The role of leukocytes in acute ischemic stroke-related thrombosis: a notable but neglected topic

Cell Mol Life Sci. 2021 Sep;78(17-18):6251-6264. doi: 10.1007/s00018-021-03897-5. Epub 2021 Aug 16.

Abstract

Ischemic stroke is one of the most serious diseases today, and only a minority of patients are provided with effective clinical treatment. Importantly, leukocytes have gradually been discovered to play vital roles in stroke thrombosis, including promoting the activation of thrombin and the adhesion and aggregation of platelets. However, they have not received enough attention in the field of acute ischemic stroke. It is possible that we could not only prevent stroke-related thrombosis by inhibiting leukocyte activation, but also target leukocyte components to dissolve thrombi in the cerebral artery. In this review, we expound the mechanisms by which leukocytes are activated and participate in the formation of stroke thrombus, then describe the histopathology of leukocytes in thrombi of stroke patients and the influence of leukocyte composition on vascular recanalization effects and patient prognosis. Finally, we discuss the relevant antithrombotic strategies targeting leukocytes.

Keywords: Fibrin; Immunity; Platelet; Thrombus.

Publication types

  • Review

MeSH terms

  • Extracellular Traps / drug effects
  • Extracellular Traps / metabolism
  • Fibrin / metabolism
  • Humans
  • Immune System / metabolism
  • Ischemic Stroke / complications
  • Ischemic Stroke / pathology*
  • Leukocytes / metabolism*
  • Platelet Activation
  • Prognosis
  • Thrombosis / drug therapy
  • Thrombosis / etiology
  • Thrombosis / pathology*
  • Tissue Plasminogen Activator / pharmacology
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Fibrin
  • Tissue Plasminogen Activator