Inflammatory Response of Ischemic Tolerance in Circulating Plasma: Preconditioning-Induced by Transient Ischemic Attack (TIA) Phenomena in Acute Ischemia Patients (AIS)

Abstract

Inflammation Response of Prior TIA days before IS. These two proteins showed an earlier inflammation profile that was not detectable by the biomarker panel. Conclusion:Inflammatory pathways were activated by transient ischemic attack, however the period of time between this event and a further ischemic stroke could be determined by a protein signature that would contribute to define the role of ischemic tolerance induced by TIA.

LncRNA KCNQ1OT1 predicts further cerebral events in patients with transient ischemic attack

“…Recent research revealed that patients whose systolic blood pressure was over 140 mmHg exposed a higher risk of recurring neurological dysfunction (de Havenon et al, 2021). Moreover, studies also discovered that further stroke was more likely to happen in TIA patients with intracranial atherosclerosis and aberrant inflammatory response (Luijendijk et al, 2011;Colas-Campas et al, 2020;Lindenholz et al, 2020). In the previous study, we have proven that overactivated autophagy and apoptosis of neurons could exacerbate cerebral ischemia-reperfusion injury and aggravated neurological impairments (Yu et al, 2020;Yu et al, 2021).…”

Transient Ischemic Attacks Preceding Ischemic Stroke and the Possible Preconditioning of the Human Brain: A Systematic Review and Meta-Analysis

“…On cellular and molecular levels, there are a few mechanisms that might contribute to the IPC in patients with TIAs prior to the stroke events compared with those without TIA history. For example, a few comparative studies demonstrated that patients with TIAs prior to strokes have lower levels of specific inflammatory markers that are known to get elevated as a part of the brain tissue response to ischemia in comparison with patients without TIAs ( 37 , 41 ). Accordingly, it is suggested that TIAs boost the brain capacity to downregulate inflammatory responses, limiting the inflammatory response triggered by ischemic strokes.…”

“…Accordingly, it is suggested that TIAs boost the brain capacity to downregulate inflammatory responses, limiting the inflammatory response triggered by ischemic strokes. Consequently, this can lead to better clinical outcomes ( 41 ). Additionally, there are a few other mechanisms of ischemic tolerance that act on cellular and subcellular levels, including new protein synthesis, activation of adenosine A1 receptors leading to the opening of adenosine-triphosphate-dependent potassium channels, stimulation of NMDA receptors, upregulation of antioxidant enzymes, and overexpression of the immediate early genes and apoptosis suppression genes ( 22 , 33 , 50 ).…”

“…Secondly, TIA patients might be more aware of their symptoms; they may seek medical advice and be hospitalized when they develop the subsequent acute ischemic stroke (AIS), which implies faster access to treatment than stroke patients without prior history of TIA ( 40 ). Moreover, the different mechanisms of stroke in TIA patients might act as a confounding factor since TIA was more common in patients who have intracranial atherosclerosis when compared with patients with cardioembolism ( 37 , 41 ). Knowing that cardioembolism is associated with larger-size ischemic brain infarcts as compared with atherosclerosis-related strokes ( 52 , 53 ), it could be assumed that patients with stroke due to atherosclerotic etiology might have a better functional outcome than patients with stroke from a cardioembolic source due to the larger size of the cardioembolic strokes, and the higher availability of collateral vascular pathways in patients with atherosclerosis ( 53 ) regardless of the neuroprotective of TIA.…”

“…Although several observational studies showed a positive impact of a prior TIA on the neurologic functional outcome of a following ischemic event ( 21 , 22 , 33 – 38 , 41 , 45 , 51 , 54 , 55 ), there are a few reports that failed to confirm this ( 39 , 40 ). Our pooled analysis showed a statistically significant difference between TIA patients and non-TIA patients regarding the initial NIHSS score after a stroke event and the mRS scores on discharge.…”