RAS modulation prevents progressive cognitive impairment after experimental stroke: A randomized, blinded preclinical trial

Heba A. Ahmed, Tauheed Ishrat, Bindu Pillai, Abdelrahman Y. Fouda, Mohammed A. Sayed, Wael Eldahshan, Jennifer L Waller, Adviye Ergul, Susan C. Fagan

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: With the aging population, the prevalence and incidence of cerebrovascular disease will continue to rise, as well as the number of individuals with vascular cognitive impairment/dementia (VCID). No specific FDA-approved treatments for VCID exist. Although clinical evidence supports that angiotensin receptor blockers (ARBs) prevent cognitive decline in older adults, whether ARBs have a similar effect on VCID after stroke is unknown. Moreover, these agents reduce BP, which is undesirable in the acute stroke period, so we believe that giving C21 in this acute phase or delaying ARB administration would enable us to achieve the neurovascular benefits without the risk of unintended and potentially dangerous, acute BP lowering. Methods: The aim of our study was to determine the impact of candesartan (ARB) or compound-21 (an angiotensin type 2 receptor--AT2R--agonist) on long-term cognitive function post-stroke, in spontaneously hypertensive rats (SHRs). We hypothesized that AT2R stimulation, either directly with C21, or indirectly by blocking the angiotensin type 1 receptor (AT1R) with candesartan, initiated after stroke, would reduce cognitive impairment. Animals were subjected to a 60-min transient middle cerebral artery occlusion and randomly assigned to either saline/C21 monotherapy, for the full study duration (30days), or given sequential therapy starting with saline/C21 (7days) followed by candesartan for the remainder of the study (21days). Outcome measures included sensorimotor/cognitive-function, amyloid-β determination, and histopathologic analyses. Results: Treatment with RAS modulators effectively preserved cognitive function, reduced cytotoxicity, and prevented chronic-reactive microgliosis in SHRs, post-stroke. These protective effects were apparent even when treatment was delayed up to 7days post-stroke and were independent of blood pressure and β-amyloid accumulation. Conclusion: Collectively, our findings demonstrate that RAS modulators effectively prevent cognitive impairment after stroke, even when treatment is delayed.

Original languageEnglish (US)
Article number229
JournalJournal of Neuroinflammation
Volume15
Issue number1
DOIs
StatePublished - Aug 13 2018

Fingerprint

Stroke
Angiotensin Receptor Antagonists
Cognition
Blood Vessels
Dementia
Inbred SHR Rats
Amyloid
Angiotensin Type 2 Receptor
Cerebrovascular Disorders
Angiotensin Type 1 Receptor
Middle Cerebral Artery Infarction
Cognitive Dysfunction
Outcome Assessment (Health Care)
Blood Pressure
Incidence
Population
candesartan
Therapeutics

Keywords

  • Angiotensin modulators
  • Cognitive-impairment
  • Hypertension
  • Stroke

ASJC Scopus subject areas

  • Neuroscience(all)
  • Immunology
  • Neurology
  • Cellular and Molecular Neuroscience

Cite this

RAS modulation prevents progressive cognitive impairment after experimental stroke : A randomized, blinded preclinical trial. / Ahmed, Heba A.; Ishrat, Tauheed; Pillai, Bindu; Fouda, Abdelrahman Y.; Sayed, Mohammed A.; Eldahshan, Wael; Waller, Jennifer L; Ergul, Adviye; Fagan, Susan C.

In: Journal of Neuroinflammation, Vol. 15, No. 1, 229, 13.08.2018.

Research output: Contribution to journalArticle

Ahmed, Heba A. ; Ishrat, Tauheed ; Pillai, Bindu ; Fouda, Abdelrahman Y. ; Sayed, Mohammed A. ; Eldahshan, Wael ; Waller, Jennifer L ; Ergul, Adviye ; Fagan, Susan C. / RAS modulation prevents progressive cognitive impairment after experimental stroke : A randomized, blinded preclinical trial. In: Journal of Neuroinflammation. 2018 ; Vol. 15, No. 1.
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AU - Sayed, Mohammed A.

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