Oxyhemoglobin as the principal cause of cerebral vasospasm: a holistic view of its actions
Oxyhemoglobin as the principal cause of cerebral vasospasm: a holistic view of its actions
复制标题
DOI：
10.1007/s003290050147
复制
发表时间：
1999-09-01
期刊：
影响因子：
--
通讯作者：
Asano, T
中科院分区：
文献类型：
--
作者：
Asano, T
虽然氧合血红蛋白（oxyHb）被认为是蛛网膜下腔出血后脑血管痉挛的主要原因，但其导致血管痉挛的机制仍不清楚。重要的是，动脉平滑肌的长时间收缩并不是脑血管痉挛的唯一特征。尤其是在人类身上。血管痉挛还与动脉壁的器质性改变以及脑微循环紊乱有关。当近端动脉的血管痉挛引起迟发性缺血性神经功能缺损和脑梗死时，这些额外的特征可能发挥关键作用。问题是，血管痉挛的所有特征是否都归因于oxyHb的作用。在这方面，由于血管生理学的最新进展，已经清楚的是，脑血管系统应被视为一个器官，而不仅仅是一个管道，其中所有细胞内机制在功能上整合用于维持和调节脑血流（CBF）。在动脉功能不只是单个细胞功能的总和的意义上，它可以被描述为“整体”。根据现有文献，oxyHb具有多种作用，可分为以下三类：（1）清除一氧化氮（NO），（2）产生活性氧（ROS），（3）激活酪氨酸激酶/丝裂原活化激酶（TK/MAPK）途径。基于这样的知识，本审查的目的是在一个投机性的合成方面如何oxyHb涉及血管痉挛的发生，其中高度集成，整体机制内的脑动脉被扰动了很长一段时间。
While oxyhemoglobin (oxyHb) is deemed to be the principal cause of cerebral vasospasm following subarachnoid hemorrhage, the mechanism(s) whereby it leads to vasospasm is by no means clear. Of importance is the fact that prolonged contraction of arterial smooth muscle is not the sole feature of cerebral vasospasm. particularly in humans. Vasospasm is also associated with the occurrence of organic changes in the arterial wall as well as the derangement of cerebral microcirculation. These additional features may play a pivotal role when vasospasm in the proximal arteries incurs delayed ischemic neurological deficits and cerebral infarction. The question then arises as to whether or not all the features of vasospasm are attributable to the actions of oxyHb. In this regard, owing to the recent advances in vascular physiology, it has become clear that the cerebral vasculature should be regarded as an organ, not a mere conduit, in which all intracellular mechanisms are functionally integrated for the maintenance and regulation of cerebral blood flow (CBF). In the sense that the arterial function is not simply a sum of the individual cellular functions, it may be described as "holistic". According to extant literature, oxyHb has multifarious actions that can be divided into the following three categories: (1) scavenging of nitric oxide (NO), (2) generation of reactive oxygen species (ROS), (3) activation of the tyrosine kinase/mitogen-activated kinase (TK/MAPK) pathway. Based on such knowledge, the present review aims at a speculative synthesis in terms of how oxyHb pertains to the occurrence of vasospasm, in which the highly integrated, holistic mechanisms within the cerebral artery are perturbed for a prolonged period.