Name: a fibrin-enriched and tpa-sensitive photothrombotic stroke model
Uploaded: 2021-06-04T12:30:00
Description: Watch this Scientific Journal Video about A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model at JoVE.com

This work was supported by the NIH grants (NS108763, NS100419, NS095064, and HD080429 to C.Y. K.; and NS106592 to Y.Y.S.).

This protocol is approved by the Institutional Animal Care and Use Committee (IACUC) at the University of Virginia and follows the National Institutes of Health Guideline for Care and Use of Laboratory Animals. Figure 1A outlines the sequence of surgical procedures of this protocol.
1. Surgery setup
<ol>
	<li>Place a warming pad with temperature setting at 37 &#176;C on the small animal adaptor at least 15 minutes before the surgery. Prepare a nose-clip roll for...

<ol>
	<li>Lyden, P. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=.">.</a> Thrombolytic Therapy for Acute Stroke. 3/e. , (2015).</li><li>Linfante, I., Cipolla, M. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improving+reperfusion+therapies+in+the+era+of+mechanical+thrombectomy.">Improving reperfusion therapies in the era of mechanical thrombectomy.</a> Translational Stroke Research. 7 (4), 294-302 (2016).</li><li>Campbell, B. 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(102), e52978 (2015).</li><li>Pena-Martinez, C., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Pharmacological+modulation+of+neutrophil+extracellular+traps+reverses+thrombotic+stroke+tPA+(tissue-type+plasminogen+activator)+resistance.">Pharmacological modulation of neutrophil extracellular traps reverses thrombotic stroke tPA (tissue-type plasminogen activator) resistance.</a> Stroke. 50 (11), 3228-3237 (2019).</li><li>Denorme, F., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=ADAMTS13-mediated+thrombolysis+of+t-PA-resistant+occlusions+in+ischemic+stroke+in+mice.">ADAMTS13-mediated thrombolysis of t-PA-resistant occlusions in ischemic stroke in mice.</a> Blood. 127 (19), 2337-2345 (2016).</li><li>Marder, V. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Analysis+of+thrombi+retrieved+from+cerebral+arteries+of+patients+with+acute+ischemic+stroke.">Analysis of thrombi retrieved from cerebral arteries of patients with acute ischemic stroke.</a> Stroke. 37 (8), 2086-2093 (2006).</li><li>Bacigaluppi, M., Semerano, A., Gullotta, G. S., Strambo, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Insights+from+thrombi+retrieved+in+stroke+due+to+large+vessel+occlusion.">Insights from thrombi retrieved in stroke due to large vessel occlusion.</a> Journal of Cerebral Blood Flow and Metabolism. 39 (8), 1433-1451 (2019).</li><li>Sun, Y. Y., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=A+murine+photothrombotic+stroke+model+with+an+increased+fibrin+content+and+improved+responses+to+tPA-lytic+treatment.">A murine photothrombotic stroke model with an increased fibrin content and improved responses to tPA-lytic treatment.</a> Blood Advances. 4 (7), 1222-1231 (2020).</li><li>Su, E. J., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Activation+of+PDGF-CC+by+tissue+plasminogen+activator+impairs+blood-brain+barrier+integrity+during+ischemic+stroke.">Activation of PDGF-CC by tissue plasminogen activator impairs blood-brain barrier integrity during ischemic stroke.</a> Nature Medicine. 14 (7), 731-737 (2008).</li><li>Gupta, A. 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The traditional RB photothrombotic stroke, introduced in 1985, is an attractive model of focal cerebral ischemia for simple surgical procedures, low mortality, and high reproducibility of brain infarction.5 In this model, the photodynamic dye RB rapidly activates platelets upon light excitation, leading to dense aggregates that occlude the blood vessel5,8,23. However, the small amount of fibrin in RB-indu...

Endovascular thrombectomy and tPA-mediated thrombolysis are the only two U.S. Food and Drug Administration (FDA)-approved therapies of acute ischemic stroke, which afflicts ~700,000 patients annually in the United States1. Because the application of thrombectomy is limited to large vessel occlusion (LVO), while tPA-thrombolysis may alleviate small vessel occlusions, both are valuable therapies of acute ischemic stroke2. Moreover, the combination of both therapies (e.g., initiation of tPA-thrombolysis within 4.5 hours of stroke onset, followed by thrombectomy) improves reperfusion and the functional outcomes3. Thus, optimizing thrombolysis remains an important goal for stroke research, even in the era of thrombectomy.
Thromboembolic models are an essential tool for preclinical stroke research aiming to improve thrombolytic therapies. This is because mechanical vascular occlusion models (e.g., intraluminal suture MCA occlusion) do not produce blood clots, and its fast recovery of cerebral blood flow after the removal of mechanical occlusion is overly idealized4,5. To date, major thromboembolic models include photothrombosis6,7,8, topical ferric chloride (FeCl3) application9, microinjection of thrombin into the MCA branch10,11, injection of ex vivo (micro)emboli into the MCA or common carotid artery (CCA)12,13,14, and transient hypoxia-ischemia (tHI)15,16,17,18. These stroke models differ in the histological composition of ensuing clots and the sensitivity to tPA-mediated lytic therapies (Table 1). They also vary in the surgical requirement of craniotomy (needed for in situ thrombin injection and topical application of FeCl3), the consistency of infarct size and location (e.g., CCA-infusion of microemboli yield very variable outcomes), and global effects on the cardiovascular system (e.g., tHI increases the heart rate and cardiac output to compensate for hypoxia-induced peripheral vasodilation).
The RB dye-based photothrombotic stroke (PTS) model has many attractive features, including simple craniotomy-free surgical procedures, low mortality (typically &#60; 5%), and a predictable size and location of infarct (in the MCA-supplying territory), but it has two major limitations.8 The first caveat is weak-to-nil response to tPA-mediated thrombolytic treatment, which is also a drawback of the FeCl3 model7,19,20. The second caveat of PTS and FeCl3 stroke models is that the ensuing thrombi consist of densely-packed platelet aggregates with a small amount of fibrin, which not only lead to its resilience to tPA-lytic therapy, but also deviates from the pattern of intermixed platelet:fibrin thrombi in acute ischemic stroke patients21,22. In contrast, the in situ thrombin-microinjection model mainly comprises polymerized fibrin and a uncertain content of platelets10.
Given the above reasoning, we hypothesized that admixture of RB and a sub-thrombotic dose of thrombin for MCA-targeted photoactivation through thinned skull may increase the fibrin component in the resultant thrombi and boost the sensitivity to tPA-mediated lytic treatment. We have confirmed this hypothesis,23 and herein we describe detail procedures of the modified (T+RB) photothrombotic stroke model.

<table>
	<tbody>
		<tr>
			<td>2,3,5-triphenyltetrazolium chloride (TTC)</td>
			<td>Sigma</td>
			<td>T8877</td>
			<td>infarct</td>
		</tr>
		<tr>
			<td>4-0 Nylon monofilament suture</td>
			<td>LOOK</td>
			<td>766B</td>
			<td>surgical supplies</td>
		</tr>
		<tr>
			<td>5-0 silk suture</td>
			<td>Harvard Apparatus</td>
			<td>624143</td>
			<td>surgical supplies</td>
		</tr>
		<tr>
			<td>543nm laser beam</td>
			<td>Melles Griot</td>
			<td>25-LGP-193-249</td>
			<td>photothrombosis</td>
		</tr>
		<tr>
			<td>adult male mice</td>
			<td>Charles River</td>
			<td>C57BL/6</td>
			<td>10~14 weeks old (22~30 g)</td>
		</tr>
		<tr>
			<td>Anesthesia bar for mouse adaptor</td>
			<td>machine shop, UVA</td>
			<td></td>
			<td>surgical setup</td>
		</tr>
		<tr>
			<td>Avertin (2, 2, 2-Tribromoethanol)</td>
			<td>Sigma</td>
			<td>T48402</td>
			<td>euthanasia</td>
		</tr>
		<tr>
			<td>Dental drill</td>
			<td>Dentamerica</td>
			<td>Rotex 782</td>
			<td>surgical setup</td>
		</tr>
		<tr>
			<td>Digital microscope</td>
			<td>Dino-Lite</td>
			<td>AM2111</td>
			<td>brain imaging</td>
		</tr>
		<tr>
			<td>Dissecting microscope</td>
			<td>Olympus</td>
			<td>SZ40</td>
			<td>surgical setup</td>
		</tr>
		<tr>
			<td>Fine curved forceps (serrated)</td>
			<td>FST</td>
			<td>11370-31</td>
			<td>surgical instrument</td>
		</tr>
		<tr>
			<td>Fine curved forceps (smooth)</td>
			<td>FST</td>
			<td>11373-12</td>
			<td>surgical instrument</td>
		</tr>
		<tr>
			<td>goat anti-rabbit Alexa Fluro 488</td>
			<td>Invitrogen</td>
			<td>A11008</td>
			<td>Immunohistochemistry</td>
		</tr>
		<tr>
			<td>Halsted-Mosquito hemostats</td>
			<td>FST</td>
			<td>13008-12</td>
			<td>surgical instrument</td>
		</tr>
		<tr>
			<td>Heat pump with warming pad</td>
			<td>Gaymar</td>
			<td>TP700</td>
			<td>surgical setup</td>
		</tr>
		<tr>
			<td>infusion pump</td>
			<td>KD Scientific</td>
			<td>200</td>
			<td>thrombolytic treatment</td>
		</tr>
		<tr>
			<td>Insulin syringe with 31G needle</td>
			<td>BD</td>
			<td>328291</td>
			<td>photothrombosis</td>
		</tr>
		<tr>
			<td>Ketamine</td>
			<td>CCM, UVA</td>
			<td></td>
			<td>anesthesia</td>
		</tr>
		<tr>
			<td>Laser protective google 532nm</td>
			<td>Thorlabs</td>
			<td>LG3</td>
			<td>photothrombosis</td>
		</tr>
		<tr>
			<td>Meloxicam SR</td>
			<td>CCM, UVA</td>
			<td></td>
			<td>NSAID analgesia</td>
		</tr>
		<tr>
			<td>micro needle holders</td>
			<td>FST</td>
			<td>12060-01</td>
			<td>surgical instrument</td>
		</tr>
		<tr>
			<td>micro scissors</td>
			<td>FST</td>
			<td>15000-03</td>
			<td>surgical instrument</td>
		</tr>
		<tr>
			<td>MoorFLPI-2 blood flow imager</td>
			<td>Moor</td>
			<td>780-nm laser source</td>
			<td>Laser Speckle Contrast Imaging</td>
		</tr>
		<tr>
			<td>Mouse adaptor</td>
			<td>RWD</td>
			<td>68014</td>
			<td>surgical setup</td>
		</tr>
		<tr>
			<td>Puralube Vet ointment</td>
			<td>Fisher</td>
			<td>NC0138063</td>
			<td>eye dryness prevention</td>
		</tr>
		<tr>
			<td>Retractor tips</td>
			<td>Kent Scientific</td>
			<td>Surgi-5014-2</td>
			<td>surgical setup</td>
		</tr>
		<tr>
			<td>Rose Bengal</td>
			<td>Sigma</td>
			<td>198250</td>
			<td>photothrombosis</td>
		</tr>
		<tr>
			<td>Thrombin</td>
			<td>Sigma</td>
			<td>T7513</td>
			<td>photothrombosis</td>
		</tr>
		<tr>
			<td>Tissue glue</td>
			<td>Abbott Laboratories</td>
			<td>NC9855218</td>
			<td>surgical supplies</td>
		</tr>
		<tr>
			<td>tPA</td>
			<td>Genetech</td>
			<td>Cathflo activase 2mg</td>
			<td>thrombolytic treatment</td>
		</tr>
		<tr>
			<td>Vibratome</td>
			<td>Stoelting</td>
			<td>51425</td>
			<td>TTC infacrt</td>
		</tr>
		<tr>
			<td>Xylazine</td>
			<td>CCM, UVA</td>
			<td></td>
			<td>anesthesia</td>
		</tr>
	</tbody>
</table>

a fibrin-enriched and tpa-sensitive photothrombotic stroke model

An ideal thromboembolic stroke model requires certain properties, including relatively simple surgical procedures with low mortality, a consistent infarction size and location, precipitation of platelet:fibrin intermixed blood clots similar to those in patients, and an adequate sensitivity to fibrinolytic treatment. The rose bengal (RB) dye-based photothrombotic stroke model meets the first two requirements but is highly refractory to tPA-mediated lytic treatment, presumably due to its platelet-rich, but fibrin-poor clot composition. We reason that combination of RB dye (50 mg/kg) and a sub-thrombotic dose of thrombin (80 U/kg) for photoactivation aimed at the proximal branch of middle cerebral artery (MCA) may produce fibrin-enriched and tPA-sensitive clots. Indeed, the thrombin and RB (T+RB)-combined photothrombosis model triggered mixed platelet:fibrin blood clots, as shown by immunostaining and immunoblots, and maintained consistent infarct sizes and locations plus low mortality. Moreover, intravenous injection of tPA (Alteplase, 10 mg/kg) within 2 h post-photoactivation significantly decreased the infarct size in T+RB photothrombosis. Thus, the thrombin-enhanced photothrombotic stroke model may be a useful experimental model to test novel thrombolytic therapies.

First, we compared the fibrin content in RB versus T+RB photothrombosis-induced blood clots. Mice were sacrificed by transcardial perfusion of fixatives at 2 h after photoactivation, and brains were removed for immunofluorescence staining of the MCA branch in longitudinal and transverse planes. In RB photothrombosis, the MCA branch was densely packed with CD41+ platelets and little fibrin (Figure 2A,C). In contrast, the MCA branch in T+RB photothrombosis was occlu...

Watch this Scientific Journal Video about A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model at JoVE.com

A Fibrin-Enriched and tPA-Sensitive Photothrombotic Stroke Model

Traditional photothrombotic stroke (PTS) models mainly induce dense platelet aggregates of a high resistance to tissue plasminogen activator (tPA)-lytic treatment. Here a modified murine PTS model is introduced by co-injecting thrombin and photosensitive dye for photoactivation. The thrombin-enhanced PTS model produces mixed platelet:fibrin clots and is highly sensitive to tPA-thrombolysis.

An ideal thromboembolic stroke model requires certain properties, including relatively simple surgical procedures with low mortality, a consistent ...

Research

JoVE Journal

Neuroscience

Retrograde Loading of Nerves, Tracts, and Spinal Roots with Fluorescent Dyes

Retrograde labeling of neurons is a standard anatomical method1,2 that has also been used to load calcium and voltage-sensitive dyes into neurons3-6. ...

Progenitor-derived Oligodendrocyte Culture System from Human Fetal Brain

Differentiation of human neural progenitors into neuronal and glial cell types offers a model to study and compare molecular regulation of neural cell ...

Deriving the Time Course of Glutamate Clearance with a Deconvolution Analysis of Astrocytic Transporter Currents

The highest density of glutamate transporters in the brain is found in astrocytes. Glutamate transporters couple the movement of glutamate across the ...

Utilizing 3D Printing Technology to Merge MRI with Histology: A Protocol for Brain Sectioning

Magnetic resonance imaging (MRI) allows for the delineation between normal and abnormal tissue on a macroscopic scale, sampling an entire tissue volume ...

A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia

MRI provides a sensitive and specific imaging tool to detect acute ischemic stroke by means of a reduced diffusion coefficient of brain water. In a rat ...

Measuring Synaptic Vesicle Endocytosis in Cultured Hippocampal Neurons

During endocytosis, fused synaptic vesicles are retrieved at nerve terminals, allowing for vesicle recycling and thus the maintenance of synaptic ...

An In Vivo Assessment of Blood-Brain Barrier Disruption in a Rat Model of Ischemic Stroke

An In Vivo Assessment of Blood-Brain Barrier Disruption in a Rat Model of Ischemic Stroke

Ischemic stroke leads to vasogenic cerebral edema and subsequent primary brain injury, which is mediated through destruction of the blood-brain barrier ...

A Preclinical Model to Assess Brain Recovery After Acute Stroke in Rats

The purpose of this study was to establish and validate an animal brain ischemia model in the recovery and sequela stages. A middle cerebral artery ...

Time-lapse Live Imaging and Quantification of Fast Dendritic Branch Dynamics in Developing Drosophila Neurons

Time-lapse Live Imaging and Quantification of Fast Dendritic Branch Dynamics in Developing Drosophila Neurons

Highly motile dendritic filopodia are widely present in neurons at early developmental stages. These exploratory dynamic branches sample the surrounding ...

Confocal Microscopy to Measure Three Modes of Fusion Pore Dynamics in Adrenal Chromaffin Cells

Dynamic fusion pore opening and closure mediate exocytosis and endocytosis and determine their kinetics. Here, it is demonstrated in detail how confocal ...