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Stroke is defined as "an acute neurological dysfunction of vascular origin with either sudden or rapid development of symptoms and signs, corresponding to the involvement of focal areas in the brain"1,2. There are two types of stroke: hemorrhagic and ischemic. When vascular dysfunction is caused either by an aneurysm or an arteriovenous malfunction, accompanied by weakening with posterior rupture of an artery, this is termed hemorrhagic stroke3 which, in most cases, leads to death. When a thrombus or an embolus obstructs blood flow, causing a temporary deprivation of oxygen and glucose to a brain region, it is called ischemic stroke4. Failure to nourish cells around the affected area or ischemic core leads to a homeostatic and metabolic imbalance, energetic dysfunction, neuronal death, and inflammation5, which can induce a life-long disability for patients6.
Ischemic stroke is a multifactorial injury involving several types of cells that react and exert their effects at different time points. Many interactions create a difficult environment to study the behavior of individual cells. So, how do we study the contribution of a specific cell type under such a complex environment? An accepted in vitro model of ischemia consists of exposing cells to oxygen and glucose deprivation (OGD), for a certain period, followed by the restoration of cells to a normoxic environment. This system simulates an ischemic stroke followed by blood reperfusion. In this method, cells or tissues are exposed to a glucose-free media in an environment purged of oxygen, using a specialized hypoxic chamber. The OGD incubation time can vary from a few minutes up to 24 h, depending on the hypothesis that wants to be tested. Studies have shown that depending on the times of OGD and normoxic environment, specific phenotypes of stroke (i.e., acute or subchronic) can be achieved. Primary isolated astrocytes, exposed to OGD with posterior restoration to normoxic conditions, is a well-studied cellular model to mimic stroke in vitro7. Using OGD is possible to reveal the independent molecular mechanisms of isolated cells under a stroke-like environment.
As our knowledge of astrocyte biology increases, it has become evident that they are crucial for maintaining synapses and sustaining neural repair, development, and plasticity8. Under normal conditions, astrocytes release and respond to cytokines, chemokines, growth factors and gliotransmitters, keeping metabolic balance and homeostasis within synapses5,9. In acute neuroinflammation, such as ischemic stroke, these cells can become reactive, show a long-term overexpression of Glial Fibrillary Acidic Protein (GFAP), and show hypertrophy in their morphology5,10,11,12. As the ischemic infarct develops, the homeostasis provided by astrocytes becomes affected, regarding normal glutamate uptake, energy metabolism, exchange of active molecules, and antioxidant activity13.
Reactivated astrocytes proliferate around the infarct tissue while leukocytes migrate towards the lesioned area14. Astrocytic proliferation can be measured using markers such as proliferating cell nuclear antigen (PCNA), Ki67, and bromodeoxyuridine (BrdU)15. This proliferative response is generated in a time-dependent manner and it helps forming the glial scar, an array of irreversibly reactive astrocytes along the parenchyma of the damaged site after an injury9. One of the initial functions of this scar is to limit the immune cell extravasation from this area. However, studies have shown that the scar becomes a physical impediment for axons to extend, as they release molecules inhibiting axonal growth, and create a physical barrier preventing axons from extending around the injured area16. Nevertheless, there is scientific evidence showing that after a spinal cord injury, completely preventing glial scar formation can impair the regeneration of axons17. Thus, the context in which the specific astrocytic response is measured, must be considered upon the framework of the injury studied.
The presented methodology can be applied to study the individualized function of astrocytes after oxygen glucose deprivation and it can be modified depending on the questions that the investigator wants to answer. For example, besides the morphological change and the markers expressed at different OGD times, the supernatants from astrocytes exposed to OGD can be further analyzed to identify soluble factors released by these cells, or used as a conditioned media to assess its effect in other brain cells. This approach enables studies on astrocyte reactivity that could lead to the elucidation of the factors that govern and modulate their response in an ischemic-stroke scenario.