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糖尿病脑缺血再灌注大鼠脑内葡萄糖转运体 1 和 3 的动态表达。

Dynamic expression of glucose transporters 1 and 3 in the brain of diabetic rats with cerebral ischemia reperfusion.

机构信息

Department of Endocrinology, Qilu Hospital of Shandong University, Jinan, Shandong 250012, China.

出版信息

Chin Med J (Engl). 2009 Sep 5;122(17):1996-2001.

Abstract

BACKGROUND

Blood glucose control improves the outcome of diabetic patients with stroke, but the target range of blood glucose control remains controversial. The functional recruitment of ischemia penumbra is extremely important to the recovery after stroke. The present study aimed to explore the expression of brain-type glucose transporters (GLUT1 and GLUT3) in cerebral ischemic penumbra at different blood glucose levels and different ischemic-reperfusion time in diabetic hypoxia-ischemia rats. The results might provide an experimental basis for clinical treatment of diabetic patients with stroke.

METHODS

The Wistar rats included in this study were randomly assigned to 4 groups (50 rats each): normal control group (NC), uncontrolled diabetic group (DM1), poorly-controlled diabetic group (DM2), and well-controlled diabetic group (DM3). Diabetic rats were induced by single intraperitoneal injection of streptozotocin, and the focal ischemic rat model of middle artery occlusion (MCAO) was made by insertion of fishing thread in 6 weeks after the establishment of the diabetic model. Each group was divided into 5 subgroups (10 rats each): four focal ischemic subgroups at different ischemic-reperfusion time (at 3,12, 24 and 72 hours after reperfusion, respectively) and one sham-operated subgroup. The mRNA and protein expression of GLUT1 and GLUT3 was assessed by RT-PCR and Western blotting, respectively.

RESULTS

There was significant difference in the mRNA expression of GLUT1 and GLUT3 between the four focal ischemic subgroups and the sham-operated subgroup at different reperfusion time in each group. The mRNA expression of GLUT1 and GLUT3 in the 4 ischemic groups began to increase at 3 hours, peaked at 24 hours after reperfusion and maintained at a higher level even at 72 hours compared with that of the sham-operated subgroup. The mRNA expression of GLUT1 increased more significantly than that of GLUT3. The mRNA expression of GLUT1 and GLUT3 was significantly different between the diabetic groups and normal control group. The mRNA expression of GLUT1 and GLUT3 was increased more significantly in the diabetic groups than that in the normal control group. There was a significant difference in the mRNA expression in the groups with different blood glucose levels. The mRNA expression tended to decrease with increased blood glucose levels. The expression trend of GLUT1 and GLUT3 protein was similar to that of GLUT1 and GLUT3 mRNA.

CONCLUSIONS

GLUT1 and GLUT3 expression was notably up-regulated in the penumbra region after cerebral ischemia in this study. But the up-regulated amplitude of GLUT1 and GLUT3 in the diabetic rats with cerebral ischemic injury became smaller than that of the normal controls. In the treatment of diabetic patients with cerebral embolism, blood glucose control should not be too strict, otherwise the up-regulation of GLUT1 and GLUT3 induced by cerebral ischemic injury might not be able to meet the needs of energy metabolism in cells.

摘要

背景

血糖控制可改善糖尿病合并卒中患者的预后,但血糖控制的目标范围仍存在争议。脑缺血半暗带的功能再摄取对卒中后恢复至关重要。本研究旨在探讨不同血糖水平和不同缺血再灌注时间下糖尿病缺氧缺血大鼠脑缺血半暗带中脑型葡萄糖转运体(GLUT1 和 GLUT3)的表达。研究结果可能为临床治疗糖尿病合并卒中患者提供实验依据。

方法

本研究纳入的 Wistar 大鼠随机分为 4 组(每组 50 只):正常对照组(NC)、未控制糖尿病组(DM1)、控制不佳糖尿病组(DM2)和控制良好糖尿病组(DM3)。糖尿病大鼠通过单次腹腔注射链脲佐菌素诱导,造模 6 周后采用插线法制作大脑中动脉闭塞(MCAO)局灶性缺血大鼠模型。每组再分为 5 个亚组(每组 10 只):分别于再灌注后 3、12、24 和 72 小时进行 4 个不同缺血再灌注时间点的局灶性缺血亚组和 1 个假手术亚组。采用 RT-PCR 和 Western blot 分别检测 GLUT1 和 GLUT3 的 mRNA 和蛋白表达。

结果

各组各再灌注时间点 4 个局灶性缺血亚组与假手术亚组之间 GLUT1 和 GLUT3 的 mRNA 表达均存在显著差异。4 个缺血组的 GLUT1 和 GLUT3 的 mRNA 表达均于 3 小时开始升高,再灌注 24 小时达峰值,72 小时仍维持在较高水平,与假手术组相比差异均有统计学意义。GLUT1 的 mRNA 表达增加较 GLUT3 更明显。与正常对照组相比,糖尿病各组 GLUT1 和 GLUT3 的 mRNA 表达差异均有统计学意义。糖尿病各组 GLUT1 和 GLUT3 的 mRNA 表达均高于正常对照组。不同血糖水平组间的 GLUT1 和 GLUT3 的 mRNA 表达差异有统计学意义,随着血糖水平升高,GLUT1 和 GLUT3 的 mRNA 表达呈下降趋势。GLUT1 和 GLUT3 蛋白的表达趋势与 GLUT1 和 GLUT3 的 mRNA 表达趋势相似。

结论

本研究发现脑缺血后半暗带区 GLUT1 和 GLUT3 表达明显上调,但糖尿病脑缺血损伤大鼠 GLUT1 和 GLUT3 的上调幅度较正常对照组减小。在治疗糖尿病合并脑栓塞患者时,血糖控制不宜过于严格,否则脑缺血损伤诱导的 GLUT1 和 GLUT3 上调可能无法满足细胞能量代谢的需要。

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