Li Mei, Cai Fang-cheng
Department of Neurology, Children's Hospital, Chongqing Medical University, Chongqing 400014, China.
Zhonghua Er Ke Za Zhi. 2003 Jun;41(6):448-52.
Glucocorticoid is considered as an effective drug for prevention and treatment of brain edema and reducing the blood-brain barrier (BBB) permeability. Intravenous immunoglobulin (IVIG) is frequently used to treat neurological diseases with immune abnormality, its function and potential mechanism on brain edema have not been reported. In this study, the roles of the total hydrosulfide group (TSH), non-protein hydrosulfide group (NPSH) and malondialdehyde (MDA) in etiology of the endotoxin brain edema in infant rats and the interfering effects of dexamethasone (DEX) and IVIG were investigated.
In 35 infant rats, 10 mg/kg lipopolysaccharide (LPS) was intraperitoneally injected. The same volume of normal saline was injected to 24 control rats. Ten mg/kg DEX and 400 mg/kg IVIG were intravenously injected respectively to 36 and 24 infant rats instantly following LPS injection. The TSH, NPSH and MDA concentrations and the brain Evans blue contents were detected at different time in the brain tissue. The brain water content was measured by drying method.
The brain water, EB and MDA contents after endotoxin injection were significantly higher than those of control group, while the brain TSH, NPSH content were significantly lower than those of control group (P < 0.05 or P < 0.01); After treatment with DEX or IVIG, the brain EB, MDA and water content significantly decreased with the peak at 6 h (P < 0.05 or P < 0.01), TSH and NPSH significantly increased compared with LPS group. However, the NPSH content in IVIG treatment group did not change significantly (P > 0.05).
Free radicals play a role in the brain edema induced by LPS in infant rats. The primary results suggested that DEX and IVIG have therapeutic effect for the endotoxin-induced brain edema by affecting the free radicals.
糖皮质激素被认为是防治脑水肿和降低血脑屏障（BBB）通透性的有效药物。静脉注射免疫球蛋白（IVIG）常用于治疗免疫异常的神经系统疾病，其对脑水肿的作用及潜在机制尚未见报道。本研究探讨了总硫化氢基团（TSH）、非蛋白硫化氢基团（NPSH）和丙二醛（MDA）在幼鼠内毒素性脑水肿病因中的作用以及地塞米松（DEX）和IVIG的干预作用。
35只幼鼠腹腔注射10mg/kg脂多糖（LPS）。24只对照鼠注射相同体积的生理盐水。36只和24只幼鼠在注射LPS后立即分别静脉注射10mg/kg DEX和400mg/kg IVIG。在不同时间检测脑组织中TSH、NPSH和MDA浓度以及脑伊文思蓝含量。采用干燥法测量脑含水量。
内毒素注射后脑含水量、EB和MDA含量显著高于对照组，而脑TSH、NPSH含量显著低于对照组（P<0.05或P<0.01）；DEX或IVIG治疗后，脑EB、MDA和含水量显著降低，6h时达到峰值（P<0.05或P<0.01），TSH和NPSH较LPS组显著升高。然而，IVIG治疗组NPSH含量变化不显著（P>0.05）。
自由基在幼鼠LPS诱导的脑水肿中起作用。初步结果表明，DEX和IVIG通过影响自由基对内毒素诱导的脑水肿有治疗作用。
