Nina Hagemann, Yachao Qi, Ayan Mohamud Yusuf, AnRan Li, Anthony Squire, Tobias Tertel, Bernd Giebel, Peter Ludewig, Philippa Spangenberg, Jianxu Chen, Axel Mosig, Matthias Gunzer and Dirk M. Hermann

2024 Arteriosclerosis, Thrombosis, and Vascular Biology

Abstract
BACKGROUND:
Until now, the analysis of microvascular networks in the reperfused ischemic brain has been limited due to tissue transparency challenges.

METHODS:
Using light sheet microscopy, we assessed microvascular network remodeling from 3 hours to 56 days post-ischemia in 2 mouse models of transient middle cerebral artery occlusion lasting 20 or 40 minutes, resulting in mild ischemic brain injury or brain infarction, respectively. We also examined the effect of a clinically applicable S1P (sphingosine-1-phosphate) analog, FTY720 (fingolimod), on microvascular network remodeling.

RESULTS:
Over 56 days, we observed progressive microvascular degeneration followed by robust angiogenesis after mild ischemic injury induced by 20-minute middle cerebral artery occlusion. However, more severe ischemic injury elicited by 40-minute middle cerebral artery occlusion resulted in incomplete microvascular remodeling. In both cases, microvascular networks did not return to their preischemic state but displayed a chronically altered pattern characterized by higher branching point density, shorter branches, higher unconnected branch density, and lower tortuosity, indicating enhanced network connectivity. FTY720 effectively increased microvascular length density, branching point density, and volume density in both models, indicating an angiogenic effect of this drug.

CONCLUSIONS:
Utilizing light sheet microscopy together with automated image analysis, we characterized microvascular remodeling post-ischemia in unprecedented detail. This technology will significantly advance our understanding of microvascular restorative processes and pave the way for novel treatment developments in the stroke field.