<?xml version="1.0" encoding="utf-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD Journal Publishing DTD v2.3 20070202//EN" "journalpublishing.dtd">
<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="2.3" xml:lang="EN">
<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Neurol.</journal-id>
<journal-title>Frontiers in Neurology</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Neurol.</abbrev-journal-title>
<issn pub-type="epub">1664-2295</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fneur.2024.1395833</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Neurology</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>MiR-122 overexpression alleviates oxygen&#x2013;glucose deprivation-induced neuronal injury by targeting sPLA2-IIA</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Yu</surname> <given-names>Yuanfang</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/2642966/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Li</surname> <given-names>Pan</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author" equal-contrib="yes">
<name><surname>Chen</surname> <given-names>Mengyuan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="author-notes" rid="fn0001"><sup>&#x2020;</sup></xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/investigation/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhan</surname> <given-names>Wenfeng</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/visualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhu</surname> <given-names>Ting</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Min</surname> <given-names>Ling</given-names></name>
<xref ref-type="aff" rid="aff4"><sup>4</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Liu</surname> <given-names>Hao</given-names></name>
<xref ref-type="aff" rid="aff3"><sup>3</sup></xref>
<xref ref-type="corresp" rid="c002"><sup>&#x002A;</sup></xref>
<role content-type="https://credit.niso.org/contributor-roles/data-curation/"/>
<role content-type="https://credit.niso.org/contributor-roles/formal-analysis/"/>
<role content-type="https://credit.niso.org/contributor-roles/validation/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-original-draft/"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Lv</surname> <given-names>Bo</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c003"><sup>&#x002A;</sup></xref>
<uri xlink:href="https://loop.frontiersin.org/people/565229/overview"/>
<role content-type="https://credit.niso.org/contributor-roles/conceptualization/"/>
<role content-type="https://credit.niso.org/contributor-roles/funding-acquisition/"/>
<role content-type="https://credit.niso.org/contributor-roles/methodology/"/>
<role content-type="https://credit.niso.org/contributor-roles/project-administration/"/>
<role content-type="https://credit.niso.org/contributor-roles/resources/"/>
<role content-type="https://credit.niso.org/contributor-roles/supervision/"/>
<role content-type="https://credit.niso.org/contributor-roles/writing-review-editing/"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Guangdong Cardiovascular Institute, Guangdong Provincial People&#x2019;s Hospital, Guangdong Academy of Medical Sciences</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of General Practice, Guangdong Geriatrics Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country></aff>
<aff id="aff3"><sup>3</sup><institution>Affiliated Cancer Hospital and Institute of Guangzhou Medical University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country></aff>
<aff id="aff4"><sup>4</sup><institution>Department of Laboratory Medicine, Affiliated Cancer Hospital and Institute of Guangzhou Medical University</institution>, <addr-line>Guangzhou</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by" id="fn0002">
<p>Edited by: Raffaele Ornello, University of L'Aquila, Italy</p>
</fn>
<fn fn-type="edited-by" id="fn0003">
<p>Reviewed by: Meihua Yang, Army Medical University, China</p>
<p>Luigi Sironi, University of Milan, Italy</p>
</fn>
<corresp id="c001">&#x002A;Correspondence: Ling Min, <email>minling1977@163.com</email></corresp>
<corresp id="c002">Hao Liu, <email>haoliu2020@163.com</email></corresp>
<corresp id="c003">Bo Lv, <email>gdlvbo@163.com</email></corresp>
<fn fn-type="equal" id="fn0001">
<p><sup>&#x2020;</sup>These authors have contributed equally to this work and share first authorship</p>
</fn>
</author-notes>
<pub-date pub-type="epub">
<day>10</day>
<month>05</month>
<year>2024</year>
</pub-date>
<pub-date pub-type="collection">
<year>2024</year>
</pub-date>
<volume>15</volume>
<elocation-id>1395833</elocation-id>
<history>
<date date-type="received">
<day>04</day>
<month>03</month>
<year>2024</year>
</date>
<date date-type="accepted">
<day>26</day>
<month>04</month>
<year>2024</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2024 Yu, Li, Chen, Zhan, Zhu, Min, Liu and Lv.</copyright-statement>
<copyright-year>2024</copyright-year>
<copyright-holder>Yu, Li, Chen, Zhan, Zhu, Min, Liu and Lv</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/">
<p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p>
</license>
</permissions>
<abstract>
<sec id="sec1">
<title>Background</title>
<p>Ischemic stroke (IS) is a neurological disease with significant disability and mortality. MicroRNAs were proven to be associated with cerebral ischemia. Previous studies have demonstrated miR-122 downregulation in both animal models of IS and the blood of IS patients. Nonetheless, the role and mechanism of miR-122-5p in IS remain unclear.</p>
</sec>
<sec id="sec2">
<title>Methods</title>
<p>We established primary human and mouse astrocytes, along with HT22 mouse hippocampal neuronal cells, through oxygen&#x2013;glucose deprivation/reoxygenation (OGD/R) treatment. To assess the impact of miR-122, we employed CCK8 assays, flow cytometry, RT-qPCR, western blotting, and ELISA to evaluate cell viability, apoptosis, reactive oxygen species (ROS) generation, and cytokine expression. A dual-luciferase reporter gene assay was employed to investigate the interaction between miR-122 and sPLA2-IIA.</p>
</sec>
<sec id="sec3">
<title>Results</title>
<p>Overexpression of miR-122 resulted in decreased apoptosis, reduced cleaved caspase-3 expression, and increased cell viability in astrocytes and HT22 cells subjected to OGD/R. RT-qPCR and ELISA analyses demonstrated a decrease in mRNA and cytokine levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-&#x03B1; in both astrocytes and HT22 cells following miR-122 overexpression. Moreover, miR-122 overexpression reversed OGD/R-induced ROS levels and 8-OHdG formation in astrocytes. Additionally, miR-122 overexpression decreased the mRNA and protein expression of inducible nitric oxide synthase (iNOS). Furthermore, we found that miR-122 attaches to the 3&#x2032;-UTR of sPLA2-IIA, thereby downregulate its expression.</p>
</sec>
<sec id="sec4">
<title>Conclusion</title>
<p>Our study demonstrates that miR-122-mediated inhibition of sPLA2-IIA attenuates OGD/R-induced neuronal injury by suppressing apoptosis, alleviating post-ischemic inflammation, and reducing ROS production. Thus, the miR-122/sPLA2-IIA axis may represent a promising target for IS treatment.</p>
</sec>
</abstract>
<kwd-group>
<kwd>microRNA-122-5p</kwd>
<kwd>ischemic stroke</kwd>
<kwd>astrocytes</kwd>
<kwd>cytokines</kwd>
<kwd>sPLA2-IIA</kwd>
</kwd-group>
<counts>
<fig-count count="4"/>
<table-count count="0"/>
<equation-count count="0"/>
<ref-count count="40"/>
<page-count count="10"/>
<word-count count="6182"/>
</counts>
<custom-meta-wrap>
<custom-meta>
<meta-name>section-at-acceptance</meta-name>
<meta-value>Stroke</meta-value>
</custom-meta>
</custom-meta-wrap>
</article-meta>
</front>
<body>
<sec sec-type="intro" id="sec5">
<title>Introduction</title>
<p>Stroke, characterized by its significant morbidity and disability burden, is one of the most devastating cerebrovascular diseases and the third leading cause of death worldwide, posing a significant public health concern. IS is an episode of neurological dysfunction caused by focal cerebral infarction resulting from arterial stenosis or occlusion. It represents for approximately 85% of all stroke cases (<xref ref-type="bibr" rid="ref1">1</xref>). Despite significant advancements in treatment, devising an effective therapeutic strategy for mitigating ischemic brain damage remains a formidable challenge. A substantial induction of pro-inflammatory cytokines and chemokines (including IL-6, IL-1&#x03B2;, TNF-&#x03B1;, IFN-&#x03B3;, CXCL1, MCP-1) were released within minutes after IS, which is a significant contributor to neuronal loss (<xref ref-type="bibr" rid="ref2 ref3 ref4 ref5">2&#x2013;5</xref>). Astrocytes, the most abundant cells in the central nervous system and crucial components of the blood&#x2013;brain barrier (<xref ref-type="bibr" rid="ref6">6</xref>). Induced by inflammatory factors (such as IL-1, TNF-&#x03B1;) and chemokines like CCL2 released by microglia, astrocytes polarize into A1 reactive astrocytes characterized by C3/iNOS expression (<xref ref-type="bibr" rid="ref7">7</xref>). Current understanding suggests that A1 reactive astrocytes exacerbate neuroinflammation by further releasing TNF-&#x03B1;, IL-6, while A2 reactive astrocytes exert neuroprotective effects by releasing neurotrophic factors and facilitating glutamate reuptake, thus playing a role in mitigating cytotoxicity (<xref ref-type="bibr" rid="ref8">8</xref>, <xref ref-type="bibr" rid="ref9">9</xref>). Previous study have demonstrated a significant increase in IL-6, TNF-&#x03B1;, and iNOS expression in astrocytes following OGD, with iNOS(+) reactive astrocytes leading to increased neuronal apoptosis (<xref ref-type="bibr" rid="ref10">10</xref>), suggesting the involvement of A1 astrocytes in post-IS inflammation and oxidative stress. Moreover, it has been found that edaravone inhibits the transformation of A1 astrocytes by suppressing the expression of inflammatory cytokines and chemokines (<xref ref-type="bibr" rid="ref11">11</xref>). Additionally, astrocytes play a critical role in the redox homeostasis during ischemic stroke, as evidenced by the significantly higher glutathione (GSH) content in astrocytes compared to neurons during OGD, with mitochondrial transfer from astrocytes to neurons aiding in maintaining neuronal mitochondrial function (<xref ref-type="bibr" rid="ref12">12</xref>). On the other hand, activated astrocytes further promote microglial activation and induce apoptosis of damaged cells by producing IL-1&#x03B2; (<xref ref-type="bibr" rid="ref13">13</xref>). In summary, astrocytes play important roles in inflammation, oxidative stress, and cell apoptosis in ischemic stroke.</p>
<p>MicroRNAs (miRNAs) comprise a group of small RNAs that are highly conserved, endogenous, non-coding and widely distributed across eukaryotes. They function primarily in the post-transcriptional regulation of gene expression (<xref ref-type="bibr" rid="ref14">14</xref>, <xref ref-type="bibr" rid="ref15">15</xref>). An expanding body of evidence underscores that miRNAs play a crucial role in the pathophysiology of IS. These miRNAs exert their influence by exaggerating inflammatory responses, impairing the BBB, and inducing cytotoxicity and apoptosis, alongside contributing to vascular injury and facilitating regeneration processes. IS, which arises from ischemia and hypoxia, may trigger alterations in miRNA expression levels (<xref ref-type="bibr" rid="ref16">16</xref>). These alterations are implicated in the progression of IS as they govern the expression of cytokines and immunomodulatory factors. Previous studies have provided evidence indicating a significant decrease in the levels of miR-122 in both rat models of middle cerebral artery occlusion and reperfusion (MCAO/R), as well as the blood of patients with acute stroke (<xref ref-type="bibr" rid="ref17 ref18 ref19">17&#x2013;19</xref>). Our previous study revealed that treatment with miR-122-5p mimics reduces the volume of cerebral infarction in rats. Furthermore, we validated that miR-122-5p reduces iNOS expression in leukocytes and brain microvascular endothelial cells (BMVECs), suggesting a cerebroprotective role of miR-122 in IR injury following IS (<xref ref-type="bibr" rid="ref20">20</xref>, <xref ref-type="bibr" rid="ref21">21</xref>). Nevertheless, the role and mechanism of miR-122-5p in IS remain unclear.</p>
<p>Phospholipase A2 (PLA2) superfamily is a group of enzymes that hydrolyze the ester bond at the second position on the glycerol backbone of phospholipid molecules (<xref ref-type="bibr" rid="ref22">22</xref>). Previous studies have revealed the presence of PLA2s in the cerebral cortex following ischemia (<xref ref-type="bibr" rid="ref23">23</xref>). PLA2s act as rate-limiting factors in the production of bioactive substances, such as arachidonic acid (AA), prostaglandins, and platelet-activating factor (PAF). Therefore, both the concentration and activity of PLA2s are considered independent biomarkers of IS (<xref ref-type="bibr" rid="ref23">23</xref>). Utilizing predictive analysis software such as TargetScan and miRanda, we suggest that miR-122-5p may exert a regulatory effect on the target gene, secreted PLA2 group IIA (sPLA2-IIA) (<xref ref-type="bibr" rid="ref20">20</xref>). Therefore, the aim of this study was to examine the regulatory influence of miR-122 on sPLA2-IIA expression and elucidate the protective effects and underlying mechanism of miR-122 in astrocytes subjected to OGD/R-induced injury.</p>
</sec>
<sec sec-type="materials|methods" id="sec6">
<title>Materials and methods</title>
<sec id="sec7">
<title>Cell culture</title>
<p>This study was approved by the Ethics Committee of Guangdong Provincial People&#x2019;s Hospital (Grant No. KY2020-563-01). Primary human astrocytes (CP-H122), mouse astrocytes (CP-M157), mouse hippocampal neuronal cell line (HT22, CL-0697) were all obtained from Wuhan Procell Life Science and Technology Co., Ltd. (Wuhan, China). The cells were all cultured in Dulbecco&#x2019;s Modified Eagle Medium (DMEM) supplemented with 10% fetal bovine serum (FBS) and a 1% mixture of penicillin and streptomycin. All cell cultures were maintained in an incubator with constant temperature and carbon dioxide levels, specifically at 37&#x00B0;C and 5% CO<sub>2</sub>.</p>
</sec>
<sec id="sec8">
<title>Cell transfection</title>
<p>The miR-122-5p mimic and its corresponding negative control (NC) were chemically synthesized by Guangzhou RiboBio Co., Ltd. (Guangzhou, China), following established protocols. The miR-122-5p mimic and its NC were transfected into the cells using Lipofectamine 3,000 (Invitrogen, Thermo Fisher Scientific Inc.) according to the manufacturer&#x2019;s instructions.</p>
</sec>
<sec id="sec9">
<title>OGD/R cell model</title>
<p>The vitro cerebral I/R injury was simulate utilizing OGD/R-treated cells. To induce OGD stimulation, the cells were cultured in hypoxic incubator with 5% CO<sub>2</sub>, 1% O<sub>2</sub>, and 94% N2 for 12&#x2009;h, using DMEM medium devoid of glucose and serum. Following OGD stimulation, the cells were subsequently incubated under normoxic conditions (5% CO2 and 95% air) for 24&#x2009;h using DMEM medium supplemented with 10% FBS and glucose to simulate reperfusion. The control group was defined as cells cultured in normal DMEM medium under normoxic conditions in an incubator.</p>
</sec>
<sec id="sec10">
<title>CCK-8 assays</title>
<p>According to the manufacturer&#x2019;s instructions for the Counting Kit-8 assay (APExBio Technology), cell viability measurements were performed by seeding 2&#x2009;&#x00D7;&#x2009;10<sup>4</sup> cells in 100&#x2009;&#x03BC;L of complete culture media mixed with 10&#x2009;&#x03BC;L CCK8 reagent per well in 96-well plates, after transfection with miR-122 or its NC for the specified duration.</p>
</sec>
<sec id="sec11">
<title>Cell apoptosis assay</title>
<p>Perform cell apoptosis detection according to the instructions provided in the Annexin V-FITC/PI Cell Apoptosis Detection Kit (TransGen Biotech, Beijing, China). Collect the treated cells from each group as instructed, followed by a thorough washing step utilizing PBS. Subsequently, resuspended the cells in the Annexin V Binding buffer, then proceed to stain the cells with Annexin V-FITC and PI and incubate the mixture in a light-protected environment for 15&#x2009;min at room temperature. Next, combine the cell suspension with Annexin V Binding buffer, place it on ice, and finally, determine the apoptosis rate by flow cytometry within 1&#x2009;h.</p>
</sec>
<sec id="sec12">
<title>Real-time quantitative RT-PCR</title>
<p>Total RNA was extracted using the E.Z.N.A. HP Total RNA kit (Omega Bio-tek, United States). The cDNA synthesis was carried out using 0.5&#x2009;&#x03BC;g of RNA with the Prime Script RT master mix (Perfect Real Time; TaKaRa, Japan). Quantitative real-time PCR analysis was conducted in triplicate on LightCycler 480 (Roche, Mannheim, Germany) using SYBR Premix Ex Taq (TaKaRa, Japan) and the datas were normalized based on the expression of GAPDH RNA. The results were calculated utilizing the &#x0394;&#x0394;CT methods. The primers for selected genes were as follows:</p>
<p>h-iNOS: 5&#x2032;-AGCTGAACTTGAGCGAGGAG-3&#x2032;, 5&#x2032;-GGAAAAGACTGCACCGAAGA-3&#x2032;;</p>
<p>h-TNF-&#x03B1;: 5&#x2032;-GTGCTTGTTCCTCAGCCTCTT-3&#x2032;, 5&#x2032;-ATGGGCTACAGGCTTGTCACT-3&#x2032;;</p>
<p>h-IL-10: 5&#x2032;-ACCTGCCTAACATGCTTCGAG-3&#x2032;, 5&#x2032;-CTGGGTCTTGGTTCTCAGCTT-3&#x2032;;</p>
<p>h-sPLA2-IIA: 5&#x2032;-TGACGACAGGAAAGGAAGCC-3&#x2032;, 5&#x2032;-CTGCTCCCCGAGTTGCTAAA-3&#x2032;;</p>
<p>h-GAPDH: 5&#x2032;-GCACCGTCAAGGCTGAGAAC-3&#x2032;, 5&#x2032;-TGGTGAAGACGCCAGTGGA-3&#x2032;;</p>
<p>m-IL-6: 5&#x2032;-CCAAGCCTTATCGGAAATGA-3&#x2032;, 5&#x2032;-TTTTCACAGGGGAGAAATCG-3&#x2032;;</p>
<p>m-TNF-&#x03B1;: 5&#x2032;-CGGTGCCTATGTCTCAGCCT-3&#x2032;, 5&#x2032;-GAGGGTCTGGGCCATAGAAC-3&#x2032;;</p>
<p>m-sPLA2-IIA: 5&#x2032;-CTGTTGCTACAAGAGCCTGG-3&#x2032;, 5&#x2032;-GCCGTTTCTGACAGGAGTTC-3&#x2032;;</p>
<p>m-GAPDH: 5&#x2032;-TGTGTCCGTCGTGGATCTGA-3&#x2032;, 5&#x2032;- TTGCTGTTGAAGTCGCAGGAG-3&#x2032;.</p>
</sec>
<sec id="sec13">
<title>Western blotting</title>
<p>Cell lysis was performed using Radioimmunoprecipitation assay buffer (Beyotime Biotechnology, China) to disrupt cellular membranes and release intracellular components. The concentration of total protein was detected using the BCA Protein Assay Kit (Thermo Fisher, Waltham, MA, United States). The proteins were then separated by 8&#x2013;12% Sodium dodecyl sulfate-polyacrylamide gel electrophoresis using an electric current, and subsequently transferring them to polyvinylidene fluoride (PVDF) membranes. The PVDF membranes were blocked with 5% skim milk, and then incubated with primary antibodies overnight at 4&#x00B0;C. Following primary antibody incubation, the membranes were washed to remove unbound antibodies and then incubated with the secondary antibodies for an hour at room temperature. Bound antibodies were visualized by ECL reagents (Thermo Fisher). In this study, the primary antibodies consist of anti-&#x03B2;-Actin antibody (#3700, Cell Signaling Technology), anti-iNOS (#68186, Cell Signaling Technology), sPLA2-IIA (sc-58363, Santa Cruz Biotechnology), anti-caspase-3 antibody (#9661, Cell Signaling Technology).</p>
</sec>
<sec id="sec14">
<title>Measurement of cytokine production</title>
<p>The supernatants were collected after the aforementioned steps and stored at &#x2212;80&#x00B0;C. The levels of TNF-&#x03B1; and IL-10 were measured utilizing sandwich ELISA with an ELISA kit (eBioscience, San Diego, CA, United States), according to the manufacturer&#x2019;s protocols.</p>
</sec>
<sec id="sec15">
<title>Measurement of intracellular ROS</title>
<p>The ROS expression were detected utilizing the fluorescent probe 2,7-dichlorodihydrofluorescein diacetate (DCFH-DA; Beyotime Institute of Biotechnology, Beijing, China) following the manufacturer&#x2019;s protocols. Intracellular ROS could oxidize non-fluorescent DCFH, the hydrolysis product of DCFH-DA upon cellular entry, to green fluorescent 2,7-dichlorofluorescein, with fluorescence intensity directly proportional to the cellular ROS levels. Subsequently, the treated cells were incubated with DCFH-DA at a temperature of 37&#x00B0;C for 20&#x2009;min, and then the fluorescence was detected using flow cytometry.</p>
</sec>
<sec id="sec16">
<title>Measurement of 8-hydroxy-2&#x2032;-deoxyguanosine</title>
<p>The oxidative stress-associated marker 8-OHdG was assessed utilizing the OxiSelect&#x2122; Oxidative DNA Damage ELISA Kit (8-OHdG Quantitation, Trial Size) (Cell Biolabs Inc., United States). After the indicated treatments, cell supernatants were collected, and the 8-OHdG levels were quantified following the manufacturer&#x2019;s protocol.</p>
</sec>
<sec id="sec17">
<title>Luciferase reporter assay</title>
<p>sPLA2-IIA containing the predicted miR-122-5p binding site were cloned into pGL3-sPLA2-IIA-Wt (wild-type) and pGL3-sPLA2-IIA-Mut (mutant type) (RiboBio Co., Ltd. Guangzhou, China), respectively. The Wt or Mut 3&#x2032;-UTR of sPLA2-IIA vector and miR-122-5p mimic or its NC were co-transfected into 293&#x2009;T cells utilizing Lipofectamine 3000 (Invitrogen, Thermo Fisher Scientific Inc.). The luciferase activity within the cells was measured 48&#x2009;h post-transfection utilizing the luciferase assay system (Ambion, Austin, TX, United States).</p>
</sec>
<sec id="sec18">
<title>Statistical analysis</title>
<p>Results were expressed as mean&#x2009;&#x00B1;&#x2009;SD based on three independent experiments unless except where noted differently. Formal analysis between two groups were performed using a two-tailed unpaired Student&#x2019;s <italic>t</italic>-test, with SD denoted by bars. All statistical analyses were conducted using GraphPad Prism 5.0 (GraphPad Software Inc., La Jolla, CA, United States). A <italic>p</italic>-value of &#x003C;0.05 was considered to be statistically significant.</p>
</sec>
</sec>
<sec sec-type="results" id="sec19">
<title>Results</title>
<sec id="sec20">
<title>MiR-122 decreases astrocyte apoptosis following an IS <italic>in vitro</italic></title>
<p>Astrocytes play a pivotal role in maintaining brain homeostasis, with their activation marking an early response to ischemia&#x2013;reperfusion IR injury. Apoptosis serves as a major mechanism contributing to neuronal loss after an IS. We therefore explored the impact of miR-122 on the apoptosis response of astrocyte <italic>in vitro</italic>. RT-qPCR analysis demonstrated that miR-122 mimic transfection successfully resulted in significant overexpression of miR-122 in astrocytes (<xref ref-type="fig" rid="fig1">Figure 1A</xref>). Importantly, treatment with miR-122 mimics promoted the survival of primary human astrocytes subjected to OGD/R (<xref ref-type="fig" rid="fig1">Figure 1B</xref>). Concurrently, miR-122 mimics significantly decreased apoptosis among astrocytes cultured under OGD/R conditions (<xref ref-type="fig" rid="fig1">Figures 1C</xref>,<xref ref-type="fig" rid="fig1">D</xref>), indicating that miR-122 might be implicated in astrocyte apoptosis triggered by ischemic conditions. Similar results were observed with primary mouse astrocytes and HT22 mouse hippocampal neuronal cells treated with miR-122 mimics (<xref ref-type="fig" rid="fig1">Figures 1E</xref>&#x2013;<xref ref-type="fig" rid="fig1">G</xref>). Moreover, we evaluated the expression of cleaved caspase-3, an apoptosis indicator, in primary astrocytes and HT22 cells through western blot analysis. In this study, we found that treatment with miR-122 mimics markedly reversed the expression of cleaved caspase-3 induced by OGD/R in both primary astrocytes and HT22 cells (<xref ref-type="fig" rid="fig1">Figures 1H</xref>&#x2013;<xref ref-type="fig" rid="fig1">J</xref>).</p>
<fig position="float" id="fig1">
<label>Figure 1</label>
<caption>
<p>MiR-122 decreases astrocyte apoptosis after IS <italic>in vitro</italic>. <bold>(A)</bold> Primary human astrocytes were transfected with miR-122 mimics and NC, the expression of miR-122 was measured by qRT-PCR. <bold>(B)</bold> Primary human astrocytes transfected with miR-122 mimics and NC were treated with OGD, cell viability was measured by CCK8 assay. <bold>(C,D)</bold> Primary human astrocytes transfected with miR-122 mimics and NC were treated with OGD, cells were then stained with Annexin V-APC and propidium iodide, cell apoptosis was analyzed by flow cytometry. <bold>(E)</bold> Primary mouse astrocytes and HT22 mouse hippocampal neuronal cells were transfected with miR-122 mimics and NC, the expression of miR-122 was measured by qRT-PCR. <bold>(F,G)</bold> Primary mouse astrocytes and HT22 mouse hippocampal neuronal cells transfected with miR-122 mimics and NC were treated with OGD, <bold>(F)</bold> cell viability was measured by CCK8 assay, <bold>(G)</bold> cell apoptosis was analyzed by flow cytometry. <bold>(H)</bold> Primary human astrocytes transfected with miR-122 mimics and NC were treated with OGD, the expression of cleaved caspase-3 were by western blot. <bold>(I)</bold> Primary mouse astrocytes transfected with miR-122 mimics and NC were treated with OGD, the expression of cleaved caspase-3 were by western blot. <bold>(J)</bold> HT22 mouse hippocampal neuronal cells transfected with miR-122 mimics and NC were treated with OGD, the expression of cleaved caspase-3 were by western blot. Each point represents the mean&#x2009;&#x00B1;&#x2009;SD. Data show a representative of three independent experiments. &#x002A;&#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.01, &#x002A;&#x002A;&#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.001.</p>
</caption>
<graphic xlink:href="fneur-15-1395833-g001.tif"/>
</fig>
</sec>
<sec id="sec21">
<title>MiR-122 inhibits pro-inflammatory</title>
<p>Previous studies have suggested that strokes can trigger an inflammatory response that promotes astrocyte activation. Thus, we evaluated the effects of miR-122 on the expression of pro-inflammatory factor. We found a significant reduction in the mRNA expression of the IL-6 and TNF-&#x03B1; in astrocytes and HT22 cells overexpressing miR-122 (<xref ref-type="fig" rid="fig2">Figure 2A</xref>). ELISA showed a significant reduction in IL-6 and TNF-&#x03B1; following miR-122 treatment in both astrocytes and HT22 cells (<xref ref-type="fig" rid="fig2">Figure 2B</xref>). We further examined the impact of miR-122 on pro-inflammatory effects induced by OGD/R. The results showed that OGD/R resulted in a significant increase in the expression of IL-6 and TNF-&#x03B1;, whereas treatment with miR-122 mimics significantly reduced IL-6 and TNF-&#x03B1; expression in both astrocytes and HT22 cells (<xref ref-type="fig" rid="fig2">Figures 2C</xref>,<xref ref-type="fig" rid="fig2">D</xref>).</p>
<fig position="float" id="fig2">
<label>Figure 2</label>
<caption>
<p>MiR-122 inhibits pro-inflammatory responses. <bold>(A)</bold> Primary human and mouse astrocytes, and HT22 mouse hippocampal neuronal cells were transfected with miR-122 mimics and NC, the expression of IL-6 and TNF-&#x03B1; were measured by qRT-PCR. <bold>(B)</bold> Primary human and mouse astrocytes, and HT22 mouse hippocampal neuronal cells were transfected with miR-122 mimics and NC, the expression of IL-6 and TNF-&#x03B1; were measured by ELISA. <bold>(C)</bold> Primary human and mouse astrocytes, and HT22 mouse hippocampal neuronal cells transfected with miR-122 mimics and NC were treated with OGD, the expression of TNF-&#x03B1; were measured by ELISA. <bold>(D)</bold> Primary human and mouse astrocytes, and HT22 mouse hippocampal neuronal cells transfected with miR-122 mimics and NC were treated with OGD, the expression of IL-6 was measured by ELISA. Each point represents the mean&#x2009;&#x00B1;&#x2009;SD. Data show a representative of three independent experiments. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, &#x002A;&#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.01.</p>
</caption>
<graphic xlink:href="fneur-15-1395833-g002.tif"/>
</fig>
</sec>
<sec id="sec22">
<title>MiR-122 inhibits oxidative responses</title>
<p>ROS production serves as an initial trigger for ischemic brain injury. Consequently, this study examined the impact of miR-122 on oxidative damage induced by OGD/R in astrocytes. We found that OGD/R resulted in a significant upsurge in ROS production, whereas treatment with miR-122 mimics significantly reduced ROS production in both primary human and mouse astrocytes (<xref ref-type="fig" rid="fig3">Figures 3A</xref>,<xref ref-type="fig" rid="fig3">B</xref>). Moreover, treatment with miR-122 mimics significantly attenuated the generation of 8-OHdG, thereby attenuating oxidative stress injury (<xref ref-type="fig" rid="fig3">Figure 3C</xref>). Furthermore, we also assessed the impact of miR-122 mimics on iNOS expression levels, a critical enzyme involved in the synthesis of ROS and nitric oxide. We observed a significant attenuation of both mRNA and protein expression of iNOS upon miR-122 overexpression in astrocytes and HT22 cells (<xref ref-type="fig" rid="fig3">Figures 3D</xref>,<xref ref-type="fig" rid="fig3">E</xref>). These results indicate that miR-122 diminishes ROS production, alleviates oxidative stress, and consequently inhibits astrocyte apoptosis in response to the OGD/R challenge.</p>
<fig position="float" id="fig3">
<label>Figure 3</label>
<caption>
<p>MiR-122 inhibits oxidative responses. <bold>(A)</bold> Primary human astrocytes transfected with miR-122 mimics and NC were treated with OGD, the levels of ROS were analyzed by flow cytometry. <bold>(B)</bold> Primary mouse astrocytes transfected with miR-122 mimics and NC were treated with OGD, the levels of ROS were analyzed by flow cytometry. <bold>(C)</bold> Primary human and mouse astrocytes transfected with miR-122 mimics and NC were treated with OGD, 8-OHdG contents were measured. <bold>(D,E)</bold> Primary human and mouse astrocytes, and HT22 mouse hippocampal neuronal cells were transfected with miR-122 mimics and NC, <bold>(D)</bold> the expression of iNOS were measured by qRT-PCR, <bold>(E)</bold> the expression of iNOS were measured by western blot. Each point represents the mean&#x2009;&#x00B1;&#x2009;SD. Data show a representative of three independent experiments. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, &#x002A;&#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.01.</p>
</caption>
<graphic xlink:href="fneur-15-1395833-g003.tif"/>
</fig>
</sec>
<sec id="sec23">
<title>sPLA2-IIA is a direct target of miR-122</title>
<p>Previous studies have suggested that human group sPLA2-IIA induces neuronal cell death via apoptosis. Exploratory Gene Association Networks have elucidated sPLA2-IIA as a prospective target of miR-122. To ascertain the direct interaction between miR-122 and the 3&#x2032;-UTR of sPLA2-IIA, we performed the dual-luciferase reporter assay as a further investigation. The results demonstrated that miR-122 overexpression inhibited luciferase activity of the reporter gene in the WT construct, while it had no effect on the sPLA2-IIA-MUT construct (<xref ref-type="fig" rid="fig4">Figure 4A</xref>). To explore the potential impact of miR-122 on sPLA2-IIA regulation, we further examined sPLA2-IIA expression in cells following transfection with either miR-122 or NC mimics. Our findings demonstrate that upregulation of miR-122 markedly reduced the sPLA2-IIA expression at both mRNA and protein levels in astrocytes, as well as HT22 cells (<xref ref-type="fig" rid="fig4">Figures 4B</xref>,<xref ref-type="fig" rid="fig4">C</xref>), suggesting that sPLA2-IIA might be a direct target of miR-122 in astrocytes.</p>
<fig position="float" id="fig4">
<label>Figure 4</label>
<caption>
<p>miR-122 directly targeted sPLA2-IIA 3&#x2032;UTR to suppress its expression. <bold>(A)</bold> HT22 mouse hippocampal neuronal cells were co-transfected with wild-type (WT) or mutant (mut) sPLA2-IIA 3&#x2032;-UTR-luciferase reporter constructs and miR-122 mimics or NC, respectively, the relative luciferase activities were measured. <bold>(B,C)</bold> Primary human and mouse astrocytes, and HT22 mouse hippocampal neuronal cells were transfected with miR-122 mimics and NC, <bold>(B)</bold> the expression of sPLA2-IIA were measured by western blot, <bold>(C)</bold> the expression of sPLA2-IIA were measured by qRT-PCR. Each point represents the mean&#x2009;&#x00B1;&#x2009;SD. Data show a representative of three independent experiments. &#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.05, &#x002A;&#x002A;<italic>p</italic>&#x2009;&#x003C;&#x2009;0.01.</p>
</caption>
<graphic xlink:href="fneur-15-1395833-g004.tif"/>
</fig>
</sec>
</sec>
<sec sec-type="discussion" id="sec24">
<title>Discussion</title>
<p>IS ranks among the leading causes of adult mortality globally. Despite significant breakthroughs in diagnostic technologies and novel clinical therapies for IS (<xref ref-type="bibr" rid="ref24 ref25 ref26">24&#x2013;26</xref>), the prognosis remains suboptimal, and the mechanisms underlying IS remain a subject of controversy. MiRNAs are emerging as key molecular mediators in IS and are considered potential diagnostic and therapeutic agents for this condition (<xref ref-type="bibr" rid="ref27">27</xref>). Earlier research has indicated a significant reduction in miR-122 levels in animal models of ischemic cerebral reperfusion and the blood of patients with acute stroke (<xref ref-type="bibr" rid="ref18">18</xref>). Our previous study demonstrated that treatment with miR-122-5p mimics reduces the volume of cerebral infarction in rats underwent MCAO/R. Furthermore, it validated that miR-122-5p reduces iNOS expression in leukocytes and BMVECs, suggesting a cerebroprotective role for miR-122 in IR injury following IS (<xref ref-type="bibr" rid="ref21">21</xref>, <xref ref-type="bibr" rid="ref28">28</xref>). We have indicated that overexpression of miR-122 reverses cell apoptosis and cleaved caspase-3 level resulting from OGD/R in primary astrocytes and HT22 cells. Furthermore, our research has shown that overexpression of miR-122 results in decreased levels of IL-6, TNF-&#x03B1;, and ROS. Moreover, we found that overexpression of miR-122 leads to its direct binding to sPLA2-IIA 3&#x2032;-UTR and the inhibition of sPLA2-IIA expression.</p>
<p>The PLA2 superfamily of enzymes comprises six subfamilies: cytosolic PLA2s, calcium-independent PLA2s, sPLA2s, lysosomal PLA2s, PAF acetylhydrolases, and adipose-specific PLA2s. These subfamilies play crucial roles in maintaining cellular membrane homeostasis under physiological conditions. Among them, sPLA2 play a pivotal role in inflammation-related diseases. sPLA2 hydrolyzes oxidized phospholipids in LDL cholesterol, generating oxidized free fatty acids. These fatty acids are precursors to the production of inflammatory substances such as AA, which is assumed to be associated with neuronal apoptosis (<xref ref-type="bibr" rid="ref29">29</xref>). Also damages the vascular endothelium. Therefore, sPLA2 has been suggested as a vasculature-specific marker of inflammation (<xref ref-type="bibr" rid="ref22">22</xref>). In the early stage after MCAO/R, a notable increase in sPLA2-IIA mRNA expression has been observed in the cerebral cortex of rats, which is attributed to the activation of astrocytes (<xref ref-type="bibr" rid="ref30">30</xref>). However, Wang&#x2019;s study has also indicated that the autocrine levels of sPLA2-IIA possibly has a protective effect in maintaining the integrity of BMVECs and reducing the increased permeability induced by lipopolysaccharide (<xref ref-type="bibr" rid="ref31">31</xref>). These findings suggest a close association between sPLA2-IIA and IS. Importantly, a previous study has demonstrated that in the MCAO/R rat model, the levels of sPLA2-IIA in the penumbra did not increase in the early stage of ischemia, but an elevation in sPLA2-IIA levels was observed in the later stage (<xref ref-type="bibr" rid="ref30">30</xref>). Therefore, sPLA2-IIA inhibitors, which can halt the reversible pro-apoptotic state in the penumbra, hold promise for reducing ischemic damage and facilitating the successful treatment of stroke.</p>
<p>At present, the standard recommended treatment for IS involves intravenous thrombolysis or interventional methods aimed at achieving vascular recanalization (<xref ref-type="bibr" rid="ref32 ref33 ref34">32&#x2013;34</xref>). These treatments are bound by strict time window requirements and carry the risk of secondary cerebral hemorrhage and reperfusion injury (<xref ref-type="bibr" rid="ref24">24</xref>, <xref ref-type="bibr" rid="ref35">35</xref>). Owing to the BBB, antioxidant drugs are unable to reach the ischemic injury site, thereby limiting their biological impact. Consequently, the efficacy of existing drug therapies is limited. MiRNAs are implicated in various human disorders. Possessing high stability in human fluids, miRNAs are promising biomarkers for disease diagnosis and prognosis. Additionally, miRNA-based therapeutics hold the potential to revolutionize the treatment of diverse human pathologies (<xref ref-type="bibr" rid="ref14">14</xref>, <xref ref-type="bibr" rid="ref36">36</xref>, <xref ref-type="bibr" rid="ref37">37</xref>). Emerging evidence suggests that miRNA expression is upregulated during stroke and is crucial in regulating the prognosis of stroke patients (<xref ref-type="bibr" rid="ref21">21</xref>, <xref ref-type="bibr" rid="ref28">28</xref>). Therefore, therapeutic and diagnostic methods in stroke management can potentially gain valuable insights from the stroke&#x2013;miRNA system. Previous studies have demonstrated a significant reduction in miR-122 levels in both animal models of ischemic cerebral reperfusion and the blood of patients with acute stroke (<xref ref-type="bibr" rid="ref17">17</xref>, <xref ref-type="bibr" rid="ref19">19</xref>). Our previous study demonstrated that treatment with miR-122-5p mimics effectively reduces the volume of cerebral infarction in rats subjected to MCAO/R (<xref ref-type="bibr" rid="ref20">20</xref>, <xref ref-type="bibr" rid="ref21">21</xref>). In line with these important observations, we validated that miR-122 mitigates astrocyte apoptosis following IS. Moreover, we elucidated sPLA2-IIA as a novel target gene of miR-122 and demonstrated that the upregulation of miR-122 markedly inhibits sPLA2-IIA expression, thereby suggesting a cerebroprotective role for the miR-122/sPLA2-IIA axis in IR injury following IS.</p>
<p>Emerging evidence suggests that astrocyte-mediated inflammatory responses play a vital role in IS and have emerged as a prime target for novel therapies for stroke (<xref ref-type="bibr" rid="ref2">2</xref>, <xref ref-type="bibr" rid="ref20">20</xref>, <xref ref-type="bibr" rid="ref38">38</xref>). Astrocytes, the predominant cell type in the brain in terms of both quantity and volume, are responsible for regulating neuronal cell development and maintaining extracellular environmental homeostasis. In pathological conditions, including IS, astrocytes become activated and release adhesion molecules, chemokines, and other inflammatory factors into the affected areas. This secretion directly or indirectly contributes to the exacerbation of brain damage, neuronal dysfunction, microglial activation, and the recruitment of peripheral immune cells. Previous studies have demonstrated that sPLA2-IIA serves as an inflammatory mediator, stimulating the generation of pro-inflammatory cytokines and chemokines. Our results further validate that overexpression of miR-122 significantly decreases the expression of TNF-&#x03B1; and IL-6 in astrocytes. This finding suggests a cerebroprotective role for miR-122 in IS. However, additional investigations are necessary to explore the impact of miR-122 on post-ischemic inflammation, long-term survival, and functional recovery outcomes in an animal model of MCAO/R.</p>
<p>ROS have traditionally been considered as harmful byproducts of mitochondrial metabolic activities and a primary injury factor contributing to macromolecular damage in various inflammatory-related diseases, including IS. ROS production has been demonstrated to remarkably increase during IR injury (<xref ref-type="bibr" rid="ref15">15</xref>). Although the sources of these ROS remain a subject of debate, IR injury arises from the interruption and subsequent restoration of blood supply to an organ, resulting in an increase in mitochondrial ROS production. Moreover, the aberrant accumulation of ROS can induce mitochondrial dysfunction, promote the generation of pro-apoptotic proteins, and trigger apoptosis, underscoring the pivotal role of ROS in reperfusion damage (<xref ref-type="bibr" rid="ref39">39</xref>). Based on this research, we have revealed that miR-122 overexpression effectively reduces ROS production in astrocytes. Moreover, our findings demonstrate that the upregulation of miR-122 also decreases both the mRNA and protein expression of iNOS in astrocytes. Previous studies have suggested that iNOS is induced after 12&#x2009;h, in the later phases of cerebral ischemia. The neurotoxic nitric oxide synthesized by iNOS has been implicated in impeding the delayed recovery from neuronal damage in the brain (<xref ref-type="bibr" rid="ref40">40</xref>). Therefore, miR-122 may be involved in mitigating oxidative stress through multiple mechanisms, thereby exerting cerebroprotective effects in IS.</p>
<p>In summary, this particular research demonstrated that overexpression of miR-122 diminishes astrocyte apoptosis following an IS. Furthermore, we have identified sPLA2-IIA as a novel target gene of miR-122, with miR-122 directly binding to the 3&#x2032;-UTR of sPLA2-IIA, leading to the inhibition of sPLA2-IIA expression. This inhibition, in turn, mitigates post-ischemic inflammation and reduces the production of ROS. Our research suggests an innovative function for miR-122 in IS, as well as highlights its potential utility in intervention strategies for IS. Nevertheless, further study utilizing animal models is warranted to contribute to a thorough comprehension of the vital effects of miR-122 in IS, particularly in relation to post-ischemic inflammation, long-term survival, and functional recovery outcomes.</p>
</sec>
<sec sec-type="data-availability" id="sec25">
<title>Data availability statement</title>
<p>The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors.</p>
</sec>
<sec sec-type="author-contributions" id="sec26">
<title>Author contributions</title>
<p>YY: Data curation, Formal analysis, Investigation, Visualization, Writing &#x2013; original draft. PL: Data curation, Formal analysis, Investigation, Visualization, Writing &#x2013; original draft. MC: Data curation, Formal analysis, Investigation, Visualization, Writing &#x2013; original draft. WZ: Formal analysis, Visualization, Writing &#x2013; original draft. TZ: Conceptualization, Formal analysis, Writing &#x2013; original draft. LM: Conceptualization, Methodology, Writing &#x2013; review &#x0026; editing. HL: Data curation, Formal analysis, Validation, Writing &#x2013; review &#x0026; editing, Writing &#x2013; original draft. BL: Conceptualization, Funding acquisition, Methodology, Project administration, Resources, Supervision, Writing &#x2013; review &#x0026; editing.</p>
</sec>
</body>
<back>
<sec sec-type="funding-information" id="sec27">
<title>Funding</title>
<p>The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of Guangdong Province, China (Grant No. 2021A1515012466) and the Science and Technology Planning Program of Guangzhou, China (Grant No. 202102080050).</p>
</sec>
<sec sec-type="COI-statement" id="sec28">
<title>Conflict of interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="disclaimer" id="sec29">
<title>Publisher&#x2019;s note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
<ref-list>
<title>References</title>
<ref id="ref1"><label>1.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Collaborators</surname> <given-names>GS</given-names></name></person-group>. <article-title>Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019</article-title>. <source>Lancet Neurol</source>. (<year>2021</year>) <volume>20</volume>:<fpage>795</fpage>&#x2013;<lpage>820</lpage>. doi: <pub-id pub-id-type="doi">10.1016/s1474-4422(21)00252-0</pub-id>, PMID: <pub-id pub-id-type="pmid">34487721</pub-id></citation></ref>
<ref id="ref2"><label>2.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Alsbrook</surname> <given-names>DL</given-names></name> <name><surname>Di Napoli</surname> <given-names>M</given-names></name> <name><surname>Bhatia</surname> <given-names>K</given-names></name> <name><surname>Biller</surname> <given-names>J</given-names></name> <name><surname>Andalib</surname> <given-names>S</given-names></name> <name><surname>Hinduja</surname> <given-names>A</given-names></name> <etal/></person-group>. <article-title>Neuroinflammation in acute ischemic and hemorrhagic stroke</article-title>. <source>Curr Neurol Neurosci Rep</source>. (<year>2023</year>) <volume>23</volume>:<fpage>407</fpage>&#x2013;<lpage>31</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s11910-023-01282-2</pub-id>, PMID: <pub-id pub-id-type="pmid">37395873</pub-id></citation></ref>
<ref id="ref3"><label>3.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Cao</surname> <given-names>Y</given-names></name> <name><surname>Yue</surname> <given-names>X</given-names></name> <name><surname>Jia</surname> <given-names>M</given-names></name> <name><surname>Wang</surname> <given-names>J</given-names></name></person-group>. <article-title>Neuroinflammation and anti-inflammatory therapy for ischemic stroke</article-title>. <source>Heliyon</source>. (<year>2023</year>) <volume>9</volume>:<fpage>e17986</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.heliyon.2023.e17986</pub-id>, PMID: <pub-id pub-id-type="pmid">37519706</pub-id></citation></ref>
<ref id="ref4"><label>4.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gr&#x00F8;nh&#x00F8;j</surname> <given-names>MH</given-names></name> <name><surname>Clausen</surname> <given-names>BH</given-names></name> <name><surname>Fenger</surname> <given-names>CD</given-names></name> <name><surname>Lambertsen</surname> <given-names>KL</given-names></name> <name><surname>Finsen</surname> <given-names>B</given-names></name></person-group>. <article-title>Beneficial potential of intravenously administered IL-6 in improving outcome after murine experimental stroke</article-title>. <source>Brain Behav Immun</source>. (<year>2017</year>) <volume>65</volume>:<fpage>296</fpage>&#x2013;<lpage>311</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.bbi.2017.05.019</pub-id>, PMID: <pub-id pub-id-type="pmid">28587928</pub-id></citation></ref>
<ref id="ref5"><label>5.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Seyedaghamiri</surname> <given-names>F</given-names></name> <name><surname>Geranmayeh</surname> <given-names>MH</given-names></name> <name><surname>Ghadiri</surname> <given-names>T</given-names></name> <name><surname>Ebrahimi-Kalan</surname> <given-names>A</given-names></name> <name><surname>Hosseini</surname> <given-names>L</given-names></name></person-group>. <article-title>A new insight into the role of pericytes in ischemic stroke</article-title>. <source>Acta Neurol Belg</source>. (<year>2023</year>) <fpage>1</fpage>&#x2013;<lpage>8</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s13760-023-02391-y</pub-id>, PMID: <pub-id pub-id-type="pmid">37805645</pub-id></citation></ref>
<ref id="ref6"><label>6.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zlokovic</surname> <given-names>BV</given-names></name></person-group>. <article-title>Neurovascular pathways to neurodegeneration in Alzheimer's disease and other disorders</article-title>. <source>Nat Rev Neurosci</source>. (<year>2011</year>) <volume>12</volume>:<fpage>723</fpage>&#x2013;<lpage>38</lpage>. doi: <pub-id pub-id-type="doi">10.1038/nrn3114</pub-id>, PMID: <pub-id pub-id-type="pmid">22048062</pub-id></citation></ref>
<ref id="ref7"><label>7.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>H</given-names></name> <name><surname>Li</surname> <given-names>J</given-names></name> <name><surname>Zhang</surname> <given-names>H</given-names></name> <name><surname>Wang</surname> <given-names>M</given-names></name> <name><surname>Xiao</surname> <given-names>L</given-names></name> <name><surname>Wang</surname> <given-names>Y</given-names></name> <etal/></person-group>. <article-title>Regulation of microglia polarization after cerebral ischemia</article-title>. <source>Front Cell Neurosci</source>. (<year>2023</year>) <volume>17</volume>:<fpage>1182621</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fncel.2023.1182621</pub-id>, PMID: <pub-id pub-id-type="pmid">37361996</pub-id></citation></ref>
<ref id="ref8"><label>8.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname> <given-names>J</given-names></name> <name><surname>Guo</surname> <given-names>Y</given-names></name> <name><surname>Zhang</surname> <given-names>Y</given-names></name> <name><surname>Zhao</surname> <given-names>X</given-names></name> <name><surname>Fu</surname> <given-names>R</given-names></name> <name><surname>Hua</surname> <given-names>S</given-names></name> <etal/></person-group>. <article-title>Astrocytes in ischemic stroke: crosstalk in central nervous system and therapeutic potential</article-title>. <source>Neuropathology</source>. (<year>2024</year>) <volume>44</volume>:<fpage>3</fpage>&#x2013;<lpage>20</lpage>. doi: <pub-id pub-id-type="doi">10.1111/neup.12928</pub-id>, PMID: <pub-id pub-id-type="pmid">37345225</pub-id></citation></ref>
<ref id="ref9"><label>9.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lu</surname> <given-names>W</given-names></name> <name><surname>Chen</surname> <given-names>Z</given-names></name> <name><surname>Wen</surname> <given-names>J</given-names></name></person-group>. <article-title>Flavonoids and ischemic stroke-induced neuroinflammation: focus on the glial cells</article-title>. <source>Biomed Pharmacother</source>. (<year>2024</year>) <volume>170</volume>:<fpage>115847</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.biopha.2023.115847</pub-id>, PMID: <pub-id pub-id-type="pmid">38016362</pub-id></citation></ref>
<ref id="ref10"><label>10.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhao</surname> <given-names>N</given-names></name> <name><surname>Xu</surname> <given-names>X</given-names></name> <name><surname>Jiang</surname> <given-names>Y</given-names></name> <name><surname>Gao</surname> <given-names>J</given-names></name> <name><surname>Wang</surname> <given-names>F</given-names></name> <name><surname>Xu</surname> <given-names>X</given-names></name> <etal/></person-group>. <article-title>Lipocalin-2 may produce damaging effect after cerebral ischemia by inducing astrocytes classical activation</article-title>. <source>J Neuroinflammation</source>. (<year>2019</year>) <volume>16</volume>:<fpage>168</fpage>. doi: <pub-id pub-id-type="doi">10.1186/s12974-019-1556-7</pub-id>, PMID: <pub-id pub-id-type="pmid">31426811</pub-id></citation></ref>
<ref id="ref11"><label>11.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>T</given-names></name> <name><surname>Tang</surname> <given-names>Y</given-names></name> <name><surname>Tao</surname> <given-names>Y</given-names></name> <name><surname>Zhou</surname> <given-names>H</given-names></name> <name><surname>Ding</surname> <given-names>D</given-names></name></person-group>. <article-title>Nucleic acid drug and delivery techniques for disease therapy: present situation and future prospect</article-title>. <source>Interdisc Med</source>. (<year>2024</year>) <volume>2</volume>:<fpage>e20230041</fpage>. doi: <pub-id pub-id-type="doi">10.1002/INMD.20230041</pub-id></citation></ref>
<ref id="ref12"><label>12.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhang</surname> <given-names>LY</given-names></name> <name><surname>Hu</surname> <given-names>YY</given-names></name> <name><surname>Liu</surname> <given-names>XY</given-names></name> <name><surname>Wang</surname> <given-names>XY</given-names></name> <name><surname>Li</surname> <given-names>SC</given-names></name> <name><surname>Zhang</surname> <given-names>JG</given-names></name> <etal/></person-group>. <article-title>The role of astrocytic mitochondria in the pathogenesis of brain ischemia</article-title>. <source>Mol Neurobiol</source>. (<year>2024</year>) <volume>61</volume>:<fpage>2270</fpage>&#x2013;<lpage>82</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s12035-023-03714-z</pub-id>, PMID: <pub-id pub-id-type="pmid">37870679</pub-id></citation></ref>
<ref id="ref13"><label>13.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Gong</surname> <given-names>Z</given-names></name> <name><surname>Guo</surname> <given-names>J</given-names></name> <name><surname>Liu</surname> <given-names>B</given-names></name> <name><surname>Guo</surname> <given-names>Y</given-names></name> <name><surname>Cheng</surname> <given-names>C</given-names></name> <name><surname>Jiang</surname> <given-names>Y</given-names></name> <etal/></person-group>. <article-title>Mechanisms of immune response and cell death in ischemic stroke and their regulation by natural compounds</article-title>. <source>Front Immunol</source>. (<year>2023</year>) <volume>14</volume>:<fpage>1287857</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fimmu.2023.1287857</pub-id>, PMID: <pub-id pub-id-type="pmid">38274789</pub-id></citation></ref>
<ref id="ref14"><label>14.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname> <given-names>JM</given-names></name> <name><surname>Li</surname> <given-names>XL</given-names></name> <name><surname>Yang</surname> <given-names>Y</given-names></name> <name><surname>Xu</surname> <given-names>SM</given-names></name> <name><surname>Chen</surname> <given-names>QF</given-names></name> <name><surname>Xu</surname> <given-names>JW</given-names></name></person-group>. <article-title>Competing endogenous RNA network analysis of the molecular mechanisms of ischemic stroke</article-title>. <source>BMC Genomics</source>. (<year>2023</year>) <volume>24</volume>:<fpage>67</fpage>. doi: <pub-id pub-id-type="doi">10.1186/s12864-023-09163-1</pub-id>, PMID: <pub-id pub-id-type="pmid">36755220</pub-id></citation></ref>
<ref id="ref15"><label>15.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Neag</surname> <given-names>MA</given-names></name> <name><surname>Mitre</surname> <given-names>AO</given-names></name> <name><surname>Burlacu</surname> <given-names>CC</given-names></name> <name><surname>Inceu</surname> <given-names>AI</given-names></name> <name><surname>Mihu</surname> <given-names>C</given-names></name> <name><surname>Melincovici</surname> <given-names>CS</given-names></name> <etal/></person-group>. <article-title>miRNA involvement in cerebral ischemia-reperfusion injury</article-title>. <source>Front Neurosci</source>. (<year>2022</year>) <volume>16</volume>:<fpage>901360</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fnins.2022.901360</pub-id>, PMID: <pub-id pub-id-type="pmid">35757539</pub-id></citation></ref>
<ref id="ref16"><label>16.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chandran</surname> <given-names>R</given-names></name> <name><surname>Mehta</surname> <given-names>SL</given-names></name> <name><surname>Vemuganti</surname> <given-names>R</given-names></name></person-group>. <article-title>Non-coding RNAs and neuroprotection after acute CNS injuries</article-title>. <source>Neurochem Int</source>. (<year>2017</year>) <volume>111</volume>:<fpage>12</fpage>&#x2013;<lpage>22</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.neuint.2017.01.015</pub-id>, PMID: <pub-id pub-id-type="pmid">28131900</pub-id></citation></ref>
<ref id="ref17"><label>17.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Jickling</surname> <given-names>GC</given-names></name> <name><surname>Ander</surname> <given-names>BP</given-names></name> <name><surname>Zhan</surname> <given-names>X</given-names></name> <name><surname>Noblett</surname> <given-names>D</given-names></name> <name><surname>Stamova</surname> <given-names>B</given-names></name> <name><surname>Liu</surname> <given-names>D</given-names></name></person-group>. <article-title>microRNA expression in peripheral blood cells following acute ischemic stroke and their predicted gene targets</article-title>. <source>PLoS One</source>. (<year>2014</year>) <volume>9</volume>:<fpage>e99283</fpage>. doi: <pub-id pub-id-type="doi">10.1371/journal.pone.0099283</pub-id>, PMID: <pub-id pub-id-type="pmid">24911610</pub-id></citation></ref>
<ref id="ref18"><label>18.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kanki</surname> <given-names>H</given-names></name> <name><surname>Matsumoto</surname> <given-names>H</given-names></name> <name><surname>Togami</surname> <given-names>Y</given-names></name> <name><surname>Okuzaki</surname> <given-names>D</given-names></name> <name><surname>Ogura</surname> <given-names>H</given-names></name> <name><surname>Sasaki</surname> <given-names>T</given-names></name> <etal/></person-group>. <article-title>Importance of microRNAs by mRNA-microRNA integration analysis in acute ischemic stroke patients</article-title>. <source>J Stroke Cerebrovasc Dis</source>. (<year>2023</year>) <volume>32</volume>:<fpage>107277</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.jstrokecerebrovasdis.2023.107277</pub-id>, PMID: <pub-id pub-id-type="pmid">37562178</pub-id></citation></ref>
<ref id="ref19"><label>19.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname> <given-names>DZ</given-names></name> <name><surname>Tian</surname> <given-names>Y</given-names></name> <name><surname>Ander</surname> <given-names>BP</given-names></name> <name><surname>Xu</surname> <given-names>H</given-names></name> <name><surname>Stamova</surname> <given-names>BS</given-names></name> <name><surname>Zhan</surname> <given-names>X</given-names></name> <etal/></person-group>. <article-title>Brain and blood microRNA expression profiling of ischemic stroke, intracerebral hemorrhage, and kainate seizures</article-title>. <source>J Cereb Blood Flow Metab</source>. (<year>2010</year>) <volume>30</volume>:<fpage>92</fpage>&#x2013;<lpage>101</lpage>. doi: <pub-id pub-id-type="doi">10.1038/jcbfm.2009.186</pub-id>, PMID: <pub-id pub-id-type="pmid">19724284</pub-id></citation></ref>
<ref id="ref20"><label>20.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname> <given-names>Z</given-names></name> <name><surname>Chopp</surname> <given-names>M</given-names></name></person-group>. <article-title>Astrocytes, therapeutic targets for neuroprotection and neurorestoration in ischemic stroke</article-title>. <source>Prog Neurobiol</source>. (<year>2016</year>) <volume>144</volume>:<fpage>103</fpage>&#x2013;<lpage>20</lpage>. doi: <pub-id pub-id-type="doi">10.1016/j.pneurobio.2015.09.008</pub-id>, PMID: <pub-id pub-id-type="pmid">26455456</pub-id></citation></ref>
<ref id="ref21"><label>21.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lv</surname> <given-names>B</given-names></name> <name><surname>Cheng</surname> <given-names>X</given-names></name> <name><surname>Sharp</surname> <given-names>FR</given-names></name> <name><surname>Ander</surname> <given-names>BP</given-names></name> <name><surname>Liu</surname> <given-names>DZ</given-names></name></person-group>. <article-title>MicroRNA-122 mimic improves stroke outcomes and indirectly inhibits NOS2 after middle cerebral artery occlusion in rats</article-title>. <source>Front Neurosci</source>. (<year>2018</year>) <volume>12</volume>:<fpage>767</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fnins.2018.00767</pub-id>, PMID: <pub-id pub-id-type="pmid">30405345</pub-id></citation></ref>
<ref id="ref22"><label>22.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Khan</surname> <given-names>SA</given-names></name> <name><surname>Ilies</surname> <given-names>MA</given-names></name></person-group>. <article-title>The phospholipase A2 superfamily: structure, isozymes, catalysis, physiologic and pathologic roles</article-title>. <source>Int J Mol Sci</source>. (<year>2023</year>) <volume>24</volume>:<fpage>1353</fpage>. doi: <pub-id pub-id-type="doi">10.3390/ijms24021353</pub-id>, PMID: <pub-id pub-id-type="pmid">36674864</pub-id></citation></ref>
<ref id="ref23"><label>23.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhou</surname> <given-names>F</given-names></name> <name><surname>Liu</surname> <given-names>Y</given-names></name> <name><surname>Shi</surname> <given-names>H</given-names></name> <name><surname>Huang</surname> <given-names>Q</given-names></name> <name><surname>Zhou</surname> <given-names>J</given-names></name></person-group>. <article-title>Relation between lipoprotein-associated phospholipase a(2) mass and incident ischemic stroke severity</article-title>. <source>Neurol Sci</source>. (<year>2018</year>) <volume>39</volume>:<fpage>1591</fpage>&#x2013;<lpage>6</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s10072-018-3474-3</pub-id>, PMID: <pub-id pub-id-type="pmid">29938341</pub-id></citation></ref>
<ref id="ref24"><label>24.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Herpich</surname> <given-names>F</given-names></name> <name><surname>Rincon</surname> <given-names>F</given-names></name></person-group>. <article-title>Management of acute ischemic stroke</article-title>. <source>Crit Care Med</source>. (<year>2020</year>) <volume>48</volume>:<fpage>1654</fpage>&#x2013;<lpage>63</lpage>. doi: <pub-id pub-id-type="doi">10.1097/ccm.0000000000004597</pub-id>, PMID: <pub-id pub-id-type="pmid">32947473</pub-id></citation></ref>
<ref id="ref25"><label>25.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Paul</surname> <given-names>S</given-names></name> <name><surname>Candelario-Jalil</surname> <given-names>E</given-names></name></person-group>. <article-title>Emerging neuroprotective strategies for the treatment of ischemic stroke: an overview of clinical and preclinical studies</article-title>. <source>Exp Neurol</source>. (<year>2021</year>) <volume>335</volume>:<fpage>113518</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.expneurol.2020.113518</pub-id>, PMID: <pub-id pub-id-type="pmid">33144066</pub-id></citation></ref>
<ref id="ref26"><label>26.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Zhao</surname> <given-names>J</given-names></name> <name><surname>Liu</surname> <given-names>S</given-names></name> <name><surname>Xiang</surname> <given-names>X</given-names></name> <name><surname>Zhu</surname> <given-names>X</given-names></name></person-group>. <article-title>Versatile strategies for adult neurogenesis: avenues to repair the injured brain</article-title>. <source>Neural Regen Res</source>. (<year>2024</year>) <volume>19</volume>:<fpage>774</fpage>&#x2013;<lpage>80</lpage>. doi: <pub-id pub-id-type="doi">10.4103/1673-5374.382224</pub-id>, PMID: <pub-id pub-id-type="pmid">37843211</pub-id></citation></ref>
<ref id="ref27"><label>27.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Kadir</surname> <given-names>RRA</given-names></name> <name><surname>Alwjwaj</surname> <given-names>M</given-names></name> <name><surname>Bayraktutan</surname> <given-names>U</given-names></name></person-group>. <article-title>MicroRNA: an emerging predictive, diagnostic, prognostic and therapeutic strategy in ischaemic stroke</article-title>. <source>Cell Mol Neurobiol</source>. (<year>2022</year>) <volume>42</volume>:<fpage>1301</fpage>&#x2013;<lpage>19</lpage>. doi: <pub-id pub-id-type="doi">10.1007/s10571-020-01028-5</pub-id>, PMID: <pub-id pub-id-type="pmid">33368054</pub-id></citation></ref>
<ref id="ref28"><label>28.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Liu da</surname> <given-names>Z</given-names></name> <name><surname>Jickling</surname> <given-names>GC</given-names></name> <name><surname>Ander</surname> <given-names>BP</given-names></name> <name><surname>Hull</surname> <given-names>H</given-names></name> <name><surname>Zhan</surname> <given-names>X</given-names></name> <name><surname>Cox</surname> <given-names>C</given-names></name> <etal/></person-group>. <article-title>Elevating microRNA-122 in blood improves outcomes after temporary middle cerebral artery occlusion in rats</article-title>. <source>J Cereb Blood Flow Metab</source>. (<year>2016</year>) <volume>36</volume>:<fpage>1374</fpage>&#x2013;<lpage>83</lpage>. doi: <pub-id pub-id-type="doi">10.1177/0271678x15610786</pub-id>, PMID: <pub-id pub-id-type="pmid">26661204</pub-id></citation></ref>
<ref id="ref29"><label>29.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Yagami</surname> <given-names>T</given-names></name> <name><surname>Ueda</surname> <given-names>K</given-names></name> <name><surname>Asakura</surname> <given-names>K</given-names></name> <name><surname>Hata</surname> <given-names>S</given-names></name> <name><surname>Kuroda</surname> <given-names>T</given-names></name> <name><surname>Sakaeda</surname> <given-names>T</given-names></name> <etal/></person-group>. <article-title>Human group IIA secretory phospholipase A2 induces neuronal cell death via apoptosis</article-title>. <source>Mol Pharmacol</source>. (<year>2002</year>) <volume>61</volume>:<fpage>114</fpage>&#x2013;<lpage>26</lpage>. doi: <pub-id pub-id-type="doi">10.1124/mol.61.1.114</pub-id>, PMID: <pub-id pub-id-type="pmid">11752212</pub-id></citation></ref>
<ref id="ref30"><label>30.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Lin</surname> <given-names>TN</given-names></name> <name><surname>Wang</surname> <given-names>Q</given-names></name> <name><surname>Simonyi</surname> <given-names>A</given-names></name> <name><surname>Chen</surname> <given-names>JJ</given-names></name> <name><surname>Cheung</surname> <given-names>WM</given-names></name> <name><surname>He</surname> <given-names>YY</given-names></name> <etal/></person-group>. <article-title>Induction of secretory phospholipase A2 in reactive astrocytes in response to transient focal cerebral ischemia in the rat brain</article-title>. <source>J Neurochem</source>. (<year>2004</year>) <volume>90</volume>:<fpage>637</fpage>&#x2013;<lpage>45</lpage>. doi: <pub-id pub-id-type="doi">10.1111/j.1471-4159.2004.02540.x</pub-id>, PMID: <pub-id pub-id-type="pmid">15255941</pub-id></citation></ref>
<ref id="ref31"><label>31.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>G</given-names></name> <name><surname>Qian</surname> <given-names>P</given-names></name> <name><surname>Xu</surname> <given-names>Z</given-names></name> <name><surname>Zhang</surname> <given-names>J</given-names></name> <name><surname>Wang</surname> <given-names>Y</given-names></name> <name><surname>Cheng</surname> <given-names>S</given-names></name> <etal/></person-group>. <article-title>Regulatory effects of the JAK3/STAT1 pathway on the release of secreted phospholipase a&#x2082;-IIA in microvascular endothelial cells of the injured brain</article-title>. <source>J Neuroinflammation</source>. (<year>2012</year>) <volume>9</volume>:<fpage>170</fpage>. doi: <pub-id pub-id-type="doi">10.1186/1742-2094-9-170</pub-id>, PMID: <pub-id pub-id-type="pmid">22788969</pub-id></citation></ref>
<ref id="ref32"><label>32.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Goldstein</surname> <given-names>LB</given-names></name> <name><surname>Adams</surname> <given-names>R</given-names></name> <name><surname>Alberts</surname> <given-names>MJ</given-names></name> <name><surname>Appel</surname> <given-names>LJ</given-names></name> <name><surname>Brass</surname> <given-names>LM</given-names></name> <name><surname>Bushnell</surname> <given-names>CD</given-names></name> <etal/></person-group>. <article-title>Primary prevention of ischemic stroke: a guideline from the American Heart Association/American Stroke Association stroke council: cosponsored by the atherosclerotic peripheral vascular disease interdisciplinary working group; cardiovascular nursing council; clinical cardiology council; nutrition, physical activity, and metabolism council; and the quality of care and outcomes research interdisciplinary working group</article-title>. <source>Circulation</source>. (<year>2006</year>) <volume>113</volume>:<fpage>e873</fpage>&#x2013;<lpage>923</lpage>. doi: <pub-id pub-id-type="doi">10.1161/01.Str.0000223048.70103.F1</pub-id>, PMID: <pub-id pub-id-type="pmid">16785347</pub-id></citation></ref>
<ref id="ref33"><label>33.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Powers</surname> <given-names>WJ</given-names></name> <name><surname>Derdeyn</surname> <given-names>CP</given-names></name> <name><surname>Biller</surname> <given-names>J</given-names></name> <name><surname>Coffey</surname> <given-names>CS</given-names></name> <name><surname>Hoh</surname> <given-names>BL</given-names></name> <name><surname>Jauch</surname> <given-names>EC</given-names></name> <etal/></person-group>. <article-title>2015 American Heart Association/American Stroke Association focused update of the 2013 guidelines for the early Management of Patients with Acute Ischemic Stroke Regarding Endovascular Treatment: a guideline for healthcare professionals from the American Heart Association/American Stroke Association</article-title>. <source>Stroke</source>. (<year>2015</year>) <volume>46</volume>:<fpage>3020</fpage>&#x2013;<lpage>35</lpage>. doi: <pub-id pub-id-type="doi">10.1161/str.0000000000000074</pub-id>, PMID: <pub-id pub-id-type="pmid">26123479</pub-id></citation></ref>
<ref id="ref34"><label>34.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Sacco</surname> <given-names>RL</given-names></name> <name><surname>Adams</surname> <given-names>R</given-names></name> <name><surname>Albers</surname> <given-names>G</given-names></name> <name><surname>Alberts</surname> <given-names>MJ</given-names></name> <name><surname>Benavente</surname> <given-names>O</given-names></name> <name><surname>Furie</surname> <given-names>K</given-names></name> <etal/></person-group>. <article-title>Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on stroke: co-sponsored by the council on cardiovascular radiology and intervention: the American Academy of Neurology affirms the value of this guideline</article-title>. <source>Circulation</source>. (<year>2006</year>) <volume>113</volume>:<fpage>e409</fpage>&#x2013;<lpage>49</lpage>. doi: <pub-id pub-id-type="doi">10.1161/01.STR.0000199147.30016.74</pub-id>, PMID: <pub-id pub-id-type="pmid">16534023</pub-id></citation></ref>
<ref id="ref35"><label>35.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Adams</surname> <given-names>HP</given-names></name> <name><surname>del Zoppo</surname> <given-names>G</given-names></name> <name><surname>Alberts</surname> <given-names>MJ</given-names></name> <name><surname>Bhatt</surname> <given-names>DL</given-names></name> <name><surname>Brass</surname> <given-names>L</given-names></name> <name><surname>Furlan</surname> <given-names>A</given-names></name> <etal/></person-group>. <article-title>Guidelines for the early management of adults with ischemic stroke: a guideline from the American Heart Association/American Stroke Association stroke council, clinical cardiology council, cardiovascular radiology and intervention council, and the atherosclerotic peripheral vascular disease and quality of care outcomes in research interdisciplinary working groups: the American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists</article-title>. <source>Circulation</source>. (<year>2007</year>) <volume>115</volume>:<fpage>e478</fpage>&#x2013;<lpage>534</lpage>. doi: <pub-id pub-id-type="doi">10.1161/circulationaha.107.181486</pub-id>, PMID: <pub-id pub-id-type="pmid">17515473</pub-id></citation></ref>
<ref id="ref36"><label>36.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Adugna</surname> <given-names>A</given-names></name></person-group>. <article-title>Therapeutic strategies and promising vaccine for hepatitis C virus infection</article-title>. <source>Immun Inflamm Dis</source>. (<year>2023</year>) <volume>11</volume>:<fpage>e977</fpage>. doi: <pub-id pub-id-type="doi">10.1002/iid3.977</pub-id>, PMID: <pub-id pub-id-type="pmid">37647422</pub-id></citation></ref>
<ref id="ref37"><label>37.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname> <given-names>D</given-names></name> <name><surname>Wang</surname> <given-names>Y</given-names></name> <name><surname>Shi</surname> <given-names>J</given-names></name> <name><surname>Jiang</surname> <given-names>W</given-names></name> <name><surname>Huang</surname> <given-names>W</given-names></name> <name><surname>Chen</surname> <given-names>K</given-names></name> <etal/></person-group>. <article-title>Edaravone dexborneol alleviates ischemic injury and neuroinflammation by modulating microglial and astrocyte polarization while inhibiting leukocyte infiltration</article-title>. <source>Int Immunopharmacol</source>. (<year>2024</year>) <volume>130</volume>:<fpage>111700</fpage>. doi: <pub-id pub-id-type="doi">10.1016/j.intimp.2024.111700</pub-id>, PMID: <pub-id pub-id-type="pmid">38382262</pub-id></citation></ref>
<ref id="ref38"><label>38.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Qiu</surname> <given-names>YM</given-names></name> <name><surname>Zhang</surname> <given-names>CL</given-names></name> <name><surname>Chen</surname> <given-names>AQ</given-names></name> <name><surname>Wang</surname> <given-names>HL</given-names></name> <name><surname>Zhou</surname> <given-names>YF</given-names></name> <name><surname>Li</surname> <given-names>YN</given-names></name> <etal/></person-group>. <article-title>Immune cells in the BBB disruption after acute ischemic stroke: targets for immune therapy?</article-title> <source>Front Immunol</source>. (<year>2021</year>) <volume>12</volume>:<fpage>678744</fpage>. doi: <pub-id pub-id-type="doi">10.3389/fimmu.2021.678744</pub-id>, PMID: <pub-id pub-id-type="pmid">34248961</pub-id></citation></ref>
<ref id="ref39"><label>39.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Garcia-Bonilla</surname> <given-names>L</given-names></name> <name><surname>Moore</surname> <given-names>JM</given-names></name> <name><surname>Racchumi</surname> <given-names>G</given-names></name> <name><surname>Zhou</surname> <given-names>P</given-names></name> <name><surname>Butler</surname> <given-names>JM</given-names></name> <name><surname>Iadecola</surname> <given-names>C</given-names></name> <etal/></person-group>. <article-title>Inducible nitric oxide synthase in neutrophils and endothelium contributes to ischemic brain injury in mice</article-title>. <source>J Immunol</source>. (<year>2014</year>) <volume>193</volume>:<fpage>2531</fpage>&#x2013;<lpage>7</lpage>. doi: <pub-id pub-id-type="doi">10.4049/jimmunol.1400918</pub-id>, PMID: <pub-id pub-id-type="pmid">25038255</pub-id></citation></ref>
<ref id="ref40"><label>40.</label> <citation citation-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname> <given-names>ZQ</given-names></name> <name><surname>Mou</surname> <given-names>RT</given-names></name> <name><surname>Feng</surname> <given-names>DX</given-names></name> <name><surname>Wang</surname> <given-names>Z</given-names></name> <name><surname>Chen</surname> <given-names>G</given-names></name></person-group>. <article-title>The role of nitric oxide in stroke</article-title>. <source>Med Gas Res</source>. (<year>2017</year>) <volume>7</volume>:<fpage>194</fpage>&#x2013;<lpage>203</lpage>. doi: <pub-id pub-id-type="doi">10.4103/2045-9912.215750</pub-id>, PMID: <pub-id pub-id-type="pmid">29152213</pub-id></citation></ref>
</ref-list>
</back>
</article>