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Ferrara, Fabienne [Author]; Zeisig, Vilia [Author]; Pietsch, Sören [Author]; Rütten, Rita [Author]; Dreyer, Antje Y. [Author]; Pieper, Laura [Author]; Schatzl, Ann-Kathrin [Author]; McLeod, Damian D. [Author]; Barthel, Henryk [Author]; Boltze, Johannes [Author]; Schrödl, Wieland [Author]; Nitzsche, Björn [Author]

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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  • Media type: E-Article
  • Title: Hypothesis and Theory: A Pathophysiological Concept of Stroke-Induced Acute Phase Response and Increased Intestinal Permeability Leading to Secondary Brain Damage
  • Contributor: Ferrara, Fabienne [Author]; Zeisig, Vilia [Author]; Pietsch, Sören [Author]; Rütten, Rita [Author]; Dreyer, Antje Y. [Author]; Pieper, Laura [Author]; Schatzl, Ann-Kathrin [Author]; McLeod, Damian D. [Author]; Barthel, Henryk [Author]; Boltze, Johannes [Author]; Schrödl, Wieland [Author]; Nitzsche, Björn [Author]
  • imprint: Lausanne: Frontiers Research Foundation, [2023]
  • Published in: Frontiers in neuroscience ; 14, (2020)
  • Language: English
  • Keywords: ischemic stroke ; acute phase proteins ; gut-brain axis ; large animal stroke models ; systemic inflammation ; intestinal permeability ; immune response ; cerebral ischemia
  • Origination:
  • Footnote:
  • Description: Gut integrity impairment leading to increased intestinal permeability (IP) is hypothesizedto be a trigger of critically illness. Approximately 15–20% of human ischemic stroke (IS)victims require intensive care, including patients with impaired level of consciousnessor a high risk for developing life-threatening cerebral edema. Local and systemicinflammatory reactions are a major component of the IS pathophysiology and cansignificantly aggravate brain tissue damage. Intracerebral inflammatory processesfollowing IS have been well studied. Until now, less is known about systemicinflammatory responses and IS consequences apart from a frequently observed post-IS immunosuppression. Here, we provide a hypothesis of a crosstalk between systemicacute phase response (APR), IP and potential secondary brain damage during acute andsubacute IS stages supported by preliminary experimental data. Alterations of the acutephase proteins (APPs) C-reactive protein and lipopolysaccharide-binding protein andserum 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 inten 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 andincreased IP, and underlines the importance of the increasingly recognized gut-brain axisand of intestinal antigen release for systemic immune responses in acute and subacutestroke stages.
  • Access State: Open Access
  • Rights information: Attribution (CC BY)