title: Cerebral ischemic damage in diabetes: an inflammatory perspective.
abstract: Stroke is one of the leading causes of death worldwide. A strong inflammatory response characterized by activation and release of cytokines, chemokines, adhesion molecules, and proteolytic enzymes contributes to brain damage following stroke. Stroke outcomes are worse among diabetics, resulting in increased mortality and disabilities. Diabetes involves chronic inflammation manifested by reactive oxygen species generation, expression of proinflammatory cytokines, and activation/expression of other inflammatory mediators. It appears that increased proinflammatory processes due to diabetes are further accelerated after cerebral ischemia, leading to increased ischemic damage. Hypoglycemia is an intrinsic side effect owing to glucose-lowering therapy in diabetics, and is known to induce proinflammatory changes as well as exacerbate cerebral damage in experimental stroke. Here, we present a review of available literature on the contribution of neuroinflammation to increased cerebral ischemic damage in diabetics. We also describe the role of hypoglycemia in neuroinflammation and cerebral ischemic damage in diabetics. Understanding the role of neuroinflammatory mechanisms in worsening stroke outcome in diabetics may help limit ischemic brain injury and improve clinical outcomes.
authors.affiliation: Cerebral Vascular Disease Research Laboratories, University of Miami School of Medicine, Miami, FL, 33136, USA.|Department of Neurology (D4-5), University of Miami Miller School of Medicine, 1420 NW 9th Ave, NRB/203E, Miami, FL, 33136, USA.
authors.forename: Vibha
authors.initials: V
authors.lastname: Shukla
authors.affiliation: Present address: Department of Microbiology and Immunology, and Center for Molecular and Tumor Virology, Louisiana State University Health Sciences Center, Shreveport, LA, 71130, USA.
authors.forename: Akhalesh Kumar
authors.initials: AK
authors.lastname: Shakya
authors.affiliation: Cerebral Vascular Disease Research Laboratories, University of Miami School of Medicine, Miami, FL, 33136, USA.|Department of Neurology (D4-5), University of Miami Miller School of Medicine, 1420 NW 9th Ave, NRB/203E, Miami, FL, 33136, USA.|Neuroscience Program, University of Miami School of Medicine, Miami, FL, 33136, USA.
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Perez-Pinzon
authors.affiliation: Cerebral Vascular Disease Research Laboratories, University of Miami School of Medicine, Miami, FL, 33136, USA. KDave@med.miami.edu.|Department of Neurology (D4-5), University of Miami Miller School of Medicine, 1420 NW 9th Ave, NRB/203E, Miami, FL, 33136, USA. KDave@med.miami.edu.|Neuroscience Program, University of Miami School of Medicine, Miami, FL, 33136, USA. KDave@med.miami.edu.
authors.forename: Kunjan R
authors.initials: KR
authors.lastname: Dave
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism; D016207:Cytokines / Q000378:metabolism; D003920:Diabetes Mellitus / Q000503:physiopathology*; D004660:Encephalitis / Q000209:etiology*; D006801:Humans; D020521:Stroke / Q000150:complications* / Q000473:pathology
chemical_list: D016207:Cytokines
keywords: Cell death; Chemokines; Cytokines; Diabetic brain; Hyperglycemia; Hypoglycemia; Immune cells; Inflammation; Stroke