@article{EssigBabilonVollmuthetal.2021,
  author    = {Essig, Fabian and Babilon, Lilith and Vollmuth, Christoph and Kollikowski, Alexander M. and Pham, Mirko and Solymosi, L{\´a}szl{\´o} and Haeusler, Karl Georg and Kraft, Peter and Stoll, Guido and Schuhmann, Michael K.},
  title     = {High mobility group box 1 protein in cerebral thromboemboli},
  series = {International Journal of Molecular Sciences},
  volume    = {22},
  journal   = {International Journal of Molecular Sciences},
  number    = {20},
  issn      = {1422-0067},
  doi       = {10.3390/ijms222011276},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-265568},
  year      = {2021},
  abstract  = {High-mobility group box 1 protein (HMGB1) is a damage-associated molecular pattern (DAMP) involved in neutrophil extracellular trap (NET) formation and thrombosis. NETs are regularly found in cerebral thromboemboli. We here analyzed associated HMGB1 expression in human thromboemboli retrieved via mechanical thrombectomy from 37 stroke patients with large vessel occlusion. HMGB1 was detected in all thromboemboli, accounting for 1.7\% (IQR 0.6-6.2\%) of the total thromboemboli area and was found to be colocalized with neutrophils and NETs and in spatial proximity to platelets. Correlation analysis revealed that the detection of HMGB1 was strongly related to the number of neutrophils (r = 0.58, p = 0.0002) and platelets (r = 0.51, p = 0.001). Our results demonstrate that HMGB1 is a substantial constituent of thromboemboli causing large vessel occlusion stroke.},
  language  = {en}
}
@article{EssigKollikowskiPhametal.2020,
  author    = {Essig, Fabian and Kollikowski, Alexander M. and Pham, Mirko and Solymosi, L{\´a}szl{\´o} and Stoll, Guido and Haeusler, Karl Georg and Kraft, Peter and Schuhmann, Michael K.},
  title     = {Immunohistological analysis of neutrophils and neutrophil extracellular traps in human thrombemboli causing acute ischemic stroke},
  series = {International Journal of Molecular Sciences},
  volume    = {21},
  journal   = {International Journal of Molecular Sciences},
  number    = {19},
  issn      = {1422-0067},
  doi       = {10.3390/ijms21197387},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-236192},
  year      = {2020},
  abstract  = {Ischemic stroke caused by thromboembolic occlusion of large cerebral arteries, such as the internal carotid (ICA) and/or the middle cerebral artery (MCA), is treated by mechanical thrombectomy (MT). MT allows salvage of the vessel-occluding thrombemboli, which most frequently originate from the left atrium or the left ventricle of the heart or from sites of plaque rupture within large arteries above the heart. Clot composition may influence the efficacy of (intravenous) thrombolysis and MT, respectively. We analyzed 37 human thrombemboli obtained from acute ischemic stroke patients during MT with special emphasis on histological staining of neutrophils and neutrophil extracellular traps (NETs). We found neutrophils as the main cellular component of cerebral thrombemboli but encountered considerable morphological heterogeneity. Neutrophils accumulated in the border region of fibrin-rich structures indicating possible interaction of neutrophils with distinct structural thrombembolus components. Web-like NETs were found in 35 of 37 thrombemboli in varying amounts. NETs were almost exclusively found within fibrin-rich areas. Importantly, stroke etiology, age and present oral anticoagulation was associated with morphological patterns and the amount of neutrophils. Correlation of histological data and imaging data revealed that relative Hounsfield units of cerebral thrombemboli positively correlated with the amount of red blood cells. In summary, our results demonstrate that neutrophils and NETs are substantial constituents of cerebral thrombemboli and contribute to their structural complexity.},
  language  = {en}
}
@article{KraftDrechslerGunrebenetal.2015,
  author    = {Kraft, Peter and Drechsler, Christiane and Gunreben, Ignaz and Heuschmann, Peter Ulrich and Kleinschnitz, Christoph},
  title     = {Case-control study of platelet glycoprotein receptor Ib and IIb/IIIa expression in patients with acute and chronic cerebrovascular disease},
  series = {PLoS ONE},
  volume    = {10},
  journal   = {PLoS ONE},
  number    = {3},
  doi       = {10.1371/journal.pone.0119810},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-148806},
  pages     = {e0119810},
  year      = {2015},
  abstract  = {Background Animal models have been instrumental in defining thrombus formation, including the role of platelet surface glycoprotein (GP) receptors, in acute ischemic stroke (AIS). However, the involvement of GP receptors in human ischemic stroke pathophysiology and their utility as biomarkers for ischemic stroke risk and severity requires elucidation. Aims To determine whether platelet GPIb and GPIIb/IIIa receptors are differentially expressed in patients with AIS and chronic cerebrovascular disease (CCD) compared with healthy volunteers (HV) and to identify predictors of GPIb and GPIIb/IIIa expression. Methods This was a case-control study of 116 patients with AIS or transient ischemic attack (TIA), 117 patients with CCD, and 104 HV who were enrolled at our University hospital from 2010 to 2013. Blood sampling was performed once in the CCD and HV groups, and at several time points in patients with AIS or TIA. Linear regression and analysis of variance were used to analyze correlations between platelet GPIb and GPIIb/IIIa receptor numbers and demographic and clinical parameters. Results GPIb and GPIIb/IIIa receptor numbers did not significantly differ between the AIS, CCD, and HV groups. GPIb receptor expression level correlated significantly with the magnitude of GPIIb/IIIa receptor expression and the neutrophil count. In contrast, GPIIb/IIIa receptor numbers were not associated with peripheral immune-cell sub-population counts. Creactive protein was an independent predictor of GPIIb/IIIa (not GPIb) receptor numbers. Conclusions Platelet GPIb and GPIIb/IIIa receptor numbers did not distinguish between patient or control groups in this study, negating their potential use as a biomarker for predicting stroke risk.},
  language  = {en}
}
@article{SmithBrayHoffmanetal.2015,
  author    = {Smith, Craig J. and Bray, Benjamin D. and Hoffman, Alex and Meisel, Andreas and Heuschmann, Peter U. and Wolfe, Charles D. A. and Tyrrell, Pippa J. and Rudd, Anthony G.},
  title     = {Can a novel clinical risk score improve pneumonia prediction in acute stroke care? A UK multicenter cohort study},
  series = {Journal of the American Heart Association},
  volume    = {4},
  journal   = {Journal of the American Heart Association},
  number    = {1},
  doi       = {10.1161/JAHA.114.001307},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-144602},
  pages     = {e001307},
  year      = {2015},
  abstract  = {Background Pneumonia frequently complicates stroke and has amajor impact on outcome. We derived and internally validated a simple clinical risk score for predicting stroke-associated pneumonia (SAP), and compared the performance with an existing score (A\(^{2}\)DS\(^{2}\)). Methods and Results We extracted data for patients with ischemic stroke or intracerebral hemorrhage from the Sentinel Stroke National Audit Programme multicenter UK registry. The data were randomly allocated into derivation (n=11 551) and validation (n=11 648) samples. A multivariable logistic regression model was fitted to the derivation data to predict SAP in the first 7 days of admission. The characteristics of the score were evaluated using receiver operating characteristics (discrimination) and by plotting predicted versus observed SAP frequency in deciles of risk (calibration). Prevalence of SAP was 6.7\% overall. The final 22-point score (ISAN: prestroke Independence [modified Rankin scale], Sex, Age, National Institutes of Health Stroke Scale) exhibited good discrimination in the ischemic stroke derivation (C-statistic 0.79; 95\% CI 0.77 to 0.81) and validation (C-statistic 0.78; 95\% CI 0.76 to 0.80) samples. It was well calibrated in ischemic stroke and was further classified into meaningful risk groups (low 0 to 5, medium6 to 10, high 11 to 14, and very high >= 15) associated with SAP frequencies of 1.6\%, 4.9\%, 12.6\%, and 26.4\%, respectively, in the validation sample. Discrimination for both scores was similar, although they performed less well in the intracerebral hemorrhage patients with an apparent ceiling effect. Conclusions The ISAN score is a simple tool for predicting SAP in clinical practice. External validation is required in ischemic and hemorrhagic stroke cohorts.},
  language  = {en}
}
@article{MinnerupSutherlandBuchanetal.2012,
  author    = {Minnerup, Jens and Sutherland, Brad A. and Buchan, Alastair M. and Kleinschnitz, Christoph},
  title     = {Neuroprotection for Stroke: Current Status and Future Perspectives},
  series = {International Journal of Molecular Science},
  volume    = {13},
  journal   = {International Journal of Molecular Science},
  number    = {9},
  doi       = {10.3390/ijms130911753},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-134730},
  pages     = {11753-11772},
  year      = {2012},
  abstract  = {Neuroprotection aims to prevent salvageable neurons from dying. Despite showing efficacy in experimental stroke studies, the concept of neuroprotection has failed in clinical trials. Reasons for the translational difficulties include a lack of methodological agreement between preclinical and clinical studies and the heterogeneity of stroke in humans compared to homogeneous strokes in animal models. Even when the international recommendations for preclinical stroke research, the Stroke Academic Industry Roundtable (STAIR) criteria, were followed, we have still seen limited success in the clinic, examples being NXY-059 and haematopoietic growth factors which fulfilled nearly all the STAIR criteria. However, there are a number of neuroprotective treatments under investigation in clinical trials such as hypothermia and ebselen. Moreover, promising neuroprotective treatments based on a deeper understanding of the complex pathophysiology of ischemic stroke such as inhibitors of NADPH oxidases and PSD-95 are currently evaluated in preclinical studies. Further concepts to improve translation include the investigation of neuroprotectants in multicenter preclinical Phase III-type studies, improved animal models, and close alignment between clinical trial and preclinical methodologies. Future successful translation will require both new concepts for preclinical testing and innovative approaches based on mechanistic insights into the ischemic cascade.},
  language  = {en}
}
@article{FluriHeinenKleinschnitz2013,
  author    = {Fluri, Felix and Heinen, Florian and Kleinschnitz, Christoph},
  title     = {Intravenous Thrombolysis in a Stroke Patient Receiving Rivaroxaban},
  series = {Cerebrovascular Disease Extra},
  volume    = {2013},
  journal   = {Cerebrovascular Disease Extra},
  number    = {3},
  doi       = {10.1159/000355839},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-128816},
  pages     = {153-155},
  year      = {2013},
  abstract  = {No abstract available.},
  language  = {en}
}
@article{FluriFleischerKleinschnitz2015,
  author    = {Fluri, Felix and Fleischer, Michael and Kleinschnitz, Christoph},
  title     = {Accidental Thrombolysis in a Stroke Patient Receiving Apixaban},
  series = {Cerebrovascular Diseases Extra},
  volume    = {5},
  journal   = {Cerebrovascular Diseases Extra},
  doi       = {10.1159/000375181},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-126326},
  pages     = {55-56},
  year      = {2015},
  abstract  = {No abstract available.},
  language  = {en}
}