Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
10739235 | Free Radical Biology and Medicine | 2005 | 20 Pages |
Abstract
Brain edema is a leading cause of death after stroke. Cytotoxic edema, which is most severe in astrocytes, begins within a few minutes of adenosine triphosphate depletion and reflects the ultimate infarct size. Vasogenic edema is caused by uncontrolled fluid leakage from the blood to the brain parenchyma through a weakened blood-brain barrier (BBB) and contributes to an actual net volume increase of the brain, which often leads to death. Recent research on ischemia-induced injury mechanisms of the microvasculature has led to the disclosure of the mechanisms and cellular pathways leading to BBB breakdown. In addition, the introduction of magnetic resonance imaging to clinical practice has enabled the evaluation of edema severity in stroke patients and differentiation between cytotoxic and vasogenic edema. Free radicals exert their deleterious actions during both cytotoxic and vasogenic edema. They can contribute to BBB disruption directly and can also trigger molecular pathways related to the dysfunction of ion transporters in the cell membrane and those related to increased vascular permeability. The development of effective therapeutic strategies aimed at reducing brain edema based on targeting specific molecular pathways involved may reduce death and disability from stroke.
Keywords
ICAMADCuPARuPALRPICPtPAcGMPNOSGSHECMAMPACBFHIFNMDAN-methyl-d-aspartateDWIAQPurokinase-type PAMMPSMCCPPtissue-type PAMMITNFMCATAAROSAdenosine TriphosphateATPaquaporintight junctionsBrain edemaα-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acidMRIMalignant middle cerebral artery infarctionCerebral infarctionIschemiainterleukinPAIplasminogen activator inhibitorhemorrhagic transformationdiffusion-weighted imagingMagnetic resonance imagingcomputed tomographycerebral blood flowintracerebral hemorrhageCNSFree radicalsSODBBBBlood–brain barrierSmooth muscle cellSuperoxide dismutasecentral nervous systemmiddle cerebral arteryapparent diffusion coefficientnuclear factorHypoxia-inducible factorVascular endothelial growth factorVascular Endothelial Growth Factor (VEGF)Platelet-activating factortumor necrosis factorintracranial pressureCerebral perfusion pressureplasminogen activatorExtracellular matrixmatrix metalloproteinaseCSFCerebrospinal fluidICHintercellular adhesion moleculecyclic guanosine monophosphateNitric oxidenitric oxide synthasePAFLow-density lipoprotein receptor-related proteinAdherens junctionGlutathioneReactive oxygen speciesuPA receptor
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Authors
Ji Hoe Heo, Sang Won Han, Seung Koo Lee,