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Review
. 2017 Jan 23;14(1):21.
doi: 10.1186/s12974-016-0774-5.

Cerebral ischemic damage in diabetes: an inflammatory perspective

Vibha Shukla  1   2 , Akhalesh Kumar Shakya  3 , Miguel A Perez-Pinzon  1   2   4 , Kunjan R Dave  5   6   7
Affiliations
Review

Cerebral ischemic damage in diabetes: an inflammatory perspective

Vibha Shukla et al. J Neuroinflammation. .

Abstract

Stroke is one of the leading causes of death worldwide. A strong inflammatory response characterized by activation and release of cytokines, chemokines, adhesion molecules, and proteolytic enzymes contributes to brain damage following stroke. Stroke outcomes are worse among diabetics, resulting in increased mortality and disabilities. Diabetes involves chronic inflammation manifested by reactive oxygen species generation, expression of proinflammatory cytokines, and activation/expression of other inflammatory mediators. It appears that increased proinflammatory processes due to diabetes are further accelerated after cerebral ischemia, leading to increased ischemic damage. Hypoglycemia is an intrinsic side effect owing to glucose-lowering therapy in diabetics, and is known to induce proinflammatory changes as well as exacerbate cerebral damage in experimental stroke. Here, we present a review of available literature on the contribution of neuroinflammation to increased cerebral ischemic damage in diabetics. We also describe the role of hypoglycemia in neuroinflammation and cerebral ischemic damage in diabetics. Understanding the role of neuroinflammatory mechanisms in worsening stroke outcome in diabetics may help limit ischemic brain injury and improve clinical outcomes.

Keywords: Cell death; Chemokines; Cytokines; Diabetic brain; Hyperglycemia; Hypoglycemia; Immune cells; Inflammation; Stroke.

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Figures

Fig. 1
Fig. 1
Schematic representation of neuroinflammatory mechanisms involved in aggravating brain damage following cerebral ischemia under hyperglycemic/hypoglycemic conditions
Fig. 2
Fig. 2
Detailed schematic representation of neuroinflammatory mechanisms involved in aggravating brain damage following cerebral ischemia in diabetes (hyperglycemic and hypoglycemic conditions)
See this image and copyright information in PMC

References

    1. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract. 2014;103:137–149. doi: 10.1016/j.diabres.2013.11.002. - DOI - PubMed
    1. Mathers CD, Loncar D. Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med. 2006;3:e442. doi: 10.1371/journal.pmed.0030442. - DOI - PMC - PubMed
    1. Prentki M, Nolan CJ. Islet beta cell failure in type 2 diabetes. J Clin Invest. 2006;116:1802–1812. doi: 10.1172/JCI29103. - DOI - PMC - PubMed
    1. Cnop M, Welsh N, Jonas JC, Jorns A, Lenzen S, Eizirik DL. Mechanisms of pancreatic beta-cell death in type 1 and type 2 diabetes: many differences, few similarities. Diabetes. 2005;54(Suppl 2):S97–107. doi: 10.2337/diabetes.54.suppl_2.S97. - DOI - PubMed
    1. Cryer PE. Hypoglycemia, functional brain failure, and brain death. J Clin Invest. 2007;117:868–870. doi: 10.1172/JCI31669. - DOI - PMC - PubMed

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