Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke

Leys, Didier; Hommet, Yannick; Jacquet, Clémence; Moulin, Solène; Sibon, Igor; Mas, Jean‐Louis; Moulin, Thierry; Giroud, Maurice; Sagnier, Sharmila; Cordonnier, Charlotte; Bustos, Elisabeth Medeiros de; Turc, Guillaume; Ronzière, Thomas; Béjot, Yannick; Detante, Olivier; Ouk, Thavarak; Mendyk, Anne‐Marie; Favrole, Pascal; Zuber, Mathieu; Triquenot-Bagan, Aude; Ozkul-Wermester, Ozlem; Montoro, Francisco Macian; Lamy, Chantal; Faivre, Anthony; Lebouvier, Laurent; Potey, Camille; Poli, Mathilde; Hénon, Hilde; Renou, Pauline; Dequatre‐Ponchelle, Nelly; Bodenant, Marie; Debruxelles, Sabrina; Rossi, Costanza; Bordet, Régis; Vivien, Denis

doi:10.1212/wnl.0000000000003399

Cited by 12 publications

(4 citation statements)

References 35 publications

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“…Both forms have the same fibrinolytic activity, but they differ in the activation of the N-methyl-D-aspartate receptor (NMDAR). The sc-rt-PA form activates the NMDAR, leading to calcium entry and excitotoxic neuronal death, whereas the tc-rt-PA form inhibits NMDAR and its secondary neurotoxicity [ 11 , 28 ]. In animal models, the rt-PA-mediated neurotoxicity varies in relation to the ratio between the sc and tc forms [ 29 ], data recently confirmed in human [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

Worse Outcome in Stroke Patients Treated with rt-PA Without Early Reperfusion: Associated Factors

Iglesias‐Rey

Rodríguez‐Yáñez

Rodríguez‐Castro

et al. 2017

Transl. Stroke Res.

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Based on preclinical studies suggesting that recombinant tissue plasminogen activator (rt-PA) may promote ischemic brain injuries, we investigated in patients the possible risk of worse clinical outcome after rt-PA treatment as a result of its inability to resolve cerebral ischemia. Here, we designed a cohort study using a retrospective analysis of patients who received treatment with intravenous (4.5-h window) or intraarterial rt-PA, without or with thrombectomy. Controls were consecutive patients who did not receive recanalization treatment, who met all inclusion criteria. As a marker of reperfusion, we defined the variable of early neurological improvement as the difference between the score of the National Institute of Health Stroke Scale (NIHSS) (at admission and 24 h). The main variable was worsening of the patient’s functional situation in the first 3 months. To compare quantitative variables, we used Student’s t test or the Mann-Whitney test. To estimate the odds ratios of each independent variable in the patient’s worsening in the first 3 months, we used a logistic regression model. We included 1154 patients; 577 received rt-PA, and 577 served as controls. In the group of patients treated with rt-PA, 39.4% who did not present clinical reperfusion data developed worsening within 3 months after stroke compared with 3.5% of patients with reperfusion (P < 0.0001). These differences were not significant in the control group. In summary, administration of rt-PA intravenously or intraarterially without reperfusion within the first 24 h may be associated with a higher risk of functional deterioration in the first 3 months.

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Section: Discussionmentioning

confidence: 99%

Worse Outcome in Stroke Patients Treated with rt-PA Without Early Reperfusion: Associated Factors

Iglesias‐Rey

Rodríguez‐Yáñez

Rodríguez‐Castro

et al. 2017

Transl. Stroke Res.

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“…The fourth section evaluated stroke functional and mortality outcome at discharge through the modified Rankin scale (mRS) which is subdivided into two categories: cutoff value of 3 and above defined as a poor prognosis and ˂3 as good prognosis (Banks & Marotta, 2007 ; Powers et al., 2015 ). Also, detailed information pertinent to PSS was collected from patients` medical records through the following questions: “is the seizure new or recurrent, timing of seizure poststroke, seizure subtype, medications given to treat seizure, and anti‐epileptic drug administered at discharge to prevent recurrence.” The data collection sheet was inspired by several recent studies focusing on the pathogenesis, prevalence, risk factors, detection, management, and clinical outcome of early seizure in different stroke types (Feher et al., 2020 ; Huang et al., 2014 ; Leys et al., 2016 ; Zhang et al., 2014 ).…”

Section: Methodsmentioning

confidence: 99%

“…Also, detailed information pertinent to PSS was collected from patients` medical records through the following questions: "is the seizure new or recurrent, timing of seizure poststroke, seizure subtype, medications given to treat seizure, and anti-epileptic drug administered at discharge to prevent recurrence." The data collection sheet was inspired by several recent studies focusing on the pathogenesis, prevalence, risk factors, detection, management, and clinical outcome of early seizure in different stroke types (Feher et al, 2020;Huang et al, 2014;Leys et al, 2016;Zhang et al, 2014).…”

Section: Data Collectionmentioning

confidence: 99%

Assessment of the incidence and risk factors of early poststroke seizures in Lebanese patients

et al. 2021

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Stroke is a cerebrovascular disorder characterized by sudden disruption of blood supply into the brain leading to injury and subsequent neurological deficit. It is estimated that the majority of stroke cases (80%) is due to the occlusion of a blood vessel by a clot resulting in an ischemic stroke (Feigin et al., 2015).Complications frequently develop after ischemic stroke and play an important role in determining the final clinical outcome and prognosis in stroke patients. Many of the complications can be prevented

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“…Further structural motifs include an EGF-like domain that interacts with the EGFR and Kringle 1 and 2 domains, where the latter binds to NMDAR ( Correa et al, 2011 ; Lesept et al, 2016 ). tPA is released as single chain and processed to its active form by plasmin or kallikrein ( Leys et al, 2016 ). High concentrations of tPA can exert neurotoxic effects by stimulating the NMDAR ( Bertrand et al, 2015 ; Chevilley et al, 2015 ; Wu et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Low-density lipoprotein receptor-related protein-1 (LRP1) in the glial lineage modulates neuronal excitability

Faissner

2023

Front. Netw. Physiol.

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The low-density lipoprotein related protein receptor 1 (LRP1), also known as CD91 or α-Macroglobulin-receptor, is a transmembrane receptor that interacts with more than 40 known ligands. It plays an important biological role as receptor of morphogens, extracellular matrix molecules, cytokines, proteases, protease inhibitors and pathogens. In the CNS, it has primarily been studied as a receptor and clearance agent of pathogenic factors such as Aβ-peptide and, lately, Tau protein that is relevant for tissue homeostasis and protection against neurodegenerative processes. Recently, it was found that LRP1 expresses the Lewis-X (Lex) carbohydrate motif and is expressed in the neural stem cell compartment. The removal of Lrp1 from the cortical radial glia compartment generates a strong phenotype with severe motor deficits, seizures and a reduced life span. The present review discusses approaches that have been taken to address the neurodevelopmental significance of LRP1 by creating novel, lineage-specific constitutive or conditional knockout mouse lines. Deficits in the stem cell compartment may be at the root of severe CNS pathologies.

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Proportion of single-chain recombinant tissue plasminogen activator and outcome after stroke

Cited by 12 publications

References 35 publications

Worse Outcome in Stroke Patients Treated with rt-PA Without Early Reperfusion: Associated Factors

Worse Outcome in Stroke Patients Treated with rt-PA Without Early Reperfusion: Associated Factors

Assessment of the incidence and risk factors of early poststroke seizures in Lebanese patients

Low-density lipoprotein receptor-related protein-1 (LRP1) in the glial lineage modulates neuronal excitability

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