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Cerebral-Cardiac Syndrome and Diabetes: Cardiac Damage After Ischemic Stroke in Diabetic State

Journal

FRONTIERS IN IMMUNOLOGY
Volume 12, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.737170

Keywords

cerebral-cardiac syndrome; ischemic stroke; cardiac damage; NLRP3 inflammasome; diabetes mellitus

Categories

Funding

  1. National Natural Science Foundation of China [81771232, 82070526, 81974192]
  2. Natural Science Foundation of Guangdong Province, China [2019A1515010654, 2021A1515011652]

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Cerebral-cardiac syndrome (CCS) involves cardiac dysfunction following brain injuries, with ischemic stroke being a common cause. Diabetes may play a significant role in CCS by exacerbating systemic inflammation and contributing to cardiac pathological changes. The NLRP3 inflammasome is suggested to be a crucial link between diabetes, stroke, and CCS.
Cerebral-cardiac syndrome (CCS) refers to cardiac dysfunction following varying brain injuries. Ischemic stroke is strongly evidenced to induce CCS characterizing as arrhythmia, myocardial damage, and heart failure. CCS is attributed to be the second leading cause of death in the post-stroke stage; however, the responsible mechanisms are obscure. Studies indicated the possible mechanisms including insular cortex injury, autonomic imbalance, catecholamine surge, immune response, and systemic inflammation. Of note, the characteristics of the stroke population reveal a common comorbidity with diabetes. The close and causative correlation of diabetes and stroke directs the involvement of diabetes in CCS. Nevertheless, the role of diabetes and its corresponding molecular mechanisms in CCS have not been clarified. Here we conclude the features of CCS and the potential role of diabetes in CCS. Diabetes drives establish a primed inflammatory microenvironment and further induces severe systemic inflammation after stroke. The boosted inflammation is suspected to provoke cardiac pathological changes and hence exacerbate CCS. Importantly, as the key element of inflammation, NOD-like receptor pyrin domain containing 3 (NLRP3) inflammasome is indicated to play an important role in diabetes, stroke, and the sequential CCS. Overall, we characterize the corresponding role of diabetes in CCS and speculate a link of NLRP3 inflammasome between them.

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