title: Bone Fracture Pre-Ischemic Stroke Exacerbates Ischemic Cerebral Injury in Mice.
abstract: Ischemic stroke is a devastating complication of bone fracture. Bone fracture shortly after stroke enhances stroke injury by augmenting inflammation. We hypothesize that bone fracture shortly before ischemic stroke also exacerbates ischemic cerebral injury. Tibia fracture was performed 6 or 24 hours before permanent middle cerebral artery occlusion (pMCAO) on C57BL/6J mice or Ccr2RFP/+Cx3cr1GFP/+ mice that have the RFP gene knocked into one allele of Ccr2 gene and GFP gene knocked into one allele of Cx3cr1 gene. Behavior was tested 3 days after pMCAO. Infarct volume, the number of CD68+ cells, apoptotic neurons, bone marrow-derived macrophages (RFP+), and microgila (GFP+) in the peri-infarct region were quantified. Compared to mice subjected to pMCAO only, bone fracture 6 or 24 hours before pMCAO increased behavioral deficits, the infarct volume, and the number of CD68+ cells and apoptotic neurons in the peri-infarct area. Both bone marrow-derived macrophages (CCR2+) and microglia (CX3CR1+) increased in the peri-infarct regions of mice subjected to bone fracture before pMCAO compared to stroke-only mice. The mice subjected to bone fracture 6 hours before pMCAO had more severe injury than mice that had bone fracture 24 hours before pMCAO. Our data showed that bone fracture shortly before stroke also increases neuroinflammation and exacerbates ischemic cerebral injury. Our findings suggest that inhibition of neuroinflammation or management of stroke risk factors before major bone surgery would be beneficial for patients who are likely to suffer from stroke.
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.|Department of Neurosurgery, Tianjin Fifth Center Hospital, Tianjin, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.|Department of Neurosurgery, Beijing Tiantan Hospital, Beijing, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Kang
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Dingquan
authors.initials: D
authors.lastname: Zou
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhan
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.|Department of Neurology, Shanghai Ninth People's Hospital, Shanghai, China.
authors.forename: Zhengxi
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Wan
authors.initials: W
authors.lastname: Zhu
authors.affiliation: Department of Anesthesia and Perioperative Care, Center for Cerebrovascular Research, University of California San Francisco, San Francisco, California, United States of America.
authors.forename: Hua
authors.initials: H
authors.lastname: Su
mesh_terms: D000818:Animals; D001522:Behavior, Animal; D001930:Brain Injuries / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D002545:Brain Ischemia / Q000209:etiology* / Q000378:metabolism / Q000473:pathology; D000073883:CX3C Chemokine Receptor 1; D016207:Cytokines / Q000378:metabolism; D004195:Disease Models, Animal; D004797:Enzyme-Linked Immunosorbent Assay; D050723:Fractures, Bone / Q000150:complications* / Q000378:metabolism / Q000473:pathology; D007124:Immunoenzyme Techniques; D020244:Infarction, Middle Cerebral Artery / Q000503:physiopathology; D007249:Inflammation / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D018345:Mice, Knockout; D008822:Mice, Transgenic; D017628:Microglia / Q000276:immunology / Q000473:pathology; D054390:Receptors, CCR2 / Q000502:physiology; D019707:Receptors, Chemokine / Q000502:physiology; D020521:Stroke / Q000209:etiology* / Q000378:metabolism / Q000473:pathology
chemical_list: D000073883:CX3C Chemokine Receptor 1; C515335:Ccr2 protein, mouse; C471885:Cx3cr1 protein, mouse; D016207:Cytokines; D054390:Receptors, CCR2; D019707:Receptors, Chemokine