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Research Paper Offsetting the impact of smoking and e-cigarette vaping on the cerebrovascular system and stroke injury: Is Metformin a viable countermeasure?

机译:研究论文抵消了吸烟和电子烟对脑血管系统和中风损伤的影响:二甲双胍是否可行?

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Recently published in vitro and in vivo findings strongly suggest that BBB impairment and increased risk for stroke by tobacco smoke ( TS ) closely resemble that of type-2 diabetes ( 2DM ) and develop largely in response to common key modulators such oxidative stress ( OS ), inflammation and alterations of the endogenous antioxidative response system ( ARE ) regulated by the nuclear factor erythroid 2-related factor ( Nrf2 ). Preclinical studies have also shown that nicotine (the principal e-liquid's ingredient used in e-cigarettes) can also cause OS, exacerbation of cerebral ischemia and secondary brain injury. Herein we provide evidence that likewise to TS, chronic e-Cigarette ( e-Cig ) vaping can be prodromal to the loss of blood-brain barrier (BBB) integrity and vascular inflammation as well as act as a promoting factor for the onset of stroke and worsening of post-ischemic brain injury. In addition, recent reports have shown that Metformin ( MF ) treatment before and after ischemic injury reduces stress and inhibits inflammatory responses. Recent published data by our group revealead that MF promotes the activation of counteractive mechanisms mediated by the activation of Nrf2 which drastically reduce TS toxicity at the brain and cerebrovascular levels and protect BBB integrity. In this study we provide additional in vivo evidence showing that MF can effectively reduce the oxidative and inflammatory risk for stroke and attenuate post-ischemic brain injury promoted by TS and e-Cig vaping. Our data also suggest that MF administration could be extended as prophylactic care during the time window required for the renormalization of the risk levels of stroke following smoking cessation thus further studies in that direction are warrated.
机译:最近发表的体内和体外研究结果强烈表明,BBB损害和烟草烟雾(TS)引起的中风风险增加与2型糖尿病(2DM)极为相似,并且在很大程度上是由于对诸如氧化应激(OS)等常见关键调节剂的反应而发展的,炎症和内源性抗氧化反应系统(ARE)的改变受核因子红系2相关因子(Nrf2)调控。临床前研究还表明,尼古丁(电子烟中使用的主要电子液体成分)也可引起OS,加剧脑缺血和继发性脑损伤。在这里,我们提供的证据表明,与TS一样,慢性电子烟(e-Cig)抽烟可能会导致血脑屏障(BBB)完整性和血管炎症的丧失,并成为中风发作的促进因素和缺血后脑损伤的恶化。另外,最近的报道表明二甲双胍(MF)治疗在缺血性损伤之前和之后可以减轻压力并抑制炎症反应。我们小组最近发表的数据表明,MF促进了由Nrf2激活介导的反作用机制的激活,这大大降低了脑和脑血管水平的TS毒性并保护了BBB的完整性。在这项研究中,我们提供了其他体内证据,表明MF可以有效降低中风的氧化和炎症风险,并减轻TS和e-Cig雾化促进的缺血性脑损伤。我们的数据还表明,在戒烟后中风风险水平重新正常化所需的时间范围内,可以将MF的使用作为预防性治疗加以扩展,因此对该方向的进一步研究进行了干预。

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