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Here, we sought to explore the association between canonical Wnt signaling and hemorrhagic transformation (HT) following intravenous thrombolysis (IVT) in acute ischemic stroke (AIS) patients as well as to determine the underlying cellular mechanisms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>355 consecutive AIS patients receiving IVT were included. Blood samples were collected on admission, and HT was detected at 24\u00a0hours after IVT. 117 single\u2010nucleotide polymorphisms (SNPs) of 28 Wnt signaling genes and exon sequences of 4 core cerebrovascular Wnt signaling components (<jats:italic>GPR124<\/jats:italic>, <jats:italic>RECK<\/jats:italic>, <jats:italic>FZD4,<\/jats:italic> and <jats:italic>CTNNB1<\/jats:italic>) were determined using a customized sequencing chip. The impact of identified genetic variants was further studied in HEK 293T cells using cellular and biochemical assays.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>During the study period, 80 patients experienced HT with 27 parenchymal hematoma (PH). Compared to the non\u2010PH patients, <jats:italic>WNT7A<\/jats:italic> SNPs (rs2163910, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.001, OR 2.727; rs1124480, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.002, OR 2.404) and <jats:italic>GPR124<\/jats:italic> SNPs (rs61738775, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.012, OR 4.883; rs146016051, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a0.001, OR 7.607; rs75336000, <jats:italic>P<\/jats:italic>\u00a0=\u00a0.044, OR 2.503) were selectively enriched in the PH patients. Interestingly, a missense variant of <jats:italic>GPR124<\/jats:italic> (rs75336000, c.3587G&gt;A) identified in the PH patients resulted in a single amino acid alteration (p.Cys1196Tyr) in the intracellular domain of GPR124. This variant substantially reduced the activity of WNT7B\u2010induced canonical Wnt signaling by decreasing the ability of GPR124 to recruit cytoplasmic DVL1 to the cellular membrane.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Variants of <jats:italic>WNT7A<\/jats:italic> and <jats:italic>GPR124<\/jats:italic> are associated with increased risk of PH in patients with AIS after intravenous thrombolysis, likely through regulating the activity of canonical Wnt signaling.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cns.13457","type":"journal-article","created":{"date-parts":[[2020,9,29]],"date-time":"2020-09-29T21:36:05Z","timestamp":1601415365000},"page":"71-81","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Variants of <i>WNT7A<\/i> and <i>GPR124<\/i> are associated with hemorrhagic transformation following intravenous thrombolysis in ischemic stroke"],"prefix":"10.1111","volume":"27","author":[{"given":"Song","family":"Ta","sequence":"first","affiliation":[{"name":"Department of Neurology The First Hospital of Jilin University  Changchun China"},{"name":"Shenzhen Key Laboratory of Biomimetic Materials and Cellular Immunomodulation, Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianfang","family":"Rong","sequence":"additional","affiliation":[{"name":"Shenzhen Key Laboratory of Biomimetic Materials and Cellular Immunomodulation, Institute of Biomedicine and Biotechnology, Shenzhen Institutes of Advanced Technology Chinese Academy of Sciences  Shenzhen China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen\u2010Ni","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hang","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fenge","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Neurology The First Hospital of Jilin University  Changchun China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhihuan","family":"Li","sequence":"additional","affiliation":[{"name":"Dongguan Enlife Stem Cell Biotechnology Institute  Dongguan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lilong","family":"Lin","sequence":"additional","affiliation":[{"name":"Dongguan Enlife Stem Cell Biotechnology Institute  Dongguan China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenqing","family":"Zheng","sequence":"additional","affiliation":[{"name":"Shenzhen RealOmics Biotech Co., Ltd.  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