• Title/Summary/Keyword: Ischemic cerebral disease

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Development of Cell Therapeutics against Ischemic Vascular Diseases Using Mesenchymal Stem Cells: From Bench to Bed (중간엽줄기세포(MSC)를 이용한 허혈성 혈관질환 치료를 위한 세포치료제 개발: 기초연구에서 임상연구)

  • Lee, Eun Ji;Park, Shin Hu;Seo, Jeong Ho;An, Hyo Gyung;Nam, Si Hyun;Kwon, Sang-Mo
    • Journal of Life Science
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    • v.32 no.7
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    • pp.567-577
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    • 2022
  • Recently, the prevalence of ischemic diseases, such as ischemic heart disease, cerebral ischemia, and peripheral arterial disease, has been continuously increasing due to the aging population. The current standardized treatment for ischemic diseases is reperfusion therapy through pharmacotherapy and surgical approaches. Although reperfusion therapy may restore the function of damaged arteries, it is not effective at restoring the function of the surrounding tissues that have been damaged due to ischemia. Therefore, it is necessary to develop a new treatment strategy that can safely and effectively treat ischemic damage and restore the function of surrounding tissues. To overcome these limitations, stem cell-based therapy to regenerate the damaged region has been studied as a promising strategy for ischemic vascular diseases. Mesenchymal stem cells (MSCs) can be isolated from diverse tissues and have been shown to be promising for the treatment of ischemic disease by regenerating damaged tissues through immunomodulation, the promotion of angiogenesis, and the secretion of various relevant factors. Moreover, new approaches to enhancing MSC function, such as cell priming or enhancing transplantation efficiency using a 3D culture method, have been studied to increase stem cell therapeutic efficacy. In this review, we provide various strategies by which MSCs are used to treat ischemic diseases, and we discuss the challenges of MSC transplantation, such as the differentiation, proliferation, and engraftment of MSCs at the ischemic site.

Effect of Chungpaesagan-tang on ischemic damage induced by MCAO in spontaneously hypertensive rats

  • Kim, Ko-Eun;Kim, Soo-Yong;Kim, Eun-Young;Kim, Bum-Hoi;Shin, Jung-Won;Lee, Hyun-Sam;Sohn, Young-Joo;Jung, Hyuk-Sang;Sohn, Nak-Won
    • Advances in Traditional Medicine
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    • v.8 no.4
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    • pp.430-439
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    • 2008
  • Chungpaesagan-tang (CPSGT) is most frequently used to treat ischemic brain injury in tradition Korean medicine. Clinically, cerebral ischemia is likely to be accompanied by preexisting or complicating disease. However, animal models used to examine the effects of herbal medicines on cerebral ischemia have not given this issue sufficient consideration. The present study was undertaken to determine the effects of CPSGT on focal cerebral ischemia in normal and SHR rats subjected to transient middle cerebral artery occlusion (MCAO). Animals were divided into four groups: Normal (Sprague-Dawley) rats subjected to MACO (the NC+MCAO group), normal rats subjected to MCAO and then administered CPSGT (NC + MCAO + CP), SHR rats subjected to MCAO (SHR + MCAO), and SHR rats subjected to MCAO and then administered CPSGT (SHR + MCAO + CP). MCAO was performed using the intraluminal method. CPSGT was administrated orally twice (1 and 4 h) after MCAO. All animals were sacrificed at 24 h postoperatively. Brain tissues were stained with hematoxylin & eosin, to examine the effect of CPSGT on ischemic brain tissues. In addition, changes in TNF-$\alpha$ expression in ischemic areas were examined by immunostaining. CPSGT was found to significantly reduce infarction areas in normal and SHR rats and infarction volumes in SHR rats. Similarly, CPGST markedly increased neuron numbers and sizes in all treated groups, except cell sizes in SHRs. Furthermore, CPSGT reduced TNF-$\alpha$ expression in MCAO administered SHR rats. The findings of the present study suggest that CPSGT effectively ameliorates neuron damage caused by MACO-induced cerebral ischemia, and that it has a significant neuroprotective effect after cerebral ischemia in SHR.

The Mechanism Study of Prescription for Treatment Abundant Expectoration due to Deficiency of Qi on Brain Disease in Rats (기허담성치방이 뇌병환에 미치는 기전연구)

  • Lee Nam Goo;Seong Sin
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.18 no.4
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    • pp.1083-1088
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    • 2004
  • This Study was designed to investigate the mechanism of Prescription for Treatment Abundant Expectoration due to Deficiency of Qi(Yukgunja-Tang, YGT) on cerebral hemodynamics [regional cerebral blood f1ow(rCBF) and pial arterial diameter(PAD)] in cerebral ischemia rats. The results were as follows: Both rCBF and PAD were significantly and stably decreased by YGT (10㎎/㎏, i.p.) during the period of cerebral reperfusion, which contrasted with the findings of rapid and marked increase in Control group. Pretreatment with indomethacin(1㎎/㎏, i.p.), an inhibitor of cyclooxygenase and methylene blue(10㎍/㎏, i.p.), an inhibitor of guanylate cyclase significantly but unstably increased the YGT-induced increases in rCBF during the period of cerebral reperfusion. Pretreatment with indomethacin significantly and stably decreased the YGT-induced increases in PAD during the period of cerebral reperfusion, but pretreatment with methylene blue increased unstably the YGT-induced increases in PAD during the period of cerebral reperfusion. In conclusion, the present authors thought that mechanism of YGT on cerebral hemodynamics was connected with guanylate cyclase in cerebral ischemia rats.

Characteristics of Cerebral Microbleeds

  • Lee, Juyoun;Sohn, Eun Hee;Oh, Eungseok;Lee, Ae Young
    • Dementia and Neurocognitive Disorders
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    • v.17 no.3
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    • pp.73-82
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    • 2018
  • Cerebral microbleeds (CMBs) are increasingly recognized neuroimaging findings, occurring with cerebrovascular disease, dementia, and aging. CMBs are associated with subsequent hemorrhagic and ischemic stroke, and also with an increased risk of cognitive deterioration and dementia. They occur in the setting of impaired small vessel integrity due to hypertension or cerebral amyloid angiopathy. This review summarizes the concepts, cause or risk factors, histopathological mechanisms, and clinical consequences of CMBs.

Acute Ischemic Stroke in Moyamoya Syndrome Associated with Thyrotoxicosis

  • Kang, Donggook;Seong, Gi-Hun;Bae, Jong Seok;Lee, Ju-Hun;Song, Hong-Ki;Kim, Yerim
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.129-133
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    • 2018
  • Background: A few cases of moyamoya syndrome associated with thyrotoxicosis have been reported. However, studies on the association of hyperthyroidism with moyamoya syndrome are insufficient. Case Report: Here we report a case of hyperthyroidism associated with moyamoya syndrome in a 41-year-old woman with aphasia and right side weakness. Brain imaging revealed acute cerebral infarction of left middle cerebral artery territory and occlusion of bilateral distal internal carotid arteries. Conclusion: Antithyroid medication stabilized the patient's neurologic deterioration, suggesting that thyrotoxicosis could aggravate acute cerebral infarction caused by moyamoya syndrome.

Yearly Report on CVA Patients(VI) (뇌졸중환자에 대한 연례보고(VI))

  • 이청정;홍의실;백은기;최유경;고승희;박세기;김동우;한양희;전찬용
    • The Journal of Korean Medicine
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    • v.22 no.3
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    • pp.81-91
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    • 2001
  • Objectives : This study was prepared for investigating the clinical features of stroke patients. Methods : We retrospectively reviewed the medical records of 177 patients who were admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University with a diagnosis of stroke from Jan. I, 1999 to Dec. 31, 1999. Results : Ischemic stroke (74.0%) was more common than hemorrhagic stroke (19.8%). The proportion of males was 53.7%, of females was 46.3%, and the most prevalent age group is those in their sixties. Cerebral infarction was most frequently noticed in MCA territory, hemorrhage in putamen. Hypertension was the most common preceding disease, followed by diabetes mellitus. The rate of recurrence was high in cerebral infarction. The onset mode of cerebral infarction was sleeping and rising and of cerebral hemorrhage was acting. Most patients visited the hospital within 24 hours. The most common symptoms at admission were motor weakness and speech disorder. The most common complication was urinary tract infection. Admission period was 29.5 days. Physical treatment from onset in cerebral infarction and in cerebral hemorrhage was 17.4 and 22.0 days, respectively. Conclusions : Our study of CVA patients was similar to previous studies from 1994 to 1998. In most cases, western and oriental treatment and medicine were given synthetically. Prescription of sasang constitutional medicine had wide application.

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Loss of Integrity: Impairment of the Blood-brain Barrier in Heavy Metal-associated Ischemic Stroke

  • Kim, Jeong-Hyeon;Byun, Hyeong-Min;Chung, Eui-Cheol;Chung, Han-Young;Bae, Ok-Nam
    • Toxicological Research
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    • v.29 no.3
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    • pp.157-164
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    • 2013
  • Although stroke is one of the leading causes of death and disability worldwide, preventive or therapeutic options are still limited. Therefore, a better understanding of the pathophysiological characteristics of this life-threatening disease is urgently needed. The incidence and prevalence of ischemic stroke are increased by exposure to certain types of xenobiotics, including heavy metals, suggesting the possible toxicological contribution of these compounds to the onset or aggravation of stroke. Among the potential targets, we have focused on alterations to cerebral endothelial cells (CECs), which play important roles in maintaining the functional integrity of brain tissue.

Yearly Report on Cerebrovascular Accident Patients(V) (뇌졸중환자에 대한 연례보고(V))

  • 고승희;전찬용;박종형
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.129-139
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    • 2000
  • Clinical observation was made on 210 cases of CVA that were confirmed through brain CT, MRI scan and clinical observation. They were hospitalized in the oriental medical hospital of Kyungwon University from January to December in 1998. Objective : To evaluate the current status of cerebrovascular disease in Korea, we performed observation on stroke patients. Methods : We performed a retrospective study on 210 cases of stroke who had been admitted to the Dept. of Internal Medicine, College of Oriental Medicine, Kyungwon University from Jan. 1, 1998 to Dec. 31, 1998. Results : The incidence was highest in the patients with the age of above fifty. The frequency of strokes was similar between male and female cases. Ischemic stroke(70.0%) was more common than hemorrhagic stroke(20.5%), with transient ischemic attacks(9.5%) occuring less frequently. Middle cerebra! arterial territory was the most commonly involved site in ischemic strokes. Among intracerebral hemorrhages, putaminal hemorrhages were found in 69.8%, and was followed by IVH(9.3%), IVH with ICH(7.0%), subcortical hemorrhages (4.7%) and pontine hemorrhages(4.7%). The most ordinary preceding disease was hypertension. The next was diabetes mellitus. Most cases were given simultaneous treatment in both western and oriental medical methods. Conclusions : Generally it is thought that CVA occurs frequently in winter. But our observations reveal no such relationship. The predisposing factors of cerebral infarction were usually initiated during the time of resting and sleeping and those of cerebral hemorrhage chiefly during the time of exercising. I Patients whose condition of consciousness was bad at the time of admission tended to have a bad prognosis. This study suggests changing trends of stroke in Korea, and that a multicenter prospective study using stroke registry is required for confirmation.

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PEGylated Erythropoietin Protects against Brain Injury in the MCAO-Induced Stroke Model by Blocking NF-κB Activation

  • Im, Jun Hyung;Yeo, In Jun;Hwang, Chul Ju;Lee, Kyung Sun;Hong, Jin Tae
    • Biomolecules & Therapeutics
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    • v.28 no.2
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    • pp.152-162
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    • 2020
  • Cerebral ischemia exhibits a multiplicity of pathophysiological mechanisms. During ischemic stroke, the reactive oxygen species (ROS) concentration rises to a peak during reperfusion, possibly underlying neuronal death. Recombinant human erythropoietin (EPO) supplementation is one method of treating neurodegenerative disease by reducing the generation of ROS. We investigated the therapeutic effect of PEGylated EPO (P-EPO) on ischemic stroke. Mice were administered P-EPO (5,000 U/kg) via intravenous injection, and middle cerebral artery occlusion (MCAO) followed by reperfusion was performed to induce in vivo ischemic stroke. P-EPO ameliorated MCAO-induced neurological deficit and reduced behavioral disorder and the infarct area. Moreover, lipid peroxidation, expression of inflammatory proteins (cyclooxygenase-2 and inducible nitric oxide synthase), and cytokine levels in blood were reduced by the P-EPO treatment. In addition, higher activation of nuclear factor kappa B (NF-κB) was found in the brain after MCAO, but NF-κB activation was reduced in the P-EPO-injected group. Treatment with the NF-κB inhibitor PS-1145 (5 mg/kg) abolished the P-EPO-induced reduction of infarct volume, neuronal death, neuroinflammation, and oxidative stress. Moreover, P-EPO was more effective than EPO (5,000 U/kg) and similar to a tissue plasminogen activator (10 mg/kg). An in vitro study revealed that P-EPO (25, 50, and 100 U/mL) treatment protected against rotenone (100 nM)-induced neuronal loss, neuroinflammation, oxidative stress, and NF-κB activity. These results indicate that the administration of P-EPO exerted neuroprotective effects on cerebral ischemia damage through anti-oxidant and anti-inflammatory properties by inhibiting NF-κB activation.

High-Resolution Magnetic Resonance Imaging Findings of Reversible Cerebral Vasoconstriction Syndrome associated with Severe Anemia: A Case Report (중증 빈혈과 관련된 가역적 뇌혈관 수축 증후군의 고해상도 자기공명영상 소견: 증례 보고)

  • Yongsang Kim;Ra Gyoung Yoon;Ji Ye Lee;Jong-Moo Park
    • Journal of the Korean Society of Radiology
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    • v.82 no.1
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    • pp.261-266
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    • 2021
  • Ischemic stroke is one of the manifestations of reversible cerebral vasoconstriction syndrome (RCVS). Many precipitants and associated disorders of RCVS have been suggested. However, few case reports have indicated an association between anemia and RCVS. Here, we report a case of a 66-year-old female with severe iron deficiency anemia (IDA), who presented with ischemic stroke and cerebral vasoconstriction, which gradually improved with conservative treatment. High-resolution vessel wall magnetic resonance imaging findings and reversibility suggested the possibility of RCVS. In patients with RCVS and ischemic stroke, IDA should be considered. Prompt management should be delivered to prevent disease progression and recurrence.