The Role of Epigenetics in Brain Aneurysm and Subarachnoid Hemorrhage: A Comprehensive Review

Fernández-Pérez I, Macias-Gómez A, Suárez-Pérez A et al. Int J Mol Sci. 2024 Mar 19;25(6):3433. doi: 10.3390/ijms25063433. PMID: 38542406

https://pubmed.ncbi.nlm.nih.gov/38542406/

Abstract: This comprehensive review explores the emerging field of epigenetics in intracranial aneurysm (IA) and aneurysmal subarachnoid hemorrhage (aSAH). Despite recent advancements, the high mortality of aSAH needs an understanding of its underlying pathophysiology, where epigenetics plays a crucial role. This review synthesizes the current knowledge, focusing on three primary epigenetic mechanisms: DNA methylation, non-coding RNA (ncRNA), and histone modification in IA and aSAH. While DNA methylation studies are relatively limited, they suggest a significant role in the pathogenesis and prognosis of IA and aSAH, highlighting differentially methylated positions in genes presumably involved in these pathologies. However, methodological limitations, including small sample sizes and a lack of diverse population studies, temper these results. The role of
ncRNAs, particularly miRNAs, has been more extensively studied, but there are still few studies focused on histone modifications. Despite methodological challenges and inconsistent findings, these studies underscore the involvement of miRNAs in key pathophysiological processes, including vascular smooth muscle regulation and the inflammatory response. This review emphasizes methodological challenges in epigenetic research, advocating for large-scale epigenome-wide associationnstudies integrating genetic and environmental factors, along with longitudinal studies. Such research could unravel the complex mechanisms behind IA and aSAH, guiding the development of targeted therapeutic approaches.

Funding: This research was supported in part by Spain’s Ministry of Health (Instituto de Salud Carlos III, Fondos FEDER, (RICORS-ICTUS/RD21/0006/0021)).

Systemic biomarker associated with poor outcome after futile reperfusion

Hervella P, Sampedro-Viana A et al.  Eur J Clin Invest. 2024 Feb 15:e14181. doi: 10.1111/eci.14181. Online ahead of print. PMID: 38361320

https://pubmed.ncbi.nlm.nih.gov/38361320/

Abstract:
Background: Successful recanalization does not lead to complete tissue reperfusion in a considerable percentage of ischemic stroke patients. This study aimed to identify biomarkers associated with futile recanalization. Leukoaraiosis predicts poor outcomes of this phenomenon. Soluble tumour necrosis factor-like weak inducer of apoptosis (sTWEAK), which is associated with leukoaraiosis degrees, could be a potential biomarker.
Methods: This study includes two cohorts of ischemic stroke patients in a multicentre retrospective observational study. Effective reperfusion, defined as a reduction of ≥8 points in the National Institutes of Health Stroke Scale (NIHSS) within the first 24 h, was used as a clinical marker of effective reperfusion.

Funding; Spanish Ministry of Science and Innovation (SAF2017- 84267-R), PDC2021-121455-I00, Xunta de Galicia (Axencia Galega de Innovación: IN607A2022–03), Instituto de
Salud Carlos III (ISCIII) (PI17/00540, PI17/01103), ISCIII/PI21/01256/Co-financed by the European Union, Spanish Research Network on Cerebrovascular Diseases RETICS-INVICTUS PLUS (RD16/0019/0001 and RD16/0019/0003), RICORS-ICTUS (Cerebrovascular diseases) RD21/0006/0003 and RD21/0006/0011. DTS/00103 (Desarrollo Tecnológico en Salud del ISCIII) M. BazarraBarreiros is a PFIS Researcher (FI22/00200) of Instituto de Salud Carlos III. T. Sobrino (CPII17/00027), F. Campos (CPII19/00020) and R. Iglesias-Rey (CP22/00061) from the Miguel Servet Program of Instituto de Salud Carlos III. Sponsors did not participate in the study design, collection, analysis, or interpretation of the data, or in writing the report.