Lectin-like oxidized low-density lipoprotein receptor 1 and matrix metalloproteinase expression in ruptured and unruptured multiple dissections of distal middle cerebral artery: case report
Lectin-like oxidized low-density lipoprotein receptor 1 and matrix metalloproteinase expression in ruptured and unruptured multiple dissections of distal middle cerebral artery: case report
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DOI：
10.1007/s00701-009-0560-6
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发表时间：
2010-07-01
影响因子：
2.4
通讯作者：
Tominaga, Teiji
中科院分区：
文献类型：
--
作者：
Saito, Atsushi;Fujimura, Miki;Tominaga, Teiji
氧化低密度脂蛋白受体1(LOX1)是多种血管疾病中动脉粥样硬化的关键因子，但其在脑动脉夹层动脉瘤中的主要作用尚不清楚。本文报道了一例破裂和未破裂的大脑中动脉夹层中LOX1的表达差异，并讨论了LOX1与基质金属蛋白酶(MMPs)的相关性。患者女，59岁，合并左侧颞叶皮质下血肿并蛛网膜下腔出血。急诊脑血管造影显示左侧颞前动脉(ATA)起始处动脉瘤样扩张，ATA远侧闭塞。排除感染性动脉瘤。术中发现左侧ATA夹层破裂，左侧M1部分的另一个颞支未破裂的动脉瘤样扩张。两个病灶均用夹子夹住并切除。组织病理学检查证实，破裂和未破裂的动脉瘤样扩张均被诊断为动脉夹层。免疫组织化学检测显示LOX1、MMP2和MMP9在破裂型夹层内膜外的肥大中膜有显著表达，而在未破裂型夹层中，LOX1、MMP2和MMPs在内膜和内膜均有表达，这是首次发现LOX1和MMPs在多层夹层中的表达。LOX1和MMPs的对比定位可能是破裂/未破裂动脉夹层动脉壁脆性的原因之一。
Oxidized low-density lipoprotein receptor 1 (LOX1) is a critical factor for atherosclerosis in a variety of vascular diseases; however, its major role in cerebral arterial dissecting aneurysm is unclear.We present a case of remarkable contrast of LOX1 expression in ruptured and unruptured multiple middle cerebral artery dissections and discuss the correlation of LOX1 with matrix metalloproteinases (MMPs). A 59-year-old woman presented with subarachnoid hemorrhage associated with left temporal subcortical hematoma. Emergent cerebral angiography demonstrated aneurysmal dilatation at the origin of the left anterior temporal artery (ATA) and occlusion on the distal side of ATA. Infectious aneurysm was excluded. Intraoperative findings showed ruptured dissection of the left ATA and unruptured aneurysmal dilatation of another temporal branch of the left M1 portion. Both lesions were trapped by clips and resected. Histopathological examination confirmed that both ruptured and unruptured aneurysmal dilatations were diagnosed as arterial dissections. Immunohistochemical examination demonstrated remarkable expressions of LOX1, MMP-2, and MMP-9 in hypertrophic media outside the intima in ruptured dissection, on the other hand, those expressions in the intima and inside hypertrophic media in the unruptured dissection.This is the first report to reveal immunohistochemical findings of LOX1 and MMPs in multiple dissections of MCA. The contrast localization of LOX1 and MMPs might contribute to the fragility of the arterial wall layer of ruptured/unruptured arterial dissections.