Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome
Background Acute ischemic stroke is a neurologic emergency associated with severe disability and death. There is growing evidence that neutrophil extracellular traps (NETs) contribute to the pathogenesis of acute stroke. By mechanical removal of the occluding thrombus from the patient's vascula...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-05-01
|
| Series: | Stroke: Vascular and Interventional Neurology |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.122.000639 |
| _version_ | 1797834884685758464 |
|---|---|
| author | Arnaud Lapostolle Chloé Loyer Mahmoud Elhorany Thomas Chaigneau Franck Bielle Sonia Alamowitch Frédéric Clarençon Carole Elbim |
| author_facet | Arnaud Lapostolle Chloé Loyer Mahmoud Elhorany Thomas Chaigneau Franck Bielle Sonia Alamowitch Frédéric Clarençon Carole Elbim |
| author_sort | Arnaud Lapostolle |
| collection | DOAJ |
| description | Background Acute ischemic stroke is a neurologic emergency associated with severe disability and death. There is growing evidence that neutrophil extracellular traps (NETs) contribute to the pathogenesis of acute stroke. By mechanical removal of the occluding thrombus from the patient's vasculature, endovascular thrombectomy enables the collection of thrombus material for immunohistologic analysis. The aim of our study was to strengthen the association of NET content in ischemic thrombi with clinical outcome and guide future therapeutics. Methods We performed an immunohistologic analysis of thrombi from 101 patients with acute ischemic stroke, focusing on the association between NET content and clinical and interventional indicators. Results NETs were present in every patient with acute ischemic stroke. Their abundance in thrombi was associated with interventional markers of thrombus stability. NET‐rich thrombi were associated with unsuccessful recanalization (modified Thrombolysis in Cerebral Infarction <2B) and longer procedure time, and NET abundance in acute ischemic stroke thrombi was associated with outcomes evaluated by patients’ postassessment National Institutes of Health Stroke Scale and modified Rankin Scale scores. Conclusion These findings suggest that NET content is critically important to thrombus stability and clinical outcome in acute stroke. They should open new perspectives for innovative immunotherapy strategies based on neutrophil modulation. |
| first_indexed | 2024-04-09T14:45:42Z |
| format | Article |
| id | doaj.art-7b1084fb65a946f9a082dbe55c0d8123 |
| institution | Directory Open Access Journal |
| issn | 2694-5746 |
| language | English |
| last_indexed | 2024-04-09T14:45:42Z |
| publishDate | 2023-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj.art-7b1084fb65a946f9a082dbe55c0d81232023-05-02T18:30:22ZengWileyStroke: Vascular and Interventional Neurology2694-57462023-05-013310.1161/SVIN.122.000639Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical OutcomeArnaud Lapostolle0Chloé Loyer1Mahmoud Elhorany2Thomas Chaigneau3Franck Bielle4Sonia Alamowitch5Frédéric Clarençon6Carole Elbim7Sorbonne Université, Inserm UMRS 938, Hôpital St‐Antoine Centre de Recherche Saint‐Antoine Paris FranceSorbonne Université, Inserm UMRS 938, Hôpital St‐Antoine Centre de Recherche Saint‐Antoine Paris FranceDépartement de Neuroradiologie Hôpital Pitié‐Salpêtrière Assistance Publique‐Hôpitaux de Paris Paris FranceSorbonne Université, Inserm UMRS 938, Hôpital St‐Antoine Centre de Recherche Saint‐Antoine Paris FranceSorbonne Université, Inserm, CNRS, UMR S 1127 Institut du Cerveau et de la Moelle épinière ICM, AP‐HP Service de Neuropathologie Laboratoire Escourolle Hôpitaux Universitaires La Pitié Salpêtrière ‐ Charles Foix Paris FranceService des urgences cérébro‐vasculaires Hôpital Pitié‐Salpêtrière Assistance Publique‐Hôpitaux de Paris Paris FranceDépartement de Neuroradiologie Hôpital Pitié‐Salpêtrière Assistance Publique‐Hôpitaux de Paris Paris FranceSorbonne Université, Inserm UMRS 938, Hôpital St‐Antoine Centre de Recherche Saint‐Antoine Paris FranceBackground Acute ischemic stroke is a neurologic emergency associated with severe disability and death. There is growing evidence that neutrophil extracellular traps (NETs) contribute to the pathogenesis of acute stroke. By mechanical removal of the occluding thrombus from the patient's vasculature, endovascular thrombectomy enables the collection of thrombus material for immunohistologic analysis. The aim of our study was to strengthen the association of NET content in ischemic thrombi with clinical outcome and guide future therapeutics. Methods We performed an immunohistologic analysis of thrombi from 101 patients with acute ischemic stroke, focusing on the association between NET content and clinical and interventional indicators. Results NETs were present in every patient with acute ischemic stroke. Their abundance in thrombi was associated with interventional markers of thrombus stability. NET‐rich thrombi were associated with unsuccessful recanalization (modified Thrombolysis in Cerebral Infarction <2B) and longer procedure time, and NET abundance in acute ischemic stroke thrombi was associated with outcomes evaluated by patients’ postassessment National Institutes of Health Stroke Scale and modified Rankin Scale scores. Conclusion These findings suggest that NET content is critically important to thrombus stability and clinical outcome in acute stroke. They should open new perspectives for innovative immunotherapy strategies based on neutrophil modulation.https://www.ahajournals.org/doi/10.1161/SVIN.122.000639ischemic strokeneutrophilsneutrophil extracellular trapsthrombectomy |
| spellingShingle | Arnaud Lapostolle Chloé Loyer Mahmoud Elhorany Thomas Chaigneau Franck Bielle Sonia Alamowitch Frédéric Clarençon Carole Elbim Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome Stroke: Vascular and Interventional Neurology ischemic stroke neutrophils neutrophil extracellular traps thrombectomy |
| title | Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome |
| title_full | Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome |
| title_fullStr | Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome |
| title_full_unstemmed | Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome |
| title_short | Neutrophil Extracellular Traps in Ischemic Stroke Thrombi Are Associated Wth Poor Clinical Outcome |
| title_sort | neutrophil extracellular traps in ischemic stroke thrombi are associated wth poor clinical outcome |
| topic | ischemic stroke neutrophils neutrophil extracellular traps thrombectomy |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.122.000639 |
| work_keys_str_mv | AT arnaudlapostolle neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT chloeloyer neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT mahmoudelhorany neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT thomaschaigneau neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT franckbielle neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT soniaalamowitch neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT fredericclarencon neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome AT caroleelbim neutrophilextracellulartrapsinischemicstrokethrombiareassociatedwthpoorclinicaloutcome |