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Alcohol exposure–induced neurovascular inflammatory priming impacts ischemic stroke and is linked with brain perivascular macrophages
Antoine Drieu, … , Denis Vivien, Marina Rubio
Antoine Drieu, … , Denis Vivien, Marina Rubio
Published January 28, 2020
Citation Information: JCI Insight. 2020;5(4):e129226. https://doi.org/10.1172/jci.insight.129226.
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Research Article Inflammation Neuroscience

Alcohol exposure–induced neurovascular inflammatory priming impacts ischemic stroke and is linked with brain perivascular macrophages

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Abstract

Alcohol abuse is a major public health problem worldwide, causing a wide range of preventable morbidity and mortality. In this translational study, we show that heavy drinking (HD) (≥6 standard drinks/day) is independently associated with a worse outcome for ischemic stroke patients. To study the underlying mechanisms of this deleterious effect of HD, we performed an extensive analysis of the brain inflammatory responses of mice chronically exposed or not to 10% alcohol before and after ischemic stroke. Inflammatory responses were analyzed at the parenchymal, perivascular, and vascular levels by using transcriptomic, immunohistochemical, in vivo 2-photon microscopy and molecular MRI analyses. Alcohol-exposed mice show, in the absence of any other insult, a neurovascular inflammatory priming (i.e., an abnormal inflammatory status including an increase in brain perivascular macrophages [PVM]) associated with exacerbated inflammatory responses after a secondary insult (ischemic stroke or LPS challenge). Similar to our clinical data, alcohol-exposed mice showed larger ischemic lesions. We show here that PVM are key players on this aggravating effect of alcohol, since their specific depletion blocks the alcohol-induced aggravation of ischemic lesions. This study opens potentially new therapeutic avenues aiming at blocking alcohol-induced exacerbation of the neurovascular inflammatory responses triggered after ischemic stroke.

Authors

Antoine Drieu, Anastasia Lanquetin, Damien Levard, Martina Glavan, Francisco Campos, Aurélien Quenault, Eloïse Lemarchand, Mikaël Naveau, Anne Lise Pitel, José Castillo, Denis Vivien, Marina Rubio

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Figure 1

Heavy drinking (HD) aggravates ischemic stroke baseline severity and outcome, and it increases early neurological deterioration (END) risk.

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Heavy drinking (HD) aggravates ischemic stroke baseline severity and out...
Inflammatory markers are independently associated to the alcohol-induced increased risk of END. (A) Schema of the study. (B) Representation of neurological stroke severity determined by the NIH Stroke Scale (NIHSS) at admission and 24 and 48 hours in stroke patients with and without heavy drinking habits. Early neurological deterioration (END) is defined as an increase of NIHSS in 4 or more points in the first 48 hours after admission. (C) Forest plot of the multivariate analysis including variables predicting END (n = 206) such as hemorrhagic transformation, infarct volume, NIHSS on admission, and HD habits (Model A). (D) Forest plot of the multivariate analysis of the variables included in the Model A and inflammatory biomarkers (axillary temperature, number of leukocytes levels, and C-reactive protein levels) (Model B).

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