Immunohematologic Mechanisms in Stroke

  • M. J. Fisher

Abstract

Stroke investigators have made great progress in defining the neurochemical consequences of brain ischemia, as well as providing a scientific foundation for the medical and surgical therapies of secondary stroke prevention. Nevertheless, it is striking that relatively little is known of the initiating process of the clinical event constituting stroke. This process, lacking precise characterization, is typically referred to as ’hypoperfusion’ or ’embolization’. Current neurodiagnostic technology has blurred, rather than clarified, this distinction. An example of this phenomenon comes from the landmark North American Symptomatic Carotid Endarterectomy Trial, in which the efficacy of surgical removal of symptomatic carotid plaques appeared to be directly related to the degree of hemodynamic compromise produced by these lesions (NASCET Collaborators 1991). Yet angiography performed in the first hours after stroke commonly shows possible embolic occlusion distal to carotid stenosis (del Zoppo et al. 1992).

Keywords

Aspirin Heparin Warfarin Prostaglandin Neurol 

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References

  1. Ameriso SF, Paganini-Hill A, Meiselman HJ, Fisher M (1990) Correlates of middle cerebral artery blood flow velocity in the elderly. Stroke 21: 1579–1583PubMedCrossRefGoogle Scholar
  2. Ameriso SF, Wong VLY, Quismorio FP, Fisher M (1991) Immunohematologic characteristics of infection-associated cerebral infarction. Stroke 22: 1004–1009PubMedCrossRefGoogle Scholar
  3. Ameriso SF, Sager P, Fisher M (1992) Atrial fibrillation, congestive heart failure, and the middle cerebral artery: an ultrasound analysis. J Neuroimag 2: 190–194Google Scholar
  4. Bauer KA, ten Cate H, Barzegar S, Spriggs DR, Sherman ML, Rosenberg RD (1989) Tumor necrosis factor infusions have a procoagulant effect on the hemostatic mechanism of humans. Blood 74: 165–172PubMedGoogle Scholar
  5. Benveniste EN (1992) Inflammatory cytokines within the central nervous system: sources, function, and mechanisms of action. Am J Physiol 263 (Cell Physiol) 32: C1–C16Google Scholar
  6. Bernard JT, Ameriso S, Kempf RA, Rosen P, Mitchell MS, Fisher M (1990) Transient focal neurologic deficits complicating interleukin-2 therapy. Neurology 40: 154–155PubMedGoogle Scholar
  7. Boey ML, Colaco CB, Gharavi AE, Elkon KB, Loizou S, Hughes GRV (1983) Thrombosis in SLE: striking association with the presence of circulating ’lupus’ anticoagulant. Br Med J 287: 1021–1023CrossRefGoogle Scholar
  8. Chung IY, Norris JG, Benveniste EN (1991) Differential tumor necrosis factor alpha expression by astrocytes from experimental allergic encephalomyelitis-susceptible and –resistant rat strains. J Exp Med 173: 801–811PubMedCrossRefGoogle Scholar
  9. Conway EM, Bach R, Rosenberg RD, Konigsberg WH (1989) Tumor necrosis factor enhances expression of tissue factor mRNA in endothelial cells. Thromb Res 53: 231–241PubMedCrossRefGoogle Scholar
  10. Coull BM, Levine SR, Brey RL (1992) The role of antiphospholipid antibodies in stroke. Neurol Clin 10: 125–142PubMedGoogle Scholar
  11. De Agostini Al, Watkins SC, Slayter HS, Youssoufian H, Rosenberg RD (1990) Localization of anticoagulantly active heparin sulfate proteoglycans in vascular endothelium: antithrombin binding on cultured endothelial cells and perfused rat aorta. J Cell Biol 111: 1293–1304CrossRefGoogle Scholar
  12. del Zoppo G, Poeck K, Pessin MS et al (1992) Recombinant tissue plasminogen activator in acute thrombotic and embolic stroke. Ann Neurol 32: 78–86PubMedCrossRefGoogle Scholar
  13. Drake TA, Morrissey JH, Edgington TS (1989) Selective eelhilar expression of tissue factor in human tissues. Am J Pathol 134: 1087–1097PubMedGoogle Scholar
  14. Eddleston M, de la Torre JC, Oldstone MBA, Loskutoff DJ,Edgington TS, Mackman N (1993) Astrocytes are the primary source of tissue factor in the murine central nervous system. J Clin Invest 92: 349–358Google Scholar
  15. Esmon CT, Taylor FB, Snow TR (1991) Inflammation and coagulation: linked processes potentially regulated through a common pathway mediated by protein C. Thromb Haemost 66: 160–165PubMedGoogle Scholar
  16. Falk E (1985) Unstable angina with fatal outcome: dynamic thrombosis leading to infarction and/or sudden death. Circulation 71: 699–708PubMedCrossRefGoogle Scholar
  17. Fisher M, Francis R (1990) Altered coagulation in cerebral ischemia: platelet, thrombin, and plasmin activity. Arch Neurol 47: 1075–1079PubMedGoogle Scholar
  18. Fleck RA, Rao LVM, Rapaport SI, Varki N (1990) Localization of human tissue factor antigen by immunostaining with monospecific, polyclonal anti-human tissue factor antibody. Thromb Res 57: 765–781CrossRefGoogle Scholar
  19. Freyssinet JM, Cazenave JP (1987) Lupus-like anticoagulants, modulation of the protein C pathway and thrombosis. Thromb Haemost 58: 679–681PubMedGoogle Scholar
  20. Furie B, Furie BC (1992) Molecular and cellular biology of blood coagulation. New Engl J Med 326: 800–806PubMedCrossRefGoogle Scholar
  21. Gershenwald JE, Fong Y, Fahey TJ et al. (1990) Interleukin 1 receptor blockade attenuates the host inflammatory response. Proc Natl Acad Sci USA 87: 4966–4970PubMedCrossRefGoogle Scholar
  22. Grotta J, Ackerman R, Correia J, Fallick G, Chang J (1982) Whole blood viscosity parameters and cerebral blood flow. Stroke 13: 296–301PubMedCrossRefGoogle Scholar
  23. Grotta JC, Yatsu FM, Pettigrew LC (1989) Prediction of carotid stenosis by lipid and hematologic measurements. Neurology 39: 1325–1331PubMedGoogle Scholar
  24. Hacke W, Zeumer H, Ferbert A et al. (1988) Intra-arterial thrombolytic therapy improves outcome in patients with acute vertebro-basilar occlusive disease. Stroke 19: 1216–1222PubMedCrossRefGoogle Scholar
  25. Hallenbeck JM, Dutka AJ, Kochanek PM, Siren A, Pezeshpour GH, Feuerstein G (1988) Stroke risk factors prepare brainstem tissues for modified local Shwartzman reaction. Stroke 19: 863–869PubMedCrossRefGoogle Scholar
  26. Hallenbeck JM, Dutka AH, Vogel SN, Heldman E, Doron D, Feuerstein G (1991) Lipopolysaccharide-induced production of tumor necrosis factor activity in rats with and without risk factors for stroke. Brain Res 541: 115–120PubMedCrossRefGoogle Scholar
  27. Hass WK, Easton JD, Adams HP et al. (1989) A randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. New Engl J Med 321: 501–507PubMedCrossRefGoogle Scholar
  28. Kalderon N, Ahonen K, Federoff S (1990) Developmental transition in plasticity properties of differentiating astrocytes: age-related biochemical profile of plasminogen activators in astroglial cultures. Glia 3: 413–426PubMedCrossRefGoogle Scholar
  29. Kannel WB, Wolf PA, Castelli WP, D’Agostino RB (1987) Fibrinogen and risk of cardiovascular disease: the Framingham Study. JAMA 258: 1183–1186PubMedCrossRefGoogle Scholar
  30. Krystosek A, Seeds NW (1981) Plasminogen activator release at the neuronal growth cone. Science 213: 1532–1534PubMedCrossRefGoogle Scholar
  31. Lee RJ, Bartzokis T, Yeoh TK, Grogin H, Choi D, Schnittger I (1991) Enhanced detection of intracardiac sources of cerebral emboli by transesophageal echocardiography. Stroke 22: 734–739PubMedCrossRefGoogle Scholar
  32. Love PE, Santoro SA (1990) Antiphospholipid antibodies: anticardiolipin and the lupus anticoagulant in systemic lupus erythematosus ( SLE) and in non-SLE disorders. Ann Intern Med 112: 682–698Google Scholar
  33. Marsh E, Biller J, Adams H et al (1990) Circadian variation in onset of acute ischemic stroke. Arch Neurol 47: 1178–1180PubMedGoogle Scholar
  34. Myers MA, Fleck A (1988) Observations on the delay in onset of the acute phase protein response. Br J Exp Pathol 69: 169–176PubMedGoogle Scholar
  35. North American Symptomatic Carotid Endarterectomy Trial Collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New Engl J Med 325: 445–453CrossRefGoogle Scholar
  36. Petersen P, Kastrup J, Videbaek R, Boysen G (1989) Cerebral blood flow before and after cardioversion of atrial fibrillation. J Cerebr Blood Flow Metab 9: 422–425CrossRefGoogle Scholar
  37. Sandset PM, Warn-Cramer BJ, Maki SL, Rapaport SI (1992) Immunodepletion of extrinsic pathway inhibitor sensitizes rabbits to endotoxin-induced intravascular coagulation and the generalized Shwartzman reaction. Blood 78: 1496–1502Google Scholar
  38. Scarpati EM, Sadler JE (1989) Regulation of endothelial cell coagulant properties. J Biol Chem 264: 20705–20713PubMedGoogle Scholar
  39. Schorer AE, Wickham NWR, Watson KV (1989) Lupus anticoagulant induces a selective defect in thrombin-mediated endothelial prostacyclin release and platelet aggregation. Br J Haematol 71: 399–407PubMedCrossRefGoogle Scholar
  40. Siebler M, Sitzer M, Steinmetz H (1992) Detection of intracranial emboli in patients with symptomatic extracranial carotid artery disease. Stroke 23: 1652–1654PubMedCrossRefGoogle Scholar
  41. Siren AL, Heldman E, Doron D et al (1992) Release of proinflammatory and prothrombotic mediators in the brain and peripheral circulation in spontaneously hypertensive and normotensive Wistar-Kyoto rats. Stroke 23: 1643–1651PubMedCrossRefGoogle Scholar
  42. Sloan DJ, Wood MJ, Charlton HM (1992) Leukocyte recruitment and inflammation in the CNS. TINS 15: 276–280PubMedGoogle Scholar
  43. Snow TR, Deal MT, Dickey DT, Esmon CT (1991) Protein C activation following coronary artery occlusion in the in situ porcine heart. Circulation 84: 293–299PubMedGoogle Scholar
  44. Suffredini AF, Harpel PC, Parrillo JE (1989) Promotion and subsequent inhibition of plasminogen activation after administration of intravenous endotoxin to normal subjects. New Engl J Med 320: 1165–1172PubMedCrossRefGoogle Scholar
  45. Syrjanen J, Valtonen W, Iivanainen M, Kaste M, Huttunen JK (1988) Preceding infection as an important risk factor for ischaemic brain infarction in young and middle aged patients. Br Med J 296: 1156–1160CrossRefGoogle Scholar
  46. Wilhelmsen L, Svardsudd K, Korsan-Bengtsen K, Larsson B, Welin L, Tibblin G (1984) Fibrinogen as a risk factor for stroke and myocardial infarction. New Engl J Med 311: 501–505PubMedCrossRefGoogle Scholar
  47. Wong VLY, Hofman F, Ishii H, Fisher M (1991) Regional distribution of thrombomodulin in human brain. Brain Res 556: 1–5PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1995

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  • M. J. Fisher

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