Systemic infection, inflammation and acute ischemic stroke

Faculty of Life Sciences, Michael Smith Building, University of Manchester, Manchester M13 9PT, UK.
Neuroscience (Impact Factor: 3.36). 09/2008; 158(3):1049-61. DOI: 10.1016/j.neuroscience.2008.08.019
Source: PubMed

ABSTRACT Extensive evidence implicates inflammation in multiple phases of stroke etiology and pathology. In particular, there is growing awareness that inflammatory events outside the brain have an important impact on stroke susceptibility and outcome. Numerous conditions, including infection and chronic non-infectious diseases, that are established risk factors for stroke are associated with an elevated systemic inflammatory profile. Recent clinical and pre-clinical studies support the concept that the systemic inflammatory status prior to and at the time of stroke is a key determinant of acute outcome and long-term prognosis. Here, we provide an overview of the impact of systemic inflammation on stroke susceptibility and outcome. We discuss potential mechanisms underlying the impact on ischemic brain injury and highlight the implications for stroke prevention, therapy and modeling.

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    • "and elevated levels of IL-1 can also affect patient susceptibility and severity of CNS injury (McColl et al., 2009; Denes et al., 2010). The overwhelming majority of patients presenting with ischemic or hemorrhagic stroke have one or more risk factors including obesity, hypertension, atherosclerosis, diabetes and infection, which account for 60–80% of stroke risk in the general population (Hankey, 2006; Emsley and Hopkins, 2008). "
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    ABSTRACT: Inflammation is the key host-defense response to infection and injury, yet also a major contributor to a diverse range of diseases, both peripheral and central in origin. Brain injury as a result of stroke or trauma is a leading cause of death and disability worldwide, yet there are no effective treatments, resulting in enormous social and economic costs. Increasing evidence, both preclinical and clinical, highlights inflammation as an important factor in stroke, both in determining outcome and as a contributor to risk. A number of inflammatory mediators have been proposed as key targets for intervention to reduce the burden of stroke, several reaching clinical trial, but as yet yielding no success. Many factors could explain these failures, including the lack of robust preclinical evidence and poorly designed clinical trials, in addition to the complex nature of the clinical condition. Lack of consideration in preclinical studies of associated co-morbidities prevalent in the clinical stroke population is now seen as an important omission in previous work. These co-morbidities (atherosclerosis, hypertension, diabetes, infection) have a strong inflammatory component, supporting the need for greater understanding of how inflammation contributes to acute brain injury. Interleukin (IL)-1 is the prototypical pro-inflammatory cytokine, first identified many years ago as the endogenous pyrogen. Research over the last 20 years or so reveals that IL-1 is an important mediator of neuronal injury and blocking the actions of IL-1 is beneficial in a number of experimental models of brain damage. Mechanisms underlying the actions of IL-1 in brain injury remain unclear, though increasing evidence indicates the cerebrovasculature as a key target. Recent literature supporting this and other aspects of how IL-1 and systemic inflammation in general contribute to acute brain injury are discussed in this review.
    Frontiers in Cellular Neuroscience 03/2015; 9. DOI:10.3389/fncel.2015.00018 · 4.29 Impact Factor
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    • "Several potential biological mechanisms may explain how infections and inflammation increase the risk of ischemic stroke [22–25]. Infection could contribute to stroke by promoting systemic procoagulant effects and local inflammation (or even direct pathogen invasion) of cervical or cerebral blood vessels [26]. "
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    ABSTRACT: Stroke is as common as brain tumor in children. The etiology of childhood arterial ischemic stroke (AIS) appears to be multifactorial, resulting from the interaction between genetic predisposition and environmental triggers. The risk factors for AIS in children are markedly different from the atherosclerotic risk factors in adults. Trauma and infections have been identified as associations in previous studies and are exposures of particular interest because of their increased prevalence in the children. The aim of this review article is to provide an overview of the research studies that have addressed the role of infections and trauma in pediatric AIS.
    Current Cardiology Reports 09/2014; 16(9):527. DOI:10.1007/s11886-014-0527-y · 1.93 Impact Factor
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    • "These cells interact with one another via intricate signaling pathways. Recent studies show that systemic inflammatory status prior to and at the time of stroke is a key determinant of acute outcome and long-term prognosis [11, 12]. Inhibiting inflammatory responses after stroke can prevent brain injury and, therefore, improve neurological outcome [13]. "
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    ABSTRACT: Inflammation has a pivotal role in the pathogenesis of ischemic stroke, and recent studies posit that inflammation acts as a double-edged sword, not only detrimentally augmenting secondary injury, but also potentially promoting recovery. An initial event of inflammation in ischemic stroke is the activation of microglia, leading to production of both pro- and anti-inflammatory mediators acting through multiple receptor signaling pathways. In this review, we discuss the role of microglial mediators in acute ischemic stroke and elaborate on preclinical and clinical studies focused on microglia in stroke models. Understanding how microglia can lead to both pro- and anti-inflammatory responses may be essential to implement therapeutic strategies using immunomodulatory interventions in ischemic stroke.
    BioMed Research International 06/2014; 2014(5):297241. DOI:10.1155/2014/297241 · 2.71 Impact Factor
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