Warner David S, Kiyoshima Takashi, Fukuda Shiro, Matsumoto Mishiya, Iida Yasuhiko, Oka Satoe, Nakakimura Kazuhiko, Sakabe Takefumi
Department of Anesthesiology-Resuscitology, Yamaguchi University School of Medicine, Japan.
Anesth Analg. 2003 Mar;96(3):839-846. doi: 10.1213/01.ANE.0000047268.41102.D4.
The mechanisms for delayed onset paraplegia after transient spinal cord ischemia are not fully understood. We investigated whether apoptotic motor neuron death is involved in its development. Spinal cord ischemia was induced for 15 min by occlusion of the abdominal aorta in rabbits. At 8, 24, or 48 h after reperfusion, hind limb motor function was assessed, and the lumbar spinal cord was examined morphologically (hematoxylin-eosin and terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate-biotin nick-end labeling staining) and biochemically (breakdown products of alpha-fodrin and patterns of DNA changes). At each time point, 14 rabbits were studied (7 for histopathology and 7 for biochemical analysis). Six rabbits served as sham controls. Delayed motor dysfunction developed in two thirds of the rabbits. The motor neurons in the rabbits with motor dysfunction (not paraplegia) showed swelling and a finely granular dispersed Nissl substance. In paraplegic rabbits, destruction of the gray matter and prominent inflammatory cell infiltration were observed. No apoptotic motor neuron was found in any rabbit. There was neither detectable increase in a caspase-3-mediated breakdown product of alpha-fodrin, nor DNA laddering in any rabbit. The results suggest that apoptosis has a negligible role in the pathophysiology of delayed paraplegia in the spinal cord ischemia model examined.
Although the possibility of apoptotic motor neuron death cannot be completely excluded, delayed onset paraplegia after transient spinal cord ischemia is largely associated with necrotic cell death.
短暂性脊髓缺血后迟发性截瘫的机制尚未完全明确。我们研究了凋亡性运动神经元死亡是否参与其发展过程。通过阻断兔腹主动脉诱导脊髓缺血15分钟。在再灌注后8、24或48小时,评估后肢运动功能,并对腰段脊髓进行形态学检查(苏木精-伊红染色和末端脱氧核苷酸转移酶介导的脱氧尿苷三磷酸生物素缺口末端标记染色)和生化分析(α- fodrin的降解产物和DNA变化模式)。在每个时间点,研究14只兔(7只用于组织病理学检查,7只用于生化分析)。6只兔作为假手术对照。三分之二的兔出现迟发性运动功能障碍。有运动功能障碍(而非截瘫)的兔的运动神经元表现为肿胀和尼氏体呈细颗粒状分散。在截瘫兔中,观察到灰质破坏和明显的炎性细胞浸润。在任何兔中均未发现凋亡性运动神经元。在任何兔中均未检测到caspase - 3介导的α- fodrin降解产物增加,也未检测到DNA梯状条带。结果表明,在所研究的脊髓缺血模型中,凋亡在迟发性截瘫的病理生理学中作用可忽略不计。
虽然不能完全排除凋亡性运动神经元死亡的可能性,但短暂性脊髓缺血后迟发性截瘫在很大程度上与坏死性细胞死亡有关。