites were significantly altered in carotid plaque when compared with thickened intima. Of these, 62 metabolites were upregulated, whereas 92 metabolites were downregulated. Support vector machines identified the 15 most important metabolites, such as N-(cyclopropylmethyl)-N'-phenylurea, 9(S)-HOTrE, ACar 12:2, quinoxaline-2,3-dithiol, and l-thyroxine, as biomarkers for high-risk plaques. Metabolic pathway analysis showed that abnormal purine and nucleotide metabolism, amino acid metabolism, glutathione metabolism, and vitamin metabolism may contribute to the occurrence and progression of carotid atherosclerotic plaque.

CONCLUSIONS

Our study identifies the biomarkers and related metabolic mechanisms of carotid plaque, which is stroke-prone, and provides insights and ideas for the precise prevention and targeted intervention of the disease.

The role of matrix metalloproteinases in the pathogenetic mechanisms of ischemic stroke

   Modern understanding of the mechanisms of the pathogenesis of ischemic stroke has expanded due to the study of neuroinfl ammation processes, in which matrix metalloproteinases (MMPs) play an important role. This literature review describes the main types of MMPs and provides current data on the pathophysiological role of this group of proteases in acute cerebral ischemia, which have multidirectional eff ects depending on the stage of the disease. Clinical studies assessing the role of MMPs in ischemic stroke are in most cases based on experimental models, and their results are ambiguous, which is determined by the versatility of their actions. MMPs are an important regulator of infl ammatory processes, the permeability of the blood-brain barrier and, as a consequence, cerebral edema. However, the positive eff ect of MMPs in the processes of angiogenesis, neurogenesis and neuroplasticity has been proven. Thus, further study of MMPs is relevant from the point of view of their role in functional recovery after ischemic stroke.

The role of P-selectin/PSGL-1 in regulating NETs as a novel mechanism in cerebral ischemic injury

In recent years, substantial advancements have been made in understanding the pathophysiology of ischemic stroke. Despite these developments, therapeutic options for cerebral ischemia remain limited due to stringent time windows and various contraindications. Consequently, there has been a concentrated effort to elucidate the underlying mechanisms of cerebral ischemic injury. Emerging research indicates that neutrophil extracellular traps (NETs) exacerbate inflammation and damage in ischemic brain tissue, contributing to neuronal cell death. The inhibition of NETs has shown potential in preventing thrombosis and the infiltration of immune cells. Central to the formation of NETs are P-selectin and its ligand, P-selectin glycoprotein ligand-1 (PSGL-1), which represent promising therapeutic targets. This review explores the detrimental impact of P-selectin, PSGL-1, and NETs on cerebral ischemia. Additionally, it delineates the processes by which P-selectin and PSGL-1 stimulate NETs production and provides evidence that blocking these molecules reduces NETs formation. This novel insight highlights a potential therapeutic avenue that warrants further investigation by researchers in the field.

Causal role of immune cells on cervical cancer onset revealed by two-sample Mendelian randomization study

Cervical cancer (CC) is a prevalent gynecological cancer worldwide that significantly impacts the quality of life and the physical and mental well-being of women. However, there have been limited studies utilizing Mendelian randomization (MR) analysis to investigate the connection between immune cells and CC. This study is to investigate the causal effects of immune traits on CC and non-neoplastic conditions of the cervix. The GWAS data for 731 immunophenotypes and six GWAS data for CC from the FinnGen database were downloaded. Subsequently, a two-sample MR analysis was conducted using the MR Egger, Weighted median, Inverse variance weighted (IVW), Simple mode, and Weighted mode methods. Our study has identified the potential causal effects of immune traits on inflammatory diseases of the cervix, other noninflammatory disorders of the cervix uteri, carcinoma in situ of cervix uteri, adenocarcinomas of cervix, squamous cell neoplasms and carcinoma of cervix, as well as malignant neoplasm of the cervix uteri, with the respective numbers being 8, 6, 11, 8, 23, and 12, respectively. A strong correlation between classic monocytes and various cervical diseases was revealed. Furthermore, we discovered that B cells expressing BAFF-R have the ability to impede the advancement of malignant CC, specifically squamous cell neoplasms and carcinoma of cervix. Our study has demonstrated a significant association between immune traits and both CC and non-neoplastic conditions of the cervix through two-sample Mendelian randomization, providing valuable insights for future clinical research.

Systemic-inflammatory indices and clinical outcomes in patients with anterior circulation acute ischemic stroke undergoing successful endovascular thrombectomy

Background

There is a lack of comprehensive profile assessment on complete blood count (CBC)-derived systemic-inflammatory indices, and their correlations with clinical outcome in patients with anterior circulation acute ischemic stroke (AIS) who achieved successful recanalization by endovascular thrombectomy (EVT).

Methods

Patients with anterior circulation AIS caused by large vessel occlusion (AIS-LVO) were retrospectively screened from December 2018 to December 2022. Systemic-inflammatory indices including ratios of neutrophil-to-lymphocyte (NLR), monocyte-to-lymphocyte (MLR), platelet-to-lymphocyte (PLR), and platelet-to-neutrophil (PNR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate inflammation systemic index (AISI) on admission and the first day post-EVT were calculated. Their correlations with symptomatic intracranial hemorrhage (sICH) and unfavorable 90-day functional outcome (modified Rankin Scale score of 3-6) were analyzed.

Results

A total of 482 patients [65 (IQR, 56-72) years; 33 % female] were enrolled, of which 231 (47.9 %) had unfavorable 90-day outcome and 50 (10.4 %) developed sICH. Day 1 neutrophil and monocyte counts, NLR, MLR, PLR, SII, SIRI, and AISI were increased, while lymphocyte and PNR were decreased compared to their admission levels. In multivariate analyses, neutrophil count, NLR, SII, and AISI on day 1 were independently associated with 90-day functional outcome. Moreover, day 1 neutrophil count, NLR, MLR, PLR, PNR, SII, and SIRI were independently linked to the occurrence of sICH. No admission variables were identified as independent risk factors for patient outcomes.

Conclusion

CBC-derived systemic-inflammatory indices measured on the first day after successful EVT are predictive of 90-day functional outcome and the sICH occurrence in patients with anterior circulation AIS-LVO.

Peripheral inflammatory response in people after acute ischaemic stroke and isolated spontaneous cervical artery dissection

The systemic inflammatory response following acute ischaemic stroke remains incompletely understood. We characterised the circulating inflammatory profile in 173 acute ischaemic stroke patients by measuring 65 cytokines and chemokines in plasma. Participants were grouped based on their inflammatory response, determined by high-sensitivity C-reactive protein levels in the acute phase. We compared stroke patients' profiles with 42 people experiencing spontaneous cervical artery dissection without stroke. Furthermore, variations in cytokine levels among stroke aetiologies were analysed. Follow-up samples were collected in a subgroup of ischaemic stroke patients at three and twelve months. Ischaemic stroke patients had elevated plasma levels of HGF and SDF-1α, and lower IL-4 levels, compared to spontaneous cervical artery dissection patients without stroke. Aetiology-subgroup analysis revealed reduced levels of nine cytokines/chemokines (HGF, SDF-1α, IL-2R, CD30, TNF-RII, IL-16, MIF, APRIL, SCF), and elevated levels of IL-4 and MIP-1β, in spontaneous cervical artery dissection (with or without ischaemic stroke as levels were comparable between both groups) compared to other aetiologies. The majority of cytokine/chemokine levels remained stable across the study period. Our research indicates that stroke due to large artery atherosclerosis, cardioembolism, and small vessel occlusion triggers a stronger inflammatory response than spontaneous cervical artery dissection.

CC Chemokine Family Members' Modulation as a Novel Approach for Treating Central Nervous System and Peripheral Nervous System Injury-A Review of Clinical and Experimental Findings

Despite significant progress in modern medicine and pharmacology, damage to the nervous system with various etiologies still poses a challenge to doctors and scientists. Injuries lead to neuroimmunological changes in the central nervous system (CNS), which may result in both secondary damage and the development of tactile and thermal hypersensitivity. In our review, based on the analysis of many experimental and clinical studies, we indicate that the mechanisms occurring both at the level of the brain after direct damage and at the level of the spinal cord after peripheral nerve damage have a common immunological basis. This suggests that there are opportunities for similar pharmacological therapeutic interventions in the damage of various etiologies. Experimental data indicate that after CNS/PNS damage, the levels of 16 among the 28 CC-family chemokines, i.e., CCL1, CCL2, CCL3, CCL4, CCL5, CCL6, CCL7, CCL8, CCL9, CCL11, CCL12, CCL17, CCL19, CCL20, CCL21, and CCL22, increase in the brain and/or spinal cord and have strong proinflammatory and/or pronociceptive effects. According to the available literature data, further investigation is still needed for understanding the role of the remaining chemokines, especially six of them which were found in humans but not in mice/rats, i.e., CCL13, CCL14, CCL15, CCL16, CCL18, and CCL23. Over the past several years, the results of studies in which available pharmacological tools were used indicated that blocking individual receptors, e.g., CCR1 (J113863 and BX513), CCR2 (RS504393, CCX872, INCB3344, and AZ889), CCR3 (SB328437), CCR4 (C021 and AZD-2098), and CCR5 (maraviroc, AZD-5672, and TAK-220), has beneficial effects after damage to both the CNS and PNS. Recently, experimental data have proved that blockades exerted by double antagonists CCR1/3 (UCB 35625) and CCR2/5 (cenicriviroc) have very good anti-inflammatory and antinociceptive effects. In addition, both single (J113863, RS504393, SB328437, C021, and maraviroc) and dual (cenicriviroc) chemokine receptor antagonists enhanced the analgesic effect of opioid drugs. This review will display the evidence that a multidirectional strategy based on the modulation of neuronal-glial-immune interactions can significantly improve the health of patients after CNS and PNS damage by changing the activity of chemokines belonging to the CC family. Moreover, in the case of pain, the combined administration of such antagonists with opioid drugs could reduce therapeutic doses and minimize the risk of complications.

Therapeutic gene delivery by mesenchymal stem cell for brain ischemia damage: Focus on molecular mechanisms in ischemic stroke

Cerebral ischemic damage is prevalent and the second highest cause of death globally across patient populations; it is as a substantial reason of morbidity and mortality. Mesenchymal stromal cells (MSCs) have garnered significant interest as a potential treatment for cerebral ischemic damage, as shown in ischemic stroke, because of their potent intrinsic features, which include self-regeneration, immunomodulation, and multi-potency. Additionally, MSCs are easily obtained, isolated, and cultured. Despite this, there are a number of obstacles that hinder the effectiveness of MSC-based treatment, such as adverse microenvironmental conditions both in vivo and in vitro. To overcome these obstacles, the naïve MSC has undergone a number of modification processes to enhance its innate therapeutic qualities. Genetic modification and preconditioning modification (with medications, growth factors, and other substances) are the two main categories into which these modification techniques can be separated. This field has advanced significantly and is still attracting attention and innovation. We examine these cutting-edge methods for preserving and even improving the natural biological functions and therapeutic potential of MSCs in relation to adhesion, migration, homing to the target site, survival, and delayed premature senescence. We address the use of genetically altered MSC in stroke-induced damage. Future strategies for improving the therapeutic result and addressing the difficulties associated with MSC modification are also discussed.

[Biomarkers of atherothrombotic and cardioembolic subtypes of acute ischemic stroke]

OBJECTIVE

To evaluate the concentrations of CC-chemokines and stable metabolites of nitric oxide (NO) and endothelin-1 (ET-1) in patients with atherothrombotic (AT) and cardioembolic (CE) subtypes of ischemic stroke (IS) in the acute period.

MATERIAL AND METHODS

Sixty patients diagnosed with IS in the carotid basin were examined. Group 1 included 30 patients with AT, group 2 - 30 patients with CE subtype of IS. The control group consisted of 20 age-matched patients without a history of stroke. All patients were assessed on admission for functional status using the Barthel Index (BI), the Modified Rankin Scale (mRS) and the National Institutes of Health Stroke Scale (NIHSS). Neuroimaging parameters were assessed using CT/MRI data. Laboratory diagnostics included assessment of serum concentrations of interleukin (IL)-1β, IL-6, IL-16, interferon gamma (IFN-γ), CC-chemokines (CCL2, CCL-7, CCL8, CCL13, CCL15, CCL23) and stable metabolites of NO and ET-1.

RESULTS

All patients with IS had moderate stroke severity scores according to NIHSS, BI and mRS. Analysis of the indices of the main clinical scales revealed.

higher NIHSS scores, the prevalence of body mass index (BMI), the size of IS foci and the presence of multifocal lesions in patients of group 2. Compared with the control group, a significant increase of IFN- γ and IL-16 was noted in patients of both groups; ET-1, CCL2 and CCL15 were elevated in group 1; IL-1β, IL-6, CCL8 and CCL23 - in group 2. A comparative analysis between groups revealed higher concentrations of ET-1, CCL2 and CCL15 in group 1 and the increase of IL-1β, IL-6, IL-16 and CCL13 in group 2.

CONCLUSION

The results allow considering cytokines CCL23, IL-6, IL-16, IL-1β and IFN-γ as indicators of IS severity; CCL2, CCL15 and ET-1 as important regulators of atherogenesis and indicators of the AT subtype of IS; IL-1β, IL-6 and CCL13 as markers of complications of atrial fibrillation. The findings indicate the necessity of multicentre studies with a large sample size to determine the potential value of CCR1/CCR2 chemokines and stable metabolites as biomarkers of course of different IS subtypes.

CNS Drug Delivery in Stroke: Improving Therapeutic Translation From the Bench to the Bedside

Drug development for ischemic stroke is challenging as evidenced by the paucity of therapeutics that have advanced beyond a phase III trial. There are many reasons for this lack of clinical translation including factors related to the experimental design of preclinical studies. Often overlooked in therapeutic development for ischemic stroke is the requirement of effective drug delivery to the brain, which is critical for neuroprotective efficacy of several small and large molecule drugs. Advancing central nervous system drug delivery technologies implies a need for detailed comprehension of the blood-brain barrier (BBB) and neurovascular unit. Such knowledge will permit the innate biology of the BBB/neurovascular unit to be leveraged for improved bench-to-bedside translation of novel stroke therapeutics. In this review, we will highlight key aspects of BBB/neurovascular unit pathophysiology and describe state-of-the-art approaches for optimization of central nervous system drug delivery (ie, passive diffusion, mechanical opening of the BBB, liposomes/nanoparticles, transcytosis, intranasal drug administration). Additionally, we will discuss how endogenous BBB transporters represent the next frontier of drug delivery strategies for stroke. Overall, this review will provide cutting edge perspective on how central nervous system drug delivery must be considered for the advancement of new stroke drugs toward human trials.

Emerging diagnostic markers and therapeutic targets in post-stroke hemorrhagic transformation and brain edema

Stroke is a devastating condition that can lead to significant morbidity and mortality. The aftermath of a stroke, particularly hemorrhagic transformation (HT) and brain edema, can significantly impact the prognosis of patients. Early detection and effective management of these complications are crucial for improving outcomes in stroke patients. This review highlights the emerging diagnostic markers and therapeutic targets including claudin, occludin, zonula occluden, s100β, albumin, MMP-9, MMP-2, MMP-12, IL-1β, TNF-α, IL-6, IFN-γ, TGF-β, IL-10, IL-4, IL-13, MCP-1/CCL2, CXCL2, CXCL8, CXCL12, CCL5, CX3CL1, ICAM-1, VCAM-1, P-selectin, E-selectin, PECAM-1/CD31, JAMs, HMGB1, vWF, VEGF, ROS, NAC, and AQP4. The clinical significance and implications of these biomarkers were also discussed.

Neuroimmune Support of Neuronal Regeneration and Neuroplasticity following Cerebral Ischemia in Juvenile Mice

Ischemic damage to the brain and loss of neurons contribute to functional disabilities in many stroke survivors. Recovery of neuroplasticity is critical to restoration of function and improved quality of life. Stroke and neurological deficits occur in both adults and children, and yet it is well documented that the developing brain has remarkable plasticity which promotes increased post-ischemic functional recovery compared with adults. However, the mechanisms underlying post-stroke recovery in the young brain have not been fully explored. We observed opposing responses to experimental cerebral ischemia in juvenile and adult mice, with substantial neural regeneration and enhanced neuroplasticity detected in the juvenile brain that was not found in adults. We demonstrate strikingly different stroke-induced neuroimmune responses that are deleterious in adults and protective in juveniles, supporting neural regeneration and plasticity. Understanding age-related differences in neuronal repair and regeneration, restoration of neural network function, and neuroimmune signaling in the stroke-injured brain may offer new insights for the development of novel therapeutic strategies for stroke rehabilitation.