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Gelderblom M, Koch S, Strecker JK, Jørgensen C, Garcia-Bonilla L, Ludewig P, Schädlich IS, Piepke M, Degenhardt K, Bernreuther C, Pinnschmidt H, Arumugam TV, Thomalla G, Faber C, Sedlacik J, Gerloff C, Minnerup J, Clausen BH, Anrather J, Magnus T. A preclinical randomized controlled multi-centre trial of anti-interleukin-17A treatment for acute ischaemic stroke. Brain Commun 2023; 5:fcad090. [PMID: 37056478 PMCID: PMC10088471 DOI: 10.1093/braincomms/fcad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 01/19/2023] [Accepted: 03/22/2023] [Indexed: 04/15/2023] Open
Abstract
Multiple consensus statements have called for preclinical randomized controlled trials to improve translation in stroke research. We investigated the efficacy of an interleukin-17A neutralizing antibody in a multi-centre preclinical randomized controlled trial using a murine ischaemia reperfusion stroke model. Twelve-week-old male C57BL/6 mice were subjected to 45 min of transient middle cerebral artery occlusion in four centres. Mice were randomly assigned (1:1) to receive either an anti-interleukin-17A (500 µg) or isotype antibody (500 µg) intravenously 1 h after reperfusion. The primary endpoint was infarct volume measured by magnetic resonance imaging three days after transient middle cerebral artery occlusion. Secondary analysis included mortality, neurological score, neutrophil infiltration and the impact of the gut microbiome on treatment effects. Out of 136 mice, 109 mice were included in the analysis of the primary endpoint. Mixed model analysis revealed that interleukin-17A neutralization significantly reduced infarct sizes (anti-interleukin-17A: 61.77 ± 31.04 mm3; IgG control: 75.66 ± 34.79 mm3; P = 0.01). Secondary outcome measures showed a decrease in mortality (hazard ratio = 3.43, 95% confidence interval = 1.157-10.18; P = 0.04) and neutrophil invasion into ischaemic cortices (anti-interleukin-17A: 7222 ± 6108 cells; IgG control: 28 153 ± 23 206 cells; P < 0.01). There was no difference in Bederson score. The analysis of the gut microbiome showed significant heterogeneity between centres (R = 0.78, P < 0.001, n = 40). Taken together, neutralization of interleukin-17A in a therapeutic time window resulted in a significant reduction of infarct sizes and mortality compared with isotype control. It suggests interleukin-17A neutralization as a potential therapeutic target in stroke.
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Affiliation(s)
- Mathias Gelderblom
- Correspondence to: Mathias Gelderblom Department of Neurology University Medical Center Hamburg-Eppendorf Martinistrasse 52, 20246 Hamburg, Germany E-mail:
| | | | - Jan-Kolja Strecker
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149 Münster, Germany
| | - Carina Jørgensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Lidia Garcia-Bonilla
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Peter Ludewig
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Ines Sophie Schädlich
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Marius Piepke
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Karoline Degenhardt
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Christian Bernreuther
- Department of Neuropathology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Hans Pinnschmidt
- Institute of Medical Biometry and Epidemiology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Thiruma V Arumugam
- Department of Physiology, Anatomy & Microbiology School of Life Sciences, La Trobe University, Melbourne 3086, Australia
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Cornelius Faber
- Translational Research Imaging Center, Clinic of Radiology, University of Münster, 48149 Münster, Germany
| | - Jan Sedlacik
- Department of Biomedical Engineering, Centre for the Developing Brain, School of Biomedical Engineering & Imaging Sciences, King's College London, London WC2R 2LS, UK
| | - Christian Gerloff
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Jens Minnerup
- Department of Neurology with Institute of Translational Neurology, University of Münster, 48149 Münster, Germany
| | - Bettina H Clausen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, 5000 Odense, Denmark
| | - Josef Anrather
- Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY 10065, USA
| | - Tim Magnus
- Department of Neurology, University Medical Center Hamburg-Eppendorf, 20246 Hamburg, Germany
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