Coagulation and Aging: Implications for the Anesthesiologist

Tschan, Sarina; Bolliger, Daniel

doi:10.1007/s40140-021-00498-7

Cited by 14 publications

(14 citation statements)

References 80 publications

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“…For example, age-related increase in plasma levels of coagulation factors (eg, fibrinogen, factors V, VII, VIII, IX, and XI) leads to a procoagulable state in the elderly and increases the risk of poststroke complications. 171 Hemorrhagic transformation is more pronounced in aged versus young mice relative to infarct size, which is related to an earlier influx of neutrophils into the aged brain that produce MMPs (metalloproteinases) and leads to BBB disruption. 172 The subsequent complement activation and the recruitment of phagocytes and granulocytes (ie, MG, mast cells, neutrophils, and macrophages) initiate the clearance of injured neuroglia.…”

Section: The Immune Response Is Different After Aged Strokementioning

confidence: 99%

Aging Microbiota-Gut-Brain Axis in Stroke Risk and Outcome

Honarpisheh

Bryan

McCullough

2022

Circulation Research

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The microbiota-gut-brain-axis (MGBA) is a bidirectional communication network between gut microbes and their host. Many environmental and host-related factors affect the gut microbiota. Dysbiosis is defined as compositional and functional alterations of the gut microbiota that contribute to the pathogenesis, progression and treatment responses to disease. Dysbiosis occurs when perturbations of microbiota composition and function exceed the ability of microbiota and its host to restore a symbiotic state. Dysbiosis leads to dysfunctional signaling of the MGBA, which regulates the development and the function of the host’s immune, metabolic, and nervous systems. Dysbiosis-induced dysfunction of the MGBA is seen with aging and stroke, and is linked to the development of common stroke risk factors such as obesity, diabetes, and atherosclerosis. Changes in the gut microbiota are also seen in response to stroke, and may impair recovery after injury. This review will begin with an overview of the tools used to study the MGBA with a discussion on limitations and potential experimental confounders. Relevant MGBA components are introduced and summarized for a better understanding of age-related changes in MGBA signaling and its dysfunction after stroke. We will then focus on the relationship between the MGBA and aging, highlighting that all components of the MGBA undergo age-related alterations that can be influenced by or even driven by the gut microbiota. In the final section, the current clinical and preclinical evidence for the role of MGBA signaling in the development of stroke risk factors such as obesity, diabetes, hypertension, and frailty are summarized, as well as microbiota changes with stroke in experimental and clinical populations. We conclude by describing the current understanding of microbiota-based therapies for stroke including the use of pre-/pro-biotics and supplementations with bacterial metabolites. Ongoing progress in this new frontier of biomedical sciences will lead to an improved understanding of the MGBA’s impact on human health and disease.

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Section: The Immune Response Is Different After Aged Strokementioning

confidence: 99%

Aging Microbiota-Gut-Brain Axis in Stroke Risk and Outcome

Honarpisheh

Bryan

McCullough

2022

Circulation Research

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“…As a result, the innate immune system is affected, and populations of dendritic cells, macrophages, and neutrophils decline [ 42 , 43 , 44 ]. In addition, the endothelial dysfunction with altered microcirculation, several coagulation factors, and platelet reactivity elevates [ 45 ], possibly leading to type I occlusions poor of neutrophil releasing NE but rich in cells from the hypercoagulation pathway.…”

Section: Discussionmentioning

confidence: 99%

A Pleomorphic Puzzle: Heterogeneous Pulmonary Vascular Occlusions in Patients with COVID-19

Singh

Herrmann

Mahajan

et al. 2022

IJMS

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Vascular occlusions in patients with coronavirus diseases 2019 (COVID-19) have been frequently reported in severe outcomes mainly due to a dysregulation of neutrophils mediating neutrophil extracellular trap (NET) formation. Lung specimens from patients with COVID-19 have previously shown a dynamic morphology, categorized into three types of pleomorphic occurrence based on histological findings in this study. These vascular occlusions in lung specimens were also detected using native endogenous fluorescence or NEF in a label-free method. The three types of vascular occlusions exhibit morphology of DNA rich neutrophil elastase (NE) poor (type I), NE rich DNA poor (type II), and DNA and NE rich (type III) cohort of eleven patients with six males and five females. Age and gender have been presented in this study as influencing variables linking the occurrence of several occlusions with pleomorphic contents within a patient specimen and amongst them. This study reports the categorization of pleomorphic occlusions in patients with COVID-19 and the detection of these occlusions in a label-free method utilizing NEF.

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“…Age influences the processes involved in the early response to stroke, including the age-related increase in the level of coagulation factors in the blood which leads to procoagulation in the elderly and increases the risk of post-stroke complications ( Tschan and Bolliger, 2021 ). Hemorrhagic transformation of stroke is more common in older mice than in young mice compared to the size of the infarction, which is related to the earlier influx of neutrophils into the aging brain that produce metalloproteinases and this leads to damage of the blood-brain barrier ( Ritzel et al, 2018 ).…”

Section: Ischemic Stroke and The Intestinal Microfloramentioning

confidence: 99%

Crosstalk between the aging intestinal microflora and the brain in ischemic stroke

Pluta

Jabłoński

Januszewski

et al. 2022

Front. Aging Neurosci.

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Aging is an inevitable phenomenon experienced by animals and humans, and its intensity varies from one individual to another. Aging has been identified as a risk factor for neurodegenerative disorders by influencing the composition of the gut microbiota, microglia activity and cognitive performance. The microbiota-gut-brain axis is a two-way communication path between the gut microbes and the host brain. The aging intestinal microbiota communicates with the brain through secreted metabolites (neurotransmitters), and this phenomenon leads to the destruction of neuronal cells. Numerous external factors, such as living conditions and internal factors related to the age of the host, affect the condition of the intestinal microflora in the form of dysbiosis. Dysbiosis is defined as changes in the composition and function of the gut microflora that affect the pathogenesis, progress, and response to treatment of a disease entity. Dysbiosis occurs when changes in the composition and function of the microbiota exceed the ability of the microflora and its host to restore equilibrium. Dysbiosis leading to dysfunction of the microbiota-gut-brain axis regulates the development and functioning of the host’s nervous, immune, and metabolic systems. Dysbiosis, which causes disturbances in the microbiota-gut-brain axis, is seen with age and with the onset of stroke, and is closely related to the development of risk factors for stroke. The review presents and summarizes the basic elements of the microbiota-gut-brain axis to better understand age-related changes in signaling along the microbiota-gut-brain axis and its dysfunction after stroke. We focused on the relationship between the microbiota-gut-brain axis and aging, emphasizing that all elements of the microbiota-gut-brain axis are subject to age-related changes. We also discuss the interaction between microbiota, microglia and neurons in the aged individuals in the brain after ischemic stroke. Finally, we presented preclinical and clinical studies on the role of the aged microbiota-gut-brain axis in the development of risk factors for stroke and changes in the post-stroke microflora.

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Coagulation and Aging: Implications for the Anesthesiologist

Cited by 14 publications

References 80 publications

Aging Microbiota-Gut-Brain Axis in Stroke Risk and Outcome

Aging Microbiota-Gut-Brain Axis in Stroke Risk and Outcome

A Pleomorphic Puzzle: Heterogeneous Pulmonary Vascular Occlusions in Patients with COVID-19

Crosstalk between the aging intestinal microflora and the brain in ischemic stroke

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