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Acid-Base and Electrolyte Changes Drive Early Pathology in Ischemic Stroke.
NeuroMolecular Medicine ( IF 3.5 ) Pub Date : 2019-07-06 , DOI: 10.1007/s12017-019-08555-5
Sarah R Martha 1 , Justin F Fraser 2, 3, 4, 5 , Keith R Pennypacker 2, 4
Affiliation  

Emergent large vessel occlusion accounts for 20–40% of ischemic strokes and is the most debilitating form of stroke. Some of the earliest changes in response to ischemic stroke occur in blood gases and electrolytes. These biochemical changes occur within minutes after occlusion in experimental models of stroke and can be utilized to predict stroke outcomes. The majority of ELVO stroke patients are middle-aged to elderly and are of both sexes, revealing that there is an age and sex mismatch between ischemic stroke patients and animal models, since most experimental studies use young male rats. Rethinking of the animal models should be considered, especially in encouraging the use of aged male and female rats with comorbidities to more closely mirror human populations. Mechanical thrombectomy provides a unique opportunity for researchers to further this work by expanding the collection and analysis of blood samples that are adjacent to the thrombus. To understand the complexity of stroke, researchers can analyze these tissues for different molecular targets that occur in response to ischemic stroke. This information may aid in the reduction of symptom burden for individuals diagnosed with ischemic stroke. Investigators should also focus on data from ischemic stroke patients and attempt to discover target molecules and then in animal models to establish mechanism, which will aid in the development of new stroke therapies. This review discusses the translation of these studies to the human patient to develop the capability to predict stroke outcomes. Future studies are needed to identify molecular targets to predict the risk of worsened long-term outcomes and/or increased risk for mortality.

中文翻译:

酸碱和电解质的变化驱动缺血性卒中的早期病理。

紧急大血管阻塞占缺血性卒中的20%至40%,是中风中最使人衰弱的形式。最早响应缺血性中风的某些变化发生在血液气体和电解质中。这些生化变化在中风的实验模型闭塞后数分钟内发生,可用于预测中风的预后。大多数的ELVO脑卒中患者是中年至老年人,并且都是性别的,这表明缺血性脑卒中患者和动物模型之间存在年龄和性别的不匹配,因为大多数实验研究都使用年轻的雄性大鼠。应该考虑对动物模型进行重新思考,特别是在鼓励使用患有合并症的成年雄性和雌性大鼠中以更紧密地反映人类种群时。机械血栓切除术为研究人员提供了独特的机会,可通过扩大血栓附近血样的收集和分析来进一步开展这项工作。为了了解中风的复杂性,研究人员可以分析这些组织中是否存在响应缺血性中风的不同分子靶标。此信息可能有助于减轻诊断为缺血性中风的患者的症状负担。研究人员还应关注缺血性中风患者的数据,并尝试发现靶分子,然后在动物模型中建立机制,这将有助于开发新的中风疗法。这篇综述讨论了这些研究对人类患者的翻译,以发展预测中风结果的能力。
更新日期:2019-07-06
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