Neuroprotection for ischemic stroke in the endovascular era: A brief report on the future of intra-arterial therapy

Publication date: Available online 17 August 2019Source: Journal of Clinical NeuroscienceAuthor(s): Julius Griauzde, Vijay M. Ravindra, Neeraj Chaudhary, Joseph J. Gemmete, Aditya S. PandeyAbstractMechanical thrombectomy is now at the forefront of the treatment of large vessel acute ischemic stroke (AIS). Selective intra-arterial (IA) access has opened a new avenue for neuroprotection in AIS that has the potential to maximize local benefit while minimizing systemic effects. On a cellular level, neuroprotective strategies are aimed at reducing inflammation and free-radical formation, maintaining blood-brain barrier fidelity, and preventing cellular death. Strategies under investigation include IA infusion of neuroprotective agents, IA administration of stem cells, and selective IA hypothermia. In this technical report, we briefly discuss pathologic mechanisms in AIS and highlight potential neuroprotective strategies that are administered selectively via the IA route.
Source: Journal of Clinical Neuroscience - Category: Neuroscience Source Type: research

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CONCLUSION: Therapeutic hypothermia upregulated Miro1 and enhanced MSC mitochondrial transfer-mediated neuroprotection in ischemic stroke. Combination of LCI with MSC therapy may facilitate clinical translation of this approach. PMID: 31454517 [PubMed - as supplied by publisher]
Source: Brain Research - Category: Neurology Authors: Tags: Brain Res Source Type: research
gh B, Vizi ES Abstract The release of [3H]dopamine ([3H]DA) and [3H]noradrenaline ([3H]NA) in acutely perfused rat striatal and cortical slice preparations was measured at 37 °C and 17 °C under ischemic conditions. The ischemia was simulated by the removal of oxygen and glucose from the Krebs solution. At 37 °C, resting release rates in response to ischemia were increased; in contrast, at 17 °C, resting release rates were significantly reduced, or resting release was completely prevented. The removal of extracellular Ca2+ further increased the release rates of [3H]DA and [3H]NA ...
Source: Neurochemical Research - Category: Neuroscience Authors: Tags: Neurochem Res Source Type: research
Publication date: Available online 4 July 2019Source: Journal of Thermal BiologyAuthor(s): Yannick Lutz, Axel Loewe, Stephan Meckel, Olaf Dössel, Giorgio CattaneoAbstractLocal brain hypothermia is an attractive method for providing cerebral neuroprotection for ischemic stroke patients and at the same time reducing systemic side effects of cooling. In acute ischemic stroke patients with large vessel occlusion, combination with endovascular mechanical recanalization treatment could potentially allow for an alleviation of inflammatory and apoptotic pathways in the critical phase of reperfusion. The direct cooling of arte...
Source: Journal of Thermal Biology - Category: Biology Source Type: research
Background: Compelling evidence from preclinical and clinical studies has shown that mild hypothermia is neuroprotective against ischemic stroke. We investigated neuroprotectiveeffect of post-risperidone (RIS) treatment against transient ischemic injury and its mechanisms in the gerbil brain.
Source: Resuscitation - Category: Emergency Medicine Authors: Tags: AP163 Source Type: research
CONCLUSION: This study showed an inhibitory effect of C+P on brain inflammation, which may be partially dependent on drug-induced hibernation, as well as other mechanisms of action by these drugs. These findings further suggest the great potential of C+P in the clinical treatment of ischemic stroke. PMID: 31232236 [PubMed - as supplied by publisher]
Source: Current Neurovascular Research - Category: Neurology Authors: Tags: Curr Neurovasc Res Source Type: research
In this issue of the Journal, Ghoreishi and colleagues1 have performed a tour de force in attempting to analyze 5 major factors potentially associated with stroke after type A aortic dissection repair. The etiology of stroke after aortic surgery is an entanglement of numerous complex factors that place patients at risk for both ischemic and embolic neurologic insults. Decisions about the extent of surgical repair, cannulation site, cerebral perfusion strategy, and degree of hypothermia are all interrelated.
Source: The Journal of Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Commentary Source Type: research
In conclusion, mild hypothermia alleviated diabetes aggravated cerebral ischemic injury via activating autophagy and inhibiting pyroptosis. PMID: 31082455 [PubMed - as supplied by publisher]
Source: Brain Research Bulletin - Category: Neurology Authors: Tags: Brain Res Bull Source Type: research
Authors: Han Y, Rajah GB, Hussain M, Geng X Abstract The damage caused by ischemic stroke is mostly refractory to medical therapies and amounts to a substantial degree of mortality and morbidity in the world. The core tenet of treatment for acute ischemic stroke (AIS) is to save 'reversible' ischemic tissue (ischemic penumbra) as quickly as possible within a limited therapeutic time window. The neuroprotective effect of hypothermia has been proven previously in a large number of animal experiments and clinical trials. Some of these animal and human studies have shown that pre-reperfusion hypothermia can reduce myoc...
Source: Neurological Research - Category: Neurology Tags: Neurol Res Source Type: research
Conclusion: Using three different strategies to either prevent formation or enhance elimination of O2⋅_ during the post-asphyxial period, we saw both reduced leukocyte adherence and preserved BBB function with treatment. These findings suggest that agents which lower O2⋅_ in brain may be attractive new therapeutic interventions for the protection of the neonatal brain following asphyxia. Introduction Asphyxia is a relatively common source of neonatal brain damage (1), affecting ~2 in every 1,000 births (2). The hypoxic ischemia resulting from this oxygen deprivation can produce long-term sequelae, includi...
Source: Frontiers in Neurology - Category: Neurology Source Type: research
Conclusions Stroke comprises ischemic stroke and ICH. The immuno-inflammatory process is involved in neural plasticity following events such as a hemorrhage or ischemic stroke. After ischemia, astrocytes, microglia, and MDMs play important roles during rehabilitation with the modulation of cytokines or chemokines, such as TNF-α and IL-1. Moreover, MiRNAs are also important posttranscriptional regulators in these glial mitochondrial responses to cerebral ischemia. ICH involves processes similar and different to those seen in ischemia, including neuronal injury, astrocytic and microglial/macrophage activation, and neu...
Source: Frontiers in Psychiatry - Category: Psychiatry Source Type: research
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