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Hypothesis and theory : a pathophysiological concept of stroke-induced acute phase response and increased intestinal permeability leading to secondary brain damage
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Ferrara, Fabienne, Zeisig, Vilia, Pietsch, Sören, Rütten, Rita, Dreyer, Antje Y., Pieper, Laura, Schatzl, Ann-Kathrin, McLeod, Damian D., Barthel, Henryk, Boltze, Johannes, Schrödl, Wieland and Nitzsche, Björn (2020) Hypothesis and theory : a pathophysiological concept of stroke-induced acute phase response and increased intestinal permeability leading to secondary brain damage. Frontiers in Neuroscience, 14 . 272. doi:10.3389/fnins.2020.00272 ISSN 1662-453X.
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WRAP-Hypothesis-theory-pathophysiological-stroke-brain-damage-Boltze-2020.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (1026Kb) | Preview |
Official URL: https://doi.org/10.3389/fnins.2020.00272
Abstract
Gut integrity impairment leading to increased intestinal permeability (IP) is hypothesized to be a trigger of critically illness. Approximately 15–20% of human ischemic stroke (IS) victims require intensive care, including patients with impaired level of consciousness or a high risk for developing life-threatening cerebral edema. Local and systemic inflammatory reactions are a major component of the IS pathophysiology and can significantly aggravate brain tissue damage. Intracerebral inflammatory processes following IS have been well studied. Until now, less is known about systemic inflammatory responses and IS consequences apart from a frequently observed post-IS immunosuppression. Here, we provide a hypothesis of a crosstalk between systemic acute phase response (APR), IP and potential secondary brain damage during acute and subacute IS stages supported by preliminary experimental data. Alterations of the acute phase proteins (APPs) C-reactive protein and lipopolysaccharide-binding protein and serum level changes of antibodies directed against Escherichia coli-cell extract antigen (IgA-, IgM-, and IgG-anti-E. coli) were investigated at 1, 2, and 7 days following IS in ten male sheep. We found an increase of both APPs as well as a decrease of all anti-E. coli antibodies within 48 h following IS. This may indicate an early systemic APR and increased IP, and underlines the importance of the increasingly recognized gut-brain axis and of intestinal antigen release for systemic immune responses in acute and subacute stroke stages.
| Item Type: | Journal Article | ||||||||
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| Subjects: | R Medicine > RB Pathology R Medicine > RC Internal medicine |
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| Divisions: | Faculty of Science, Engineering and Medicine > Science > Life Sciences (2010- ) | ||||||||
| SWORD Depositor: | Library Publications Router | ||||||||
| Library of Congress Subject Headings (LCSH): | Cerebral ischemia, Intestines -- Permeability, Acute phase proteins, Septicemia -- Pathophysiology | ||||||||
| Journal or Publication Title: | Frontiers in Neuroscience | ||||||||
| Publisher: | Frontiers Media S.A. | ||||||||
| ISSN: | 1662-453X | ||||||||
| Official Date: | 21 April 2020 | ||||||||
| Dates: |
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| Volume: | 14 | ||||||||
| Article Number: | 272 | ||||||||
| DOI: | 10.3389/fnins.2020.00272 | ||||||||
| Status: | Peer Reviewed | ||||||||
| Publication Status: | Published | ||||||||
| Reuse Statement (publisher, data, author rights): | ** From Frontiers via Jisc Publications Router ** History: received 17-05-2019; collection 2020; accepted 10-03-2020; epub 21-04-2020. ** Licence for this article: http://creativecommons.org/licenses/by/4.0/ | ||||||||
| Access rights to Published version: | Open Access (Creative Commons) | ||||||||
| Copyright Holders: | Copyright © 2020 Ferrara, Zeisig, Pietsch, Rütten, Dreyer, Pieper, Schatzl, McLeod, Barthel, Boltze, Schrödl and Nitzsche. | ||||||||
| Date of first compliant deposit: | 18 May 2020 | ||||||||
| Date of first compliant Open Access: | 20 May 2020 | ||||||||
| RIOXX Funder/Project Grant: |
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