Lu Kang, Cho Chung-Lung, Liang Cheng-Loong, Chen Shang-Der, Liliang Po-Chou, Wang Shin-Yuan, Chen Han-Jung
Department of Neurosurgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
J Thorac Cardiovasc Surg. 2007 Apr;133(4):934-41. doi: 10.1016/j.jtcvs.2006.11.038.
Ischemic spinal cord injury is a serious complication of aortic surgery. Although the extracellular signal-regulated kinases 1 and 2 are generally regarded as related to cell proliferation and survival, increasing evidence suggests that the role of the extracellular signal-regulated kinase pathway in ischemia/reperfusion injury is much more sophisticated.
Spinal cord ischemia in rats was induced by occluding the thoracic descending aorta with a balloon catheter introduced through a femoral artery, accompanied by concomitant exsanguination. Rats in the control group were given dimethyl sulfoxide (vehicle) before undergoing spinal cord ischemia/reperfusion injury. In the U0126-treated group, rats were pretreated with a specific inhibitor of the mitogen-activated protein kinase/extracellular signal-regulated kinases 1 and 2, U0126, to inhibit extracellular signal-regulated kinases 1 and 2 phosphorylation. The sham-operated rats underwent aortic catheterization without occlusion. Parameters, including neurologic performance, neuronal survival, inflammatory cell infiltration, and interleukin-1beta production in the spinal cords, were compared between groups.
Early extracellular signal-regulated kinases 1 and 2 phosphorylation was observed after injury in the control group, followed by abundant microglial accumulation in the infarct area and increased interleukin-1beta expression. In the U0126 group, U0126 treatment completely blocked extracellular signal-regulated kinases 1 and 2 phosphorylation. Microglial activation and spinal cord interleukin-1beta levels were significantly reduced. Neuronal survival and functional performance were improved.
The mitogen-activated protein kinase/extracellular signal-regulated kinase pathway may play a noxious role in spinal cord ischemia/reperfusion injury by participating in inflammatory reactions and cytokine production. Targeting this pathway may be of potential value in terms of therapeutic intervention.
缺血性脊髓损伤是主动脉手术的一种严重并发症。虽然细胞外信号调节激酶1和2通常被认为与细胞增殖和存活有关,但越来越多的证据表明,细胞外信号调节激酶通路在缺血/再灌注损伤中的作用要复杂得多。
通过经股动脉插入球囊导管阻断胸降主动脉诱导大鼠脊髓缺血,并伴有放血。对照组大鼠在经历脊髓缺血/再灌注损伤前给予二甲基亚砜(溶剂)。在U0126治疗组中,大鼠用丝裂原活化蛋白激酶/细胞外信号调节激酶1和2的特异性抑制剂U0126预处理,以抑制细胞外信号调节激酶1和2的磷酸化。假手术大鼠接受主动脉插管但不阻断。比较各组之间的参数,包括神经功能、神经元存活、炎性细胞浸润和脊髓中白细胞介素-1β的产生。
对照组损伤后早期观察到细胞外信号调节激酶1和2磷酸化,随后梗死区域有大量小胶质细胞积聚,白细胞介素-1β表达增加。在U0126组中,U0126治疗完全阻断了细胞外信号调节激酶1和2磷酸化。小胶质细胞活化和脊髓白细胞介素-1β水平显著降低。神经元存活和功能表现得到改善。
丝裂原活化蛋白激酶/细胞外信号调节激酶通路可能通过参与炎症反应和细胞因子产生在脊髓缺血/再灌注损伤中发挥有害作用。针对该通路进行治疗干预可能具有潜在价值。