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Neurovascular injury in acute hyperglycemia and diabetes: A comparative analysis in experimental stroke.
MedLine Citation:
PMID:  21909340     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Admission hyperglycemia impacts ischemic stroke deleteriously but the relative role of acute hyperglycemia (HG) versus diabetes in the pathogenesis of this poor outcome is not clear. PURPOSE: To determine the effect of acute HG on neurovascular outcomes of stroke under control and diabetic conditions. METHODS: Moderate acute HG (140-200 mg/dl) was achieved by glucose injection before middle cerebral artery occlusion (MCAO) in control Wistar and diabetic Goto-Kakizaki (GK) rats. Following 3 h MCAO/21 h reperfusion, we measured infarct size, hemorrhagic transformation (HT) frequency, excess hemoglobin, neurobehavioral outcome and plasma and MCA matrix metalloprotease (MMP) activity. RESULTS: Infarct size was significantly smaller in diabetic rats. Moderate acute HG increased neuronal damage in diabetic but not in control rats. HT frequency and hemoglobin were significantly higher in diabetic rats. HG augmented vascular damage in control rats and had no additional effect on bleeding in diabetic rats. Baseline plasma MMP-9 activity was significantly higher in diabetic rats. HG increased MMP-9 activity in control and diabetic rats. Neurological deficit was greater in diabetic rats and was worsened by HG. CONCLUSIONS: The finding that functional outcome is poorer in both acute HG and diabetes without a significant increase in infarct size suggests that amplified vascular damage contributes to neurological deficit in hyperglycemia. These results highlight the importance of vascular protection to improve neurological outcome in acute ischemic stroke.
Authors:
Mostafa M Elgebaly; Safia Ogbi; Weiguo Li; Erin M Mezzetti; Roshini Prakash; Maribeth H Johnson; Askiel Bruno; Susan C Fagan; Adviye Ergul
Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  Translational stroke research     Volume:  2     ISSN:  1868-601X     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101517297     Medline TA:  Transl Stroke Res     Country:  -    
Other Details:
Languages:  ENG     Pagination:  391-398     Citation Subset:  -    
Affiliation:
Program in Clinical and Experimental Therapeutics, Department of Clinical and Administrative Pharmacy, College of Pharmacy, University of Georgia; MCG, UGA Clinical Pharmacy Program, HM-1200, Augusta, GA, 30912, USA.
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Descriptor/Qualifier:
Grant Support
ID/Acronym/Agency:
R21 NS070239-01A1//NINDS NIH HHS

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