Stroke by mechanism of thrombotic cerebral ischemia is one of the leading causes of death and/or disability worldwide. Current research is under consensus that there are sex-based differences in both the prevalence and presentation of stroke and thrombosis. Here we discuss the interrelation between thrombosis and inflammation and call attention to points in the cerebral ischemic cascade where estrogen may be involved in neuroprotection. Cerebral ischemia triggers a series of events including inflammation, which is deeply interrelated with thrombosis; inflammation not only produces local thrombosis, but thrombosis can also amplify inflammation especially through the synergism of leukocyte and platelet activity. Research involving experimental animal models of cerebral ischemia has shown that sex hormones, especially estrogen, offer a degree of neuroprotection. Mechanisms of this neuroprotection may be linked to certain anti-inflammatory properties of estrogen, as well as estrogen’s regulation of thrombosis through the lowering of coagulation factors, among others. It is also understood that sex hormones alter the function and morphology of platelets and fibrin networks, and changes in platelet and fibrin network morphology offer one of the earliest confirmations of inflammation. Sex hormone levels, inflammatory processes, and thrombotic mechanisms are profoundly interconnected in predicting the outcome of cerebral ischemia.
About the authors
Wendy Jeannette van der Spuy is PhD student with the Department of Anatomy’s Division of Histology and Cell Biology at the University of Pretoria, South Africa. She has a passion for electron microscopy, biological research and scientific writing. She is credited as primary or co-author of 14 scientific publications since 2009, with a further number of articles in the peer-review process for 2012. Together with Professor Etheresia Pretorius, her supervisor, she wishes to continue in the field of stroke and inflammatory research.
Etheresia (Resia) Pretorius received her PhD in 1998, and is a Professor in the Department of Physiology, University of Pretoria, South Africa. She has published over 150 peer reviewed manuscripts and book chapters and, since 2000, has also been mentor to 28 successful MSc and PhD students. Her focus is diseases associated with inflammation and she combines ultrastructure and electron microscopy with physiology. Particularly, her focus is the effect of inflammation on platelets, red blood cells and the coagulation system. In December 2011, Resia was named the Southern African Regional winner in the category, Basic Science, Technology and Innovation, of the prestigious African Union Kwame Nkrumah Scientific Awards, which forms part of the African Union Scientific Awards Programme.
©2012 by Walter de Gruyter Berlin Boston