Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
J Cereb Blood Flow Metab. 2010 Jun;30(6):1178-87. doi: 10.1038/jcbfm.2009.287. Epub 2010 Jan 20.
The pathogenesis of stroke is multifactorial, and inflammation is thought to have a critical function in lesion progression at early time points. Detection of inflammatory processes associated with cerebral ischemia would be greatly beneficial in both designing individual therapeutic strategies and monitoring outcome. We have recently developed a new approach to imaging components of the inflammatory response, namely endovascular adhesion molecule expression on the brain endothelium. In this study, we show specific imaging of vascular cell adhesion molecule (VCAM)-1 expression in a mouse model of middle cerebral artery occlusion (MCAO), and a reduction in this inflammatory response, associated with improved behavioral outcome, as a result of preconditioning. The spatial extent of VCAM-1 expression is considerably greater than the detectable lesion using diffusion-weighted imaging (25% versus 3% total brain volume), which is generally taken to reflect the core of the lesion at early time points. Thus, VCAM-1 imaging seems to reveal both core and penumbral regions, and our data implicate VCAM-1 upregulation and associated inflammatory processes in the progression of penumbral tissue to infarction. Our findings indicate that such molecular magnetic resonance imaging (MRI) approaches could be important clinical tools for patient evaluation, acute monitoring of therapy, and design of specific treatment strategies.
中风的发病机制是多因素的,炎症被认为在早期病变进展中起着关键作用。检测与脑缺血相关的炎症过程将极大地有益于设计个体化治疗策略和监测结果。我们最近开发了一种新的方法来对炎症反应的成分进行成像,即血管内皮细胞上的血管细胞黏附分子(VCAM-1)的表达。在这项研究中,我们显示了在大脑中动脉闭塞(MCAO)的小鼠模型中,血管细胞黏附分子(VCAM-1)表达的特异性成像,以及炎症反应的减少与预处理相关的行为结果的改善。VCAM-1 表达的空间范围明显大于弥散加权成像(DWI)检测到的病变范围(25%总脑体积与 3%),DWI 通常被认为反映了早期病变的核心区域。因此,VCAM-1 成像似乎揭示了核心和半影区,我们的数据表明 VCAM-1 的上调和相关炎症过程参与了半影区组织向梗死的进展。我们的发现表明,这种分子磁共振成像(MRI)方法可能是评估患者、急性监测治疗和设计特定治疗策略的重要临床工具。