Blood-Brain Barrier Permeability and Kinetics of Inflammatory Markers in Acute Stroke Patients Treated With Thrombectomy.
Journal
Neurology
ISSN: 1526-632X
Titre abrégé: Neurology
Pays: United States
ID NLM: 0401060
Informations de publication
Date de publication:
01 08 2023
01 08 2023
Historique:
received:
15
11
2022
accepted:
13
04
2023
pmc-release:
01
08
2024
medline:
7
8
2023
pubmed:
9
6
2023
entrez:
8
6
2023
Statut:
ppublish
Résumé
The aim of this study was to investigate the relationship between baseline blood-brain barrier (BBB) permeability and the kinetics of circulating inflammatory markers in a cohort of acute ischemic stroke (AIS) patients treated with mechanical thrombectomy. The CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke includes AIS patients treated with mechanical thrombectomy after admission MRI and undergoing a sequential assessment of circulating inflammatory markers. Baseline dynamic susceptibility perfusion MRI was postprocessed with arrival time correction to provide K2 maps reflecting BBB permeability. After coregistration of apparent diffusion coefficient and K2 maps, the 90th percentile of K2 value was extracted within baseline ischemic core and expressed as a percentage change compared with contralateral normal-appearing white matter. Population was dichotomized according to the median K2 value. Univariable and multiple variable logistic regression analyses were performed to investigate factors associated with increased pretreatment BBB permeability in the whole population and in patients with symptom onset <6 hours. In the whole population (n = 105 patients, median K2 = 1.59), patients with an increased BBB permeability had higher serum levels of matrix metalloproteinase (MMP)-9 at H48 ( In AIS patients, increased BBB permeability is associated with a larger ischemic core. In the subgroup of patients with symptom onset <6 hours, increased BBB permeability is independently associated with higher H0 MMP-9 levels and a larger ischemic core.
Sections du résumé
BACKGROUND AND OBJECTIVES
The aim of this study was to investigate the relationship between baseline blood-brain barrier (BBB) permeability and the kinetics of circulating inflammatory markers in a cohort of acute ischemic stroke (AIS) patients treated with mechanical thrombectomy.
METHODS
The CoHort of Patients to Identify Biological and Imaging markerS of CardiovascUlar Outcomes in Stroke includes AIS patients treated with mechanical thrombectomy after admission MRI and undergoing a sequential assessment of circulating inflammatory markers. Baseline dynamic susceptibility perfusion MRI was postprocessed with arrival time correction to provide K2 maps reflecting BBB permeability. After coregistration of apparent diffusion coefficient and K2 maps, the 90th percentile of K2 value was extracted within baseline ischemic core and expressed as a percentage change compared with contralateral normal-appearing white matter. Population was dichotomized according to the median K2 value. Univariable and multiple variable logistic regression analyses were performed to investigate factors associated with increased pretreatment BBB permeability in the whole population and in patients with symptom onset <6 hours.
RESULTS
In the whole population (n = 105 patients, median K2 = 1.59), patients with an increased BBB permeability had higher serum levels of matrix metalloproteinase (MMP)-9 at H48 (
DISCUSSION
In AIS patients, increased BBB permeability is associated with a larger ischemic core. In the subgroup of patients with symptom onset <6 hours, increased BBB permeability is independently associated with higher H0 MMP-9 levels and a larger ischemic core.
Identifiants
pubmed: 37290975
pii: WNL.0000000000207460
doi: 10.1212/WNL.0000000000207460
pmc: PMC10401692
doi:
Substances chimiques
Matrix Metalloproteinase 9
EC 3.4.24.35
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
e502-e511Informations de copyright
© 2023 American Academy of Neurology.
Références
Neuroradiology. 2018 May;60(5):557-563
pubmed: 29574600
J Neurosci. 2005 Jul 6;25(27):6401-8
pubmed: 16000631
PLoS One. 2012;7(12):e52656
pubmed: 23285132
Front Neurol. 2013 Apr 03;4:32
pubmed: 23565108
Nat Rev Neurol. 2019 Aug;15(8):473-481
pubmed: 31263257
Lancet. 1998 Oct 17;352(9136):1245-51
pubmed: 9788453
Ann Neurol. 2004 Oct;56(4):468-77
pubmed: 15389899
Eur Stroke J. 2021 Mar;6(1):I-LXII
pubmed: 33817340
Front Neurol. 2020 Dec 09;11:594672
pubmed: 33362697
PLoS One. 2017 Feb 16;12(2):e0171558
pubmed: 28207745
J Cereb Blood Flow Metab. 2009 Nov;29(11):1846-55
pubmed: 19654585
Stroke. 2003 Dec;34(12):2851-5
pubmed: 14605329
Front Neurol. 2020 Dec 11;11:599908
pubmed: 33362701
Mol Neurobiol. 2014 Feb;49(1):563-73
pubmed: 24026771
Stroke. 2017 Mar;48(3):664-670
pubmed: 28138001
J Cereb Blood Flow Metab. 2018 Jan;38(1):75-86
pubmed: 28481164
Drug Discov Today. 2011 Sep;16(17-18):762-78
pubmed: 21745586
Prog Neurobiol. 2018 Apr - May;163-164:144-171
pubmed: 28987927
Curr Neuropharmacol. 2009 Dec;7(4):269-75
pubmed: 20514206
AJNR Am J Neuroradiol. 2016 Jan;37(1):80-7
pubmed: 26427833
Ther Adv Neurol Disord. 2018 May 22;11:1756286418774254
pubmed: 29854002
Front Cell Neurosci. 2016 Mar 04;10:56
pubmed: 26973468
Neurosurg Focus. 2007 May 15;22(5):E4
pubmed: 17613235
Stroke. 2004 Nov;35(11 Suppl 1):2659-61
pubmed: 15472105
Stroke. 2007 Jun;38(6):1855-9
pubmed: 17478737
J Cereb Blood Flow Metab. 2008 Aug;28(8):1491-501
pubmed: 18478021
J Cereb Blood Flow Metab. 2010 Jun;30(6):1188-99
pubmed: 20197780
Ann Neurol. 2020 Sep;88(3):466-476
pubmed: 32418242
J Cereb Blood Flow Metab. 2003 Dec;23(12):1408-19
pubmed: 14663336
Am J Physiol Cell Physiol. 2019 Feb 1;316(2):C135-C153
pubmed: 30379577
AJNR Am J Neuroradiol. 2006 Apr;27(4):859-67
pubmed: 16611779
Neurology. 2012 Sep 25;79(13 Suppl 1):S52-7
pubmed: 23008413
Stroke. 2014 Apr;45(4):1018-23
pubmed: 24595591
Stroke. 2003 Aug;34(8):2025-30
pubmed: 12855824
Stroke. 2016 Apr;47(4):1165-72
pubmed: 26786115
Stroke. 2014 Jul;45(7):2030-5
pubmed: 24876245
Neurology. 2016 Jul 19;87(3):263-9
pubmed: 27316247
Am J Physiol Cell Physiol. 2018 Sep 1;315(3):C343-C356
pubmed: 29949404
Stroke. 2004 May;35(5):1169-74
pubmed: 15060315
Stroke. 2001 Dec 1;32(12):2762-7
pubmed: 11739970
Stroke. 2016 Sep;47(9):2405-8
pubmed: 27462115
Stroke. 2010 Mar;41(3):e123-8
pubmed: 20035078
Neurology. 2021 Feb 2;96(5):e752-e757
pubmed: 33262232
Stroke. 2001 Aug;32(8):1759-66
pubmed: 11486102