Role of organic osmolytes in myelinolysis. A topographic study in rats after rapid correction of hyponatremia.
Role of organic osmolytes in myelinolysis. A topographic study in rats after rapid correction of hyponatremia.
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有机渗透剂在髓鞘溶解中的作用。
DOI：
10.1172/jci117831
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Lien,YH
中科院分区：
文献类型：
--
作者：
Lien,YH
有机渗压物质与髓鞘溶解的发病机制有关，因为它们中的一些在慢性低钠血症的纠正过程中缓慢积累。我调查了慢性低钠血症快速纠正后脱髓鞘病变与有机渗透压的区域变化之间是否存在地形相关性。在正常雌性Sprague-Dawley大鼠中，谷氨酸盐、谷氨酰胺、牛磺酸和甜菜碱的浓度在大脑皮层中最高，并朝向脑干降低。相反，甘氨酸水平是最高的脑干，并向皮质下降。肌醇、甘油磷酸胆碱、甘油磷酸乙醇胺和肌酸分布更均匀。在慢性低钠血症大鼠（血浆钠110 +/- 4毫当量/升），有机渗透压降低全球总损失范围从13（髓质）至24（小脑）mmol/kg H2O。经腹腔注射高渗盐水快速纠正后，大脑皮质、小脑和延髓的有机渗透物质损失恢复率为48%，脑桥为44%，但中脑仅为17%，纹状体为36%。在纠正低钠血症后2-7天，对9只大鼠进行了脑组织学检查。大的脱髓鞘病变在中脑和纹状体持续可见，较小的病变在大脑，小脑和脑桥被发现的频率较低。这是首次报道脑有机渗透物质的区域分布。慢性低钠血症快速纠正后，脱髓鞘病变与有机渗透压物质延迟蓄积之间存在地形相关性。图像
Organic osmolytes have been implicated in the pathogenesis of myelinolysis because some of them are accumulated slowly during correction of chronic hyponatremia. I investigated whether there was a topographic correlation between demyelinative lesions and the regional changes of organic osmolytes after rapid correction of chronic hyponatremia. In normal female Sprague-Dawley rats, concentrations of glutamate, glutamine, taurine, and betaine were highest in the cerebral cortex and decreased toward the brain stem. Conversely, glycine level was highest in the brainstem, and decreased toward the cortex. Myoinositol, glycerophosphorylcholine, glycerophosphorylethanolamine, and creatine were distributed more evenly. In chronic hyponatremic rats (plasma Na 110 +/- 4 meq/liter), organic osmolytes decreased globally with the total loss ranging from 13 (medulla) to 24 (cerebellum) mmol/kg H2O. After rapid correction with intraperitoneal injection of hypertonic saline, the recovery of the loss of organic osmolytes was 48% in the cerebral cortex, cerebellum, and medulla oblongata, 44% in pons, but only 17% in midbrain and 36% in striatum. Histopathology of the brain was examined in nine rats 2-7 d after correction of hyponatremia. Large demyelinative lesions were seen persistently in the midbrain and striatum, and smaller lesions in cerebrum, cerebellum, and pons were found less frequently. This is the first report of regional distribution of brain organic osmolytes. After rapid correction of chronic hyponatremia, a topographic correlation between demyelination lesions and delayed accumulation of organic osmolytes exists.Images