Topographic distribution of inflammation factors in a healing aneurysm.

Grüter, Basil E; Canzanella, Gwendoline; Hägler, Joshua; Rey, Jeannine; Wanderer, Stefan; von Gunten, Michael; Galván, José A; Grobholz, Rainer; Widmer, Hans-Rudolf; Remonda, Luca; Andereggen, Lukas; Marbacher, Serge (2023). Topographic distribution of inflammation factors in a healing aneurysm. Journal of neuroinflammation, 20(1), p. 182. BioMed Central 10.1186/s12974-023-02863-1

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BACKGROUND

Healing of intracranial aneurysms following endovascular treatment relies on the organization of early thrombus into mature scar tissue and neointima formation. Activation and deactivation of the inflammation cascade plays an important role in this process. In addition to timely evolution, its topographic distribution is hypothesized to be crucial for successful aneurysm healing.

METHODS

Decellularized saccular sidewall aneurysms were created in Lewis rats and coiled. At follow-up (after 3 days (n = 16); 7 days (n = 19); 21 days (n = 8)), aneurysms were harvested and assessed for healing status. In situ hybridization was performed for soluble inflammatory markers (IL6, MMP2, MMP9, TNF-α, FGF23, VEGF), and immunohistochemical analysis to visualize inflammatory cells (CD45, CD3, CD20, CD31, CD163, HLA-DR). These markers were specifically documented for five regions of interest: aneurysm neck, dome, neointima, thrombus, and adjacent vessel wall.

RESULTS

Coiled aneurysms showed enhanced patterns of thrombus organization and neointima formation, whereas those without treatment demonstrated heterogeneous patterns of thrombosis, thrombus recanalization, and aneurysm growth (p = 0.02). In coiled aneurysms, inflammation markers tended to accumulate inside the thrombus and in the neointima (p < 0.001). Endothelial cells accumulated directly in the neointima (p < 0.0001), and their presence was associated with complete aneurysm healing.

CONCLUSION

The presence of proinflammatory cells plays a crucial role in aneurysm remodeling after coiling. Whereas thrombus organization is hallmarked by a pronounced intra-thrombotic inflammatory reaction, neointima maturation is characterized by direct invasion of endothelial cells. Knowledge concerning topographic distribution of regenerative inflammatory processes may pave the way for future treatment modalities which enhance aneurysm healing after endovascular therapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > BioMedical Research (DBMR) > Forschungsbereich Mu50 > Forschungsgruppe Neurochirurgie
04 Faculty of Medicine > Service Sector > Institute of Pathology
04 Faculty of Medicine > Service Sector > Institute of Pathology > Translational Research Unit

UniBE Contributor:

Galván Hernández, José Alberto, Widmer, Hans Rudolf, Andereggen, Lukas

Subjects:

600 Technology > 610 Medicine & health
500 Science > 570 Life sciences; biology

ISSN:

1742-2094

Publisher:

BioMed Central

Language:

English

Submitter:

Pubmed Import

Date Deposited:

03 Aug 2023 10:04

Last Modified:

20 Aug 2023 02:37

Publisher DOI:

10.1186/s12974-023-02863-1

PubMed ID:

37533024

Uncontrolled Keywords:

Animal Endovascular procedures Inflammation Intracranial aneurysm Models Neointima

BORIS DOI:

10.48350/185193

URI:

https://boris.unibe.ch/id/eprint/185193

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