Evidence map›Paper›PMID 21317271›Full record

ArticleStroke2011

Endothelial nitric oxide synthase mediates endogenous protection against subarachnoid hemorrhage-induced cerebral vasospasm.

Ananth K Vellimana, Eric Milner, Tej D Azad, Michael D Harries, Meng-Liang Zhou, Jeffrey M Gidday, Byung Hee Han, Gregory J Zipfel

Open access · bronzeAbstract readComparative Study
In one paragraph

Article in Stroke, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 61 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
61citing papers in PubMed, 3 pooled it
6.0field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

61 citing papers in PubMed, 3 syntheses or guidelines pooled it, 106 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Article
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  7. Role of adenosine AEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
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  10. Conditioning-based therapeutics for aneurysmal subarachnoid hemorrhage - A critical review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024
    Review
  11. Peripheral macrophages in the development and progression of structural cerebrovascular pathologies.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2024
    Review
  12. Article
  13. Article
  14. Candidate neuroinflammatory markers of cerebral autoregulation dysfunction in human acute brain injury.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2023
    Review
  15. Review
  16. SIRT1 mediates hypoxic postconditioning- and resveratrol-induced protection against functional connectivity deficits after subarachnoid hemorrhage.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2022
    Article
  17. Article
  18. Article
  19. Article
  20. Article

1 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Ananth K VellimanaDepartment of Neurological Surgery, Washington University School of Medicine, 660 S Euclid Avenue, St Louis, MO 63110, USA.
Eric Milner
Tej D Azad
Michael D Harries
Meng-Liang Zhou
Jeffrey M Gidday
Byung Hee Han
Gregory J Zipfel
MACOM (United States) · US

Funding

WASHINGTON UNIVERSITY NEUROSURGERY RESIDENT RESEARCH EDUCATION PROGRAMR25NS090978 · NINDS · WASHINGTON UNIVERSITY · PI ZIPFEL, GREGORY J · 2015 to 2023
$2.1M
Cerebral Amyloid Angiopathy, Vascular Dysfunction & Ischemic Brain InjuryK08NS053899 · NINDS · WASHINGTON UNIVERSITY · PI ZIPFEL, GREGORY J · 2006 to 2010
$789k
Howard Hughes Medical InstituteNINDS NIH HHS K08 NS053899NINDS NIH HHS R25 NS090978
6 · The paper itself

Abstract

background and purposeVasospasm-induced delayed cerebral ischemia remains a major source of morbidity in patients with aneurysmal subarachnoid hemorrhage (SAH). We hypothesized that activating innate neurovascular protective mechanisms by preconditioning (PC) may represent a novel therapeutic approach against SAH-induced vasospasm and neurological deficits and, secondarily, that the neurovascular protection it provides is mediated by endothelial nitric oxide synthase (eNOS).

methodsWild-type mice were subjected to hypoxic PC or normoxia followed 24 hours later by SAH. Neurological function was analyzed daily; vasospasm was assessed on post-surgery Day 2. Nitric oxide availability, eNOS expression, and eNOS activity were also assessed. In a separate experiment, wild-type and eNOS-null mice were subjected to hypoxic PC or normoxia followed by SAH and assessed for vasospasm and neurological deficits.

resultsPC nearly completely prevented SAH-induced vasospasm and neurological deficits. It also prevented SAH-induced reduction in nitric oxide availability and increased eNOS activity in mice with and without SAH. PC-induced protection against vasospasm and neurological deficits was lost in wild-type mice treated with the nitric oxide synthase inhibitor N(G)-nitro-l-arginine methyl ester and in eNOS-null mice.

conclusionsEndogenous protective mechanisms against vasospasm exist, are powerful, and can be induced by PC. eNOS-derived nitric oxide is a critical mediator of PC-induced neurovascular protection. These data provide strong "proof-of-principle" evidence that PC represents a promising new strategy to reduce vasospasm and delayed cerebral ischemia after SAH.

Indexed as

AnimalsBehavior, AnimalIschemic PreconditioningMaleMiceMice, 129 StrainMice, Inbred C57BLMice, KnockoutMice, TransgenicNitric OxideNitric Oxide Synthase Type IIISubarachnoid HemorrhageVasospasm, IntracranialNitric OxideNitric Oxide Synthase Type III

Identifiers

PMID21317271
PMCPMC3042520
OpenAlexW2104205655

What OpenQuestion holds

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LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.