Zhang Z G, Zhang L, Tsang W, Goussev A, Powers C, Ho K L, Morris D, Smyth S S, Coller B S, Chopp M
Department of Neurology, Henry Ford Health Sciences Center, 2799 West Grand Boulevard, Detroit, MI 48202, USA.
Brain Res. 2001 Sep 7;912(2):181-94. doi: 10.1016/s0006-8993(01)02735-4.
Information is lacking regarding dynamic platelet accumulation at the site of the occluded middle cerebral artery (MCA) and the relationship between platelet aggregation in downstream cerebral microvessels and loss of perfusion and vascular integrity of these microvessels. In the present study, we employed a model of embolic MCA occlusion in the rat to simultaneously measure temporal and spatial profiles of platelet accumulation at the site of the embolus occluding the MCA and within downstream cerebral microvessels. We also measured the integrity of microvessels and matrix metalloproteinase (MMP) activity in ischemic brain. Rats (n=36) were subjected to embolic MCA occlusion. Immunohistochemistry was used to detect microvascular integrity, plasminogen activator inhibitor 1 (PAI-1) and the deposition of fibrin. SDS-PAGE zymography was used to measure MMP2 and MMP9 activities. Accumulation of platelets and increases in PAI-1 immunoreactivity at the site of the embolus occluding the MCA were detected 1 h (n=7) and 4 h (n=7) after ischemia, respectively, and numbers of GPIIb/IIIa immunoreactive downstream cerebral microvessels increased significantly (209+/-59; n=7; P<0.05) 4 h after ischemia, suggesting dynamic platelet aggregation. A significant (n=7; P<0.01) diffuse loss of type IV collagen immunoreactivity in microvessels was temporally associated with platelet GPIIb/IIIa immunoreactivity within the vessels. Triple immunostaining revealed that microvessels containing platelet aggregates exhibited loss of type IV collagen immunoreactivity and both intra- and extra-vascular fibrin deposition, suggesting that intravascular platelet aggregation is associated with decreases in the integrity of the microvascular basal lamina and blood-brain barrier leakage. A significant increase (P<0.05) in MMP9 was detected at 4 h (n=3) and 24 h (n=3) after ischemia but levels of MMP2 were not significantly changed in ischemic brain. Our data suggest that dynamic platelet aggregation in ischemic brain may contribute to time-dependent resistance to fibrinolysis. In addition, platelet deposition and increased MMP9 coincided with degradation of type IV collagen and loss of vascular integrity. These data suggest an important role for post-occlusive distal platelet deposition in the pathophysiology of stroke.
关于大脑中动脉(MCA)闭塞部位血小板的动态聚集,以及大脑下游微血管中血小板聚集与这些微血管灌注丧失和血管完整性之间的关系,目前仍缺乏相关信息。在本研究中,我们采用大鼠大脑中动脉栓塞闭塞模型,同时测量在栓塞物阻塞大脑中动脉部位及大脑下游微血管内血小板聚集的时间和空间分布情况。我们还测量了缺血脑组织中微血管的完整性及基质金属蛋白酶(MMP)活性。将36只大鼠进行大脑中动脉栓塞闭塞手术。采用免疫组织化学法检测微血管完整性、纤溶酶原激活物抑制剂1(PAI - 1)及纤维蛋白沉积情况。采用SDS - PAGE酶谱法测量MMP2和MMP9活性。在缺血后1小时(n = 7)和4小时(n = 7),分别检测到阻塞大脑中动脉的栓塞部位血小板聚集及PAI - 1免疫反应性增加,且缺血4小时后大脑下游微血管中糖蛋白IIb/IIIa免疫反应性数量显著增加(209±59;n = 7;P < 0.05),提示血小板动态聚集。微血管中IV型胶原免疫反应性显著(n = 7;P < 0.01)弥漫性丧失与血管内血小板糖蛋白IIb/IIIa免疫反应性在时间上相关。三重免疫染色显示,含有血小板聚集体的微血管表现出IV型胶原免疫反应性丧失及血管内和血管外纤维蛋白沉积,提示血管内血小板聚集与微血管基膜完整性降低及血脑屏障渗漏有关。缺血后4小时(n = 3)和24小时(n = 3)检测到MMP9显著增加(P < 0.05),但缺血脑组织中MMP2水平无显著变化。我们的数据表明,缺血脑组织中血小板动态聚集可能导致对纤溶的时间依赖性抵抗。此外,血小板沉积和MMP9增加与IV型胶原降解及血管完整性丧失同时出现。这些数据表明,闭塞后远端血小板沉积在中风病理生理学中起重要作用。