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Koseki et al. Inflammatory cells in intracranial aneurysm

agent. Hence, if such a kind of contrast agent can be A, Torner J, Derdeyn C, Raabe A, Mocco J, Korja M, Abdulazim A,
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developed for clinical usage, rupture-prone IAs could Amin-Hanjani S, Al-Shahi Salman R, Barrow D, Bederson J, Bonafe A,
presumably be differentiated from stable lesions. Dumont A, Fiorella D, Gruber A, Hankey G, Hasan D, Hoh B, Jabbour
P, Kasuya H, Kelly M, Kirkpatrick P, Knuckey N, Koivisto T, Krings T,
Lawton M, Marotta T, Mayer S, Mee E, Pereira V, Molyneux A, Morgan
CONCLUSION M, Mori K, Murayama Y, Nagahiro S, Nakayama N, Niemelä M, Ogilvy
C, Pierot L, Rabinstein A, Roos Y, Rinne J, Rosenwasser R, Ronkainen
The accumulation of histopathological and experimental A, Schaller K, Seifert V, Solomon R, Spears J, Steiger H, Vergouwen
evidence from human IA specimens and animal IA M, Wanke I, Wermer M, Wong G, Wong J, Zipfel G, Connolly EJ,
models has significantly promoted the conceptual Steinmetz H, Lanzino G, Pasqualin A, Rüfenacht D, Vajkoczy P,
understanding of the pathogenesis of IA and has McDougall C, Hänggi D, LeRoux P, Rinkel G, Macdonald R. The
unruptured intracranial aneurysm treatment score: a multidisciplinary
defined IA as a macrophage-mediated chronic consensus. Neurology 2015;85:881-9.
inflammatory disease of the arterial walls. This recent 6. Greving JP, Wermer MJ, Brown RD Jr., Morita A, Juvela S, Yonekura M,
advancement in the understanding of IA pathogenesis Ishibashi T, Torner JC, Nakayama T, Rinkel GJ, Algra A. Development
greatly encourages the development of not only novel of the PHASES score for prediction of risk of rupture of intracranial
diagnostic methods for the detection of rupture- aneurysms: a pooled analysis of six prospective cohort studies. Lancet
prone IAs, but also the development of medical Neurol 2014;13:59-66.
therapy targeting macrophages. In the near future, the 7. Yoshimura Y, Murakami Y, Saitoh M, Yokoi T, Aoki T, Miura K,
Ueshima H, Nozaki K. Statin use and risk of cerebral aneurysm rupture:
diagnosis and treatment of unruptured IAs will enter a a hospital-based case-control study in Japan. J Stroke Cerebrovasc Dis
phase of major change. We hope that many patients 2014;23:343-8.
with this disease will be more properly diagnosed and 8. Tulamo R, Frosen J, Hernesniemi J, Niemela M. Inflammatory changes
more safely treated. in the aneurysm wall: a review. J Neurointerv Surg 2010;2:120-30.
9. Kataoka K, Taneda M, Asai T, Kinoshita A, Ito M, Kuroda R. Structural
Acknowledgments fragility and inflammatory response of ruptured cerebral aneurysms.
Authors would like to express our sincere gratitude to A comparative study between ruptured and unruptured cerebral
aneurysms. Stroke 1999;30:1396-401.
all the researchers, collaborators, technical assistants 10. Aoki T, Nishimura M. Targeting chronic inflammation in cerebral
and secretaries contributing to our studies and also to aneurysms: focusing on NF-kappaB as a putative target of medical
grants supporting our research work. therapy. Expert Opin Ther Targets 2010;14:265-73.
11. Fukuda M, Aoki T. Molecular basis for intracranial aneurysm formation.
Financial support and sponsorship Acta Neurochir Suppl 2015;120:13-5.
T.A. is supported by the Coordination Fund from JST 12. Aoki T, Narumiya S. Prostaglandins and chronic inflammation. Trends
and Astellas Pharma Inc. Pharmacol Sci 2012;33:304-11.
13. Aoki T, Kataoka H, Shimamura M, Nakagami H, Wakayama K,
Conflicts of interest Moriwaki T, Ishibashi R, Nozaki K, Morishita R, Hashimoto N. NF-
kappaB is a key mediator of cerebral aneurysm formation. Circulation
There are no conflicts of interest. 2007;116:2830-40.
14. Frosen J, Piippo A, Paetau A, Kangasniemi M, Niemela M, Hernesniemi
Patient consent J, Jaaskelainen J. Remodeling of saccular cerebral artery aneurysm wall
No patient involved. is associated with rupture: histological analysis of 24 unruptured and 42
ruptured cases. Stroke 2004;35:2287-93.
Ethics approval 15. Chyatte D, Bruno G, Desai S, Todor DR. Inflammation and intracranial
This article does not contain any studies with human aneurysms. Neurosurgery 1999;45:1137-46.
participants or animals. 16. Hasan D, Chalouhi N, Jabbour P, Hashimoto T. Macrophage imbalance
(M1 vs. M2) and upregulation of mast cells in wall of ruptured
human cerebral aneurysms: preliminary results. J Neuroinflammation
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178 Neuroimmunology and Neuroinflammation ¦ Volume 3 ¦ August 31, 2016