Risultati per: Lo stress può essere causa di infarto ed ictus

Stroke, Volume 55, Issue Suppl_1, Page AWP142-AWP142, February 1, 2024. Background:Intracranial atherosclerotic disease (ICAD) is associated with high recurrence rates of stroke despite aggressive medical management. Low wall shear stress (WSS) alters endothelial function and changes in WSS within the post-stenotic region of ICAD lesions is a potential driver of stroke recurrence.Methods:Using the SAMMPRIS imaging dataset, we identified medically managed patients with symptomatic middle cerebral artery (MCA) stenosis measured by CTA. WSS was calculated by creating a 3D volumetric mesh from CTA source imaging. Pulsatile flow profile reference standard boundary conditions were applied at pressure outlets to simulate normal hemodynamics. Arterial segments extending from the stenosis to the MCA bifurcation were captured and quantified. Contralateral arterial segments were matched by length and area. The ratio of area with low WSS (

Stroke, Volume 55, Issue Suppl_1, Page AWMP1-AWMP1, February 1, 2024. Background:NBO has emerged as a promising neuroprotective strategy for ischemic stroke. Key to comprehending these effects is understanding its mechanisms. This study examines the pivotal roles of HIF-1α as an oxygen sensor, the protective emergence of stress granules (SGs) in response to various stimuli, and the inflammatory cell death process known as pyroptosis, triggered by inflammasomes. We elucidated the interplay between HIF-1α, SGs, inflammasomes in ischemia/reperfusion injury and in NBO-induced neuroprotection.Methods:A total of 132 adult male SD rats were subjected to 2 h middle cerebral artery occlusion (MCAO), followed by 2, 6, 24 or 48 h of reperfusion. At the onset of reperfusion, oxygen was inhaled for 2 h at concentration of 95% and flow rate of 2 L/min. YC-1 (HIF-1α inhibitor) was administered 2 h before MCAO. Brain damage was evaluated by infarct volumes (TTC), LDH and ROS levels (ELISA), apoptotic cell death (flow cytometry and TUNEL). Pyroptosis was evaluated by flow cytometry. mRNA and protein levels of HIF-1α and inflammasome related factors, including IL-18, IL-1β, ASC, NLRP3, TXNIP, N-GSDMD, cleaved-Caspase-1, as well as SGs proteins including DDX3X, G3BP1, TIA-1 were examined. Co-IP was used to detect the interaction between DDX3X and G3BP1, as well as DDX3X and NLRP3.Results:Infarct volumes, LDH and ROS levels, apoptotic and pyroptotic cell death, as well as HIF-1α expression were all increased after ischemia/reperfusion. All these increases were reversed by either NBO or YC-1. NBO or YC-1 further reversed the increase in expression of NLRP3 inflammasome related proteins and suppressed the interaction between DDX3X and NLRP3, thereby suppressing inflammasome activation. NBO or YC-1 stimulated the expressions of SGs proteins and facilitated the interaction between DDX3X and G3BP1, thereby promoting the formation of SGs, in association with cell protection.Conclusion:Our findings highlight the neuroprotective effects of NBO in ischemic stroke. This protection is attributed to its dual capacity to inhibit NLRP3 inflammasome activation while simultaneously promoting formation of SGs. Central to these processes, HIF-1α, as an instrumental modulator, sheds light on potential therapeutic targets for stroke intervention.

Stroke, Volume 55, Issue Suppl_1, Page ATP316-ATP316, February 1, 2024. Introduction:Tamoxifen (TAM), a selective estrogen receptor modulator, is a first-line treatment to prevent recurrence of hormone receptor positive breast cancer. Stroke risk is increased in women with low estrogen and doubles in women after the age of 55 (average age of menopause). Critically, women taking TAM as breast cancer therapy had increased risk of ischemic stroke (82%). We hypothesize treatment with TAM will increase stroke severity, which is associated with increased blood brain barrier (BBB) damage and worsened neuroinflammation. We investigated effects of TAM on mitochondrial stress and cellular function in astrocytes and microglia, key cells of the BBB and neuroimmune response, respectively.Methods:Cultured female human astrocytes and HMC3 microglia were treated with TAM (1uM), 17ß-estradiol (10nM, E2), or vehicle (DMSO) for 24 hours. Cells were separated into two groups: normoxic (21% O2, 25mM glucose) or oxygen and glucose deprivation (OGD) conditions 6 hours before analysis. Mitochondrial function was assessed using a Seahorse XFe96 Analyzer. Microglial expression of mitochondrial proteins (Complex I & III and DRP1) was analyzed with western blot, and function was assessed with flow cytometry afterin vitrophagocytosis of pHrodo red zymosan.Results:TAM reduced maximal (p =0.0174) and basal respiration (p =0.0149) under OGD conditions in microglia compared with DMSO or E2 treatment. However, in astrocytes, maximal and basal respiration were increased in OGD (p =0.0003, p =0.0002). There was no significant difference in expression of mitochondrial proteins or phagocytic function in HMC3 microglia under either normoxic or OGD conditions after TAM treatment.Conclusions:TAM treatment resulted in a cell type-specific alteration in mitochondrial stress response. Since mitochondrial stress is a hallmark of stroke pathophysiology, and microglia and astrocytes are among the earliest cells to respond to ischemia, treatment with tamoxifen might alter the cellular environment, by its divergent actions on these two cell types, leading to worsened stroke outcomes. These data support the need forin vivoinvestigation to elucidate the mechanism by which TAM is altering cellular response. Support: RFAG042189 to FS, 1F30NS131053 to MEZ

Stroke, Volume 55, Issue Suppl_1, Page AWP289-AWP289, February 1, 2024. Introduction:Blunted night-to-day blood pressure (BP) dipping was common in ischemic cerebrovascular disease (ICVD). BP dipping could be influenced by baroreflex, which stabilized BP by regulating sympathovagal balance. We sought to determine the relationship between baroreflex function and BP dipping in patients with ICVD.Methods:Patients with ICVD stable for at least 3 days were enrolled. Beat-to-beat BP and ECG were monitored in 3 phases of active standing [supine (S), supine to upright (SU), upright (U), 4 min each]. Baroreflex function was evaluated by time-domain and frequency-domain baroreflex sensitivity (BRS) and by indices of sympathovagal balance [low (0.04-0.15 Hz) to high (0.15-0.4 Hz) frequency ratio (LHR) of systolic BP (SBP) and RR interval (RRI)]. BP dipping was measured as percentage with 24h ambulatory BP monitoring. SBP dipping

Stroke, Volume 55, Issue Suppl_1, Page AWMP63-AWMP63, February 1, 2024. Introduction:Physiological imaging studies in patients with severe steno-occlusive carotid disease (SSCD) reveal hemodynamic compromise as a mechanism underlying watershed infarcts (WI). However, it is unclear if the watershed region (WR) is intrinsically vulnerable in healthy individuals. We measured cerebral blood flow (CBF) and oxygen extraction fraction (OEF) in healthy individuals to determine if the WR was under metabolic stress, and therefore an intrinsically vulnerable region.Methods:To define a common WR, we created an “average WI density map” using MRIs from patients with diffusion restriction ipsilateral to SSCD from a single academic center (7/10 to 8/20). WI density maps were created using 5%, 10% and 15% incidence thresholds. Maps were overlaid onto coregistered CBF and OEF maps generated from pseudo-continuous arterial spin labeling (pCASL) and asymmetric spin echo sequences, respectively, performed on healthy controls aged

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Group 3 innate lymphoid cells (ILC3s) recently emerged as important regulators and potential drug targets for IBD. However, the response of ILC3s to environmental stimuli during intestinal inflammation remains elusive. IRE1a-XBP1 serves as the regulatory hub of the endoplasmic reticulum stress response that plays a vital role in intestinal inflammation.

Objectives
This study aimed to examine the prevalence of post-traumatic stress disorder (PTSD) in victims-survivors of intimate partner violence (IPV) consulting at the specialised and original facility ‘Maison des Femmes’ (MdF) or in two close municipal health centres (MHCs).

Design
A mixed-methods study using a convergent parallel design from July 2020 to June 2021.

Setting/participants
A questionnaire was proposed to women aged 18 years and over having suffered from IPV, in the MdF and in two MHCs. We also conducted qualitative interviews with a subsample of the women, asking for victim-survivors’ perceptions of the effect of the MdF’s care.

Primary and secondary outcome measures
The presence of a PTSD using the PTSD self-report checklist of symptoms, possibility of reaching women by phone 6 months after the inclusion visit, level of self-rated global health, number of emergency visits in the past 6 months, substances use, readiness to change and safety behaviours.

Results
A total of 67 women (mean age: 34 years (SD=9.7)) responded to our questionnaire. PTSD diagnosis was retained for 40 women (59.7%). Around 30% of participants self-rated their global health as bad. Less than 30% (n=18) of women were regular smokers, and only 7.5% of participants had a problematic alcohol use (Alcohol Use Disorders Identification Test-Consumption score ≥4), 19.4% women used psychotropic drugs. Six months after inclusion, half of participants had been reached by phone. Analysis of the qualitative interviews clarified victim-survivors’ perceptions of the MdF’s specific care: social networking, multidisciplinary approach, specialised listening, healthcare facilities, evasion and ‘feeling at home’.

Conclusions
The high prevalence of PTSD at inclusion was nearly the same between the three centres. This mixed-methods comparison will serve as a pilot study for a larger comparative trial to assess the long-term impact of the MdF’s specialised care on victims-survivors’ mental health, compared with the care of uncoordinated structures.

Trial registration number
NCT04304469.

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