Abstract P433: Multipotent Adult Progenitor Cells as a Highly Promising Therapy for Treatment of Intracerebral Hemorrhage

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Xiurong Zhao ◽  
Lidiya Obertas ◽  
Guanghua Sun ◽  
Shun Ming Ting ◽  
Andrew Goh ◽  
...  
Keyword(s):  
Body Weight ◽  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Progenitor Cells ◽  
Ventricular Hypertrophy ◽  
Autologous Blood ◽  
Adult Stem Cell ◽  
Optimal Dose ◽  
Spleen Size ◽  
Multipotent Adult Progenitor Cells

Background: Multipotent adult progenitor cells (MAPC) are an adherent adult stem cell being evaluated as a treatment for ischemic stroke in humans under the name MultiStem®. However, the efficacy of MAPC cells for the treatment of intracerebral hemorrhage (ICH), the most devastating form of stroke for which there is no effective treatment, is not clear Method: The therapeutic efficacy of MAPC administration was evaluated in both autologous blood injection (ABI) and collagenase (COL) rat ICH models. We treated rats intravenously with 1.2x10 6 cells (sub-optimal dose based on MAPC efficacy in ischemic stroke) and 1.2x10 7 cells (optimal dose) at either 2 or 24h after ICH, and used 2 different doses of collagenase to better understand the dose responses. Outcome measurements included 4 sensorimotor tests (up to 28d), ventricular hypertrophy, spleen size, and body weight (N=128 rats tested across 4 separate experiments). Results: MAPC offered a robust benefit in both ICH models in a dose-dependent fashion. (1) ABI model: at the sub-optimal dose MAPCs had no significant effect on behavioral performance, but effectively reduced ventricular hypertrophy. At an optimal dose, MAPCs at 2h or 24h after ICH, robustly reduced deficits in all 4 behavioral tests, and reduced ventricular hypertrophy by 59% and 35% in 2h and 24h post-treatment groups, respectively. No difference in body weight and spleen size was observed. (2) COL model: MAPC administered 2h after high collagenase dose, reduced hematoma volume (hemispheric hemoglobin level), as measured at 48h after collagenase injection. In addition, MAPC administration significantly reduced neurological deficit in the COL model. Conclusions: MAPC provide a uniquely robust therapeutic effect on clinically relevant neurological and morphological outcomes in two different ICH models. MAPC also reduced bleeding in the COL model, suggesting the potential for MAPC as a safe acute therapeutic treatment after ICH. In addition to having beneficial effects on recovery processes, MAPC could be further evaluated as a candidate to limit the hematoma enlargement during the initial postictal period. We are currently investigating the mechanism of MAPC-induced post-ICH recovery as well as hemostasis using tissue microarray analysis.

Factor V Leiden Mutation in Cerebrovascular Disease

2005 ◽  
Vol 11 (3) ◽  
pp. 339-342 ◽  
Author(s):  
Nur Buyru ◽  
Julide Altinisik ◽  
Goksel Somay ◽  
Turgut Ulutin
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Cerebrovascular Disease ◽  
Smoking Status ◽  
Factor V Leiden ◽  
Restriction Enzyme Digestion ◽  
Factor V ◽  
Mutation Site ◽  
Factor V Leiden Mutation ◽  
High Prevalence

Several studies indicate a high prevalence of factor V Leiden mutation as the most frequent coagulation defect found in patients with venous thrombosis. The relationship between this mutation and cerebrovascular disease has not been established in adults. In this investigation, we studied 29 patients with ischemic stroke and 20 with intracerebral hemorrhage, all of whom were compared with 20 controls. A region of the factor V gene containing the Leiden mutation site was amplified with polymerase chain reaction and the presence of mutation was determined with restriction enzyme digestion. We found no evidence of an association between factor V Leiden mutation and ischemic stroke or intracerebral hemorrhage. There was no evidence of association in subgroup the analysis by age, smoking status, myocardial infarction, hypertension, diabetes mellitus, or coronary disease. Factor V Leiden mutation doesn’t seem to be associated with a risk of cerebrovascular disease.

scholarly journals Immunological characteristics of human mesenchymal stem cells and multipotent adult progenitor cells

2013 ◽  
Vol 91 (1) ◽  
pp. 32-39 ◽  
Author(s):  
Sandra A Jacobs ◽  
Valerie D Roobrouck ◽  
Catherine M Verfaillie ◽  
Stefaan W Van Gool
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Progenitor Cells ◽  
Human Mesenchymal Stem Cells ◽  
Multipotent Adult Progenitor Cells

scholarly journals Predicting the Risk of Symptomatic Intracerebral Hemorrhage in Ischemic Stroke Treated With Intravenous Alteplase

Stroke ◽  
2012 ◽  
Vol 43 (6) ◽  
pp. 1524-1531 ◽  
Author(s):  
Michael Mazya ◽  
José A. Egido ◽  
Gary A. Ford ◽  
Kennedy R. Lees ◽  
Robert Mikulik ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Symptomatic Intracerebral Hemorrhage ◽  
Intravenous Alteplase

Acute intracranial stenting with mechanical thrombectomy is safe and efficacious in patients diagnosed with underlying intracranial atherosclerotic disease

2021 ◽  
pp. 159101992110394
Author(s):  
Ameer E Hassan ◽  
Victor M Ringheanu ◽  
Laurie Preston ◽  
Wondwossen G Tekle ◽  
Adnan I Qureshi
Keyword(s):  
Ischemic Stroke ◽  
Length Of Stay ◽  
Intracerebral Hemorrhage ◽  
Cerebral Infarction ◽  
Acute Ischemic Stroke ◽  
Mechanical Thrombectomy ◽  
Modified Rankin Scale ◽  
Stroke Patients ◽  
Intracranial Stenting ◽  
Intracranial Atherosclerotic Disease

Objective To investigate whether significant differences exist in recanalization rates and primary outcomes between patients who undergo mechanical thrombectomy alone versus those who undergo mechanical thrombectomy with acute intracranial stenting. Methods Through the utilization of a prospectively collected endovascular database at a comprehensive stroke center between 2012 and 2020, variables such as demographics, co-morbid conditions, symptomatic intracerebral hemorrhage, mortality rate at discharge, and good/poor outcomes in regard to modified thrombolysis in cerebral infarction score and modified Rankin Scale were examined. The outcomes between patients receiving acute intracranial stenting + mechanical thrombectomy and patients that underwent mechanical thrombectomy alone were compared. Results There were a total of 420 acute ischemic stroke patients who met criteria for the study (average age 70.6 ± 13.01 years; 46.9% were women). Analysis of 46 patients from the acute stenting + mechanical thrombectomy group (average age 70.34 ± 13.75 years; 37.0% were women), and 374 patients from the mechanical thrombectomy alone group (average age 70.64 ± 12.92 years; 48.1% were women). Four patients (8.7%) in the acute stenting + mechanical thrombectomy group experienced intracerebral hemorrhage versus 45 patients (12.0%) in the mechanical thrombectomy alone group ( p = 0.506); no significant increases were noted in the median length of stay (7 vs 8 days; p = 0.208), rates of modified thrombolysis in cerebral infarction 2B-3 recanalization ( p = 0.758), or good modified Rankin Scale scores ( p = 0.806). Conclusion Acute intracranial stenting in addition to mechanical thrombectomy was not associated with an increase in overall length of stay, intracerebral hemorrhage rates, or any change in discharge modified Rankin Scale. Further research is required to determine whether mechanical thrombectomy and acute intracranial stenting in acute ischemic stroke patients is unsafe.

Dysphagia screening after intracerebral hemorrhage

2017 ◽  
Vol 13 (5) ◽  
pp. 503-510 ◽  
Author(s):  
Raed A Joundi ◽  
Rosemary Martino ◽  
Gustavo Saposnik ◽  
Vasily Giannakeas ◽  
Jiming Fang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
Acute Stroke ◽  
Clinical Severity ◽  
Stroke Severity ◽  
Stroke Registry ◽  
Patients At Risk ◽  
Poor Outcomes ◽  
Risk Of Aspiration ◽  
To Receive

Background Dysphagia screening is recommended after acute stroke to identify patients at risk of aspiration and implement appropriate care. However, little is known about the frequency and outcomes of patients undergoing dysphagia screening after intracerebral hemorrhage (ICH). Methods We used the Ontario Stroke Registry from 1 April 2010 to 31 March 2013 to identify patients hospitalized with acute stroke and to compare dysphagia screening rates in those with ICH and ischemic stroke. In patients with ICH we assessed predictors of receiving dysphagia screening, predictors of failing screening, and outcomes after failing screening. Results Among 1091 eligible patients with ICH, 354 (32.4%) patients did not have documented dysphagia screening. Patients with mild ICH were less likely to receive screening (40.4% of patients were omitted, adjusted odds ratio (aOR) 0.40, 95% confidence interval (CI) 0.26–0.63). Older age, greater stroke severity, speech deficits, lower initial level of consciousness, and admission to intensive care unit were predictive of failing the screening test. Failing screening was associated with poor outcomes, including pneumonia (aOR 5.3, 95% CI 2.36–11.88), severe disability (aOR 4.78, 95% CI 3.08–7.41), and 1-year mortality (adjusted hazard ratio 2.1, 95% CI 1.38–3.17). When compared to patients with ischemic stroke, patients with ICH were less likely to receive dysphagia screening (aOR 0.64, 95% CI 0.54–0.76) and more likely to fail screening (aOR 1.98, 95% 1.62–2.42). Conclusion One-third of patients with ICH did not have documented dysphagia screening, increasing to 40% in patients with mild clinical severity. Failing screening was associated with poor outcomes. Patients with ICH were less like to receive screening and twice as likely to fail compared to patients with ischemic stroke, and thus efforts should be made to include ICH patients in dysphagia screening protocols whenever possible.

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