Granulocyte colony-stimulating factor attenuates delayed tPA-induced hemorrhagic transformation in ischemic stroke rats by enhancing angiogenesis and vasculogenesis

J Cereb Blood Flow Metab. 2015 Feb;35(2):338-46. doi: 10.1038/jcbfm.2014.208. Epub 2014 Nov 26.

Abstract

Treatment with tissue plasminogen activator (tPA) beyond the therapeutic time window (>4.5 hours post stroke) may produce hemorrhagic transformation (HT). Strategies that could extend the narrow time window of tPA will benefit a significant number of stroke patients. Male Sprague-Dawley rats underwent middle cerebral artery occlusion (MCAo) and given vehicle, tPA (10 mg/kg), or tPA and granulocyte colony-stimulating factor (G-CSF, 300 μg/kg), at 6 hours after MCAo. Twenty-four hours post treatment, G-CSF+tPA-treated stroke rats displayed 25% improvement in neurological functions and 38.9% reduction of hemorrhage, with Western blots showing 1.9- and 1.2-fold increments in Ang-2 expression in the ischemic cortex and striatum, respectively, and 3-fold increase in phosphorylated endothelial nitric oxide synthase expression in the ipsilateral cortex relative to tPA-treated rats. Immunohistochemistry also showed 2- and 2.8-fold increase in von-Willebrand expression, 3.2- and 2.2-fold increased CD34+ expression, and 4- and 13-fold upregulation of VEGFR-2 expression in the ischemic cortex and striatum, respectively, in G-CSF+tPA-treated stroke rats relative to tPA-treated subjects. Altogether, these findings indicate that G-CSF attenuated delayed tPA-induced HT likely via the enhancement of angiogenesis and vasculogenesis. The use of G-CSF to protect the vasculature may improve the clinical outcome of tPA even outside the currently indicated therapeutic window for ischemic stroke.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antigens, CD34 / biosynthesis
  • Brain Ischemia* / drug therapy
  • Brain Ischemia* / metabolism
  • Brain Ischemia* / pathology
  • Cerebral Cortex / metabolism
  • Cerebral Cortex / pathology
  • Corpus Striatum / metabolism
  • Corpus Striatum / pathology
  • Gene Expression Regulation / drug effects
  • Intracranial Hemorrhages* / chemically induced
  • Intracranial Hemorrhages* / drug therapy
  • Intracranial Hemorrhages* / pathology
  • Male
  • Neovascularization, Physiologic / drug effects*
  • Rats
  • Rats, Sprague-Dawley
  • Stroke* / drug therapy
  • Stroke* / metabolism
  • Stroke* / pathology
  • Tissue Plasminogen Activator / adverse effects*
  • Tissue Plasminogen Activator / pharmacology
  • Vascular Endothelial Growth Factor Receptor-2 / biosynthesis
  • von Willebrand Factor / biosynthesis

Substances

  • Antigens, CD34
  • von Willebrand Factor
  • Vascular Endothelial Growth Factor Receptor-2
  • Tissue Plasminogen Activator