Armstead William M, Cines Douglas B, Bdeir Khalil, Kulikovskaya Irina, Stein Sherman C, Higazi Abd Al-Roof
Department of Anesthesiology and Critical Care, University of Pennsylvania, Philadelphia, PA 19104, USA.
Brain Res. 2008 Sep 22;1231:121-31. doi: 10.1016/j.brainres.2008.06.115. Epub 2008 Jul 8.
We have previously observed that soluble urokinase plasminogen activator receptor (suPAR) prevents impairment of cerebrovasodilation induced by hypercapnia and hypotension after hypoxia/ischemia (H/I) in the newborn pig. In this study, we investigated the role of low-density lipoprotein-related protein (LRP) receptor and the ERK isoform of mitogen activated protein kinase (MAPK) in uPA-mediated impairment of vasodilation after H/I in piglets equipped with a closed cranial window. CSF uPA increased from 9+/-2 to 52+/-8 and 140+/-21 ng/ml at 1 and 4 h after H/I, respectively. The LRP antagonist receptor associated protein (RAP) and anti-LRP antibody blunted the increase in CSF uPA at 1 h (17+/-2 ng/ml) but not 4 h post insult. uPA detectable in sham-treated cortex by immunohistochemistry was markedly elevated 4 h after H/I. Phosphorylation (activation) of CSF ERK MAPK was detected at 1 and 4 h post H/I and blocked by RAP. Exogenous uPA administered at 4 h post H/I further stimulated ERK MAPK phosphorylation, which was blocked by RAP. Pre-treatment of piglets with RAP, anti-LRP, and suPAR completely prevented, and the ERK MAPK antagonist U 0126 partially prevented, impaired responses to hypotension and hypercapnia post H/I, but none of these antagonists affected the response to isoproterenol. These data indicate that uPA is upregulated after H/I through an LRP-dependent process and that the released uPA impairs hypercapnic and hypotensive dilation through an LRP- and ERK MAPK dependent pathway. These data suggest that modulation of uPA upregulation and/or uPA-mediated signal transduction may preserve cerebrohemodynamic control after hypoxia/ischemia.
我们之前观察到,可溶性尿激酶型纤溶酶原激活物受体(suPAR)可预防新生猪缺氧/缺血(H/I)后高碳酸血症和低血压诱导的脑血管舒张功能受损。在本研究中,我们研究了低密度脂蛋白相关蛋白(LRP)受体和丝裂原活化蛋白激酶(MAPK)的ERK亚型在配备闭合式颅窗的仔猪H/I后uPA介导的血管舒张功能受损中的作用。H/I后1小时和4小时,脑脊液uPA分别从9±2 ng/ml增加至52±8 ng/ml和140±21 ng/ml。LRP拮抗剂受体相关蛋白(RAP)和抗LRP抗体在损伤后1小时(17±2 ng/ml)可抑制脑脊液uPA的增加,但在损伤后4小时则无此作用。通过免疫组织化学在假手术处理的皮层中可检测到的uPA在H/I后4小时显著升高。脑脊液ERK MAPK的磷酸化(激活)在H/I后1小时和4小时被检测到,并被RAP阻断。H/I后4小时给予外源性uPA可进一步刺激ERK MAPK磷酸化,这被RAP阻断。用RAP、抗LRP和suPAR对仔猪进行预处理可完全预防,而ERK MAPK拮抗剂U 0126部分预防H/I后对低血压和高碳酸血症的反应受损,但这些拮抗剂均不影响对异丙肾上腺素的反应。这些数据表明,H/I后uPA通过LRP依赖的过程上调,并且释放的uPA通过LRP和ERK MAPK依赖的途径损害高碳酸血症和低血压性舒张。这些数据表明,调节uPA上调和/或uPA介导的信号转导可能在缺氧/缺血后维持脑血流动力学控制。