Melo-Filho Antônio Aldo, Weber Guimarães Barreto Maria, Capelli Nassr Azize Cristina, Rogério Fábio, Langone Francesco, Pereira Luis Antonio Violin, Sbragia Lourenço
Division of Pediatric Surgery, Department of Surgery, Faculty of Medical Sciences, University of Campinas, UNICAMP, Campinas, Brazil.
Pediatr Neurosurg. 2009;45(3):198-204. doi: 10.1159/000222670. Epub 2009 Jun 3.
Exposure of the spinal cord in myelomeningocele (MM) throughout gestation increases spinal injury. Astrocyte activation evidenced by glial fibrillary acidic proteins (GFAP) indicates the extent of injury. Corticosteroids modulate GFAP synthesis, but their effect in MM is unclear. The purpose of this study was to evaluate the GFAP expression in a fetal rat model of dysraphism and the effect of corticosteroid treatment on this marker and on clinical neurological disabilities.
Dysraphism was surgically created in 2 groups of 48 rat fetuses; group 1: control, and group 2: treated with corticosteroid. Each group was subdivided into fetuses with surgically created MM, controls and shams on day 18.5 of gestation (term = 22 days). Fetuses were harvested on day 21.5, examined for evidence of neurological deficits, and the following clinical parameters were registered: kyphosis, tail deformities, leg deformities, leg paralysis or paresis and pain perception. The fetuses were fixed for GFAP immunostaining.
All fetuses with MM in group 1 presented neurological deficits and glial reactions with GFAP expression, as opposed to controls and shams. In group 2, corticosteroid treatment prevented some neurological deficits (18-25%), reducing glial response and GFAP expression.
Experimentally induced dysraphism in the rat fetus is related to glial response and increased GFAP expression in the spinal cord. Corticoid treatment clinically improved nerve injury in some fetuses. It reduced glial reaction and GFAP expression.
在整个妊娠期，脊髓脊膜膨出（MM）患者的脊髓暴露会增加脊髓损伤。胶质纤维酸性蛋白（GFAP）证实的星形胶质细胞活化表明损伤程度。皮质类固醇可调节GFAP合成，但其在MM中的作用尚不清楚。本研究的目的是评估神经管闭合不全胎鼠模型中GFAP的表达，以及皮质类固醇治疗对该标志物和临床神经功能障碍的影响。
对两组共48只胎鼠进行手术制造神经管闭合不全；第1组：对照组，第2组：接受皮质类固醇治疗。每组在妊娠第18.5天（足月为22天）再细分为手术制造MM的胎鼠、对照组和假手术组。在第21.5天收获胎鼠，检查神经功能缺损的证据，并记录以下临床参数：脊柱后凸、尾巴畸形、腿部畸形、腿部麻痹或轻瘫以及痛觉。将胎鼠固定进行GFAP免疫染色。
与对照组和假手术组相比，第1组所有患有MM的胎鼠均出现神经功能缺损和GFAP表达的胶质反应。在第2组中，皮质类固醇治疗预防了一些神经功能缺损（18%-25%），减少了胶质反应和GFAP表达。
实验诱导的胎鼠神经管闭合不全与胶质反应及脊髓中GFAP表达增加有关。皮质类固醇治疗在临床上改善了一些胎鼠的神经损伤。它减少了胶质反应和GFAP表达。
