Publications by authors named "Bartosz Karaszewski"

Research indicates a role for EBI2 receptor in remyelination, demonstrating that its deficiency or antagonism inhibits this process. However, activation of EBI2 with its endogenous ligand, oxysterol 7α,25-dihydroxycholesterol (7α,25OHC), does not enhance remyelination beyond the levels observed in spontaneously remyelinating tissue. We hypothesized that the short half-life of the natural ligand might explain this lack of beneficial effects and tested a synthetic analogue, CF-7α,25OHC, in the cuprizone model.

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Background: Hemorrhagic transformation (HT) in acute ischemic stroke is likely to occur in patients treated with intravenous thrombolysis (IVT) and may lead to neurological deterioration and symptomatic intracranial hemorrhage (sICH). Despite the complex inclusion and exclusion criteria for IVT and some useful tools to stratify HT risk, sICH still occurs in approximately 6% of patients because some of the risk factors for this complication remain unknown.

Objective: This study aimed to explore whether there are any differences in circulating microRNA (miRNA) profiles between patients who develop HT after thrombolysis and those who do not.

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Introduction: The differences in vascular risk factors' and stroke burden across Europe are notable, however there is limited understanding of the influence of socioeconomic environment on the quality of secondary prevention and outcome after acute ischemic stroke.

Patients And Methods: In this observational multicenter cohort study, we analyzed baseline characteristics, reperfusion treatment, outcome and secondary prevention in patients with acute ischemic stroke from three tertiary-care teaching hospitals with similar service population size in different socioeconomic environments: Bern/CH/ = 293 (high-income), Gdansk/PL/ = 140 (high-income), and Lutsk/UA/ = 188 (lower-middle-income).

Results: We analyzed 621 patients (43.

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Acidosis is one of the hallmarks of demyelinating central nervous system (CNS) lesions in multiple sclerosis (MS). The response to acidic pH is primarily mediated by a family of G protein-coupled proton-sensing receptors: OGR1, GPR4 and TDAG8. These receptors are inactive at alkaline pH, reaching maximal activation at acidic pH.

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Andexanet alfa (AA) is a recombinant inactive analog of human activated factor X (FXa), effectively reversing the effects of its inhibitors - rivaroxaban and apixaban, which are available in Poland. The drug was approved for clinical use registration after the publication of the results of the ANNEXA-4 trial (Andexanet Alfa, a Novel Antidote to the Anticoagulation Effects of FXa Inhibitors 4), in which its efficacy in restoring hemostasis in life-threatening hemorrhages in patients receiving using the aforementioned anticoagulants was demonstrated. Hence, AA is now recommended for patients on apixaban or rivaroxaban therapy with massive and uncontrollable hemorrhages, including hemorrhagic strokes (HS) and gastrointestinal bleeding.

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Unlabelled: Patients with non-large vessel occlusion acute ischemic stroke (NL-AIS) on oral anticoagulants (OAC) constitute the biggest portion among those who cannot receive any potential-reperfusion treatment even if they appear early in the hospital. We present the first case of therapy for NL-AIS in a patient with active anti-Xa anticoagulation, combining andexanet alfa and rtPA, who was recruited for STRoke On AntiCoagulants for Thrombolysis (acronym: STROACT), an ongoing therapeutic trial for non-LVO ischemic stroke on a DOAC. This is also the first report of the use of andexanet alfa-rtPA for AIS in a patient on rivaroxaban, which is the most frequently used non-vitamin K antagonist oral anticoagulant.

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Introduction: Currently, clinical trials of DMTs strive to determine their effect on neuroinflammation and neurodegeneration. We aimed to determine the impact of currently used DMTs on brain atrophy and disability in RRMS. The main goal of this review is to evaluate the neuroprotective potential of MS therapy and assess its impact on disability.

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Background: Information processing speed (IPS) deterioration is common in relapsing-remitting multiple sclerosis (RRMS) patients [1] and might severely affect quality of life and occupational activity. However, understanding of its neural substrate is not fully elucidated. We aimed to investigate the associations between MRI-derived metrics of neuroanatomical structures, including the tracts, and IPS.

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Article Synopsis
  • * Results showed an increased ADA1 to ADA2 ratio in MS patients, with significant increases in plasma ADA1 and a decrease in CSF ADA2, while also revealing that endothelial cells have higher ADA1 activity compared to astrocytes and pericytes.
  • * The research concludes that pro-inflammatory cytokines affect the activities of ADA1 and ADA2 differently in various brain cell types, reflecting the changes seen in MS patients' CSF, potentially influencing the neuroinflammatory
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Article Synopsis
  • - The study investigates the increasing rates of stroke hospitalisations among young adults in Poland (ages 18-44) from 2010-2019, juxtaposed with a decline in rates among those over 64.
  • - Data was gathered from the Polish National Health Fund, including both hospital discharge and cause of death records, revealing that 69.6% of young adult strokes were ischaemic, with a marked rise in cases since 2017.
  • - The research found a decrease in case fatality ratios for both ischaemic and haemorrhagic strokes across all ages, while pinpointing that most ischaemic strokes in young adults were of identifiable causes.
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Background: Changes of the coagulation system are promoted by serious infectious or noninfectious diseases, surgical procedures, and exogenous substances, including drugs. This study aimed to assess the effect of methylprednisolone pulses on selected parameters of the coagulation system.

Methods: The study group consisted of patients suffering from multiple sclerosis, thyroid orbitopathy, or sudden sensorineural hearing loss.

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Background: Peak width of Skeletonized Mean Diffusivity (PSMD), as a novel marker of white matter (WM) microstructure damage, is associated with cognitive decline in several WM pathologies (i.e., small vessel disorders).

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Article Synopsis
  • The study examines the association between intravenous administration of recombinant tissue plasminogen activator (rtPA) for acute ischemic stroke (AIS) and the formation of cerebral microbleeds (CMBs) following treatment.
  • Researchers conducted MRI scans on 59 AIS patients before and after receiving rtPA to assess the appearance of new CMBs and their relationship with hemorrhagic transformation.
  • Findings revealed that about 30% of patients developed new CMBs post-treatment, with pre-existing CMBs significantly increasing the risk of new ones, but the initial load of CMBs did not predict hemorrhagic transformation.
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Background: Multiple sclerosis (MS) is associated with progressive brain atrophy, which in turn correlates with disability, depression, and cognitive impairment. Relapsing-remitting multiple sclerosis (RRMS) is a type of MS in which relapses of the disease are followed by remission periods. This is the most common type of the disease.

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Purpose: Wake-up stroke constitutes up to 1/4 of all ischaemic strokes; however, its pathomechanisms remain largely unknown. Although low nocturnal blood flow may be the underlying cause, little is known about blood pressure (BP) characteristic of wake-up stroke patients. The aim of our study was to look for differences in BP variables between wake-up stroke and known-onset stroke patients and to seek BP indices which could distinguish wake-up stroke patients from other stroke patients.

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Intravenous recombinant tissue plasminogen activator (rtPA) is, besides mechanical thrombectomy, the highest class evidence based reperfusion treatment of acute ischemic stroke (AIS). The biggest concern of the therapy is symptomatic intracranial hemorrhage (sICH), which occurs in 3-7% of all treated patients, and is associated with worse functional outcome. Finding a method of the powerful identification of patients at highest risk of sICH, in order to increase the percentage of stroke patients safely treated with rtPA, is one of the most important challenges in stroke research.

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EBI2 receptor regulates the immune system, and in multiple, sclerosis is upregulated in the central nervous system infiltrating lymphocytes. In newborn EBI2-deficient mice, myelin development is delayed, and its persistent antagonism inhibits remyelination in chemically demyelinated organotypic cerebellar slices. We used the cuprizone model of multiple sclerosis to elucidate the role of central nervous system-expressed EBI2 in de- and remyelination.

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Intravenous recombinant tissue plasminogen activator (iv-rtPA) has been routinely used to treat ischemic stroke for 25 years, following large clinical trials. However, there are few prospective studies on the efficacy and safety of this therapy in strokes attributed to cerebral small vessel disease (SVD). We evaluated functional outcome (modified Rankin scale, mRS) and symptomatic intracerebral hemorrhage (sICH) using all available data on the effects of iv-rtPA in SVD-related ischemic stroke (defined either using neuroimaging, clinical features, or both).

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Background: Multiple sclerosis (MS) is an immune-mediated disease in which autoimmune T conventional (T) cells break the blood-brain barrier and destroy neurons of the central nervous system. It is hypothesized that CD4CD25CD127FoxP3 T regulatory (T) cells may inhibit this destruction through suppressive activity exerted on T cells.

Methods: We present the results of a phase 1b/2a, open-label, two-arm clinical trial in 14 patients treated with autologous T cells for relapsing-remitting MS.

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Purpose Of Review: Abrupt blood pressure (BP) rise is the most common clinical symptom of acute ischemic stroke (AIS). However, BP alterations during AIS reflect many diverse mechanisms, both stroke-related and nonspecific epiphenomena, which change over time and across patients. While extremes of BP as well as high BP variability have been related with worse outcomes in observational studies, optimal BP management after AIS remains challenging.

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Article Synopsis
  • The text talks about a study on how stroke care in Poland was analyzed using healthcare data from 2017.
  • It focused on patients with acute ischaemic strokes, which means a type of stroke that blocks blood flow to the brain.
  • The study found big differences in the quality of stroke care across different regions in Poland, showing the need for better organization in treatment and rehabilitation.
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