Terao Satoshi, Yilmaz Gokhan, Stokes Karen Y, Ishikawa Mami, Kawase Takeshi, Granger D Neil
Department of Molecular and Cellular Physiology, Louisiana State University Health Sciences Center, 1501 Kings Highway, Shreveport, LA 71130, USA.
Stroke. 2008 Mar;39(3):943-50. doi: 10.1161/STROKEAHA.107.494542. Epub 2008 Jan 31.
Although epidemiological studies reveal an increased incidence of obesity and an association between obesity and the prevalence/severity of ischemic stroke, little is known about the mechanisms that link obesity to ischemic stroke. This study tested the hypothesis that obesity exacerbates the cerebrovascular dysfunction and tissue injury induced by brain ischemia and reperfusion.
The adhesion of leukocytes and platelets in cerebral venules, blood-brain barrier permeability, brain water content, and infarct volume were measured in wild-type, obese (ob/ob), and leptin-reconstituted ob/ob mice subjected to 30 minutes middle cerebral artery occlusion and reperfusion. Tissue and plasma cytokine levels were determined by cytometric bead array, and a role for monocyte chemoattractant protein-1 and interleukin-6 was assessed using blocking antibodies.
Compared with wild-type mice, ob/ob exhibited larger increases in leukocyte and platelet adhesion, blood-brain barrier permeability, water content, and infarct volume after middle cerebral artery occlusion-reperfusion. Reconstitution of leptin in ob/ob mice tended to further enhance all reperfusion-induced responses. Ob/ob mice also exhibited higher plasma levels of monocyte chemoattractant protein-1 and interleukin-6 than wild-type mice. Immunoneutralization of monocyte chemoattractant protein-1, but not interleukin-6, reduced infarct volume in ob/ob mice.
Obesity worsens the inflammatory and injury responses to middle cerebral artery occlusion and reperfusion by a mechanism independent of leptin deficiency. monocyte chemoattractant protein-1 appears to contribute to the exaggerated responses to ischemic stroke in obese mice.
尽管流行病学研究显示肥胖发病率上升,且肥胖与缺血性卒中的患病率/严重程度之间存在关联,但对于将肥胖与缺血性卒中联系起来的机制知之甚少。本研究检验了肥胖会加剧脑缺血再灌注诱导的脑血管功能障碍和组织损伤这一假说。
在经历30分钟大脑中动脉闭塞和再灌注的野生型、肥胖(ob/ob)及瘦素重构的ob/ob小鼠中,测量脑静脉中小白细胞和血小板的黏附、血脑屏障通透性、脑含水量和梗死体积。通过细胞计数珠阵列测定组织和血浆细胞因子水平,并使用阻断抗体评估单核细胞趋化蛋白-1和白细胞介素-6的作用。
与野生型小鼠相比,ob/ob小鼠在大脑中动脉闭塞再灌注后,白细胞和血小板黏附、血脑屏障通透性、含水量和梗死体积的增加幅度更大。在ob/ob小鼠中重构瘦素往往会进一步增强所有再灌注诱导的反应。ob/ob小鼠的血浆单核细胞趋化蛋白-1和白细胞介素-6水平也高于野生型小鼠。单核细胞趋化蛋白-1的免疫中和而非白细胞介素-6的免疫中和可减少ob/ob小鼠的梗死体积。
肥胖通过一种独立于瘦素缺乏的机制,加剧了对大脑中动脉闭塞和再灌注的炎症及损伤反应。单核细胞趋化蛋白-1似乎促成了肥胖小鼠对缺血性卒中的过度反应。