Evolution of cerebral tumor necrosis factor-alpha production during human ischemic stroke

• Published in: Stroke (1970) 2001-08, Vol.32 (8), p.1750-1758
• Main Authors: Sairanen, T, Carpén, O, Karjalainen-Lindsberg, M L, Paetau, A, Turpeinen, U, Kaste, M, Lindsberg, P J
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Apoptosis; Brain - metabolism; Brain - pathology; Brain Ischemia - complications; Brain Ischemia - metabolism; Brain Ischemia - pathology; Disease Progression; Female; Fluorescence; Humans; Immunohistochemistry; In Situ Nick-End Labeling; Male; Microcirculation - metabolism; Microcirculation - pathology; Middle Aged; Neuroglia - metabolism; Neuroglia - pathology; Neurons - metabolism; Neurons - pathology; Phagocytes - metabolism; Phagocytes - pathology; Stroke - complications; Stroke - metabolism; Stroke - pathology; Tumor Necrosis Factor-alpha - metabolism
• ISSN: 0039-2499; 1524-4628
• DOI: 10.1161/01.STR.32.8.1750

Tumor necrosis factor-alpha (TNF-alpha) is detected in ischemic brain cells in experimental animal models and is believed to play an important role in apoptosis. However, the natural expression of TNF-alpha during human stroke is not known. We examined TNF-alpha immunohistochemistry and terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) in brain samples of stroke victims (n=16) after variable survival (15 hours to 18 days). Systemic TNF-alpha content from a separate cohort including severe or lethal stroke cases (n=26) was also assayed. Neuronal TNF-alpha was demonstrated from 0.6 to 5.4 days after the onset of stroke symptoms, peaking bilaterally during days 2 and 3. Bilateral glial TNF-alpha immunoreactivity was detected during the acute phase, with the astrocytic TNF-alpha expression dominating in later phases and persisting contralaterally to the infarct in more matured phases (17 to 18 days). Invading inflammatory cells were TNF-alpha immunopositive beginning on the third day. Besides, vascular wall structures showed immunoreactivity sporadically. TNF-alpha levels were mostly nondetectable in peripheral blood. TUNEL labeling and TNF-alpha staining overlapped, although not completely, during the first days. The data support the hypothesis that TNF-alpha may be involved both in the acute propagation of inflammatory processes and cell death and possibly in the more delayed reconstitutive processes of human ischemic stroke.