VEGF治疗脑缺血再灌注损伤的分子机制研究

目的 通过检测血管内皮生长因子（VEGF）治疗兔脑缺血再灌注损伤的有关分子表达情况,探讨其分子机制.方法 采用兔大脑中动脉阻塞（MCAO）2h再灌注72h模型,在再灌注即刻,应用微量进样器将VEGF立体定向导入梗死灶周,于再灌注72h断头取脑,应用免疫组化方法检测缺血半暗带区caspase-3和细胞外信号调节激酶1（estracellular signal-regulated kinase,ERK1）的表达情况.结果 VEGF治疗后缺血半暗带区caspase-3和ERK1表达明显减低.结论 VEGF可能通过抑制caspase-3和ERK1表达发挥治疗作用.     

细胞外信号调节激酶在实验性脑缺血损伤皮层区的动态时空变化

目的探讨细胞外信号调节激酶(ERK)在局灶性脑缺血/再灌注损伤梗死灶周皮层区的动态时空变化及其作用机制。方法建立兔大脑中动脉阻断(MCAO)局灶性脑缺血再灌注模型,应用免疫组化检测ERK1在脑缺血2h再灌注不同时间灶周皮层的动态表达规律,同时应用免疫组化和流式细胞术检测细胞凋亡状态的动态变化。结果免疫组化分析显示,缺血2h再灌注灶周皮层区1hERK1表达开始增多,6h数目明显增多,3d达高峰,然后逐渐下降,14d回落到基线水平,其阳性细胞数分别为0.22±0.02、0.25±0.02、0.42±0.04、0.14±0.02。其表达时程变化与灶周皮层凋亡的变化相一致。结论脑缺血损伤诱导ERK表达增强,ERK在介导神经细胞凋亡和缺血性损伤中起重要作用。这为脑缺血治疗提供了新的思路。     

丁苯酞对大鼠局灶性脑缺血再灌注损伤后caspase-3表达的影响

目的:观察丁苯酞(NBP)对脑缺血再灌注损伤后的神经保护作用及caspase-3表达的影响。方法:SD大鼠46只随机分成假手术组(n=6)、缺血再灌注组(n=10)、NBP大剂量组(80mg·kg-1,n=10)、NBP中剂量组(40mg·kg-1,n=10)和NBP小剂量组(20mg·kg-1,n=10),采用ZeaLonga法制作局灶性脑缺血再灌注大鼠模型,观察NBP对大鼠脑缺血再灌注后的神经功能症状、组织形态学改变、以及对caspase-3表达的影响。结果:与假手术组相比,缺血再灌注组大鼠出现严重的神经功能缺失症状,光镜下脑组织出现明显的梗死缺血灶,皮质和海马区caspase-3表达增强;与缺血再灌注组比较,NBP治疗组能显著改善大鼠神经功能缺失症状,减少脑组织的梗死缺血损伤,降低caspase-3的表达,其中以NBP大剂量组的神经保护作用最为显著(P<0.001)。结论:NBP对大鼠局灶性脑缺血再灌注损伤具有保护作用,其作用机制可能与抑制caspase-3表达相关。     

依达拉奉对局灶性脑缺血再灌注损伤大鼠caspase-3、Bcl-2表达的影响

目的 对局灶性脑缺血再灌注损伤大鼠,给予自由基清除剂依达拉奉后,观察再灌注不同时间点脑组织caspase-3和Bcl-2蛋白表达情况,探讨依达拉奉对脑缺血再灌注损伤的保护作用.方法 制作局灶性脑缺血再灌注模型.随机分为正常组、假手术组、脑缺血组、依达拉奉组.假手术组于术后,脑缺血组和依达拉奉组于缺血1h后再灌注2h、6h、12h、24h、48h不同时间点,依达拉奉组于再灌注后30min腹腔内及皮下各注射依达拉奉1 次(3mg/kg.wt),30min 后重复1次.按时间点处死大鼠,灌注固定、取脑,行免疫组化染色,观察和计数不同脑区的caspase-3和Bcl-2蛋白表达阳性细胞数.结果 脑缺血组再灌注后2h在大脑额、顶叶皮质和海马均可见到caspase-3和Bcl-2阳性细胞,caspase-3表达高峰在12h;Bcl-2表达高峰在6h.依达拉奉组各时间点caspase-3阳性细胞较脑缺血组明显减少,而Bcl-2阳性细胞数明显增加 (均为P＜0.05).结论 依达拉奉可抑制caspase-3,提高Bcl-2的蛋白表达,对脑缺血再灌注损害有明显的保护作用.     

神经生长因子对兔局灶性脑缺血再灌注神经功能修复的影响和MR影像学评价

目的:研究神经生长因子(NGF)对兔局灶性脑缺血再灌注损伤神经功能修复的影响,并利用MR成像技术进行评价。方法:采用兔大脑中动脉阻断(MCAO)局灶性脑缺血再灌注模型,分别在缺血2h再灌注损伤后0、1、3和6h应用微量进样器将NGF立体定向导入梗死灶周,于再灌注72h,应用MR影像学、TTC染色和流式细胞术评价兔梗死体积、水肿体积、表观弥散系数(ADC)及神经功能缺损和凋亡状态。结果:缺血再灌注0h、1h、3h和6h灶周给予NGF,梗死体积分别比对照组下降50.1%、48.4%、37.6%和13.7%。同时再灌注3h内应用NGF水肿体积、神经功能缺损评分、灶周凋亡率及caspase-3含量明显下降,梗死中心区及灶周ADC比率(ADCR)升高;再灌注6h后给药,则无明显作用。相关分析显示各组灶周ADCR与灶周凋亡率具有明显负相关。结论:NGF对兔局灶性脑缺血再灌注损伤有保护作用,抑制caspase-3活性的表达和细胞凋亡是其保护机制之一,MR影像学检查可作为定量评价基因疗效的可靠指标。     

人尿激肽原酶对大鼠局灶性脑缺血再灌注损伤的保护作用及对Caspase-3表达的影响

目的 观察人尿激肽原酶(HUK)对局灶性脑缺血再灌注损伤大鼠神经细胞凋亡及Caspase-3表达的影响. 方法 66只SD大鼠按随机数字表法分为假手术组(n=6)、缺血再灌注损伤组和HUK处理组,后两组又按不同观察时间点分为再灌注6h、12h、24 h、72 h、168 h共5个亚组(n=6).缺血再灌注损伤组和HUK处理组采用线栓法建立大鼠大脑中动脉局灶性脑缺血再灌注损伤模型,HUK处理组按浓度17.5×10-3PNAU/mL,1.0 mL/kg,于再灌注后3h尾静脉注射给药,1次/d.采用TUNEL法及免疫组化染色检测各组大鼠脑组织中凋亡细胞及Caspase-3阳性细胞的数量变化. 结果 脑缺血再灌注损伤后6h即有细胞凋亡,于24 h达到高峰,至168 h仍可见凋亡细胞.Caspase-3阳性细胞表达均于再灌注24 h达高峰,至168 h仍有较多表达.除168 h时间点外,其余各时间点HUK处理组大鼠神经细胞凋亡数量、Caspase-3阳性细胞数量均明显低于缺血再灌注损伤组,差异均有统计学意义(P＜0.05). 结论 HUK在大鼠局灶性脑缺血再灌注损伤早期(6～72h)时能抑制细胞凋亡,推测与其减少Caspase-3的表达有关.     

神经生长因子的脑保护作用与Caspase-3表达的相关性

目的 研究神经生长因子(NGF)的脑保护时间窗与半胱天冬酶-3(Caspase-3)表达的相关性.方法 采用兔局灶性脑缺血再灌注损伤模型,分别于再灌注后0h、1h、3h和6h将NGF立体定向导入梗死灶周,再灌注72h观察神经功能、梗死体积、灶周凋亡率和Caspase-3表达.结果 再灌注0h、1h和3 h灶周给予NGF,梗死体积分别较对照组下降50.1%、42.5%和35.2%,相应的灶周凋亡率及Caspase-3表达明显下降,神经功能恢复较好,用药越早越明显;再灌注6h给药,则无明显作用.相关分析显示梗死体积变化与Caspase-3表达具有明显相关性(P＜0.05).结论 NGF脑保护治疗时间窗与Caspase-3表达相关,抑制Caspase-3表达可能是NGF介导神经保护作用的机制之一.     

ERK通路参与蛇毒型神经生长因子诱导的中枢神经保护作用

目的观察经侧脑室给予蛇毒型神经生长因子（vNGF）对脑缺血再灌注损伤后细胞外信号调节激酶（extracellular signal—regulated kinase,ERK）表达的影响,探讨外源性vNGF通过影响ERK的表达减轻神经元损伤的可能机理。方法取健康清洁级雄性Wistar大鼠,按随机分组原则分为2d组（n=30）、7d组（n=30）、14d组（n=30）。每个时间点再分为五个亚组vNGF25U、vNGF50U、vNGF100U、生理盐水对照组、以及假手术组,每个亚组6只大鼠。生理盐水对照组和vNGF各亚组大鼠采用大脑中动脉线栓法建立局灶性脑缺血-再灌注损伤模型,术后各时间点vNGF亚组采用改良的侧脑室置管术法给予相应剂量蛇毒型神经生长因子,生理盐水对照组给予等渗盐水。采用免疫组织化学法测定术后第2d、第7d以及第14d缺血皮质周围和海马CA3／DG区ERK阳性细胞数。结果（1）与对照组相比,经侧脑室给予蛇毒型神经生长因子各组大鼠神经功能明显改善,显示了外源性补充蛇毒型神经生长因子的明显正性干预作用。（2）ERK免疫组织化学结果显示：经侧脑室给予vNGF各亚组ERK阳性细胞在缺血皮质周围和海马CA3／DG区第2d表达为高峰,第7d明显下降,第14d恢复基线水平。与相应时间点对照组相比,呈明显下降趋势。结论局灶性脑缺血再灌注后磷酸化ERK表达增加,NGF可能通过抑制ERK途径而发挥神经保护作用。     

活性氧在脑缺血-再灌注损伤后动态表达

目的观察活性氧(ROS)在大鼠脑缺血—再灌注损伤不同时间缺血灶周区皮质的动态表达。方法健康成年SD雄性大鼠(n=55),随机分成假手术组(n=5)和模型组(n=50),模型组按再灌注时间分为10个组,即脑缺血—再灌注1h、3h、6h、12h、1d、3d、5d、7d、14d和28d组,每组5只大鼠。通过阻塞大脑中动脉(MCAO)制作大鼠局灶性脑缺血—再灌注损伤模型,采用改良神经功能严重性评分(m NSS)对不同时间点大鼠的神经功能进行评价,采用流式细胞术检测缺血灶周区ROS和血管内皮生长因子(VEGF)动态时空表达。结果假手术组未见神经功能损伤,评分为0。脑缺血—再灌注1h大鼠出现神经损伤,3h~1d时症状加重,3~7d时症状有所改善,14~28d症状明显好转。假手术组有少量ROS和VEGF表达,脑缺血再灌注损伤后1h缺血灶周区ROS急剧上升,3~6h有所下降,但仍远高于假手术组,后逐渐下降,3d时降到最低,与假手术组相仿,随后迅速上升,5d时已超过6h数值,7d时接近1h高度,后ROS表达呈平台期,VEGF表达趋势与其相仿,ROS表达与神经功能评分呈负相关。结论 ROS可能在脑缺血损伤中起双相作用,在超早期参与脑损伤过程,后期可能参与脑修复作用。     

腺苷预处理对大鼠脑缺血再灌注损伤后VEGF的表达

目的通过观察腺苷预处理后大鼠局灶性脑缺血再灌注区脑组织的病理结构、脑梗死面积及血管内皮生长因子(VEGF)的表达,探讨腺苷预处理诱导脑缺血耐受的可能作用机制。方法制作大鼠脑缺血再灌注损伤模型。60只SD大鼠随机分为3组:假手术组(F组)、缺血再灌注组(IR组)、腺苷预处理组(AP组),再按缺血再灌注后不同时间把各组随机分成4个亚组(每亚组5只大鼠)。通过TTC染色观察脑梗死体积,并应用免疫组化法检测各组大鼠脑组织VEGF的表达。结果 (1)TTC染色正常脑组织呈鲜红色,梗死区脑组织呈苍白色,并且随着再灌注时间的延长可见梗死区扩大,腺苷预处理组的脑梗死体积小于缺血再灌注组。(2)F组可见少量VEGF阳性表达,IR组和AP组在脑缺血再灌注后2 h开始出现VEGF阳性表达的细胞数量增多,24 h达到高峰,72 h下降,AP组在6 h、24 h VEGF阳性表达比IR组增强(P均<0.05),在72 h时AP组VEGF阳性表达较IR组减少(P<0.05)。结论腺苷预处理能够进一步增强大鼠局灶性脑缺血再灌注损伤后VEGF的表达;VEGF的表达增加可能是腺苷预处理诱导脑缺血耐受和产生神经保护作用的分子机制之一。     

Neuroprotective effect of postischemic administration of sodium orthovanadate in rats with transient middle cerebral artery occlusion.

Orthovanadate is a competitive inhibitor of protein tyrosine phosphatases. Some of its reported biologic effects are its insulin mimetic property and its activation of phosphoinositide 3-kinase and extracellular-signal regulated kinase (ERK). The authors previously reported its neuroprotective effect on delayed neuronal death of gerbil hippocampal CA1 neurons via Akt and ERK activation after transient forebrain ischemia. In the present study, the neuroprotective effect of postischemic intraperitoneal administration of sodium orthovanadate (2 l/kg of 50-mmol/l sodium orthovanadate in saline) was investigated in rats with transient middle cerebral artery occlusion. Ischemic neuronal injury was evaluated 1 day and 28 days after ischemia. The neuroprotective effect of orthovanadate was significant in the cortex but not the caudate putamen (ischemic core) at both 1 and 28 days after ischemia. In orthovanadate group, the activities of Akt and ERK were maintained after reperfusion; they were decreased in saline group. Blood glucose level decreased but within normal range. Regional cerebral blood flow was lower than that of saline group only at 0 hours after reperfusion. These data suggest that orthovanadate has neuroprotective effects in rats with transient middle cerebral artery occlusion and that these effects are mediated by Akt and ERK activation. Furthermore, low blood glucose levels and gradual recovery of regional cerebral blood flow may contribute to neuroprotection.     

Remifentanil postconditioning improves global cerebral ischemia-induced spatial learning and memory deficit in rats via inhibition of neuronal apoptosis through the PI3K signaling pathway

Global cerebral ischemia followed by reperfusion, which leads to extensive neuronal damage, particularly the neurons in the hippocampal CA1 region. Apoptosis is one of the major mechanisms that lead to neuronal death after cerebral ischemia and reperfusion. The neuroprotective effects of remifentanil preconditioning against cerebral ischemia/reperfusion injury have been recently reported. Here we investigated whether remifentanil postconditioning exerts neuroprotective effects against global cerebral ischemia/reperfusion injury in rats and its potential mechanisms. Global cerebral ischemia was performed via 10 min of four-vessel occlusion. Terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling positive cells and expression of Bcl-2 and Bax in the hippocampal CA1 region were assessed after reperfusion. Morris water maze task was used to quantify spatial learning and memory deficits after reperfusion. We found remifentanil postconditioning markedly improved the spatial learning and memory as well as attenuated neuronal apoptosis in hippocampus caused by cerebral ischemia/reperfusion injury. In addition, remifentanil postconditioning enhanced the expression of anti-apoptotic gene Bcl-2 while suppressed the expression of pro-apoptotic gene Bax in hippocampal CA1 region. However, the neuroprotective effects of remifentanil postconditioning were abolished by pretreatment of the PI3K inhibitor LY294002. The results suggest that remifentanil postconditioning exhibits neuroprotective effects against global cerebral ischemia/reperfusion injury in rats, and its mechanisms might involve inhibition of neuronal apoptosis through the PI3K pathway.     

Apelin-13 as a novel target for intervention in secondar y injur y after traumatic brain injur y

The adipocytokine, apelin-13, is an abundantly expressed peptide in the nervous system. Apelin-13 protects the brain against ischemia/reperfusion injury and attenuates traumatic brain injury by suppressing autophagy. However, secondary apelin-13 effects on traumatic brain injury-induced neural cell death and blood-brain barrier integrity are still not clear. Here, we found that apelin-13 signiifcantly de-creases cerebral water content, mitigates blood-brain barrier destruction, reduces aquaporin-4 expression, diminishes caspase-3 and Bax expression in the cerebral cortex and hippocampus, and reduces apoptosis. These results show that apelin-13 attenuates secondary injury after traumatic brain injury and exerts a neuroprotective effect.     

神经生长因子对大鼠脑缺血再灌注海马神经细胞损伤的影响

目的 :观察神经生长因子 (NGF)对脑缺血再灌注后海马CA1区神经细胞损伤的影响。方法 :采用大鼠脑缺血再灌注模型 ,在光镜和透射电镜下观察NGF治疗组和缺血再灌组动物脑缺血 3 0min再灌注 2 4h和 72h时海马组织学及超微结构的改变。结果 :在缺血 3 0min再灌注 2 4h和 72h时 ,NGF治疗组海马CA1区神经细胞的结构损伤与缺血再灌组比较显著减轻 ;NGF可以减轻海马迟发性神经细胞死亡 (DND)性损伤。结论 :NGF对缺血再灌注所致的神经细胞损伤可能具有一定的保护作用     

托吡酯对大鼠脑缺血再灌注后神经细胞凋亡和HSP-70表达的影响

目的 了解托吡酯(topiramate)对大鼠局灶性脑缺血再灌注后神经细胞凋亡和热休克蛋白-70(HSP-70) 蛋白表达的影响,探讨托吡酯的神经保护作用机制.方法 用线栓法制备SD大鼠大脑中动脉阻塞再灌注(MCAO)模型, 托吡酯100mg/kg灌胃,qd,应用原位末端标记(TUNEL) 和HSP-70免疫组化染色分别观察大鼠脑缺血再灌注后神经细胞凋亡和HSP-70表达.结果 脑缺血再灌注后2h即出现凋亡细胞,并逐渐增加,2d达高峰,之后逐渐减少.托吡酯干预后,凋亡神经细胞减少,其中再灌注12～48h与对照组比较差异有显著性.脑缺血再灌注后HSP-70的表达于2h逐渐增加,24h达高峰,72h后逐渐降低.托吡酯干预后, 再灌注12h～72h HSP-70表达较对照组显著升高.结论 HSP-70及神经细胞凋亡均参与了脑缺血的病理生理过程,托吡酯具有抑制细胞凋亡和神经保护作用.     

Differential changes of bax, caspase-3 and p21 mRNA expression after transient focal brain ischemia in the rat

Recent studies of transient focal ischemia have focused interest on apoptotic mechanisms of neuronal cell death involving constitutive pro-apoptotic proteins. The finding of specific patterns of novel gene expression might indicate the activation of pro-apoptotic genes in previously ischemic areas. Thus, we investigated gene expression for the pro-apoptotic regulators, Bax and caspase-3, after transient focal brain ischemia, together with the p53-regulated cell cycle inhibitor, p21/WAF1/CIP1. Reversible occlusion of the middle cerebral artery for 2 h was carried out in halothane-anesthetized rats using the poly-L-lysine coated filament method. In situ hybridization was performed at 0, 1, 3, 6 h and 1, 3 and 7 d of recirculation and in sham controls. Radioactive antisense probes served for detection of bax, p21 and caspase-3 mRNAs on brain sections, and quantitative film autoradiography was combined with image-averaging techniques. Bax mRNA tended to decline after focal brain ischemia within 1 d. p21 mRNA was upregulated with a perifocal pattern at 3 h and 1 d after ischemia whereas the ischemic regions themselves failed to show significant upregulation. Caspase-3 mRNA was elevated in the resistant dorsomedial cortex at 1 d. A pro-apoptotic pattern of novel gene expression, involving Bax and caspase-3, was not observed after transient focal brain ischemia. Rather, the perifocal expression of p21 and caspase-3 mRNAs observed at 1 d after ischemia points to reactive changes in resistant brain areas.     

硫酸镁对脑缺血再灌注大鼠脑组织Bcl-2表达的影响及神经保护作用

目的探讨硫酸镁对脑缺血再灌注大鼠脑组织抗凋亡蛋白Bcl-2表达的影响及脑保护作用。方法将32只大鼠随机分为缺血组(n=15)、硫酸镁组(n=15)和正常对照组(n=2)。采用改良的Pulsinelli法建立脑缺血再灌注大鼠模型;制模后分别给予缺血组和硫酸镁组大鼠腹腔注射生理盐水(1.5 ml/d)及硫酸镁(90 mg/kg.d)。缺血再灌注第1、3、7 d分别观察各组大鼠海马CA1区病理学改变和Bcl-2的表达水平。结果正常对照组大鼠海马CA1区神经细胞数量多,排列整齐。缺血再灌注1 d时,缺血组及硫酸镁组大鼠海马CA1区神经元均未见明显死亡;3 d时,缺血组海马CA1区神经元可见少量死亡,残存神经细胞呈较严重缺血性改变,硫酸镁组海马CA1区神经元无明显死亡;7 d时,缺血组海马CA1区神经元大部分死亡,伴有小胶质细胞增生,硫酸镁组仅见部分神经元死亡。与缺血组相比,硫酸镁组神经元受损程度较轻,坏死区较小。硫酸镁组缺血再灌注各时间点大鼠Bcl-2阳性细胞较缺血组均明显增加(均P<0.05)。结论硫酸镁能上调脑组织Bcl-2的表达,对缺血再灌注大鼠的脑组织有明显的保护作用。