Nitric Oxide–Related Brain Damage in Acute Ischemic Stroke

Abstract

Background and Purpose-The neurotoxic and neuroprotective role of nitric oxide (NO) in experimental cerebral ischemia has generated considerable debate. The aim of this study was to analyze the relationship between NO metabolite (NO-m) concentrations in cerebrospinal fluid (CSF) and clinical and neuroimaging parameters of brain injury in patients with acute ischemic stroke. Methods-We studied 102 patients and 24 control subjects who were included in a larger previous study conducted to analyze risk factors of progressing stroke. NO generation was calculated by quantifying nitrates and nitrites with a colorimetric assay in CSF samples obtained within the first 24 hours from symptoms onset. Early neurological deterioration was defined as a fall of 1 or more points in Canadian Stroke Scale score between admission and 48 hours after inclusion. Infarct volume was measured on days 4 to 7 by cranial CT. Results-Median

Plasma and Cerebrospinal Fluid Homocysteine, Nitric Oxide and Malondialdehyde Levels in Acute Ischemic Stroke: Possible Role of Free Radicals in the Development of Brain Injury

“…The significant elevation of NO is most probably due to the induction of NO synthase by the effect of ischemic condition. Such an observed increase in CSF NO levels in our patients matches the observation of Castillo et al (33) and raise NO levels in plasma seems to be consistent with El-Kossi et al study (8).…”

“…Those studies indicate that in patients who suffer from ischemic stroke there is a strong induction of NO production within the CNS which is hypothesized to contribute to oxidative stress and subsequent neuronal damage. In Castillo et al study, it was also shown that increased NO in CSF of stroke patients is associated with a greater brain injury and early neurological deterioration (33). A significant negative correlation was found between duration of diabetes with CSF NO.…”

“…Castillo et al (33) have previously shown that significantly increased NO in CSF of ischemic stroke patients. Those studies indicate that in patients who suffer from ischemic stroke there is a strong induction of NO production within the CNS which is hypothesized to contribute to oxidative stress and subsequent neuronal damage.…”

Blood Biomarkers of Ischemic Stroke

“…MMP-9 and MMP-13 independently predict lesion volume expansion in ischemic stroke [56]. CSF nitric oxide levels >5umol/ml also predict END [70].…”

Nitric oxide in cerebrospinal fluid of central nervous system tuberculosis: correlations with culture, antibody response, and cell count

“…The metabolic pathways and the half-life of nitrite in the CSF are still unknown (21). In a study on TBM, increased levels of NO along with arginine were found to be of significance in neuronal death (22).…”