Adviye Ergul

Bio: Adviye Ergul is an academic researcher from Medical University of South Carolina. The author has contributed to research in topics: Stroke & Diabetes mellitus. The author has an hindex of 48, co-authored 188 publications receiving 7678 citations. Previous affiliations of Adviye Ergul include Charlie Norwood VA Medical Center & United States Department of Veterans Affairs.

Oxidative stress and the use of antioxidants in diabetes: Linking basic science to clinical practice

Abstract: Cardiovascular complications, characterized by endothelial dysfunction and accelerated atherosclerosis, are the leading cause of morbidity and mortality associated with diabetes. There is growing evidence that excess generation of highly reactive free radicals, largely due to hyperglycemia, causes oxidative stress, which further exacerbates the development and progression of diabetes and its complications. Overproduction and/or insufficient removal of these free radicals result in vascular dysfunction, damage to cellular proteins, membrane lipids and nucleic acids. Despite overwhelming evidence on the damaging consequences of oxidative stress and its role in experimental diabetes, large scale clinical trials with classic antioxidants failed to demonstrate any benefit for diabetic patients. As our understanding of the mechanisms of free radical generation evolves, it is becoming clear that rather than merely scavenging reactive radicals, a more comprehensive approach aimed at preventing the generation of these reactive species as well as scavenging may prove more beneficial. Therefore, new strategies with classic as well as new antioxidants should be implemented in the treatment of diabetes.

Targets for Vascular Protection After Acute Ischemic Stroke

Abstract: Background— Vascular damage caused by cerebral ischemia leads to edema, hemorrhage formation, and worsened outcomes in ischemic stroke patients. Therapeutic interventions need to be developed to provide vascular protection. The purpose of this review is to identify the pathophysiologic processes involved in vascular damage after ischemia, which may lead to strategies to provide vascular protection in ischemic stroke patients. Summary of Comment— The pathologic processes caused by vascular injury after an occlusion of a cerebral artery can be separated into acute (hours), subacute (hours to days), and chronic (days to months). Targets for intervention can be identified for all 3 stages. Acutely, superoxide is the predominant mediator, followed by inflammatory mediators and proteases subacutely. In the chronic phase, proapoptotic gene products have been implicated. Conclusions— Pharmacological agents designed to target specific pathologic and protective processes affecting the vasculature should be used in ...

Angiogenesis A Harmonized Target for Recovery After Stroke

Abstract: It is now appreciated that emerging therapeutic strategies for recovery must include the cerebral vasculature and that induction of angiogenesis will stimulate endogenous recovery mechanisms, including neurogenesis, synaptogenesis, and neuronal and synaptic plasticity. These events are all involved in the long-term repair and restoration process of the brain after an ischemic event. Several recent excellent reviews provided detailed information on the mechanisms and molecular targets for angiogenesis after stroke.1,2 The purpose of this review is to evaluate the evidence that angiogenesis is a target for recovery after an ischemic stroke. ### Angiogenic Response to Ischemic Brain Injury: A Multipurpose Pathway Early reports of increased angiogenesis in the ischemic border zone of human brain autopsy sections,3 which was decreased in patients of advanced age,4 led to interest in the time course and impact of this phenomenon on functional recovery. It is clear that angiogenesis genes are upregulated within minutes of the onset of cerebral ischemia in rodents5 and angiogenic proteins remain increased in the area of ischemia for days to weeks.6 It is unclear, however, whether the angiogenic response leads to the development of functional new blood vessels that improve brain function after stroke. Clinical and experimental studies in other vascular beds have emphasized the potential for adverse consequences related to neovascularization.7,8 In the diabetic retina, for example, pathological angiogenesis results in hemorrhage, edema, and, ultimately, blindness.9 In the brain, pathological angiogenesis is implicated in the development of hereditary hemorrhagic telangiectasia.10 The correlation between angiogenesis and improved functional outcome after ischemic stroke remains and is seen in both animal models and in human patients with stroke.5,11–13 It is likely that the “proangiogenic state,” induced in response to an ischemic insult, has multiple purposes in the hours to weeks after the injury (Figure). First, the …

Minocycline to Improve Neurologic Outcome in Stroke (MINOS): A Dose-Finding Study

Abstract: Background and Purpose—Minocycline is a promising anti-inflammatory and protease inhibitor that is effective in multiple preclinical stroke models. We conducted an early phase trial of intravenous minocycline in acute ischemic stroke. Methods—Following an open-label, dose-escalation design, minocycline was administered intravenously within 6 hours of stroke symptom onset in preset dose tiers of 3, 4.5, 6, or 10 mg/kg daily over 72 hours. Minocycline concentrations for pharmacokinetic analysis were measured in a subset of patients. Subjects were followed for 90 days. Results—Sixty patients were enrolled, 41 at the highest dose tier of 10 mg/kg. Overall age (65±13.7 years), race (83% white), and sex (47% female) were consistent across the doses. The mean baseline National Institutes of Health Stroke Scale score was 8.5±5.8 and 60% received tissue plasminogen activator. Minocycline infusion was well tolerated with only 1 dose limiting toxicity at the 10-mg/kg dose. No severe hemorrhages occurred in tissue pl...

Within the Brain: The Renin Angiotensin System.

Abstract: For many years, modulators of the renin angiotensin system (RAS) have been trusted by clinicians for the control of essential hypertension. It was recently demonstrated that these modulators have other pleiotropic properties independent of their hypotensive effects, such as enhancement of cognition. Within the brain, different components of the RAS have been extensively studied in the context of neuroprotection and cognition. Interestingly, a crosstalk between the RAS and other systems such as cholinergic, dopaminergic and adrenergic systems have been demonstrated. In this review, the preclinical and clinical evidence for the impact of RAS modulators on cognitive impairment of multiple etiologies will be discussed. In addition, the expression and function of different receptor subtypes within the RAS such as: Angiotensin II type I receptor (AT1R), Angiotensin II type II receptor (AT2R), Angiotensin IV receptor (AT4R), Mas receptor (MasR), and Mas-related-G protein-coupled receptor (MrgD), on different cell types within the brain will be presented. We aim to direct the attention of the scientific community to the plethora of evidence on the importance of the RAS on cognition and to the different disease conditions in which these agents can be beneficial.

Metal-organic frameworks in biomedicine.

Abstract: Metal Organic Frameworks in Biomedicine Patricia Horcajada,* Ruxandra Gref, Tarek Baati, Phoebe K. Allan, Guillaume Maurin, Patrick Couvreur, G erard F erey, Russell E. Morris, and Christian Serre* Institut Lavoisier, UMR CNRS 8180, Universit e de Versailles St-Quentin en Yvelines, 45 Avenue des Etats-Unis, 78035 Versailles Cedex, France Facult e de Pharmacie, UMR CNRS 8612, Universit e Paris-Sud, 92296 Châtenay-Malabry Cedex, France Institut Charles Gerhardt Montpellier, UMR CNRS 5253, Universit e Montpellier 2, 34095 Montpellier cedex 05, France EaStChem School of Chemistry, University of St. Andrews Purdie Building, St Andrews, KY16 9ST U.K.

The immunology of stroke: from mechanisms to translation

Abstract: Immunity and inflammation are key elements of the pathobiology of stroke, a devastating illness second only to cardiac ischemia as a cause of death worldwide. The immune system participates in the brain damage produced by ischemia, and the damaged brain, in turn, exerts an immunosuppressive effect that promotes fatal infections that threaten the survival of people after stroke. Inflammatory signaling is involved in all stages of the ischemic cascade, from the early damaging events triggered by arterial occlusion to the late regenerative processes underlying post-ischemic tissue repair. Recent developments have revealed that stroke engages both innate and adaptive immunity. But adaptive immunity triggered by newly exposed brain antigens does not have an impact on the acute phase of the damage. Nevertheless, modulation of adaptive immunity exerts a remarkable protective effect on the ischemic brain and offers the prospect of new stroke therapies. As immunomodulation is not devoid of deleterious side effects, a better understanding of the reciprocal interaction between the immune system and the ischemic brain is essential to harness the full therapeutic potential of the immunology of stroke.

Inflammatory mechanisms in ischemic stroke: role of inflammatory cells.

Abstract: Inflammation plays an important role in the pathogenesis of ischemic stroke and other forms of ischemic brain injury. Experimentally and clinically, the brain responds to ischemic injury with an acute and prolonged inflammatory process, characterized by rapid activation of resident cells (mainly microglia), production of proinflammatory mediators, and infiltration of various types of inflammatory cells (including neutrophils, different subtypes of T cells, monocyte/macrophages, and other cells) into the ischemic brain tissue. These cellular events collaboratively contribute to ischemic brain injury. Despite intense investigation, there are still numerous controversies concerning the time course of the recruitment of inflammatory cells in the brain and their pathogenic roles in ischemic brain injury. In this review, we provide an overview of the time-dependent recruitment of different inflammatory cells following focal cerebral I/R. We discuss how these cells contribute to ischemic brain injury and highlight certain recent findings and currently unanswered questions about inflammatory cells in the pathophysiology of ischemic stroke.