Changes in Spleen Size in Patients with Acute Ischemic Stroke: A Pilot Observational Study

Sahota, Preeti; Vahidy, Farhaan S; Nguyen, Claude; Bui, Tuan Anh; Yang, Bing; Parsha, Kaushik; Garrett, Jennifer; Bambhroliya, Arvind; Barreto, Andrew D; Grotta, James C.; Aronowski, Jaroslaw; Rahbar, Mohammad Hossein; Savitz, Sean I

doi:10.1111/ijs.12022

Cited by 74 publications

(78 citation statements)

References 16 publications

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“…The role of the spleen in cerebral ischemia has also been investigated. Both clinical and animal studies have demonstrated transient reduction in spleen size following stroke, which has been attributed to the poststroke deployment of splenocytes, including monocytes [25,[83][84][85]. The extent of spleen atrophy is associated with the severity of stroke-induced brain injury, leading to the view that the spleen plays a contributory role in stroke pathology [26,86].…”

Section: Monocytes and Monocyte-derived Macrophagesmentioning

confidence: 99%

Microglia and Monocyte-Derived Macrophages in Stroke

2016

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Historically, the brain has been considered an immune-privileged organ separated from the peripheral immune system by the blood-brain barrier. However, immune responses do occur in the brain in neurological conditions in which the integrity of the blood-brain barrier is compromised, exposing the brain to peripheral antigens and endogenous danger signals. While most of the associated pathological processes occur in the central nervous system, it is now clear that peripheral immune cells, especially mononuclear phagocytes, that infiltrate into the injury site play a key role in modulating the progression of primary brain injury development. As inflammation is a necessary and critical component for the subsequent injury resolution process, understanding the contribution of mononuclear phagocytes on the regulation of inflammatory responses may provide novel approaches for potential therapies. Furthermore, predisposed comorbid conditions at the time of stroke cause the alteration of stroke-induced immune and inflammatory responses and subsequently influence stroke outcome. In this review, we summarize a role for microglia and monocytes/macrophages in acute ischemic stroke in the context of normal and metabolically compromised conditions.

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Section: Monocytes and Monocyte-derived Macrophagesmentioning

confidence: 99%

Microglia and Monocyte-Derived Macrophages in Stroke

2016

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“…Elevated sympathetic tone has been documented previously in OSA [79] and possibly may contribute to the increased cardiovascular risk, perhaps through spleen contraction and an increase in peripheral MPV. Moreover, Sahota et al [80] found splenic contraction after ischemic stroke followed by a re-expansion. Characterization of the splenic response after stroke and its contribution to cerebral ischemic injury has the potential to provide new opportunities for the development of novel stroke therapies [80].…”

Section: Fainting During Breath-holdmentioning

confidence: 99%

“…Moreover, Sahota et al [80] found splenic contraction after ischemic stroke followed by a re-expansion. Characterization of the splenic response after stroke and its contribution to cerebral ischemic injury has the potential to provide new opportunities for the development of novel stroke therapies [80]. …”

Section: Fainting During Breath-holdmentioning

confidence: 99%

Breath-hold diving as a brain survival response

Dujić

Brešković

Baković

2013

Translational Neuroscience

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Apnea disciplines and current records BREATH HOLD DIVING AS A BRAIN SURVIVAL RESPONSE AbstractElite breath-hold divers are unique athletes challenged with compression induced by hydrostatic pressure and extreme hypoxia/hypercapnia during maximal field dives. The current world records for men are 214 meters for depth (Herbert Nitsch, No-Limits Apnea discipline), 11:35 minutes for duration (Stephane Mifsud, Static Apnea discipline), and 281 meters for distance (Goran Čolak, Dynamic Apnea with Fins discipline). The major physiological adaptations that allow breath-hold divers to achieve such depths and duration are called the "diving response" that is comprised of peripheral vasoconstriction and increased blood pressure, bradycardia, decreased cardiac output, increased cerebral and myocardial blood flow, splenic contraction, and preserved O 2 delivery to the brain and heart. This complex of physiological adaptations is not unique to humans, but can be found in all diving mammals. Despite these profound physiological adaptations, divers may frequently show hypoxic loss of consciousness. The breath-hold starts with an easy-going phase in which respiratory muscles are inactive, whereas during the second so-called "struggle" phase, involuntary breathing movements start. These contractions increase cerebral blood flow by facilitating left stroke volume, cardiac output, and arterial pressure. The analysis of the compensatory mechanisms involved in maximal breath-holds can improve brain survival during conditions involving profound brain hypoperfusion and deoxygenation.

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“…24 The predominant mechanism of action is therefore assumed to be paracrine, with effects on inflammation, immune modulation and stimulation of endogenous recovery processes including neurogenesis and angiogenesis. In animal models of stroke, and also in humans, 25 there is an acute reduction in splenic volume followed by expansion and release of cells that is postulated to mediate secondary inflammatory brain injury. Intravenous stem cell administration appears to modify this response.…”

Section: The Acute or Early Subacute Paradigmmentioning

confidence: 99%

Clinical trial design for stem cell therapies in stroke: What have we learned?

Muir

2017

Neurochemistry International

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Stem cells of various sources have been investigated in a series of small, safety and feasibility-focused studies over the past 15 years. Understanding of mechanisms of action has evolved and the trial paradigms have become focused on two different approaches -one being an early subacute delivery of cells to reduce acute tissue injury and modify the tissue environment in a direction favourable to reparative processes (for example by being anti-inflammatory, antiapoptotic, and encouraging endogenous stem cell mobilisation); the other exploring later delivery of cells during the recovery phase after stroke to modulate the local environment in favour of angiogenesis and neurogenesis. The former approach has generally investigated intravenous or intra-arterial delivery of cells with an expected paracrine mode of action and no expected engraftment within the brain. The latter has explored direct intracerebral implantation adjacent to the infarct. Several relevant trials have been conducted, including two controlled trials of intravenously delivered bone marrow-derived cells in the early subacute stage, and two small singlearm phase 1 trials of intracerebrally implanted cells. The findings of these studies and their implications for future trial design are considered.Introduction:

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Changes in Spleen Size in Patients with Acute Ischemic Stroke: A Pilot Observational Study

Cited by 74 publications

References 16 publications

Microglia and Monocyte-Derived Macrophages in Stroke

Microglia and Monocyte-Derived Macrophages in Stroke

Breath-hold diving as a brain survival response

Clinical trial design for stem cell therapies in stroke: What have we learned?

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