Inflammatory mediator expression within retrieved clots in acute ischemic stroke.

Area of Science:

• Neuroscience
• Molecular Biology
• Radiology

Background:

• Acute ischemic stroke (AIS) is a leading cause of long-term disability.
• Mechanical thrombectomy is a key treatment for AIS, retrieving intracranial clots.
• Understanding stroke etiology is crucial for effective treatment and prevention.

Purpose of the Study:

• To investigate the association between inflammatory mediator expression in retrieved clots, stroke etiology, and the susceptibility vessel sign (SVS) on gradient-echo (GRE) MRI.
• To explore the potential of molecular clot analysis for determining stroke mechanisms.

Main Methods:

• Molecular analysis of intracranial clots from 82 AIS patients treated with mechanical thrombectomy.
• Quantitative real-time polymerase chain reaction (PCR) to measure inflammatory mediator expression (IL-1β, TNF-α, MMP-9).
• Assessment of associations between mediator expression, stroke etiology (cardioembolism, large artery atherosclerosis, undetermined), and GRE SVS presence.

Main Results:

• Clots from large artery atherosclerosis strokes showed significantly higher IL-1β expression compared to other etiologies.
• Higher expression of IL-1β, TNF-α, and MMP-9 was observed in clots with a negative SVS compared to those with a positive SVS.
• Significant differences in inflammatory mediator expression were found based on stroke etiology and SVS presence.

Conclusions:

• Inflammatory mediator profiles in intracranial clots vary significantly with stroke etiology and SVS.
• Molecular analysis of retrieved clots offers a promising approach to elucidate stroke mechanisms in AIS.
• This approach may aid in identifying the underlying cause of stroke, guiding personalized treatment strategies.