Neuroserpin, primarily localized to CNS neurons, inhibits the adverse effects of tissue-type plasminogen activator (tPA) on the neurovascular unit and has neuroprotective effects in animal models of ischemic stroke. We sought to evaluate the association of neuroserpin polymorphisms with risk for ischemic stroke among young women.
A population-based case-control study of stroke among women aged 15-49 identified 224 cases of first ischemic stroke (47.3% African-American) and 211 age-matched control subjects (43.1% African-American). Neuroserpin single nucleotide polymorphisms (SNPs) chosen through HapMap were genotyped in the study population and assessed for association with stroke.
Of the five SNPs analyzed, the A allele (frequency; Caucasian = 0.56, African-American = 0.42) of SNP rs6797312 located in intron 1 was associated with stroke in an age-adjusted dominant model (AA and AT vs. TT) among Caucasians (OR = 2.05, p = 0.023) but not African-Americans (OR = 0.71, p = 0.387). Models adjusting for other risk factors strengthened the association. Race-specific haplotype analyses, inclusive of SNP rs6797312, again demonstrated significant associations with stroke among Caucasians only.
This study provides the first evidence that neuroserpin is associated with early-onset ischemic stroke among Caucasian women.
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"In animal models of ischemic stroke overexpression of neuroserpin and treatment with neuroserpin led to a decrease in infarct size , . Moreover, decreased levels of neuroserpin following stroke correlated with brain damage and polymorphisms in the neuroserpin gene may be associated with the risk of early onset stroke in Caucasian women –. "
[Show abstract][Hide abstract] ABSTRACT: The only approved pharmacological treatment for ischemic stroke is intravenous administration of plasminogen activator (tPA) to re-canalize the occluded cerebral vessel. Not only reperfusion but also tPA itself can induce an inflammatory response. Microglia are the innate immune cells of the central nervous system and the first immune cells to become activated in stroke. Neuroserpin, an endogenous inhibitor of tPA, is up-regulated following cerebral ischemia. To examine neuroserpin-dependent mechanisms of neuroprotection in stroke, we studied neuroserpin deficient (Ns(-/-) ) mice in an animal model of temporal focal ischemic stroke. Infarct size and neurological outcome were worse in neuroserpin deficient mice even though the fibrinolytic activity in the ischemic brain was increased. The increased infarct size was paralleled by a selective increase in proinflammatory microglia activation in Ns(-/-) mice. Our results show excessive microglial activation in Ns(-/-) mice mediated by an increased activity of tPA. This activation results in a worse outcome further underscoring the potential detrimental proinflammatory effects of tPA.
[Show abstract][Hide abstract] ABSTRACT: Despite recent advances in acute stroke therapy, stroke remains the leading cause of severe disability and the third leading cause of death, after heart disease and cancer, in Western countries and Japan. The identification of biomarkers of stroke risk is thus important both for risk prediction and for intervention to avert future events. Although genetic linkage analyses of families and sib-pairs as well as candidate gene and genome-wide association studies have implicated several loci and candidate genes in predisposition to ischemic or hemorrhagic stroke, the genes that contribute to genetic susceptibility to these conditions remain to be identified definitively. Given that vascular inflammation has been recognized as an important mechanism of atherosclerotic disease, proinflammatory genes may play pivotal roles in the pathogenesis of ischemic stroke. In this review, we summarize candidate genes that have been implicated in common forms of ischemic stroke by linkage analyses and association studies. We also review in more detail studies that have revealed an association of ischemic stroke with polymorphisms of proinflammatory genes of particular interest (LTA, IL6, and ALOX5AP) as well as with polymorphisms at chromosomal region 9p21.3, which has recently been identified as a susceptibility locus for coronary heart disease. Such studies may provide insight into the function of implicated genes as well as into the role of genetic factors in the development of ischemic stroke.
No preview · Article · Feb 2008 · Current pharmaceutical design