Impaired Collateral Flow Compensation During Chronic Cerebral Hypoperfusion in the Type 2 Diabetic Mice.
Impaired Collateral Flow Compensation During Chronic Cerebral Hypoperfusion in the Type 2 Diabetic Mice.
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DOI：
10.1161/strokeaha.116.014882
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发表时间：
2016-12
期刊：
影响因子：
8.3
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Nishijima Y;Akamatsu Y;Yang SY;Lee CC;Baran U;Song S;Wang RK;Tominaga T;Liu J
侧支循环的存在与狭窄闭塞性颈动脉疾病患者中风和短暂性脑缺血发作（TIA）风险降低相关。尽管代谢综合征对侧支状态有负面影响，但目前尚不清楚2型糖尿病（T2 DM）是否以及在多大程度上影响低灌注期间的脑侧支血流调节。在db/+和db/db小鼠单侧颈总动脉闭塞（CCAO）后两周内，我们使用光学相干断层扫描检查了软脑膜侧支血流的时空变化以及MCA和ACA远端分支穿透性小动脉的血流动力学。我们还通过测量CW血管直径评估了CCAO后Willis环（CW）的时间适应性。在单侧CCAO后，与db/+小鼠相比，db/db小鼠表现出柔脑膜侧支血流代偿减少，这与远端ACA分支扩张减少一致，不仅导致软脑膜血管中的血流减少，而且导致与远端MCA和ACA接壤的穿透性小动脉中的血流减少。然而，在CCAO后的第一周内，在两种小鼠中均未检测到明显的细胞死亡。与db/+小鼠相比，db/db小鼠还经历了CW中几个同侧主要供血动脉的血管直径的更严重的早期减小，以及延迟的CCAO后适应性反应一到两周。T2 DM是脑灌注不足期间血流动力学受损的额外风险因素，可能会增加卒中或TIA的严重程度和风险。
The presence of collaterals is associated with a reduced risk of stroke and transient ischemic attack (TIA) in patients with steno-occlusive carotid artery disease. Although metabolic syndrome negatively impacts collateral status, it is unclear whether and to what extent type 2 diabetes (T2DM) affects cerebral collateral flow regulation during hypoperfusion. We examined the spatial and temporal changes of the leptomeningeal collateral flow and the flow dynamics of the penetrating arterioles in the distal MCA and ACA branches over two weeks following unilateral common carotid artery occlusion (CCAO) using optical coherent tomography in db/+ and db/db mice. We also assessed the temporal adaptation of the circle of Willis (CW) following CCAO by measuring CW vessel diameters. Following unilateral CCAO, db/db mice exhibited diminished leptomeningeal collateral flow compensation compared to db/+ mice, which coincided with a reduced dilation of distal ACA branches, leading to reduced flow not only in pial vessels, but also in penetrating arterioles bordering the distal MCA and ACA. However, no apparent cell death was detected in either strain of mice during the first week after CCAO. db/db mice also experienced a more severe early reduction in the vessel diameters of several ipsilateral main feeding arteries in the CW, in addition to a delayed post-CCAO adaptive response by one to two weeks compared to db/+ mice. T2DM is an additional risk factor for hemodynamic compromise during cerebral hypoperfusion, which may increase the severity and the risk of stroke or TIA.