Abstract

After stroke, secondary brain damage is influenced by the extent of fibrin clot formation. This is counteracted by the endogenous fibrinolysis. Of major interest are the key players of the fibrinolytic plasminogen activator system including the urokinase plasminogen activator (uPA), the tissue-type plasminogen activator (tPA), and their endogenous inhibitors plasminogen activator inhibitor 1 (PAI-1) and PAI-2. The role of PAI-1 in brain injury is well established, whereas the importance of PAI-2 is unknown at present. The objectives of the present were twofold: first, to characterize the time-dependent cerebral mRNA expression of the plasminogen activator system (PAS) after brain ischemia and second, to investigate the impact of PAI-1 and PAI-2 on brain infarct volume using gene-deficient mice. Adult C57Bl/6J mice were subjected to unilateral transient middle cerebral artery occlusion (MCAO) followed by reperfusion for 3, 24, 72, or 120 h. Quantitative PCR revealed that brain mRNA expression levels of the PAS components, and particularly of PAI-1 (237-fold) and PAI-2 (19-fold), peaked at 24 h after stroke. Accordingly, PAI-1 plasma activity was strongly increased. Brain infarct volume in TTC (2,3,5-triphenyltetrazolium chloride)-stained brain sections was significantly smaller 24 h after MCAO in PAI-1-deficient mice (− 31%), but not in PAI-2-deficient mice (− 6%). Thus, endogenous upregulation of PAI-1, but not of PAI-2, might contribute to increased brain damage after acute ischemic stroke. The present study therefore shows that PAI-2 is induced by brain ischemia, but does not play an important or relevant role for secondary brain damage after brain injury.

Highlights

  • Stroke is the fourth leading cause of death and about 87% of the cases are caused by ischemic occlusion of a cerebral artery [1]

  • The time-dependent effects after middle cerebral artery occlusion (MCAO) on mRNA expression of the plasminogen activator system components type plasminogen activator (tPA), urokinase PA (uPA), plasminogen activator inhibitor 1 (PAI-1), and Plasminogen activator inhibitors (PAIs)-2 were quantified in peri-ischemic tissue at 3, 24, 72, and 120 h after reperfusion and were compared to sham surgery

  • The present study focused on the questions whether the plasminogen activator system is influenced by stroke and how this interferes with the extent of brain injury

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Summary

Introduction

Stroke is the fourth leading cause of death and about 87% of the cases are caused by ischemic occlusion of a cerebral artery [1]. Therapeutic standard procedures are endovascular revascularization or systemic thrombolysis via tissue-type plasminogen activator (tPA) within 3 to 4.5 h after insult, but more than 90% of patients do not receive this treatment due to strict. Eva-Verena Griemert and Kirsten Recarte Pelz contributed to this work High levels of PAI-1 impair the fibrinolytic system by binding to tPA and promoting stable fibrin clot formation, which obstruct micro vessels in the ischemic zone [9,10,11,12]

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