Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches
Abstract
:1. Introduction
2. Neuroinflammation in Ischemic Stroke
3. Roles of Cytokines in Cerebral Ischemia
3.1. TNF-α
3.2. IL-1β
3.3. IL-6
3.4. IFN-γ
4. Role of Anti-Inflammatory Cytokines
5. Pro and Anti-Inflammatory Cytokine Interplay in Ischemic Stroke
6. Recruitment of Inflammatory Cells in Ischemic Brain Injury
6.1. Microglia
6.2. Astrocytes
6.3. Neutrophils
6.4. T Lymphocytes
7. The Interplay between Immune Cell Populations in Ischemic Stroke
8. The Interaction between Brain and Heart: Cardiac Complications after Stroke
8.1. Myocardial Injury as a Consequence of Brain Damage
8.2. Ischemic Stroke Caused Cardiac Injury
8.3. Mechanisms Underlying Brain–Heart Interaction
9. Cardioembolic Stroke
9.1. Risk Factors for Cardioembolic Stroke
9.1.1. Atrial Fibrillation
9.1.2. Heart Failure
9.1.3. Patent Foramen Ovale
9.1.4. Myocardial Infarction
9.1.5. Prosthetic Heart Valves
9.1.6. Infective Endocarditis
9.1.7. Other Causes
10. Diagnostic Criteria for Cardioembolic Stroke
11. Inflammation Background in Cardioembolic Stroke
12. Therapeutic Strategy for Cardioembolic Stroke
13. Potential Treatment Strategies in Neuroinflammation after Ischemic Stroke
14. Discussion
Author Contributions
Funding
Conflicts of Interest
References
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Target | Subjects | Result | Reference |
---|---|---|---|
Interleukin (IL)-1 | IL-1a and IL-1b deficient mice | Subjects showed a reduction of the ischemic area compared to wild-type mice | H. Boutin, R.A. LeFeuvre, R. Horai, M. Asano, Y. Iwakura, and N.J. Rothwell, “Role of IL-1α and IL-1β in ischemic brain damage,” The Journal of Neuroscience, vol. 21, no. 15, pp. 5528–5534, 2001. |
IL-1 | Mice treated with rhIL-1ra after the ligation of a carotid artery | Subjects showed a reduction of neurological deficit | Martin D, Chinookoswong N, Miller G. The interleukin-1 receptor antagonist (rhIL-1ra) protects against cerebral infarction in a rat model of hypoxia-ischemia. Exp Neurol 1994; 130(2): 362–367. |
Tumor necrosis factor (TNF)-α | Mice treated with antibodies anti-TNF-α after reversible temporary occlusion of the middle cerebral artery (MCAO) | Subjects showed a better neurological outcome | Lavine SD, Hofman FM, Zlokovic BV. Circulating antibody against tumor necrosis factor-alpha protects rat brain from reperfusion injury. J Cereb Blood Flow Metab 1998; 18(1): 52–58. |
IL-10 | IL-1T mice after permanent MCAO | Subjects showed a 40% reduction of the area involved in ischemia | F. de Bilbao, D. Arsenijevic, T. Moll et al., “In vivo overexpression of interleukin-10 increases resistance to focal brain ischemia in mice,” Journal of Neurochemistry, vol. 110, no. 1, pp. 12–22, 2009 |
Insulin-like growth factor 1 (IGF-1) | Mice treated with IGF-1 subcutaneously after permanent MCAO | Subjects showed a reduction of the ischemic area with an improvement of sensibility and mobility | D. de Geyter, W. Stoop, S. Sarre, J. de Keyser, and R. Kooijman, “Neuroprotective efficacy of subcutaneous insulin-like growth factor-I administration in normotensive and hypertensive rats with an ischemic stroke,” Neuroscience, vol. 250, pp. 253–262, 2013. |
TLR4 | Knock out mice for TLR4 24 h after induced cerebral ischemia and successive reperfusion | Subjects showed a reduction of the ischemic area compared to wild-type mice | K. Hyakkoku, J. Hamanaka, K. Tsuruma et al., “Toll-like receptor 4 (TLR4), but not TLR3 or TLR9, knock-out mice have neuroprotective effects against focal cerebral ischemia,” Neuroscience, vol. 171, no. 1, pp. 258–267, 2010. |
T cells | Mice deficient in T cell subsets | Subjects showed a smaller ischemic area compared to wild-type mice | Hurn PD, Subramanian S, Parker SM, et al. T- and B- cell-deficient mice with experimental stroke have reduced lesion size and inflammation. J Cereb Blood Flow Metab 2007; 27: 1798–1805. |
Leukocyte very late antigen-4 and endothelial vascular cell adhesion molecule-1 | Mice affected by cerebral ischemia | The inhibition of these molecules resulted in a reduction of the leukocytes’ recruitment in ischemic parenchyma with consequent decreased neuronal damage | Liesz A1, Zhou W, Mracskó É, Karcher S, Bauer H, Schwarting S, Sun L, Bruder D, Stegemann S, Cerwenka A, Sommer C, Dalpke AH, Veltkamp R. Inhibition of lymphocyte trafficking shields the brain against deleterious neuroinflammation after stroke. Brain. 2011 Mar;134(Pt 3):704–20. DOI: 10.1093/brain/awr008. |
Hypoxia-inducible factor (HIF)-1α | Ischemic cerebral tissue in vitro | The stimulation of HIF-1α resulted in a reduced neuronal death, on the other hand, its suppression by small interfering RNA (siRNA) was associated with increased production of reactive oxygen species (ROS) | Guo S, Miyake M, Liu KJ, Shi H. Specific inhibition of hypoxia-inducible factor exaggerates cell injury induced by in vitro ischemia through deteriorating cellular redox environment. J Neurochem 2009; 5:1309–1321. |
HIF-1α | Mice after induced MCAO | The inhibition of HIF-1α was associated with a better neurological outcome by the suppression of BNIP3 (BCL2/adenovirus E1B 19 kDa protein-interacting protein 3) which is responsible for mitochondrial dysfunction | Chen C, Hu Q, Yan J, Lei J, Qin L, Shi X, Luan L, Yang L, Wang K, Han J, Nanda A, Zhou C., Multiple effects of 2ME2 and D609 on the cortical expression of HIF-1α and apoptotic genes in a middle cerebral artery occlusion-induced focal ischemia rat model. J Neurochem. 2007 |
HIF-1α | Mice after 30-min MCAO | The inhibition of HIF-1α was associated with a worse neurological outcome | Baranova O, Miranda LF, Pichiule P, Dragatsis I, Johnson RS, Chavez JC. Neuron-specific inactivation of the hypoxia-inducible factor 1α increases brain injury in a mouse model of transient focal cerebral ischemia. J Neurosci 2007; 23:6320–6332. |
HIF-1α | Mice after 75-min bilateral occlusion of carotid arteries | The stimulation of HIF-1α was associated with a worse neurological outcome | Helton R, Cui J, Scheel JR, Ellison JA, Ames C, Gibson C, Blouw B, Ouyang L, Dragatsis I, Zeitlin S, Johnson RS, Lipton SA, Barlow C. Brain-specific knock-out of hypoxia-inducible factor-1α reduces rather than increases hypoxic-ischemic damage. J Neurosci 2005;16: 4099–4107. |
Heme oxygenase (HO)-1 | Rats treated with viral carries expressing HO-1 after MCAO | Subjects showed a reduction of the ischemic area and an improvement of the neurological symptomatology | Chao XD, Ma YH, Luo P, et al. Up-regulation of heme oxygenase-1 attenuates brain damage after cerebral ischemia via simultaneous inhibition of superoxide production and preservation of NO bioavailability. Exp Neurol 2013; 239: 163–9. |
HO-1 | Transgenic mice expressing HO-1 after permanent MCAO | Subjects showed a reduction of the ischemic area and an improvement of the neurological symptomatology | Panahian N, Yoshiura M, Maines MD. Overexpression of heme oxygenase-1 is neuroprotective in a model of permanent middle cerebral artery occlusion in transgenic mice. J Neurochem 1999; 72: 1187–203. |
HO-1 | HO-1 knockout mice affected by cerebral ischemia | Subjects showed an increased ischemic area compared to wild-type mice | Shah ZA, Nada SE, Dore S. Heme oxygenase 1, beneficial role in permanent ischemic stroke and in Gingko biloba (EGb 761) neuroprotection. Neuroscience 2011; 180: 248–55. |
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Maida, C.D.; Norrito, R.L.; Daidone, M.; Tuttolomondo, A.; Pinto, A. Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches. Int. J. Mol. Sci. 2020, 21, 6454. https://doi.org/10.3390/ijms21186454
Maida CD, Norrito RL, Daidone M, Tuttolomondo A, Pinto A. Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches. International Journal of Molecular Sciences. 2020; 21(18):6454. https://doi.org/10.3390/ijms21186454
Chicago/Turabian StyleMaida, Carlo Domenico, Rosario Luca Norrito, Mario Daidone, Antonino Tuttolomondo, and Antonio Pinto. 2020. "Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches" International Journal of Molecular Sciences 21, no. 18: 6454. https://doi.org/10.3390/ijms21186454
APA StyleMaida, C. D., Norrito, R. L., Daidone, M., Tuttolomondo, A., & Pinto, A. (2020). Neuroinflammatory Mechanisms in Ischemic Stroke: Focus on Cardioembolic Stroke, Background, and Therapeutic Approaches. International Journal of Molecular Sciences, 21(18), 6454. https://doi.org/10.3390/ijms21186454