Aquaporin-4 autoantibodies increase vasogenic edema formation and infarct size in a rat stroke model

Juenemann, Martin; Braun, Tobias; Doenges, Simone; Nedelmann, Max; Mueller, Clemens; Bachmann, Georg; Singh, Pratibha; Blaes, Franz; Gerriets, Tibo; Tschernatsch, Marlene

doi:10.1186/s12865-015-0087-y

Cited by 15 publications

(9 citation statements)

References 42 publications

(54 reference statements)

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“… [6] In a rat model, AQP4 antibodies have been demonstrated to worsen edema in the event of an ischemic stroke. [7] Furthermore, AQP4 antibodies may also damage the structural integrity of astrocytes by way of some immunoregulatory pathway, such as the activation of the classical complement cascade, or granulocyte recruitment, which consequently increases blood brain barrier (BBB) permeability. [8] It should also be noted that AQP4-dependent water flow through the cell membrane is an important mechanism for angioedema alleviation.…”

Section: Discussionmentioning

confidence: 99%

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Acute bilateral cerebral infarction in the presence of neuromyelitis optica spectrum disorder

Wang

Wang²,

Guo³

et al. 2020

Medicine

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Rationale: Neuromyelitis optica spectrum disorders (NMOSDs) are inflammatory demyelinating disorders of the central nervous system; they are characterized by severe optic neuritis and transverse myelitis. Intravenous methylprednisolone pulse (IVMP) therapy is an effective treatment that is administered to patients in the acute phase of NMOSD; this therapy has achieved remarkable results in clinical practice. However, there are no reports on NMOSD patients who have experienced an acute bilateral cerebral infarction while undergoing IVMP treatment. Patient concerns: We report on a 62-yr-old woman who was undergoing IVMP therapy for the primary diagnosis of NMOSD. Unexpectedly, the patient's existing limb weakness worsened, and she developed motor aphasia on the second day of IVMP treatment. Additionally, brain magnetic resonance imaging revealed acute bilateral cerebral infarction. Diagnosis: The patient's clinical manifestations, medical imaging results, and laboratory test results were taken into consideration; the final diagnosis was acute bilateral cerebral infarction in the presence of NMOSD. Interventions: Subsequent to the onset of acute cerebral infarction, the patient was immediately treated with oral aspirin, atorvastatin, and intravenous butylphthalide. The hormone dose was adjusted to an oral 60-mg/d dose for maintenance; this was followed by immunoadsorption plasmapheresis for 3 days, and double-filtration plasmapheresis for 2 days. Outcomes: Following treatment onset, the patient's ocular symptoms significantly improved, and her limb muscle strength gradually recovered. Two months after discharge, the patient's husband reported that she was able to walk with the help of others and take care of herself, and that there was no recurrence. Lessons: Medical professionals must be aware of the possibility of NMOSD patients with cerebrovascular risk factors suffering an acute cerebral infarction while undergoing high-dose IVMP therapy, as this therapy can exacerbate existing problems.

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Section: Discussionmentioning

confidence: 99%

“… [9] Once a cerebral infarction occurs, AQP4 antibodies can also down-regulate the expression of the glutamate transporter EAAT2, which causes glutamate circulation disorders and results in a more severe infarction. [7] …”

Section: Discussionmentioning

confidence: 99%

Acute bilateral cerebral infarction in the presence of neuromyelitis optica spectrum disorder

Wang

Wang²,

Guo³

et al. 2020

Medicine

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“…Nishiyama et al suggested that certain immunologic events that increase in the Blood brain barrier (BBB) permeability are needed to allow entry and binding to AQP4 on astrocytes [11]. Recently, however, Jueneman et al reported that in a rat stroke model, the animal infused with AQP4 antibodies suffered more vasogenic edema formation as compared to the controls, and that the size of the infarct was larger in the AQP4 antibody infused animals [12].…”

Section: Discussionmentioning

confidence: 99%

Neuromyelitis optica spectrum disorder with massive basal ganglia involvement: a case report

et al. 2019

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BackgroundOccurrence of basal ganglia involvement in neuromyelitis optica spectrum disorders (NMOSD) has rarely been reported and none documented pathologically.Case presentationA 73-year-old female was clinically diagnosed with a NMOSD based on the clinical and radiological features and positive serum autoantibodies to AQP4. One month before her death, she became acutely ill with disturbed consciousness and right hemiparesis, and was diagnosed and treated as having basal ganglia infarction based on the brain CT. She made a partial recovery but later died from heart failure. At autopsy, the corresponding basal ganglia process revealed a large fresh area of necrosis. Histologically, several pathological signatures of NMOSD could be recognized in the lesion, including inflammatory cell infiltrations by B and T lymphocytes, perivascular complement and fibrinogen deposition, and the appearance of numerous phagocytosed corpora amylacea within the infiltrating macrophages.ConclusionsThe present case illustrates that basal ganglia may be directly involved in the pathological processes of NMOSD, although the possibility of modification of the lesions by superimposed regional ischemia could not be excluded.

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“…Measurements were obtained at the level of the maximum lateral displacement of the ventricle. MLS was calculated using the following equation: MLS = (A − B)/2, as described previously [ 23 ].…”

Section: Methodsmentioning

confidence: 99%

The administration of hydrogen sulphide prior to ischemic reperfusion has neuroprotective effects in an acute stroke model

et al. 2017

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Emerging evidence has suggested that hydrogen sulfide (H2S) may alleviate the cellular damage associated with cerebral ischemia/reperfusion (I/R) injury. In this study, we assessed using 1H-magnetic resonance imaging/magnetic resonance spectroscopy (1H-MRI/MRS) and histologic analysis whether H2S administration prior to reperfusion has neuroprotective effects. We also evaluated for differences in the effects of H2S treatment at 2 time points. 1H-MRI/MRS data were obtained at baseline, and at 3, 9, and 24 h after ischemia from 4 groups: sham, control (I/R injury), sodium hydrosulfide (NaHS)-30 and NaHS-1 (NaHS delivery at 30 and 1 min before reperfusion, respectively). The total infarct volume and the midline shift at 24 h post-ischemia were lowest in the NaHS-1, followed by the NaHS-30 and control groups. Peri-infarct volume was significantly lower in the NaHS-1 compared to NaHS-30 and control animals. The relative apparent diffusion coefficient (ADC) in the peri-infarct region showed that the NaHS-1 group had significantly lower values compared to the NaHS-30 and control animals and that NaHS-1 rats showed significantly higher relative T2 values in the peri-infarct region compared to the controls. The relative ADC value, relative T2 value, levels of N-acetyl-L-aspartate (NAA), and the NAA, glutamate, and taurine combination score (NGT) in the ischemic core region at 24 h post-ischemia did not differ significantly between the 2 NaHS groups and the control except that the NAA and NGT values were higher in the peri-infarct region of the NaHS-1 animals at 9 h post-ischemia. In the ischemic core and peri-infarct regions, the apoptosis rate was lowest in the NaHS-1 group, followed by the NaHS-30 and control groups. Our results suggest that H2S treatment has neuroprotective effects on the peri-infarct region during the evolution of I/R injury. Furthermore, our findings indicate that the administration of H2S immediately prior to reperfusion produces the highest neuroprotective effects.

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Aquaporin-4 autoantibodies increase vasogenic edema formation and infarct size in a rat stroke model

Cited by 15 publications

References 42 publications

Acute bilateral cerebral infarction in the presence of neuromyelitis optica spectrum disorder

Acute bilateral cerebral infarction in the presence of neuromyelitis optica spectrum disorder

Neuromyelitis optica spectrum disorder with massive basal ganglia involvement: a case report

The administration of hydrogen sulphide prior to ischemic reperfusion has neuroprotective effects in an acute stroke model

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