Leukocyte plugging and cortical capillary flow after subarachnoid hemorrhage
Leukocyte plugging and cortical capillary flow after subarachnoid hemorrhage
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DOI：
10.1007/s00701-016-2792-6
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发表时间：
2016-06-01
影响因子：
2.4
通讯作者：
Suematsu, Makoto
中科院分区：
文献类型：
--
作者：
Ishikawa, Mami;Kajimura, Mayumi;Suematsu, Makoto
据信，蛛网膜下腔出血（SAH）后颅内压立即升高会引起广泛的脑缺血，并导致临床状态恶化。无论SAH后世界神经学会联合会分级的严重程度如何，在夹闭手术期间，脑表面的动脉血流在临床上保持良好。为了探讨大脑皮层微循环发生了什么样的变化，而不是在大脑表面，我们用双光子激光扫描显微镜（TPLSM）检查SAH后的大脑皮层微循环。应用TPLSM线扫描法，连续注射罗丹明6 G，测定SAH后60 min皮质毛细血管中标记血小板、白细胞和未标记红细胞（RBC）的运动速度，并与假手术组和P-选择素单克隆抗体治疗组比较。滚动和粘附的白细胞突然阻止其他血细胞在毛细血管中流动。蛛网膜下腔出血后各毛细血管内的流动血细胞也明显减少。这种由白细胞堵塞引起的无复流现象在SAH组中经常观察到，而在假手术组中没有观察到。血细胞流速的下降可通过预先用P-选择素单克隆抗体（一种表达于内皮细胞和血小板表面的粘附分子）逆转。白细胞堵塞毛细血管是SAH后皮质微循环恶化的原因之一。
It is believed that increased intracranial pressure immediately after subarachnoid hemorrhage (SAH) causes extensive brain ischemia and results in worsening clinical status. Arterial flow to the cerebral surfaces is clinically well maintained during clipping surgery regardless of the severity of the World Federation of Neurological Societies grade after SAH. To explore what kinds of changes occur in the cortical microcirculation, not at the cerebral surface, we examined cortical microcirculation after SAH using two-photon laser scanning microscopy (TPLSM).SAH was induced in mice with an endovascular perforation model. Following continuous injection of rhodamine 6G, velocities of labeled platelets and leukocytes and unlabeled red blood cells (RBCs) were measured in the cortical capillaries 60 min after SAH with a line-scan method using TPLSM, and the data were compared to a sham group and P-selectin monoclonal antibody-treated group.Velocities of leukocytes, platelets, and RBCs in capillaries decreased significantly 60 min after SAH. Rolling and adherent leukocytes suddenly prevented other blood cells from flowing in the capillaries. Flowing blood cells also decreased significantly in each capillary after SAH. This no-reflow phenomenon induced by plugging leukocytes was often observed in the SAH group but not in the sham group. The decreased velocities of blood cells were reversed by pretreatment with the monoclonal antibody of P-selection, an adhesion molecule expressed on the surfaces of both endothelial cells and platelets.SAH caused sudden worsening of cortical microcirculation at the onset. Leukocyte plugging in capillaries is one of the reasons why cortical microcirculation is aggravated after SAH.