The pathologic cascade of cerebrovascular lesions in SHRSP: is erythrocyte accumulation an early phase?
The pathologic cascade of cerebrovascular lesions in SHRSP: is erythrocyte accumulation an early phase?
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DOI：
10.1038/jcbfm.2011.122
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发表时间：
2012-02-01
影响因子：
6.3
通讯作者：
Braun, Holger
中科院分区：
文献类型：
--
作者：
Schreiber, Stefanie;Bueche, Celine Z.;Braun, Holger
脑小血管病（CSVD）与血管壁改变、微出血、血脑屏障（BBB）紊乱以及脑血流量（CBF）减少有关。由于易卒中型自发性高血压大鼠（SHRSP）可能是人类CSVD某些方面的有效模型，我们旨在确定这些变化是否在特定的时间阶段发生，以及在这些常见的血管改变之外是否存在初始现象。对51只SHRSP按年龄分组，同时采用组织学（苏木精 - 伊红染色、IgG免疫组织化学、血管直径测量）和影像学方法（磁共振成像，作为初步研究的二乙基二硫代氨基甲酸 - 201铊/99m锝 - 六甲基丙二胺肟单光子发射计算机断层扫描）进行检查。SHRSP的血管病理变化按特定阶段发展，而红细胞在毛细血管和小动脉中随年龄增长的积聚是该疾病均匀一致的初始步骤。红细胞积聚之后是血脑屏障紊乱和微出血，两者也随年龄增长而增加。微血栓形成、伴有脑血流量减少的组织梗死以及钾摄取紊乱代表了SHRSP血管病理的最终阶段。红细胞积聚——我们简约地解释为血流淤滞——在没有脑组织损伤的情况下，代表了SHRSP血管病理的第一步。如果这种初始现象能够在患者中被识别，这些红细胞积聚可能是在人类CSVD中实施预防和治疗策略的一个有希望的靶点。《脑血流与代谢杂志》（2012年）32卷，278 - 290页；doi:10.1038/jcbfm.2011.122；2011年8月31日在线发表
Cerebral small vessel disease (CSVD) is associated with vessel wall changes, microbleeds, blood-brain barrier (BBB) disturbances, and reduced cerebral blood flow (CBF). As spontaneously hypertensive stroke-prone rats (SHRSP) may be a valid model of some aspects of human CSVD, we aimed to identify whether those changes occur in definite temporal stages and whether there is an initial phenomenon beyond those common vascular alterations. Groups of 51 SHRSP were examined simultaneously by histologic (Hematoxylin-Eosin, IgG-Immunohistochemistry, vessel diameter measurement) and imaging methods (Magnetic Resonance Imaging, 201-Thallium-Diethyldithiocarbamate/99m-Technetium-HMPAO Single Photon Emission Computed Tomography conducted as pilot study) at different stages of age. Vascular pathology in SHRSP proceeds in definite stages, whereas an age-dependent accumulation of erythrocytes in capillaries and arterioles represents the homogeneous initial step of the disease. Erythrocyte accumulations are followed by BBB disturbances and microbleeds, both also increasing with age. Microthromboses, tissue infarctions with CBF reduction, and disturbed potassium uptake represent the final stage of vascular pathology in SHRSP. Erythrocyte accumulations-we parsimoniously interpreted as stases-without cerebral tissue damage represent the first step of vascular pathology in SHRSP. If that initial phenomenon could be identified in patients, these erythrocyte accumulations might be a promising target for implementing prophylactic and therapeutic strategies in human CSVD. Journal of Cerebral Blood Flow & Metabolism (2012) 32, 278-290; doi:10.1038/jcbfm.2011.122; published online 31 August 2011