Development of Collateral Circulation in the Ischemic Brain

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Enhancing collateral artery growth is a potent therapeutic approach to treat ischemic brain disease from occlusive artery. Brain ischemia was created by occluding left common carotid artery (CCA) in C57/BL6 mice. Following the surgery, G (granulocyte)-CSF (100μg/kg/day) was administered daily for 5 days. G-CSF increased circulating blood monocytes and Mac-2 positive cells in the brain dorsal surface, and promoted leptomeningeal collateral growth. In spontaneously hypertensive rats (SHR), CCA occlusion did not enlarge the leptomeningeal anastomosis in contrast to that in normotensive rats. However, decreasing blood pressure using an angiotensin II AT1 receptor blocker restored the beneficial effect of CCA occlusion on collateral growth. Enhancement or preservation of collateral growth by G-CSF or anti-hypertensive treatment would be a future target for developing a new strategy against ischemic brain disease.