RT Journal Article T1 Toll-Like Receptor 4 Mediates Hemorrhagic Transformation After Delayed Tissue Plasminogen Activator Administration in In Situ Thromboembolic Stroke A1 García Culebras, Alicia A1 Palma Tortosa, Sara A1 Moraga Yébenes, Ana A1 García Yébenes, Isaac A1 Durán Laforet, Violeta A1 Cuartero Desviat, María Isabel A1 Parra Gonzalo, Juan De La A1 Barrios Muñoz, Ana L. A1 Díaz Guzmán, Jaime A1 Pradillo Justo, Jesús Miguel A1 Moro Sánchez, María Ángeles A1 Lizasoaín Hernández, Ignacio AB Background and purpose: Hemorrhagic transformation is the main complication of revascularization therapies after stroke. Toll-like receptor 4 (TLR4) is implicated in cerebral damage and inflammation in stroke. This study was designed to determine the role of TLR4 in hemorrhagic transformation development after tissue plasminogen activator (tPA) administration.Methods: Mice expressing (TLR4+/+) or lacking functional TLR4 (TLR4-/-) were subjected to middle cerebral artery occlusion using an in situ thromboembolic model by thrombin injection into the middle cerebral artery, and tPA (10 mg/kg) was administered 20 minutes or 3 hours after ischemia. Infarct size, hemorrhages, IgG extravasation, matrix metalloproteinase 9 expression, and neutrophil infiltration were assessed 24 hours after ischemia.Results: In TLR4+/+, early reperfusion (tPA at 20 minutes) resulted infarct volume, whereas late recanalization (tPA at 3 hours) did not modify lesion size and increased the rate of the most severe hemorrhages. In TLR4-/- mice, both early and late reperfusion did not modify lesion size. Importantly, late tPA administration did not result in worse hemorrhages and in an increased bleeding area as occurred in TLR4+/+ group. In TLR4-/- animals, late reperfusion produced a lesser increase in matrix metalloproteinase 9 expression when compared with TLR4+/+ animals.Conclusions: Our results demonstrate TLR4 involvement in hemorrhagic transformation induced by delayed tPA administration, very likely by increasing matrix metalloproteinase 9 expression. PB Lippincott, Williams & Wilkins SN 0039-2499 YR 2017 FD 2017-06 LK https://hdl.handle.net/20.500.14352/95746 UL https://hdl.handle.net/20.500.14352/95746 LA eng NO García-Culebras A, Palma-Tortosa S, Moraga A, García-Yébenes I, Durán-Laforet V, Cuartero MI, de la Parra J, Barrios-Muñoz AL, Díaz-Guzmán J, Pradillo JM, Moro MA, Lizasoain I. Toll-Like Receptor 4 Mediates Hemorrhagic Transformation After Delayed Tissue Plasminogen Activator Administration in In Situ Thromboembolic Stroke. Stroke. 2017 Jun;48(6):1695-1699. doi: 10.1161/STROKEAHA.116.015956 NO Unión Europea NO Ministerio de Economía y Competitividad NO Instituto de Salud Carlos III DS Docta Complutense RD 9 abr 2025