Key result
Apixaban protects blood-brain barrier integrity, whereas dabigatran disrupts barrier function in preclinical models.
Why the study?
Hemorrhagic transformation and cerebral edema in cerebral infarction are linked to blood-brain barrier disruption and anticoagulation, suggesting DOAC effects on blood-brain barrier integrity may influence stroke prognosis.
Does the choice of direct oral anticoagulant affect blood-brain barrier integrity in an in vitro model?
Does the choice of direct oral anticoagulant affect blood-brain barrier integrity in an in vitro model?
Apixaban may provide superior protection for blood-brain barrier integrity compared to dabigatran, suggesting potential prognostic advantages in patients with cerebral infarction.
Introduction: In cerebral infarction, major prognostic factors include hemorrhagic transformation and cerebral edema, both partially associated with blood-brain barrier (BBB) disruption. Anticoagulation therapy, especially with direct oral anticoagulants (DOACs), is linked to these outcomes, suggesting that the effect of DOACs on BBB integrity may influence stroke prognosis and recovery. Methods: Two in vitro BBB models-a monolayer model and a co-culture model-were constructed using rat brain endothelial cells (RBECs), pericytes, and astrocytes. Each model was treated with one of three DOACs: apixaban, rivaroxaban, or dabigatran. Transendothelial electrical resistance (TEER) was measured to assess BBB integrity. Results: In the monolayer model, TEER increased significantly with 10 μM apixaban and decreased significantly with 50 μM dabigatran. In the co-culture model, a significant TEER reduction was observed in the 10 μM dabigatran group, while no significant differences were found for apixaban or rivaroxaban. Conclusion: These preliminary findings suggest that apixaban may help preserve BBB integrity, while dabigatran at certain concentrations may compromise it.
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Sato et al. (2025) studied Blood-brain barrier disruption (in vitro model). Direct oral anticoagulants (apixaban, rivaroxaban, dabigatran) vs. Vehicle/control was evaluated on Transendothelial electrical resistance (TEER) assessing blood-brain barrier integrity (p=<0.05). Apixaban at 10 μM significantly increased TEER (preserving blood-brain barrier integrity), while dabigatran decreased TEER at 50 μM in the monolayer model and 10 μM in the co-culture model.
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