Free Radical Damage in Ischemia-Reperfusion Injury: An Obstacle in Acute Ischemic Stroke after Revascularization Therapy

Figure 2

Complications after revascularization therapy. Severe complications include hemorrhagic transformation and cerebral edema. Hemorrhagic transformation is connected with the increase in the permeability of BBB. H₂O₂ generated from NADPH oxidase modifies tight junctions by redistribution of occludin and ZO-1. NO/ONOO⁻ degrades collagen and laminin in the basal membrane by the activation of MMP pathways. Free radicals also cause lipid peroxidation and protein dysfunction. All these pathophysiologic processes lead to BBB breakdown and subsequently result in hemorrhagic transformation and vasogenic edema. Cytotoxic edema is associated with the dysfunction of the ion transport in the membranes which suffer lipid peroxidation and protein oxidation. BBB: blood-brain barrier; TJs: tight junctions. The meaning of letter in blood-brain barrier: E: endothelial cells; P: pericytes; A: astrocyte end feet.