人脑出血后血肿周围组织HO-1、GFAP和cyclinD1的表达研究

目的探讨脑出血后血肿周围组织血红素氧合酶-1（HO-1）、胶质纤维酸性蛋白（GFAP）和细胞周期蛋白D1（cvclinD1）表达规律,及其与神经修复之间的关系。方法HE染色观察脑出血后神经元和星形胶质细胞形态变化,免疫组织化学染色检测脑出血后不同时间点血肿周固组织HO-1、GFAP和cvclinD1表达水平。结果脑出血后2h星形胶质细胞胞质内即开始表达HO-1[（5．30±1．00、）个,高倍视野]、GFAP[（22．60±1．40）个／高倍视野]和cyclinD1[（11．50±1．20）个,高倍视野],达峰值水平后逐渐下降,脑出血后不同时间点表达水平均高于健侧正常脑组织．且差异具有统计学意义（均P=0.000）。结论人脑出血后血肿周围组织HO-1、GFAP和cvclinD1表达变化呈“抛物线”样,HO-1和evclinD1共同参与了脑出血后星形胶质细胞的增生与活化,以及脑出血后的继发性损伤和修复。     

高血压性脑出血患者血肿周围组织GFAP和cyclinDl的表达

目的 探讨脑出血后血肿周围组织GFAP和cyclinD1的表达与脑出血后神经修复的关系.方法 选取30例高血压性脑出血后不同时间死亡患者的脑组织,自出血灶边缘向外1～3cm及出血灶对侧相应部位的脑组织进行取材,出血灶对侧设为对照组.应用HE染色,免疫组织化学技术观察不同时间点出血灶周围GFAP和eyclinD1在脑组织中的表达和变化规律,实验结果应用SPSS11.5软件进行统计学分析.结果 脑出血2h后出血灶周围GFAP阳性细胞数量开始增)311(22.6±1.4个/高倍视野).4～5d进一步增多(44.5±1.5个/高倍视野),6～15d达高峰(52.5±2.1个/高倍视野);15～19d后逐渐减弱(38.0±1.7个/高倍视野),与对照组比较,差异显著(P＜0.01).脑出血2h后出血灶周围星形胶质细胞即有cyclinD1的表达(11.5±1.2个/高倍视野),1～5d cyclinD1阳性表达的胶质细胞数量逐渐增多,6～15d达高峰(42.6±1.3个/高倍视野);16～19d后逐渐减弱(29.9±1.2个/高倍视野),仍显著高于对照组(P～0.01).GFAP与cyclinD1之间存在明显的相关性.结论 人脑出血后出血灶周围GFAP与cyclinD1表达增加,对脑出血后神经修复有促进作用.cyclinD1参与了脑出血后胶质细胞的增生和活化.     

高血压性脑出血患者血肿周围组织基质金属蛋白酶-9和细胞间黏附分子-1的表达及意义

目的 探讨脑出血后血肿周围组织基质金属蛋白酶-9(MMP-9)和细胞间黏附分子-1(ICAM-1)的表达与脑水肿的关系.方法 ①解剖39例脑出血后不同时间死亡患者的脑组织,自出血灶边缘向外1～3 cm及出血灶对侧相应部位的脑组织进行取材,出血灶对侧设为对照组.②采用HE染色、免疫组织化学技术观察不同时间点出血灶周围MMP-9与ICAM-1在脑组织中的表达和变化规律,实验结果应用SPSS 11.5软件进行统计学分析.结果 ①脑出血2 h后出血灶周围血管内皮细胞即有MMP-9的表达[(1.2±0.8)个/高倍视野],5～10 h后血肿周围MMP-9阳性微血管数明显增高[(4.1±0.8)个/高倍视野],45～48 h达到高峰[(10.6±1.4)个/高倍视野],96～120 h后逐渐减弱[(5.0±1.1)个/高倍视野],与对照组比较,差异均有统计学意义(P＜0.05),360～408 h接近零表达.对照组没有MMP-9表达.②脑出血后2 h出血灶周围血管和神经细胞即有ICAM-1的表达[(2.1±0.3)个/高倍视野],17～24 h血肿周围ICAM-1阳性微血管数开始明显增加[(6.0±1.1)个/高倍视野],72 h达到高峰[(11.1±0.9)个/高倍视野],168～312 h后逐渐减弱[(4.1±0.6)个/高倍视野],仍高于对照组(P＜0.05).此外,对侧脑实质内可见少量阳性神经细胞及ICAM-1阳性微血管.③MMP-9和ICAM-1之间有明显的相关性.结论 脑出血后出血灶周围MMP-9及ICAM-1的表达增加,对脑出血后脑水肿的形成可能有促进作用;MMP-9与ICAM-1之间可能有协同作用.     

高血压脑出血血肿周围脑组织缺氧诱导因子-1α的表达及意义

目的研究高血压脑出血患者血肿周围脑组织缺氧诱导因子-1α的表达及其与继发性神经元损伤的关系。方法选择行血肿清除术的脑出血患者32例,选取手术过程中获得的血肿周围脑组织,采用免疫组织化学技术、HE染色及TUNEL染色方法检测缺氧诱导因子-1α的表达及凋亡细胞的变化。结果出血4h,血肿周围脑组织即可见散在缺氧诱导因子-1α表达的神经元[(2.8±0.8)个/高倍视野],24~48h时达到高峰[(12.5±3.9)个/高倍视野],49~72h高表达持续存在[(12.2±1.8)个/高倍视野];出血4h可见神经元细胞及血管内皮细胞肿胀,出血12h可检测到明显的凋亡细胞[阳性细胞数为(11.2±4.1)个/高倍视野],24~48h凋亡细胞明显增多[(29.7±8.4)个/高倍视野],49~72h达到高峰[(33.2±4.3)个/高倍视野]。缺氧诱导因子-1α的表达与凋亡细胞呈正相关性(r=0.788,t=7.02,P<0.01)。结论脑出血后血肿周围神经元发生一系列形态学变化,其演变规律与缺氧诱导因子-1α的表达有密切相关性。     

实验性大鼠脑出血血肿周围组织胶质细胞纤维酸性蛋白的动态表达

目的:动态观察胶质细胞纤维酸性蛋白(GFAP)在脑出血动物模型脑组织中的表达及其意义。方法应用脑立体定向技术,建立大鼠脑出血模型,假手术作为对照组。分别测定脑组织含水量,观察血肿周围GFAP的表达规律。结果:大鼠脑出血后脑水肿于48h达到高峰,与对照组比较有统计学意义(P<0.05)。脑出血后脑内GFAP阳性细胞数6h表达最强,在72h时表达最少,7d的阳性细胞数量比72h增加(P<0.05),但数量少于6h(P<0.05)。相应时间点出血组阳性细胞数与对照组比较,有明显统计学意义,(P<0.05)。结论:脑出血后脑内GFAP的表达与脑水肿相关,提示星形胶质细胞在脑出血的病理变化过程中有重要作用。星形胶质细胞在损伤的修复作用具有二重性,即可以抑制也可以促进损伤修复。     

星形胶质细胞在脑出血后脑水肿中作用的研究

目的　观察星形细胞在脑出血急性期周围脑组织中的作用。方法　获取 30例脑出血患者出血灶周围脑组织标本 ,根据脑出血时间分为三组 ,超早期 (<8小时 ) ,8例 :早期 (8～ 4 8小时 ) ,16例 ;延期(>4 8小时 ) ,6例。应用胶质纤维酸性蛋白 (GFAP)进行免疫组织化学染色 ,观察其表达程度。结果　随着脑出血后时间的延长 ,GFAP染色灰度值越低 ,说明星形细胞增生越明显。结论　星形胶质细胞参与脑水肿的病理过程 ,并对组织修复可能具有重要作用。     

缺血缺氧对体外培养星形胶质细胞细胞周期和增殖的影响

目的 观察缺血缺氧损伤对星形胶质细胞细胞周期和增殖的影响。方法 用流式细胞仪检测缺血缺氧后不同时问点星形胶质细胞细胞周期变化，并用荧光免疫细胞化学技术测定胶质细胞纤维酸性蛋白(GFAP)和增殖细胞核抗原(PCNA)的表达水平。结果 体外缺血缺氧损伤后星形胶质细胞S期较正常组明显增高，6h达高峰，而随后则呈下降趋势。PCNA阳性反应损伤后表达均增加，6h表达最高；在缺血缺氧早期，GFAP阳性染色增强，6h最高；缺血缺氧12h后GFAP阳性染色变弱。结论 缺血缺氧损伤后星形胶质细胞活化进入增殖期；PCNA参与了损伤后星形胶质细胞的修复和增殖；细胞周期事件与星形胶质细胞的活化密切相关。     

大鼠脑出血后活化星形胶质细胞EGFR-JAK1/STAT3表达及Genistein的抑制作用

目的探讨EGFR-JAK1/STAT3信号通路在大鼠脑出血后星形胶质细胞活化中的作用。方法 SD大鼠60只,随机分为ICH组、DMSO组、GST组,每组20只,Ⅶ型胶原酶注入苍白球进行脑出血造模。GST组在造模后每天腹腔注射Genistein溶液(50 mg/kg),DMSO组腹腔注射相同剂量DMSO溶液,一次/d。取术后1 d、7 d、14 d、28 d共4个时间点进行神经功能评分,各时间点每组随机取5只大鼠处死取脑,免疫组化检测EGFR、GFAP在星形胶质细胞中的表达变化,Western blot检测每各组p-JAK1、p-STAT3蛋白水平的表达。结果神经功能评分:GST组优于ICH组与DMSO组、ICH组与DMSO组比较差异无统计学意义(P>0.05);免疫组化显示脑出血后EGFR、GFAP表达增高,给予GST干预后,GFAP、EGFR表达显著少于ICH组及DMSO组,差异有统计学意义(P<0.05);7 d时p-JAK1/p-STAT3蛋白表达显著上升,予GST干预后,p-JAK1/p-STAT3蛋白水平较ICH组明显降低,差异有统计学意义(P<0.05),DMSO组EGFR、GFAP及p-JAK1/p-STAT3蛋白表达水平,与ICH组比较,差异无统计学意义(P<0.05)。结论脑出血所致星形胶质细胞活化与EGFR表达上调有关,抑制EGFR表达,可使pJAK1/p-STAT3蛋白表达水平下调,提示EGFR-JAK1/STAT3信号通路可能与脑出血后星形胶质细胞活化相关。     

急性脑出血血肿周围组织水通道蛋白-4表达与血脑屏障损伤的关系

目的研究急性脑出血血肿周围组织水通道蛋白-4表达与血脑屏障损伤之间的关系。方法采用立体定向注射无肝素自体动脉血制作大鼠脑出血模型,对脑含水量、血脑屏障损害进行观察,RT-PCR和免疫印迹检测水通道蛋白-4 mRNA和蛋白表达,同时观察参与紧密连接的咬合蛋白(occ lud in)和带状闭合蛋白-1(zona occ ludens-1,ZO-1)表达和水通道蛋白-4表达的相关关系。电镜下观察不同时间点血脑屏障和神经星形胶质细胞终足改变。结果电镜提示出血后6 h血脑屏障紧密连接未破坏,但神经胶质细胞终足已经肿胀。与假手术组相比,此时的脑出血血肿周围组织大鼠水通道蛋白-4表达增高(P<0.05):脑出血3 h水通道蛋白-4 mRNA开始增强(吸光度比值1.05±0.13),水通道蛋白-4蛋白6 h开始增强(0.62±0.05),第3天达峰值(1.46±0.02)。电镜和伊文蓝显示血脑屏障从12 h才开始明显损害[12 h脑组织伊文蓝含量为(12.91±0.64)μg/g],同时ZO-1和occ lud in蛋白表达减弱,分别为0.71±0.05和0.72±0.04。与水通道蛋白-4蛋白表达呈负相关。结论脑出血后水通道蛋白-4增高和血脑屏障损伤之间存在相关关系;水通道蛋白-4增高和星形胶质细胞肿胀可能是血脑屏障损伤的因素之一。     

细胞周期抑制剂对大鼠局灶性脑缺血后胶质细胞增殖和瘢痕形成的影响及对神经元的保护作用

目的 观察选择性细胞周期抑制剂olomoucine对胶质细胞增殖和瘢痕形成及神经元凋亡的影响.方法 建立光化学法诱导大鼠局灶性脑缺血模型,随机分为假手术组、对照组和干预组,采用MRI显示梗死灶并计算其梗死灶体积;应用免疫荧光化学法检测胶质纤维酸性蛋白(GFAP)的表达及通过TUNEL方法检测神经元凋亡;免疫印迹法观察光照侧皮质GFAP、增殖细胞核抗原(proliferation cell nuclear antigen,PCNA)、周期素蛋白A和周期素蛋白B1蛋白的表达.结果 缺血后3、7、30 d对照组(5.10%±0.35%,4.60%±0.26%,3.96%±0.28%)梗死灶体积占全脑体积百分比值的平均值明显大于干预组(2.27%±0.28%,1.87%±0.19%,1.08%±0.18%,P＜0.05);缺血后各时间点组GFAP表达明显增强,对照组明显强于干预组,并且7、30 d对照组梗死灶周边可见明显的胶质瘢痕形成,以30 d最为显著;缺血后3 d梗死灶周围可见大量TUNEL阳性染色细胞,对照组[(41±11)个/高倍视野]数量明显多于干预组[(26±8)个/高倍视野,P＜0.05];干预组大鼠(22.44%±2.17%)NeuN+TUNEL双标阳性表达明显弱于对照组大鼠(34.41%±3.10%,P＜0.05);3、7、30 d的GFAP、PCNA、周期素蛋白A和周期素蛋白B1蛋白量表达,对照组明显高于干预组.结论 通过对细胞周期的调控,可部分抑制胶质细胞的活化增殖及瘢痕形成,同时减小脑梗死体积及减少神经元凋亡.     

Astrocyte-specific heme oxygenase-1 hyperexpression attenuates heme-mediated oxidative injury

In prior studies, we have observed that HO activity protects astrocytes from heme-mediated injury, but paradoxically increases neuronal injury. In this study, we tested the hypothesis that an adenovirus encoding the human HO-1 gene driven by an enhanced glial fibrillary acidic protein promoter (Ad-GFAP-HO-1) would increase HO-1 expression selectively in astrocytes, and provide cytoprotection. Treatment with 100 MOI Ad-GFAP-HO-1 for 24 h resulted in HO-1 expression that was 6.4-fold higher in cultured primary astrocytes than in neurons. Astrocyte HO activity was increased by approximately fourfold over baseline, which was sufficient to reduce cell death after 24-h hemin exposure by 60%, as assessed by both MTT and LDH release assays. A similar reduction in cell protein oxidation, quantified by carbonyl assay, was also observed. These results suggest that HO-1 transgene expression regulated by an enhanced GFAP promoter selectively increases HO-1 expression in astrocytes, and is cytoprotective. Further investigation of this strategy in vivo is warranted.     

Adenoviral transfer of the heme oxygenase-1 gene protects striatal astrocytes from heme-mediated oxidative injury

Heme oxygenase-1 (HO-1) is induced in the CNS after hemorrhage, and may have an effect on injury to surrounding tissue. Hemin, the preferred substrate of HO, is a neurotoxin that is present in intracranial hematomas. In a prior study, we observed that HO inhibitors increased the vulnerability of cultured cortical astrocytes to heme-mediated oxidative injury. To investigate the effect of HO more specifically, we used an adenoviral vector encoding the human HO-1 gene to specifically increase HO-1 expression. Incubation with 100 MOI of the HO-1 adenovirus (Adv-HHO-1) for 24 h increased both HO-1 protein and HO activity; a control adenovirus lacking the HO-1 gene had no effect. Using a DNA probe that was specific for human HO-1, 80.5 +/- 7.2% of astrocytes were observed to be infected by in situ hybridization. The cell death produced by 30-60 microM hemin was significantly reduced by pretreatment with 100 MOI Adv-HHO-1, as assessed by LDH release, propidium iodide exclusion, and MTT reduction assay. The threefold increase in cell protein oxidation produced by hemin was also attenuated in cultures pretreated with Adv-HHO-1. These results support the hypothesis that HO-1 protects astrocytes from heme-mediated oxidative injury. Specifically increasing astrocytic HO-1 by gene transfer may have a beneficial effect on hemorrhagic CNS injury.     

水通道蛋白-4在脑出血大鼠脑组织的分布

目的 观察脑出血大鼠水通道蛋白-4(AQP4)在脑组织的分布变化及其在出血性脑水肿中的作用。方法 采用定量胶原酶注人大鼠尾状核建立脑出血模型，应用免疫组化法观察脑出血后不同时间大鼠脑组织AQP4的表达。结果 AQP4阳性细胞主要分布在脑出血血肿周围区和大脑皮质的星形胶质细胞、脑室周围、视上核和室旁核。脑出血后6h起，AQP4表达增强，出血后72h达高峰，出血1周后仍高于正常水平。结论 脑出血后，AQP4在与水代谢密切相关的部位表达明显增强，提示AQP4在出血性脑水肿的形成过程中起重要作用。     

Perihematomal pathological changes in neurons and astrocytes following acute cerebral hemorrhage

We aim to investigate the pathological temporospatial characteristics of brain cell injury in the perihematomal areas. Brain autopsy samples from 44 consecutive cases of intracerebral hemorrhage were processed and analyzed following immunohistochemical staining for neurofilament (NF) and glial fibrillary acidic protein (GFAP). NF and GFAP positive cells were scored and graded according to the distance from the hematoma and the time from the onset of hematoma formation. The tissues from the same region on the contralateral side of the brain were used as controls. Neurons in the perihematomal areas exhibited pyknosis or swollen necrosis, while astrocytes were swollen. Morphological abnormalities pertaining to NF appearance were attenuated with increasing distance from the hematoma wall, but were exacerbated with prolonged bleeding time. The level of NF staining abnormality was positively correlated with time from the onset of hematoma within 7 days of intracerebral hemorrhage. In contrast, the intensity of GFAP staining was negatively correlated with time from the onset of hematoma formation. This immunoreactivity was significantly higher closer to hematoma. Taken together, these data indicate that pathological alterations in neurons and astrocytes in the perihematomal area change with time from the onset of hematoma formation.     

血红素加氧酶-1基因转染对神经元损伤的保护作用

目的观察腺病毒介导的血红素加氧酶-1（HO—1）基因转染大鼠后对脑缺血再灌注损伤的保护作用。方法雄性SD大鼠随机分为4组：假手术对照组（SH）、生理盐水组（V）、空载体组（Ad）和Ad—HO-1转染组（HO）。后三组在缺血前3d于右侧脑室部分别注射20μl生理盐水、含1μl空载体腺病毒（1．0×10^10plaque-forming unit／ml,PFU／ml）的生理盐水或含1μl重组HO-1腺病毒（1．0×10^10PFU／ml）的生理盐水,连续注射3d后,采用右侧大脑中动脉栓塞法（MCAO）建立脑缺血再灌注模型。每组大鼠测定神经功能后,处死大鼠并取全脑标本,测定右脑梗死体积及细胞凋亡指标,荧光显微镜下观察脑组织荧光蛋白的表达情况,Western blot检测脑组织HO-1的表达。结果HO组中HO-1表达量明显高于Ad组和V组,Ad组和HO组可见有荧光蛋白表达,转染率为34．5％±3．4％。HO组神经功能显著优于Ad组和V组（P〈0．001）。与SH组比较,V组、Ad组脑梗死体积、神经细胞凋亡明显升高。与V组及Ad组比较,HO组脑梗死体积显著减小（P〈0．01）、神经元凋亡显著减少（P〈0．01）。结论腺病毒携带的HO-1基因能有效的转染脑组织,并在脑内稳定表达;HO-1基因转染显著减轻脑缺血再灌注后神经细胞损伤。     

脑出血患者血肿周围组织中NF-κB的病理学观察

目的 探讨脑出血患者脑组织中NF-κB(nuclear factor-kappaB)的表达特征及意义.方法 筛选临床脑出血患者死亡病例21例,按出血时间(发病至死亡时间)分为6组:0～6h、6～12h、12～24h、24～48h、48～72h、72～96h.自出血灶边缘13cm处、海马和大脑皮层及出血灶对侧相应部位的脑组织取材,出血灶对侧设为对照组.采用免疫组织化学染色观察NF-κB在脑组织中的表达.结果 脑出血后6h时出血灶周围即有NF-κB蛋白表达(5.27±0.12),6～12h表达增加(8.52±0.66),24～48h时达高峰(34.47±2.81),72～96h表达减少(19.50±2.69),与对照组比较差异无统计学意义(P>0.05),但与0～6h组比较差异有统计学意义(P<0.05).NF-κB蛋白还表达于两侧海马和大脑皮层.结论 脑出血后脑组织中NF-κB表达增加,对脑水肿的形成可能有一定的促进作用.

Abstract：

Objective To study the expression and significance of NF-κB in human brain after intracerebral hemorrhage. Method 21 human clinical fatal cases with ICH were divided into 6 groups according to different onset time :0 6h,6 12h, 12 24h,24 48h,48 72h and 72 96h group. The brain tissues were removed frome 1 3cm away from the margin of the hemorrhagic lesion, hippocampus and cerebral cortex of the side of hematoma, as well as tissues from the corresponding areas of other side were taken as controls. NF-κB expression was detected by immunohistochemistry. Result There was little expression of NF-κB at 6h after ICH (5.27±0.12). The expression of NF-κB begun to increase at 6～12h (8.52±0.66), reached the peak at 24～48h (34.47±2.81 ), and gradually decreased at 72～96h ( 19.5±2.69). There had no significant difference compared with normal contralateral regions (P > 0. 05 ), but had significant difference compared with 0 -6h group (P < 0.05). There was expression of NF-κB in hippocampus and cortex. Conclusion The increased expression of NF-κB after intracerebral hemorrhage is probably correlated with the brain edema formation in the brain tissues around the hematoma.     

胶质纤维酸性蛋白与非溶栓性出血性转化关系的研究

目的探讨脑梗死患者血浆胶质纤维酸性蛋白水平变化对非溶栓性出血性转化的预测作用。方法选择78例人院时间<72h且头部MRI检查无出血的急性脑梗死患者,发病7～10d后复查MRI,梯度回波序列显示低信号为出血性转化;酶联免疫吸附法定量检测血浆胶质纤维酸性蛋白水平;并探讨影响出血性转化的可能危险因素。结果 78例患者中11例梯度回波序列呈现低信号。脑梗死组患者血浆胶质纤维酸性蛋白水平[(2798.46±1072.66)ng/L]与正常对照组[(2173.37±867.77)ng/L]之间,差异有统计学意义(P=0.000);其中出血性转化组血浆胶质纤维酸性蛋白水平[(3660.03±629.64)ng/L]明显高于非转化组[(2657.01±1066.89)ng/L]和正常对照组[(2173.37±867.77)ng/L;(P=0.000,P=0.005)]。多因素Logistic逐步回归分析显示,血浆胶质纤维酸性蛋白水平及房颤为出血性转化的危险因素(P=0.005,P=0.017)。结论急性脑梗死患者发病72h内血浆胶质纤维酸性蛋白水平高于2856.90 ng/L,对非溶栓性出血性转化的发生具有预测意义,可作为预测非溶栓性出血性转化的标志物之一。     

Iron toxicity in mice with collagenase-induced intracerebral hemorrhage

Intracerebral hemorrhage (ICH) is a devastating form of stroke. In this study, we examined the efficacy of deferoxamine (DFX), an iron chelator, after collagenase-induced ICH in 12-month-old mice. Intracerebral hemorrhage was induced by intrastriatal injection of collagenase. Deferoxamine (200 mg/kg, intraperitoneal) or vehicle was administrated 6 hours after ICH and then every 12 hours for up to 3 days. Neurologic deficits were examined on days 1 and 3 after ICH. Mice were killed after 1 or 3 days of DFX treatment for examination of iron deposition, neuronal death, oxidative stress, microglia/astrocyte activation, neutrophil infiltration, brain injury volume, and brain edema and swelling. Collagenase-induced ICH resulted in iron overload in the perihematomal region on day 3. Systemic administration of DFX decreased iron accumulation and neuronal death, attenuated production of reactive oxygen species, and reduced microglial activation and neutrophil infiltration without affecting astrocytes. Although DFX did not reduce brain injury volume, edema, or swelling, it improved neurologic function. Results of our study indicate that iron toxicity contributes to collagenase-induced hemorrhagic brain injury and that reducing iron accumulation can reduce neuronal death and modestly improve functional outcome after ICH in mice.