Uhl E, Beck J, Stummer W, Lehmberg J, Baethmann A
Department of Neurosurgery, Grosshadern University Hospital, Ludwig-Maximilians-University, Munich, Germany.
J Cereb Blood Flow Metab. 2000 Jun;20(6):979-87. doi: 10.1097/00004647-200006000-00010.
The contribution of leukocytes to secondary brain damage after cerebral ischemia is still under discussion. The purpose of the present study was to examine the pial microcirculation after global cerebral ischemia while focusing on leukocyte-endothelium interactions during the early and late reperfusion period of up to 4 days. A closed cranial window technique that leaves the dura mater intact was used. Global cerebral ischemia of 15 minutes' duration was induced in male Mongolian gerbils (n = 91). Pial microcirculation was observed by intravital fluorescence microscopy. Leukocyte-endothelium interactions (LEIs) in pial venules, vessel diameters, capillary density, and regional microvascular blood flow measured by laser Doppler flowmetry were quantified during 3 hours of reperfusion and in intervals up to 4 days after ischemia. Within 3 hours of reperfusion, the number of leukocytes (cells/100 microm x minute) rolling along or adhering to the venular endothelium increased from 0.1 +/- 0.2 to 28.4 +/- 17.4 (P < 0.01 vs. control) and from 0.2 +/- 0.2 to 4.0 +/- 3.8 (P < 0.05), respectively. There was no capillary plugging by leukocytes; capillary density remained unchanged. In the late reperfusion period, at 7 hours after ischemia, LEIs had returned to baseline values. Furthermore, from 12 hours to 4 days after ischemia, no LEIs were observed. Changes in regional microvascular blood flow did not correlate with LEIs. Global cerebral ischemia of 15 minutes' duration induces transient LEIs that reach a maximum within 3 hours of reperfusion and return to baseline at 7 hours after ischemia. LEIs are not related to changes in microvascular perfusion, which suggests mainly that the expression of adhesion receptors is necessary to induce LEIs rather than rheologic factors. It seems unlikely that this short-lasting activation of leukocytes can play a role in the development of secondary brain damage.
白细胞在脑缺血后继发性脑损伤中的作用仍在讨论之中。本研究的目的是在长达4天的早期和晚期再灌注期内,在关注白细胞与内皮细胞相互作用的同时,检测全脑缺血后的软脑膜微循环。采用了一种使硬脑膜保持完整的闭合性颅窗技术。对雄性蒙古沙鼠(n = 91)进行了持续15分钟的全脑缺血诱导。通过活体荧光显微镜观察软脑膜微循环。在再灌注3小时期间以及缺血后长达4天的间隔时间内,对软脑膜小静脉中的白细胞 - 内皮细胞相互作用(LEIs)、血管直径、毛细血管密度以及通过激光多普勒血流仪测量的局部微血管血流进行了量化。在再灌注3小时内,沿小静脉内皮滚动或黏附的白细胞数量(细胞/100微米×分钟)分别从0.1±0.2增加至28.4±17.4(与对照组相比,P < 0.01)以及从0.2±0.2增加至4.0±3.8(P < 0.05)。没有白细胞堵塞毛细血管;毛细血管密度保持不变。在再灌注后期,缺血后7小时,LEIs已恢复至基线值。此外,在缺血后12小时至4天,未观察到LEIs。局部微血管血流的变化与LEIs不相关。持续15分钟的全脑缺血诱导短暂的LEIs,其在再灌注3小时内达到最大值,并在缺血后7小时恢复至基线。LEIs与微血管灌注的变化无关,这主要表明黏附受体的表达对于诱导LEIs是必要的,而非流变学因素。白细胞的这种短暂激活似乎不太可能在继发性脑损伤的发展中起作用。