Progress on siRNA-based gene therapy targeting secondary injury after intracerebral hemorrhage

Gene Therapy ◽  
2021 ◽  
Author(s):  
Daniyah A. Almarghalani ◽  
Zahoor A. Shah
Keyword(s):  
Gene Therapy ◽  
Intracerebral Hemorrhage ◽  
Secondary Injury

Abstract TP331: Plasma IL-6 Levels are Independently Associated With Functional Outcome and Markers of Secondary Injury in Spontaneous Intracerebral Hemorrhage

Stroke ◽  
2018 ◽  
Vol 49 (Suppl_1) ◽  
Author(s):  
Audrey C Leasure ◽  
Arthur F Steinschneider ◽  
Guido J Falcone ◽  
Emily J Gilmore ◽  
Lauren H Sansing ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Functional Outcome ◽  
Secondary Injury ◽  
Spontaneous Intracerebral Hemorrhage

scholarly journals Intracerebral Hemorrhage: A Brief Evidence-Based Review of Common Etiologies, Mechanisms of Secondary Injury, and Medical and Surgical Management

2019 ◽  
Vol 06 (02) ◽  
pp. 119-130
Author(s):  
Anand K. Sarma ◽  
Shivani Ghoshal ◽  
Spencer J. Craven ◽  
Aarti Sarwal
Keyword(s):  
Intracerebral Hemorrhage ◽  
Surgical Management ◽  
Surgical Care ◽  
Pressure Control ◽  
Treatment Modalities ◽  
Initial Contact ◽  
Secondary Injury ◽  
Golden Hour ◽  
Blood Aspiration ◽  
Perihematomal Edema

AbstractIntracerebral hemorrhage (ICH) accounts for only 10 to 15% of all strokes but remains a significant cause of morbidity and mortality. Despite lengthy stays in critical care units, only one-half of those experiencing an ICH survive after 30 days, and those who do are often left with considerable disability. Treatment has traditionally focused on minimizing the hemorrhage expansion and reducing clot volume through both medical and surgical means. Management of ICH is a complex and multidisciplinary process. This review will discuss a few common etiologies, explore the pathophysiology of secondary neuronal injury after ICH, review the basics of ICH imaging with computed tomography and magnetic resonance imaging, and highlight latest practices in medical and surgical management. Secondary injury mechanisms such as perihematomal edema and disordered cerebral autoregulation are discussed as potential targets for new treatment modalities. Emergent treatment in the “golden hour” after ictus provides a template of measures to adopt from initial contact with emergency medical services, to the emergency department, and thereafter, triage to the intensive care unit. Medical management including blood pressure control, hemostasis, and coagulopathy reversal are discussed and evidence from trials such as INTERACT 2, ATACH 2, and ANNEXA-4 are given a clinical context. Surgical management including intracranial pressure monitoring, surgical evacuation with open craniotomy, and minimally invasive approaches such as stereotactic-guided aspiration and thrombolysis, ultrasound-induced thrombolysis, image-guided stereotactic endoscopic aspiration, and stereotactic ICH underwater blood aspiration are enumerated. The outcomes and relevance of STICH, MISTIE, and CLEAR trials to present surgical care are elaborated. The review summarizes the current guidelines for the treatment of ICH and the latest literature in the field they are based upon. It aims to provide a concise article beneficial to the emergency physicians and neurointensivists/neuroanesthesiologists.

Sex-specific Association of Matrix Metalloproteinases with Secondary Injury and Outcomes after Intracerebral Hemorrhage

2019 ◽  
Vol 28 (6) ◽  
pp. 1718-1725 ◽  
Author(s):  
Matthew D. Howe ◽  
J. Weldon Furr ◽  
Liang Zhu ◽  
Nancy J. Edwards ◽  
Louise D. McCullough ◽  
...  
Keyword(s):  
Matrix Metalloproteinases ◽  
Intracerebral Hemorrhage ◽  
Secondary Injury ◽  
Specific Association

scholarly journals Alpha-7 nicotinic acetylcholine receptor agonists in intracerebral hemorrhage: an evaluation of the current evidence for a novel therapeutic agent

2013 ◽  
Vol 34 (5) ◽  
pp. E10 ◽  
Author(s):  
Eric S. Sussman ◽  
Christopher P. Kellner ◽  
Michael M. McDowell ◽  
Samuel S. Bruce ◽  
Simon G. Heuts ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Acetylcholine Receptor ◽  
Nicotinic Acetylcholine Receptor ◽  
Therapeutic Agent ◽  
Current Evidence ◽  
Secondary Injury ◽  
Nicotinic Acetylcholine ◽  
Α7 Nachr ◽  
Alpha 7 ◽  
Novel Therapeutic

Intracerebral hemorrhage (ICH) is the most deadly and least treatable subtype of stroke, and at the present time there are no evidence-based therapeutic interventions for patients with this disease. Secondary injury mechanisms are known to cause substantial rates of morbidity and mortality following ICH, and the inflammatory cascade is a major contributor to this post-ICH secondary injury. The alpha-7 nicotinic acetylcholine receptor (α7-nAChR) agonists have a well-established antiinflammatory effect and have been shown to attenuate perihematomal edema volume and to improve functional outcome in experimental ICH. The authors evaluate the current evidence for the use of an α7-nAChR agonist as a novel therapeutic agent in patients with ICH.

Metformin ameliorates neuronal necroptosis after intracerebral hemorrhage by activating AMPK

2021 ◽  
Vol 18 ◽  
Author(s):  
Chenhan Lin ◽  
Kaichuang Yang ◽  
Guoqiang Zhang ◽  
Jun Yu
Keyword(s):  
Type 2 Diabetes ◽  
Cell Death ◽  
Intracerebral Hemorrhage ◽  
Neurological Function ◽  
Future Research ◽  
Secondary Injury ◽  
First Line ◽  
New Perspective ◽  
Related Pathway

Background: Intracerebral hemorrhage (ICH) is a major cause of death and disability globally. As a type of secondary injury after ICH, treatment for cell death can promote the recovery of neurological function. Methods: Among all the cell death, neuronal necroptosis has recently been demonstrated of significance in the pathogenesis of ICH. However, the administration of drugs against necroptosis has many limitations. Results: In the present study, we found that metformin, a first-line medication for the treatment of type 2 diabetes, can effectively inhibit neuronal necroptosis after ICH through activating AMPK related pathway, thereby significantly improving neurological function scores and reducing brain edema. Conclusion: These results will provide a new perspective for future research in necroptosis.

scholarly journals Disability-Adjusted Life-Years Associated With Intracerebral Hemorrhage and Secondary Injury

2021 ◽  
Vol 4 (7) ◽  
pp. e2115859
Author(s):  
David Haupenthal ◽  
Joji B. Kuramatsu ◽  
Bastian Volbers ◽  
Jochen A. Sembill ◽  
Anne Mrochen ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Secondary Injury ◽  
Disability Adjusted Life Years ◽  
Disability Adjusted Life ◽  
Life Years

scholarly journals Preclinical Studies and Translational Applications of Intracerebral Hemorrhage

2017 ◽  
Vol 2017 ◽  
pp. 1-18 ◽  
Author(s):  
Felix Siaw-Debrah ◽  
Mark Nyanzu ◽  
Haoqi Ni ◽  
Xiao Lin ◽  
Zhu Xu ◽  
...  
Keyword(s):  
Intracerebral Hemorrhage ◽  
Conservative Therapy ◽  
Treatment Options ◽  
Disease Process ◽  
Clinical Applications ◽  
Secondary Injury ◽  
Preclinical Studies ◽  
Experimental Drugs ◽  
Disability Rate ◽  
The Brain

Intracerebral hemorrhage (ICH) which refers to bleeding in the brain is a very deleterious condition with high mortality and disability rate. Surgery or conservative therapy remains the treatment option. Various studies have divided the disease process of ICH into primary and secondary injury, for which knowledge into these processes has yielded many preclinical and clinical treatment options. The aim of this review is to highlight some of the new experimental drugs as well as other treatment options like stem cell therapy, rehabilitation, and nanomedicine and mention some translational clinical applications that have been done with these treatment options.

scholarly journals Berberine exhibits neuroprotective effects through inhibited autophagy and promoted microglial M1 transferred to M2 polarization

2020 ◽  
Author(s):  
Qiang Lei ◽  
Zhiping Hu ◽  
Binbin Yang ◽  
Zheng Jiang ◽  
Fangfang Zhou
Keyword(s):  
Intracerebral Hemorrhage ◽  
Neuroprotective Effect ◽  
Neurological Deficits ◽  
Current Evidence ◽  
Secondary Injury ◽  
Neuroprotective Effects ◽  
Neurological Outcomes ◽  
Microglial Polarization ◽  
The Brain ◽  
M1 Type

Abstract Background: Intracerebral haemorrhage (ICH) induces autophagy excessive activation and microglia mainly switched into proinflammatory M1 type, which can cause severe secondary injury. Current evidence has implied that berberine has a protective effect against ischaemic stroke through mediated autophagy and microglial polarization. However, the neuroprotective effect of berberine in intracerebral hemorrhage (ICH) remains unclear.Method: In this study the effect of berberine on rats model of intracerebral hemorrhage were investigated through Immunofluorescence, qPCR, ELISA, and western blot.Result: Berberine administration significantly reduces neurological deficits and the brain water content via inhibited autophagy, promoted M1 type microglia to M2 type, and subsequently exerts anti-inflammation effects in a rat model of ICH.Conclusion: These results suggest that berberine reduced secondary injury and improved neurological outcomes in ICH model.

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