Kim Dong Wook, Im So-Hyang, Kim Jeong-Yeon, Kim Dong-Eog, Oh Goo Taeg, Jeong Sang-Wuk
Department of Pediatrics, Ilsan Paik Hospital, Inje University, College of Medicine, Goyang, Korea.
J Neurosurg. 2009 Nov;111(5):995-1000. doi: 10.3171/2009.3.JNS081285.
Hematoma size and brain edema after intracerebral hemorrhage (ICH) are important prognostic factors. Inducible nitric oxide synthase (iNOS) is induced after cerebral ischemia and is known to be involved in secondary neuronal injury, but its significance in ICH is unknown. The authors tested whether iNOS would influence hematoma size and brain edema after ICH.
The authors used C57BL/6 and iNOS knockout mice for all the experiments. Experimental ICH was induced by the intrastriatal stereotactic administration of bacterial collagenase. Brain tissue was obtained at 72 hours after ICH. The volume of hematoma was quantified by spectrophotometric assay, and the brain water content was measured. The investigators also measured blood-brain barrier permeability using Evans blue dye.
There was no significant difference in hematoma size between the 2 groups. The brain water content of the lesional hemisphere was higher in C57BL/6 mice than in iNOS knockout mice. More Evans blue leakage in the brain was observed in C57BL/6 control mice than in iNOS knockout mice. Immunohistochemistry showed iNOS immunoreactivity in the perihematoma areas of C57BL/6 mice but not in the iNOS knockout mice.
When hematoma size was similar, iNOS knockout mice had significantly less brain edema than their littermates. These results suggest that iNOS modulation might become an antiedematous therapy for ICH.
脑出血(ICH)后的血肿大小和脑水肿是重要的预后因素。诱导型一氧化氮合酶(iNOS)在脑缺血后被诱导产生,已知其参与继发性神经元损伤,但其在ICH中的意义尚不清楚。作者测试了iNOS是否会影响ICH后的血肿大小和脑水肿。
作者在所有实验中使用C57BL/6和iNOS基因敲除小鼠。通过纹状体内立体定向注射细菌胶原酶诱导实验性ICH。在ICH后72小时获取脑组织。通过分光光度法测定血肿体积,并测量脑含水量。研究人员还使用伊文思蓝染料测量血脑屏障通透性。
两组之间血肿大小无显著差异。C57BL/6小鼠损伤半球的脑含水量高于iNOS基因敲除小鼠。与iNOS基因敲除小鼠相比,C57BL/6对照小鼠脑内伊文思蓝渗漏更多。免疫组织化学显示C57BL/6小鼠血肿周围区域有iNOS免疫反应性,而iNOS基因敲除小鼠则没有。
当血肿大小相似时,iNOS基因敲除小鼠的脑水肿明显少于其同窝小鼠。这些结果表明,调节iNOS可能成为一种治疗ICH脑水肿的方法。