Abstract

The major pathological consequences of cerebral ischemia are characterized by neurological deficits commonly ascribed to the infarcted tissue and its surrounding region, however, brain areas, as well as peripheral organs, distal from the original injury may manifest as subtle disease sequelae that can increase the risks of co-morbidities complicating the disease symptoms. To evaluate the vulnerability of the cerebellum and the heart to secondary injuries in the late stage of transient global ischemia (TGI) model in non-human primates (NHP), brain and heart tissues were collected at six months post-TGI. Unbiased stereological analyses of immunostained tissues showed significant Purkinje cells loss in lobule III and lobule IX of the TGI cerebellum relative to sham cerebellum, with corresponding upregulation of inflammatory and apoptotic cells. Similarly, TGI hearts revealed significant activation of inflammatory and apoptotic cells relative to sham hearts. Aberrant inflammation and apoptosis in the cerebellum and the heart of chronic TGI-exposed NHPs suggest distal secondary injuries manifesting both centrally and peripherally. These results advance our understanding on the sustained propagation of chronic secondary injuries after TGI, highlighting the need to develop therapeutic interventions targeting the brain, as well as the heart, in order to abrogate cerebral ischemia and its related co-morbidities.

Highlights

  • Global ischemic injury caused by circulatory arrest has long been associated with physical changes in the human brain [1]

  • There were significant reductions in calbindin+ Purkinje cells in the cerebellum of the transient global ischemia (TGI) non-human primates (NHP), in lobule III and lobule IX compared to the same areas in the cerebellum of the sham NHPs (Student t-test, p’s < 0.05), indicating TGI resulted in secondary damage to the cerebellum

  • We investigated the degenerative consequences of global cerebral ischemia model in distal areas including the cerebellum and the heart

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Summary

Introduction

Global ischemic injury caused by circulatory arrest has long been associated with physical changes in the human brain [1] To date, these brain tissue modifications that follow global ischemia have been studied using both nonsurgical [2, 3] and surgical models [4]. Cellular death signals in cardiac tissue are upregulated following cerebral ischemia in both in vitro experiments and in vivo rodent models [7, 10]. These observations potentially explain the notable percentage of cardiac-related deaths in humans within 3 months of ischemic cerebral injury [7, 11, 12]. These results revealed that all cell death markers were detectable in both the brain and the heart after ischemic stroke, advancing the www.impactjournals.com/oncotarget concept of a pathological link between the cerebrovascular and cardiovascular diseases

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