Lu Hong, Sun Shan-Quan
Department of Kadiology, Daping Hospital, Third Military University, Chongqing 400042, China.
Chin Med J (Engl). 2003 Jul;116(7):1063-9.
To investigate the rule of the aquaporin-4 (AQP4) expression in acute ischemic brain edema, and to study the correlation between AQP4 expression and diffusion-weighted imaging (DWI).
Thirty-six Wistar rats were divided into 2 groups randomly, control group (n = 12) and operation group (n = 24) in which right middle cerebral artery of each animal had been occluded unilaterally (MCAO) at interval times of: 15 minutes, 30 minutes, 1 hours, 3 hours, 6 hours and 24 hours, respectively. The operation process of the control group was the same as the operation group except for the MCAO. All groups were examined using DWI. The apparent diffusion coefficient (ADC), relative density (rd) and relative area (rs) of the biggest hyperintensity signal layer on DWI were measured. After that the animals were sacrificed and perfused with the mixture solution consisting of TTC. The biggest layers of the ischemic cerebral tissues in each rat corresponding to the DWI were stained with TTC and examined with immunochemistry (DeltaS), in situ hybridization (alpha) and histology.
There was no significant change in the control group. In the operation group, a hyperintensity signal was found in the DWI of the right MAC territory at 15 minutes after MCAO. The ADC value decreased quickly within one hour after MCAO, while the AQP4 expression, rd-DWI and rs-DWI increased rapidly during this stage. As time progressed, the ADC value decreased further to (2.1 +/- 0.6) x 10(-4) mm(2)/s at 3 hours, and then began to increase slowly till 24 hours. But the AQP4 expression (DeltaS and alpha) and rd as well as the rs continuously increased slowly between 1 hour and 6 hours after MCAO, followed a peak after 6 hours. The AQP4 expression (alpha) showed a positive relationship with the rs-DWI, they all presented two peaks and a plateau. The corresponding sequential pathologic changes were a gradual increase of intracellular edema (within one hour), then an emergence of vasogenic edema (1-6 hours), and final necrosis and liquefaction (6 - 24 hours).
Upregulated expression of AQP4 may play a significant role in acute ischemic brain edema, especially during the stages of intracellular edema and necrosis, but it has no correlation to vasogenic edema. Certainly, the high expression of AQP4 is perhaps one of the most important reasons of the decrease of ADC and hyperintensity on the DWI in the intracellular edema.
探讨水通道蛋白4(AQP4)在急性缺血性脑水肿中的表达规律,研究AQP4表达与弥散加权成像(DWI)之间的相关性。
将36只Wistar大鼠随机分为2组,对照组(n = 12)和手术组(n = 24)。手术组每只动物的右侧大脑中动脉分别在15分钟、30分钟、1小时、3小时、6小时和24小时进行单侧闭塞(大脑中动脉闭塞,MCAO)。对照组的手术过程与手术组相同,只是不进行MCAO操作。所有组均采用DWI检查。测量DWI上最大高信号层的表观扩散系数(ADC)、相对密度(rd)和相对面积(rs)。之后处死动物,用含TTC的混合溶液进行灌注。将每只大鼠与DWI对应的缺血脑组织最大层用TTC染色,并进行免疫化学(DeltaS)、原位杂交(alpha)和组织学检查。
对照组无明显变化。手术组在MCAO后15分钟,右侧大脑中动脉供血区的DWI上出现高信号。MCAO后1小时内ADC值迅速下降,而在此阶段AQP4表达、rd-DWI和rs-DWI迅速升高。随着时间推移,3小时时ADC值进一步降至(2.1±0.6)×10⁻⁴mm²/s,然后开始缓慢上升直至24小时。但MCAO后1小时至6小时,AQP4表达(DeltaS和alpha)、rd以及rs持续缓慢升高,6小时后达到峰值。AQP4表达(alpha)与rs-DWI呈正相关,二者均呈现两个峰值和一个平台期。相应的病理变化依次为细胞内水肿逐渐增加(1小时内),然后出现血管源性水肿(1 - 6小时),最终坏死和液化(6 - 24小时)。
AQP4表达上调可能在急性缺血性脑水肿中起重要作用,尤其是在细胞内水肿和坏死阶段,但与血管源性水肿无关。当然,AQP4的高表达可能是细胞内水肿时ADC值降低和DWI上出现高信号的最重要原因之一。