Plasma VAP-1/SSAO Activity Predicts Intracranial Hemorrhages and Adverse Neurological Outcome After Tissue Plasminogen Activator Treatment in Stroke

Vascular adhesion protein-1 (VAP-1) is a cell surface and circulating enzyme involved in recruitment of lymphocytes and neutrophils through its semicarbazide-sensitive amine oxidase (SSAO) activity. We aimed to study plasma VAP-1/SSAO activity in relation to the risk for intracranial bleeding compli...

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Veröffentlicht in:Stroke (1970) 2010-07, Vol.41 (7), p.1528-1535
Hauptverfasser: HERNANDEZ-GUILLAMON, Mar, GARCIA-BONILLA, Lidia, QUINTANA, Manolo, MOLINA, Carlos A, ALVAREZ-SABIN, José, ROSELL, Anna, UNZETA, Mercedes, MONTANER, Joan, SOLE, Montse, SOSTI, Victoria, PARES, Mireia, CAMPOS, Mireia, ORTEGA-AZNAR, Arantxa, DOMINGUEZ, Carmen, RUBIERA, Marta, RIBO, Marc
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container_end_page 1535
container_issue 7
container_start_page 1528
container_title Stroke (1970)
container_volume 41
creator HERNANDEZ-GUILLAMON, Mar
GARCIA-BONILLA, Lidia
QUINTANA, Manolo
MOLINA, Carlos A
ALVAREZ-SABIN, José
ROSELL, Anna
UNZETA, Mercedes
MONTANER, Joan
SOLE, Montse
SOSTI, Victoria
PARES, Mireia
CAMPOS, Mireia
ORTEGA-AZNAR, Arantxa
DOMINGUEZ, Carmen
RUBIERA, Marta
RIBO, Marc
description Vascular adhesion protein-1 (VAP-1) is a cell surface and circulating enzyme involved in recruitment of lymphocytes and neutrophils through its semicarbazide-sensitive amine oxidase (SSAO) activity. We aimed to study plasma VAP-1/SSAO activity in relation to the risk for intracranial bleeding complications in patients with stroke treated with tissue plasminogen activator (tPA), the greatest safety concern with this treatment. In 141 patients with ischemic stroke, we measured VAP-1/SSAO activity in plasma taken before tPA administration. Hemorrhagic events were classified according to brain CT criteria and functional outcomes evaluated using the National Institutes of Health Stroke Scale. We also assessed the potential therapeutic effect of blocking VAP-1/SSAO activity in a rat embolic stroke model treated with tPA. We saw significantly higher levels of plasma VAP-1/SSAO activity in patients who subsequently experienced hemorrhagic transformation. Elevated plasma VAP-1/SSAO activity also predicted worse neurological outcome in these patients. In the rat model, we confirmed that use of the inhibitor semicarbazide prevented adverse effects caused by delayed tPA administration, leading to a smaller infarct volume. Our data demonstrate that baseline VAP-1/SSAO activity predicts parenchymal hemorrhage after tPA, suggesting the safety of thrombolytic agents could be improved by considering VAP-1/SSAO activity. Furthermore, anti-VAP-1/SSAO drugs given with tPA may prevent neurological worsening in patients with ischemic stroke.
doi_str_mv 10.1161/STROKEAHA.110.584623
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In the rat model, we confirmed that use of the inhibitor semicarbazide prevented adverse effects caused by delayed tPA administration, leading to a smaller infarct volume. Our data demonstrate that baseline VAP-1/SSAO activity predicts parenchymal hemorrhage after tPA, suggesting the safety of thrombolytic agents could be improved by considering VAP-1/SSAO activity. Furthermore, anti-VAP-1/SSAO drugs given with tPA may prevent neurological worsening in patients with ischemic stroke.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams &amp; Wilkins</pub><pmid>20538694</pmid><doi>10.1161/STROKEAHA.110.584623</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; American Heart Association Journals; Journals@Ovid Complete; EZB-FREE-00999 freely available EZB journals; Alma/SFX Local Collection
subjects Aged
Aged, 80 and over
Amine Oxidase (Copper-Containing) - blood
Animals
Biological and medical sciences
Biomarkers - blood
Blood. Blood coagulation. Reticuloendothelial system
Cell Adhesion Molecules - blood
Enzyme Activation - drug effects
Enzyme Activation - physiology
Female
Humans
Intracranial Hemorrhages - drug therapy
Intracranial Hemorrhages - enzymology
Intracranial Hemorrhages - etiology
Male
Medical sciences
Middle Aged
Nervous System Diseases - drug therapy
Nervous System Diseases - enzymology
Nervous System Diseases - etiology
Neurology
Pharmacology. Drug treatments
Predictive Value of Tests
Prospective Studies
Rats
Rats, Sprague-Dawley
Stroke - complications
Stroke - drug therapy
Stroke - enzymology
Tissue Plasminogen Activator - adverse effects
Treatment Outcome
Vascular diseases and vascular malformations of the nervous system
title Plasma VAP-1/SSAO Activity Predicts Intracranial Hemorrhages and Adverse Neurological Outcome After Tissue Plasminogen Activator Treatment in Stroke
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