Acute ischemic stroke is the leading cause of disability in the United States. Therapeutic strategies to improve functional outcome by stimulating brain's recovery mechanisms hold a great promise for more than 700,000 annual stroke victims. Since brain function is heavily dependent on cerebral blood flow, enhancement of angiogenesis by proangiogenic agents and/or stem cells is being evaluated as a therapeutic modality in experimental models of stroke. Although type 2 diabetes is present in almost 40% of the acute ischemic stroke patients and worsens stroke outcome, how diabetes affects cerebral angiogenesis and neurovascular unit architecture that overall may influence the pathophysiology and magnitude of brain injury and recovery is not known. The objective of this exploratory R21 application is to understand the impact of type 2 diabetes on brain neovascularization and neurovascular patterning before and after stroke. We showed that diabetes stimulates cerebrovascular remodeling/arteriogenesis and ischemic brain injury superimposed on this pathology results in smaller infarcts but greater hemorrhagic transformation (HT) and poor functional outcomes. Our recent exciting data in nondiabetic rats suggested that angiogenic response after ischemic stroke depends on the optimization of redox signaling. Based on these findings, the central hypothesis is that diabetes differentially regulates cerebral angiogenesis before and after stroke in a redox-dependent manner. We will test this hypothesis in 2 specific aims:
Aim 1 : Determine the effect of diabetes and diabetic stroke on cerebral angiogenesis, and Aim 2: Determine the role of ischemia/reperfusion-generated oxidative stress on angiogenic vascular endothelial growth factor (VEGF) signaling in diabetes. An enhanced understanding of cerebrovascular networking in the setting of diabetes would not only allow us to develop preventive and therapeutic strategies for stroke in high risk patients but also improve therapeutic angiogenesis in stroke. Given that more than 40% of 700,000 annual ischemic stroke patients have a history of diabetes, we believe this project is translational in nature and will have a significant positive impact on human health.

Public Health Relevance

A great majority of stoke patients have diabetes. These patients have severe stroke outcomes. This project will determine the mechanisms of vascular protection before and after stroke under diabetic conditions to develop treatment strategies in these high risk patients.

Agency
National Institute of Health (NIH)
Institute
National Institute of Neurological Disorders and Stroke (NINDS)
Type
Exploratory/Developmental Grants (R21)
Project #
5R21NS070239-02
Application #
8225147
Study Section
Special Emphasis Panel (ZRG1-EMNR-P (02))
Program Officer
Koenig, James I
Project Start
2011-03-01
Project End
2014-02-28
Budget Start
2012-03-01
Budget End
2014-02-28
Support Year
2
Fiscal Year
2012
Total Cost
$187,084
Indirect Cost
$62,084
Name
Georgia Regents University
Department
Physiology
Type
Schools of Medicine
DUNS #
966668691
City
Augusta
State
GA
Country
United States
Zip Code
30912
Abdelsaid, Mohammed; Williams, Raeonda; Hardigan, Trevor et al. (2016) Linagliptin attenuates diabetes-induced cerebral pathological neovascularization in a blood glucose-independent manner: Potential role of ET-1. Life Sci 159:83-9
Hardigan, Trevor; Abdul, Yasir; Ergul, Adviye (2016) Linagliptin reduces effects of ET-1 and TLR2-mediated cerebrovascular hyperreactivity in diabetes. Life Sci 159:90-6
Yasir, Abdul; Hardigan, Trevor; Ergul, Adviye (2016) Diabetes-mediated middle cerebral artery remodeling is restored by linagliptin: Interaction with the vascular smooth muscle cell endothelin system. Life Sci 159:76-82
Abdelsaid, Mohammed; Prakash, Roshini; Li, Weiguo et al. (2015) Metformin treatment in the period after stroke prevents nitrative stress and restores angiogenic signaling in the brain in diabetes. Diabetes 64:1804-17
Abdelsaid, Mohammed; Ma, Handong; Coucha, Maha et al. (2014) Late dual endothelin receptor blockade with bosentan restores impaired cerebrovascular function in diabetes. Life Sci 118:263-7
Abdelsaid, Mohammed; Kaczmarek, Jessica; Coucha, Maha et al. (2014) Dual endothelin receptor antagonism with bosentan reverses established vascular remodeling and dysfunctional angiogenesis in diabetic rats: relevance to glycemic control. Life Sci 118:268-73
Alhusban, Ahmed; Kozak, Anna; Ergul, Adviye et al. (2013) AT1 receptor antagonism is proangiogenic in the brain: BDNF a novel mediator. J Pharmacol Exp Ther 344:348-59
Fagan, Susan C; Lapchak, Paul A; Liebeskind, David S et al. (2013) Recommendations for preclinical research in hemorrhagic transformation. Transl Stroke Res 4:322-7
Li, Weiguo; Qu, Zhi; Prakash, Roshini et al. (2013) Comparative analysis of the neurovascular injury and functional outcomes in experimental stroke models in diabetic Goto-Kakizaki rats. Brain Res 1541:106-14
Prakash, Roshini; Li, Weiguo; Qu, Zhi et al. (2013) Vascularization pattern after ischemic stroke is different in control versus diabetic rats: relevance to stroke recovery. Stroke 44:2875-82

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