Frietsch Thomas, Maurer Martin H, Vogel Johannes, Gassmann Max, Kuschinsky Wolfgang, Waschke Klaus F
Department of Anesthesiology and Critical Care Medicine, Faculty of Clinical Medicine Mannheim, Mannheim, Germany.
J Cereb Blood Flow Metab. 2007 Mar;27(3):469-76. doi: 10.1038/sj.jcbfm.9600360. Epub 2006 Jun 28.
To examine the impact of excessive erythrocytosis on local cerebral blood flow (CBF) and cerebral glucose metabolic rate (CMR(glc)), we made use of our constitutively erythropoietin (Epo)-overexpressing transgenic mouse line (tg-6) that reach a mean hematocrit of 0.87. Compared with wild-type (wt) control siblings, CBF decreased by 44% in tg-6 mice, while upon hemodilution (tg-6-HD) to a physiologic hematocrit (e.g., 0.44) tg-6-HD mice returned the CBF to wt levels. Cerebral blood flow was determined in another transgenic mouse line that overexpresses human Epo in the brain only (tg-21): CBF increased by 17% compared with wt controls. However, oxygen delivery was similar in all four mouse groups tested (wt, tg-6, tg-6-HD and tg-21). Mean CMR(glc) was higher in tg-6 (+72%), tg-6-HD mice (+43%) and tg-21 (+22%) than in wt mice. Local CMR(glc) was higher in all 40 brain regions in tg-6 but only in 15 and 8 regions in tg-6-HD and tg-21 mice. These results show that prolonged increases in hematocrit did not alter cerebral oxygen delivery at a decreased CBF and increased CMR(glc). Hemodilution suggests that high blood viscosity is a cause of the decrease in CBF and partly of the increase in CMR(glc). Cerebral glucose metabolic rate may also be increased by a direct effect of Epo in the brain (tg-21 mice).
为研究红细胞增多症对局部脑血流量(CBF)和脑葡萄糖代谢率(CMR(glc))的影响,我们利用了组成型促红细胞生成素(Epo)过表达转基因小鼠品系(tg-6),其平均血细胞比容达到0.87。与野生型(wt)对照同窝小鼠相比,tg-6小鼠的CBF降低了44%,而在血液稀释(tg-6-HD)至生理血细胞比容(如0.44)后,tg-6-HD小鼠的CBF恢复到wt水平。在另一种仅在脑内过表达人Epo的转基因小鼠品系(tg-21)中测定脑血流量:与wt对照相比,CBF增加了17%。然而,在测试的所有四个小鼠组(wt、tg-6、tg-6-HD和tg-21)中,氧输送相似。tg-6(升高72%)、tg-6-HD小鼠(升高43%)和tg-21(升高22%)的平均CMR(glc)高于wt小鼠。tg-6小鼠的所有40个脑区局部CMR(glc)均升高,但tg-6-HD和tg-21小鼠仅分别有15个和8个脑区升高。这些结果表明,血细胞比容的长期升高在CBF降低和CMR(glc)升高的情况下并未改变脑氧输送。血液稀释表明高血粘度是CBF降低以及部分CMR(glc)升高的原因。脑内Epo的直接作用(tg-21小鼠)也可能使脑葡萄糖代谢率升高。