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Han Z, Li L, Tao Z, Wang R, Zhao H, Zheng Y, Yang Z, Zhong L, Fan J, Luo Y. Neutrophilic noncoding RNAs predict outcomes of acute ischemic stroke patients treated with recombinant tissue plasminogen activator. Front Pharmacol 2022; 13:1003806. [PMID: 36278201 PMCID: PMC9582270 DOI: 10.3389/fphar.2022.1003806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 09/21/2022] [Indexed: 11/13/2022] Open
Abstract
There’s no evidence demonstrating the association between noncoding RNAs levels before IV recombinant tissue plasminogen activator (rtPA) administration and the outcomes of acute ischemic stroke (AIS). 145 AIS patients received rtPA treatment were recruited at the stroke center from 2018 to 2019, and 103 patients were included in this study. A panel of noncoding RNAs (miRNA-23a, miRNA-193a, miRNA-128, miRNA-99a, miRNA-let-7a, miRNA-494, miRNA-424, and lncRNA H19) were measured in the circulating neutrophils of AIS patients before rtPA treatment. Endpoints included excellent outcome (modified Rankin Scale score [mRS] 0–1) or poor outcome (mRS > 1) at 3 months and symptomatic intracerebral hemorrhage (sICH) after rtPA treatment. Among the eight noncoding RNAs detected in circulating neutrophils of the 103 participants, miRNA-23a levels were associated with the stroke severity on admission and symptom progression at 24 h after rtPA treatment. A noncoding RNA score composed of miRNA-23a, miRNA-99a, and lncRNA H19 was screened to predict the functional outcome at 3 months and the incidence of sICH after rtPA treatment. In the logistic regression analysis, the noncoding RNA score ≥ −0.336 (OR = 2.862 [1.029–7.958], p = 0.044) was an independent predictor of the poor outcome at 3 months after adjustment of clinical variables, the addition of the noncoding RNA score to the clinical model improved the discrimination (IDI% = 4.68 [0.65–8.71], p = 0.020), as well as the net reclassification (NRI% = 33.04 [0.54–71.49], p = 0.016). The noncoding RNA score ≥ −0.336 (OR = 5.250 [1.096–25.135], p = 0.038) was also independently predicted the sICH, the addition of the noncoding RNA score to the clinical variables improved discrimination and reclassification as well. The noncoding RNA score was also associated with the infarct volume and symptom improvement at 7 days after rtPA treatment. In conclusion, a higher neutrophilic noncoding RNA score provides predictive value to identify AIS patients with worse outcomes after rtPA treatment. miRNA-23a, miRNA-99a, and lncRNA H19 are worth further investigation for their effects in thrombolysis after AIS.
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Affiliation(s)
- Ziping Han
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Lingzhi Li
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Zhen Tao
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Rongliang Wang
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Haiping Zhao
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Yangmin Zheng
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Zhenhong Yang
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Liyuan Zhong
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
| | - Junfen Fan
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
- *Correspondence: Junfen Fan, ; Yumin Luo,
| | - Yumin Luo
- Institute of Cerebrovascular Diseases Research and Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Key Laboratory of Translational Medicine for Cerebrovascular Diseases, Beijing, China
- Beijing Institute for Brain Disorders, Beijing, China
- *Correspondence: Junfen Fan, ; Yumin Luo,
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Liu Y, Li Y, Zang J, Zhang T, Li Y, Tan Z, Ma D, Zhang T, Wang S, Zhang Y, Huang L, Wu Y, Su X, Weng Z, Deng D, Kwan Tsang C, Xu A, Lu D. CircOGDH Is a Penumbra Biomarker and Therapeutic Target in Acute Ischemic Stroke. Circ Res 2022; 130:907-924. [PMID: 35189704 DOI: 10.1161/circresaha.121.319412] [Citation(s) in RCA: 76] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acute ischemic stroke (AIS) is a leading cause of disability and mortality worldwide. Prediction of penumbra existence after AIS is crucial for making decision on reperfusion therapy. Yet a fast, inexpensive, simple, and noninvasive predictive biomarker for the poststroke penumbra with clinical translational potential is still lacking. We aim to investigate whether the CircOGDH (circular RNA derived from oxoglutarate dehydrogenase) is a potential biomarker for penumbra in patients with AIS and its role in ischemic neuronal damage. METHODS CircOGDH was screened from penumbra of middle cerebral artery occlusion mice and was assessed in plasma of patients with AIS by quantitative polymerase chain reaction. Magnetic resonance imaging was used to examine the penumbra volumes. CircOGDH interacted with miR-5112 in primary cortical neurons was detected by fluorescence in situ hybridization, RNA immunoprecipitation, and luciferase reporter assay. ADV-mediated CircOGDH knockdown ameliorated neuronal apoptosis induced by COL4A4 (Gallus collagen, type VI, alpha VI) overexpression. Transmission electron microscope, nanoparticle tracking analysis, and Western blot were performed to confirm exosomes. RESULTS CircOGDH expression was dramatically and selectively upregulated in the penumbra tissue of middle cerebral artery occlusion mice and in the plasma of 45 patients with AIS showing a 54-fold enhancement versus noncerebrovascular disease controls. Partial regression analysis revealed that CircOGDH expression was positively correlated with the size of penumbra in patients with AIS. Sequestering of miR-5112 by CircOGDH enhanced COL4A4 expression to elevate neuron damage. Additionally, knockdown of CircOGDH significantly enhanced neuronal cell viability under ischemic conditions. Furthermore, the expression of CircOGDH in brain tissue was closely related to that in the serum of middle cerebral artery occlusion mice. Finally, we found that CircOGDH was highly expressed in plasma exosomes of patients with AIS compared with those in noncerebrovascular disease individuals. CONCLUSIONS These results demonstrate that CircOGDH is a potential therapeutic target for regulating ischemia neuronal viability, and is enriched in neuron-derived exosomes in the peripheral blood, exhibiting a predictive biomarker of penumbra in patients with AIS.
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Affiliation(s)
- Yanfang Liu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Yufeng Li
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Jiankun Zang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Tianyuan Zhang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Yaojie Li
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Zefeng Tan
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Dan Ma
- Departments of Chemistry and Biological Sciences, University of Southern California, Los Angeles (D.M.)
| | - Tao Zhang
- Department of Cardiology, The First Affiliated Hospital of Jinan University, Guangzhou, China. (T.Z.)
| | - Shiyong Wang
- Department of Neurosurgery, The First Affiliated Hospital of Jinan University, Guangzhou, China. (S.W.)
| | - Yusheng Zhang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Lian Huang
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Yousheng Wu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Xuanlin Su
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Zean Weng
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Die Deng
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Chi Kwan Tsang
- Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Anding Xu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
| | - Dan Lu
- Department of Neurology and Stroke Center, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., A.X., D.L.).,Clinical Neuroscience Institute, The First Affiliated Hospital of Jinan University, Guangzhou, China. (Y. Liu, Y. Li, J.Z., T.Z., Y.L., Z.T., Y.Z., L.H., Y.W., X.S., Z.W., D.D., C.K.T., A.X., D.L.)
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