Switching Off Vascular MAPK Signaling : A Novel Strategy to Prevent Delayed Cerebral Ischemia Following Subarachnoid Hemorrhage
(2024) In Translational Stroke Research- Abstract
Patients who initially survive the rupture and repair of a brain aneurysm often take a devastating turn for the worse some days later and die or suffer permanent neurologic deficits. This catastrophic sequela is attributed to a delayed phase of global cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH), but we lack effective treatment. Here we present our view, based on 20 years of research, that the initial drop in blood flow at the time of rupture triggers genomic responses throughout the brain vasculature that manifest days later as increased vasoconstriction and decreased cerebral blood flow. We propose a novel treatment strategy to prevent DCI by early inhibition of the vascular mitogen-activated protein... (More)
Patients who initially survive the rupture and repair of a brain aneurysm often take a devastating turn for the worse some days later and die or suffer permanent neurologic deficits. This catastrophic sequela is attributed to a delayed phase of global cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH), but we lack effective treatment. Here we present our view, based on 20 years of research, that the initial drop in blood flow at the time of rupture triggers genomic responses throughout the brain vasculature that manifest days later as increased vasoconstriction and decreased cerebral blood flow. We propose a novel treatment strategy to prevent DCI by early inhibition of the vascular mitogen-activated protein kinase (MAPK) pathway that triggers expression of vasoconstrictor and inflammatory mediators. We summarize evidence from experimental SAH models showing early treatment with MAPK inhibitors “switches off” these detrimental responses, maintains flow, and improves neurological outcome. This promising therapy is currently being evaluated in clinical trials.
(Less)
- author
- Edvinsson, Lars LU and Krause, Diana N. LU
- organization
- publishing date
- 2024
- type
- Contribution to journal
- publication status
- epub
- subject
- keywords
- Cerebral vasculature, Delayed cerebral ischemia, MAPK kinase inhibitor, Subarachnoid hemorrhage, Vasoconstriction
- in
- Translational Stroke Research
- publisher
- Springer
- external identifiers
-
- pmid:38334872
- scopus:85184507967
- ISSN
- 1868-4483
- DOI
- 10.1007/s12975-024-01234-z
- language
- English
- LU publication?
- yes
- id
- 75573299-3c8d-4fff-a361-fcfa6af0a816
- date added to LUP
- 2024-02-29 14:04:34
- date last changed
- 2024-04-14 09:57:09
@article{75573299-3c8d-4fff-a361-fcfa6af0a816,
abstract = {{<p>Patients who initially survive the rupture and repair of a brain aneurysm often take a devastating turn for the worse some days later and die or suffer permanent neurologic deficits. This catastrophic sequela is attributed to a delayed phase of global cerebral ischemia (DCI) following aneurysmal subarachnoid hemorrhage (aSAH), but we lack effective treatment. Here we present our view, based on 20 years of research, that the initial drop in blood flow at the time of rupture triggers genomic responses throughout the brain vasculature that manifest days later as increased vasoconstriction and decreased cerebral blood flow. We propose a novel treatment strategy to prevent DCI by early inhibition of the vascular mitogen-activated protein kinase (MAPK) pathway that triggers expression of vasoconstrictor and inflammatory mediators. We summarize evidence from experimental SAH models showing early treatment with MAPK inhibitors “switches off” these detrimental responses, maintains flow, and improves neurological outcome. This promising therapy is currently being evaluated in clinical trials.</p>}},
author = {{Edvinsson, Lars and Krause, Diana N.}},
issn = {{1868-4483}},
keywords = {{Cerebral vasculature; Delayed cerebral ischemia; MAPK kinase inhibitor; Subarachnoid hemorrhage; Vasoconstriction}},
language = {{eng}},
publisher = {{Springer}},
series = {{Translational Stroke Research}},
title = {{Switching Off Vascular MAPK Signaling : A Novel Strategy to Prevent Delayed Cerebral Ischemia Following Subarachnoid Hemorrhage}},
url = {{http://dx.doi.org/10.1007/s12975-024-01234-z}},
doi = {{10.1007/s12975-024-01234-z}},
year = {{2024}},
}