Dreier Jens P, Tille Katrin, Dirnagl Ulrich
Department of Experimental Neurology, Charité, University Medicine Berlin, and Psychiatry, Wenckebach Hospital, Berlin, Germany.
Neurocrit Care. 2004;1(1):85-94. doi: 10.1385/NCC:1:1:85.
Fundamental principles in the central nervous system are that primary depolarization of neurons causes hyperemia, whereas focal cerebral ischemia causes secondary neuronal depolarization. In rats, an exception to these rules was discovered recently in which primary neuronal depolarization led to focal cerebral ischemia via inverse coupling between neuronal metabolism and cerebral blood flow (CBF). Adenosine is one of the classical candidate factors to mediate the coupling between neuronal metabolism and CBF. Therefore, the effect of topically applied adenosine on cortical spreading ischemia was studied.
A cranial window was implanted in 10 rats. At the window, CBF (laser Doppler flowmetry) and the subarachnoid direct current potential were recorded; the cortical surface was superfused with artificial cerebrospinal fluid (ACSF). Aspreading neuronal/astroglial depolarization wave was triggered at a remote site, from which it propagated to the cranial window.
In all rats, the depolarization wave triggered a hyperemic event under physiological conditions. When ACSF containing the nitric oxide (NO)- synthase inhibitor NG-nitro-L-arginine (L-NNA) at 10(-3) Mand K+ at 20x10(-3) M was subsequently superfused, the depolarization wave triggered an ischemic event. In 5 of 10 animals, a second depolarization wave under LNNA and elevated K+ also triggered an ischemic event. In contrast, in the remaining five animals, the depolarization wave triggered a significantly smaller and shorter hypoperfusion when adenosine at 100 microM was coapplied with L-NNA and elevated K+.
The results of this study suggest that adenosine, like other vasodilators, is unable to antagonize the initial hypoperfusion in response to a spreading neuronal/astroglial depolarization wave when the NO concentration is reduced and K+ is elevated but shortens the hypoperfusion phase significantly.
中枢神经系统的基本原理是神经元的初级去极化会导致充血,而局灶性脑缺血会导致继发性神经元去极化。在大鼠中,最近发现了这些规则的一个例外情况,即原发性神经元去极化通过神经元代谢与脑血流量(CBF)之间的反向耦合导致局灶性脑缺血。腺苷是介导神经元代谢与CBF之间耦合的经典候选因子之一。因此,研究了局部应用腺苷对皮质扩散性缺血的影响。
在10只大鼠中植入颅骨视窗。在视窗处,记录CBF(激光多普勒血流仪)和蛛网膜下腔直流电位;皮质表面用人工脑脊液(ACSF)进行灌流。在远处触发一个扩散的神经元/星形胶质细胞去极化波,该波从远处传播到颅骨视窗。
在所有大鼠中,去极化波在生理条件下触发了充血事件。当随后灌流含有10^(-3)M的一氧化氮(NO)合酶抑制剂NG-硝基-L-精氨酸(L-NNA)和20×10^(-3)M钾离子的ACSF时,去极化波触发了缺血事件。在10只动物中的5只中,在L-NNA和高钾条件下的第二个去极化波也触发了缺血事件。相比之下,在其余5只动物中,当100μM的腺苷与L-NNA和高钾共同应用时,去极化波触发的低灌注明显更小且更短。
本研究结果表明,与其他血管扩张剂一样,当NO浓度降低且钾离子升高时,腺苷无法拮抗因扩散的神经元/星形胶质细胞去极化波而引起的初始低灌注,但能显著缩短低灌注期。