多微生物脓毒症中血脑屏障的损伤及细胞间黏附分子-1的上调

Injury of the blood brain barrier and up-regulation of icam-1 in polymicrobial sepsis.

作者信息

Hofer Stefan, Bopp Christian, Hoerner Christian, Plaschke Konstanze, Faden Rita M, Martin Eike, Bardenheuer Hubert J, Weigand Markus A

机构信息

Department of Anesthesiology, University of Heidelberg, Heidelberg, Germany.

出版信息

J Surg Res. 2008 May 15;146(2):276-81. doi: 10.1016/j.jss.2007.07.021. Epub 2007 Aug 23.

Abstract

BACKGROUND

The pathogenesis and mechanisms of septic encephalopathy are not completely understood. We compared two different models of sepsis: lipopolysaccharide-induced endotoxemia and cecal ligation and puncture (CLP) bacteremia in rats with respect to changes in endothelial expression of the adhesion molecules intercellular adhesion molecule-1 (ICAM-1), platelet-endothelial cell adhesion molecule-1 (PECAM-1), and of cerebral albumin extravasation as a marker for capillary breakdown of the blood brain barrier.

MATERIAL AND METHODS

Male Wistar rats were divided into control, endotoxemia, or CLP-group. Mean arterial blood pressure was measured via femoral artery catheterization. Brain tissue for immunohistochemistry was harvested at 1 h, 6 h, and 24 h after induction of sepsis.

RESULTS

The CLP-group showed a decrease in mean arterial pressure after 24 h in comparison with the sham-group (P < 0.05). Cerebral ICAM-1 expression was at its maximum 24 h after induction of sepsis, with the highest expression in the CLP-group. There was no difference in PECAM-1 expression between the groups. Cerebral albumin extravasation increased early after 6 h in both septic groups with a maximum at 24 h after induction of sepsis.

CONCLUSION

These results suggest that there are early changes in the integrity of the blood-brain barrier in the central nervous system in an ongoing septic progress. This provides evidence that these changes are due to inflammatory mediators, and not to the presence of live bacteria. Increased ICAM-1 expression might be an early factor involved in these pathogenic events. Although the role of PECAM-1 cannot conclusively be determined, we were able to show its expression on cerebral endothelium in all groups.

摘要

背景

脓毒症性脑病的发病机制尚未完全明确。我们比较了两种不同的脓毒症模型:脂多糖诱导的内毒素血症模型和盲肠结扎穿孔(CLP)菌血症模型,观察大鼠体内细胞间黏附分子-1(ICAM-1)、血小板内皮细胞黏附分子-1(PECAM-1)等黏附分子在内皮细胞中的表达变化,以及脑白蛋白外渗情况,以此作为血脑屏障毛细血管破裂的标志物。

材料与方法

雄性Wistar大鼠分为对照组、内毒素血症组或CLP组。通过股动脉插管测量平均动脉血压。在诱导脓毒症后1小时、6小时和24小时采集脑组织用于免疫组织化学检测。

结果

与假手术组相比,CLP组在24小时后平均动脉压降低(P < 0.05)。脓毒症诱导后24小时,脑ICAM-1表达达到峰值,CLP组表达最高。各组间PECAM-1表达无差异。两个脓毒症组在诱导脓毒症6小时后早期脑白蛋白外渗增加,在诱导后24小时达到峰值。

结论

这些结果表明,在持续性脓毒症进展过程中,中枢神经系统血脑屏障的完整性会出现早期变化。这证明这些变化是由炎症介质引起的,而非活菌的存在。ICAM-1表达增加可能是这些致病事件中的一个早期因素。尽管PECAM-1的作用尚不能最终确定,但我们能够证明其在所有组的脑内皮细胞上均有表达。

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