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The use of hypothermia to mitigate cerebral ischemic injury is not new. From early studies, it has been clear that cooling is remarkably neuroprotective when applied during global or focal ischemia. In contrast, the value of postischemic cooling is typically viewed with skepticism because of early clinical difficulties and conflicting animal data. However, more recent rodent experiments have shown that a protracted reduction in temperature of only a few degrees Celsius can provide sustained behavioral and histological neuroprotection. Conversely, brief or very mild hypothermia may only delay neuronal damage. Accordingly, protracted hypothermia of 32-34 degrees C may be beneficial following acute clinical stroke. A thorough mechanistic understanding of postischemic hypothermia would lead to a more selective and effective therapy. Unfortunately, few studies have investigated the mechanisms by which postischemic cooling conveys its beneficial effect. The purpose of this article is to evaluate critically the effects of postischemic temperature changes with a comparison to some current drug therapies. This article will stimulate new research into the mechanisms of lengthy postischemic hypothermia and its potential as a therapy for stroke patients.
Mol Neurobiol 1997 Jun
PMID:Postischemic hypothermia. A critical appraisal with implications for clinical treatment. 929 62

Hypertension is a significant risk factor for heart attack and stroke and represents a major public health burden because of its high prevalence (e.g. 15-20% of the European and American populations). Although blood pressure is known to have a strong genetic determination, the genes responsible for susceptibility to essential hypertension are mostly unknown. Loci involved in blood pressure regulation have been found by linkage in experimental hereditary hypertensive rat strains, but their relationship to human hypertension has not been extensively investigated. One of the principal blood pressure loci has been mapped to rat chromosome 10 and we have undertaken an investigation of the homologous region on human chromosome 17 in familial essential hypertension. Affected sib-pair analysis and parametric analysis with ascertainment correction gave significant evidence of linkage ( P <0.0001 in some analyses) near two closely linked microsatellite markers, D17S183 and D17S934, that reside 18 cM proximal to the ACE locus in the homology region. Our results indicate that chromosome 17q could contain a susceptibility locus for human hypertension and show that comparative mapping may be a useful approach for identification of such loci in humans.
Hum Mol Genet 1997 Nov
PMID:Genetic susceptibility for human familial essential hypertension in a region of homology with blood pressure linkage on rat chromosome 10. 932 71

Various molecules expressed on the surface of platelets have been shown to mediate the protective or deleterious role of these cells in immuno-inflammatory mechanisms. Increasing evidence points to the involvement of the cell adhesion molecules, gpIIb-IIIa, P-selectin, CD31, LFA-1, and CD36 in the interaction between platelets and endothelial cells as well as other cell types. The possible role of these molecules in the ability of platelets to support endothelium and to protect against tumour necrosis factor mediated cytolysis or parasitic invasion are reviewed. The involvement of platelets as effectors of tissue damage in cerebral malaria, lipopolysaccharide induced pathology, and pulmonary fibrosis is also discussed. This has then been extended to include the intercellular mechanisms underpinning their pathogenic role in metastasis, transplant rejection, stroke, brain hypoxia, and related conditions. A better understanding of the complex regulation and hierarchical organisation of these various platelet adhesion molecules may prove useful in the development of new approaches to the treatment of such diseases.
Mol Pathol 1997 Aug
PMID:Role of platelet adhesion in homeostasis and immunopathology. 935 Mar

Administration of adenosine A1 receptor agonists in vivo is neuroprotective in various stroke models. Experiments using either mixed cultures of neurons and astrocytes or brain slices, in which several cell types are present, have demonstrated that activation of A1 receptors also id protective against hypoxia and/or hypoglycemia in vitro. In this study, we have examined the effect of the A1 agonist cyclopentyladenosine (CPA) on cellular damage, measured by efflux of lactate dehydrogenase (LDH), in highly enriched primary cultures of either neurons of astrocytes exposed to different metabolic insults. CPA reduced neuronal LDH release induced by a combination of hypoxia and substrate deprivation ("simulated ischemia"; IC50 = 28 nM) of by hypoxia alone (IC50 = 170 nM). In contrast, CPA had no effect on neuronal damage induced by substrate deprivation alone, not did it affect ischemic death to astrocytes. The neuroprotective effect of CPA during simulated ischemia and hypoxia were reversed by the A1 antagonist 1,3-dipropyl-8-cyclopentylxanthine (DPCPX). These data demonstrate that activation of an adenosine A1 receptor on neurons, but not astrocytes, is protective against cellular damage of death induced specifically by hypoxia as opposed to other metabolic insults such as hypoglycemia.
Mol Chem Neuropathol 1997 Jun
PMID:Adenosine A1 receptor activation preferentially protects cultured cerebellar neurons versus astrocytes against hypoxia-induced death. 937 19

Atherosclerosis is a disease of the large arteries that is the cause of heart disease and stroke. It is a highly complex disorder with multiple genetic and environmental influences. The mouse model has proved very useful for studying atherosclerosis because genetic analysis and planned genetic modification are feasible in this organism. In this brief review, some recent findings are summarized and future prospects using mouse models to study atherosclerosis-related traits are discussed.
Mol Med Today 1995 Nov
PMID:New insights into atherosclerosis from studies with mouse models. 941 82

The angiotensin-converting enzyme (ACE) is an integral part of two enzymatic cascades, one leading to the generation of angiotensin II and the other to the degradation of bradykinin. The great variety of cardiovascular effects mediated by these vasoactive peptides and the efficacy of ACE inhibitors in the treatment of hypertension and heart failure emphasize the prominent role of ACE in the cardiovascular system. Early in this decade convincing experimental evidence demonstrated the induction of this enzyme in several pathophysiological conditions, including myocardial infarction and left ventricular hypertrophy. In parallel, a deletion/insertion (D/I) polymorphism of the human ACE gene was characterized that is related to 14-50% of the interindividual variance in serum ACE activity. More recently this polymorphism has been implicated in the pathogenesis of a variety of cardiovascular disorders, including myocardial infarction, left ventricular hypertrophy, hypertension, diabetic and IgA nephropathy, carotid artery thickening, and lacunar cerebral stroke. However, the associations between the ACE D/I polymorphism and most of these conditions were found to be inconsistent when additional populations were investigated. This contribution reviews the current evidence on the relationship between the ACE D/I polymorphism and cardiovascular disease.
J Mol Med (Berl)
PMID:Polymorphism of the angiotensin-converting enzyme gene and cardiovascular disease. 942 19

Previous studies on male stroke-prone spontaneously hypertensive rats (SHRSP) have shown that a high-salt diet accelerated the onset of hypertension and stroke, resulting in an increased mortality rate at a younger age. The purpose of this study was to examine whether a similar effect is present in female SHRSP. After weaning at 4 weeks of age, 32 female SHRSP were placed on a Japanese-style rat diet containing either 0.3% NaCl or 4% NaCl. Blood pressure (BP), heart rate, and body weight were measured weekly. Beginning at 9 weeks of age, the SHRSP on the 4% NaCl diet began to show a consistently and significantly higher BP than those in the 0.3% NaCl group, reaching an average BP of 245 +/- 9 mmHg at 16 weeks of age as compared to 184 +/- 3 mmHg in the 0.3% NaCl group. Some female SHRSP in the 4% NaCl group started to exhibit behavioral signs of stroke at 12 weeks of age and 100% mortality was found by 20 weeks. There was 0% mortality in the 0.3% NaCl group at that age. A positive correlation was found between the age at which BP surpassed 220 mmHg and the age death occurred due to stroke. No significant difference was noted in the heart rate or body weight measurements between the two groups. The increased mortality rate in the 4% NaCl diet group was accompanied by organ damage as evidenced by the presence of left ventricular hypertrophy, edematous kidneys, renal malfunction, kidney lesions, and cerebral lesions in these female SHRSP. It is concluded that a high-salt diet exacerbates hypertension and caused an increased mortality rate. This increased mortality rate was associated with an increased left ventricular hypertrophy, kidney damage and subsequent malfunction, and cerebrovascular lesions in these female SHRSP.
Exp Mol Pathol 1997
PMID:The effects of dietary sodium on hypertension and stroke development in female stroke-prone spontaneously hypertensive rats. 943 82

Platelet activation is central to the pathogenesis of hemostasis and arterial thrombosis. Platelet aggregation plays a major role in acute coronary artery diseases, myocardial infarction, unstable angina, and stroke. ADP is the first known and an important agonist for platelet aggregation. ADP not only causes primary aggregation of platelets but is also responsible for the secondary aggregation induced by ADP and other agonists. ADP also induces platelet shape change, secretion from storage granules, influx and intracellular mobilization of Ca2+, and inhibition of stimulated adenylyl cyclase activity. The ADP-receptor protein mediating ADP-induced platelet responses has neither been purified nor cloned. Therefore, signal transduction mechanisms underlying ADP-induced platelet responses either remain uncertain or less well understood. Recent contributions from chemists, biochemists, cell biologists, pharmacologists, molecular biologists, and clinical investigators have added considerably to and enhanced our knowledge of ADP-induced platelet responses. Although considerable efforts have been directed toward identifying and cloning the ADP-receptor, these have not been completely successful or without controversy. Considerable progress has been made toward understanding the mechanisms of ADP-induced platelet responses but disagreements persist. New drugs that do not mimic ADP have been found to inhibit fairly selectively ADP-induced platelet activation ex vivo. Drugs that mimic ADP and selectively act at the platelet ADP-receptor have been designed, synthesized, and evaluated for their therapeutic efficacy to block selectively ADP-induced platelet responses. This review examines in detail the developments that have taken place to identify the ADP-receptor protein and to better understand mechanisms underlying ADP-induced platelet responses to develop strategies for designing innovative drugs that block ADP-induced platelet responses by acting selectively at the ADP-receptor and/or by selectively interfering with components of ADP-induced platelet activation mechanisms.
Crit Rev Biochem Mol Biol 1997
PMID:ADP-induced platelet activation. 944 77

As stroke is a major cause of disability and death in the western world, there is great interest in the basic mechanisms by which ischemia/reperfusion (I/R) causes damage. To this end, extensive research has been carried out which identifies reactive oxygen species (ROS) as key participants in brain damage resultant from I/R. Brain tissue is protected from ROS damage by antioxidant enzymes, such as superoxide dismutase (SOD) and glutathione peroxidase (GP). Overexpression of SOD in transgenic mice has already been demonstrated to confer protection against I/R damage in murine stroke models. We are using transgenic mice overexpressing the intracellular form of glutathione peroxidase (GP1) to determine the protective capacity of overexpression of this enzyme on stroke damage. 1 h of focal cerebral ischemia followed by 24 h of reperfusion was induced using the intraliminal suture method. Volume of infarction was reduced by 48% in GP1 mice compared to nontransgenic littermates. Brain edema was reduced by 33%. Behavioral deficits agreed with histologic data. Overexpression of glutathione peroxidase confers significant protection against I/R damage in our stroke model possibly through direct scavenging of ROS or through the influencing of signalling mechanisms which lead to tissue damage.
Brain Res Mol Brain Res 1998 Jan
PMID:Overexpression of human glutathione peroxidase protects transgenic mice against focal cerebral ischemia/reperfusion damage. 947 16

Excitatory amino acid (EAA) receptors play an important role in neuronal cell death in acute cerebral ischemia. Blocking the alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionate (AMPA) subtype of EAA receptor has been shown to reduce cell death in global cerebral ischemia. However their role in focal stroke, although suggestive, has remained more contentious. To clarify this issue, we generated transgenic mice overexpressing the AMPA receptor (AMPAR) subunit GluR2-flip which would increase AMPAR-mediated currents. Excitatory neurons in these transgenic mice are thus predicted to be more susceptible than wild-type neurons to EAA (glutamate)-induced excitotoxic damage. Consistent with this prediction, cultured neurons from transgenic mice had a lower LD50 for exposure to glutamate (10(-3)-10(-5) M for 5 min) compared to wild-type neurons. Moreover, transgenic mice subjected to permanent focal ischemia of the middle cerebral artery (MCA) using the intralumenal filament model sustained larger infarctions compared to wild-type controls. Hence we have developed a genetic mouse model that demonstrates the crucial role of AMPAR containing GluR2-flip in the pathogenesis of focal hypoxic-ischemic neuronal cell death. This model will be a valuable tool in elucidating molecular mechanisms of glutamate excitotoxicity and evaluating the efficacy of glutamate receptor antagonists in attenuating post-ischemic neuronal cell death.
Brain Res Mol Brain Res 1997 Dec 15
PMID:Enhanced neuronal death from focal ischemia in AMPA-receptor transgenic mice. 949 44


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