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[高压氧治疗对短暂性局灶性脑缺血后细胞凋亡死亡途径的影响]

[Effect of hyperbaric oxygenation treatment on the apoptotic cell death pathway after transient focal cerebral ischemia].

作者信息

Lou Min, Ding Mei-Ping, Wen Shu-Qun

机构信息

Department of Neurology, Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou 310009, China.

出版信息

Zhongguo Ying Yong Sheng Li Xue Za Zhi. 2006 Feb;22(1):1-5.

PMID:21186562
Abstract

AIM

To evaluate the effects of administration of hyperbaric oxygenation(HBO) when initiated at different time after acute transient ischemia. Apoptosis in the ischemic penumbra was further investigated to search for the possible mechanism.

METHODS

The male SD rats were randomly assigned to the following groups: control, HBO therapy initiated 3 h after ischemia, HBO therapy initiated 6 h after ischemia, HBO therapy initiated 12 h after ischemia. All animals were subjected to 90 min intraluminal middle cerebral artery occlusion (MCAO) with the regional cerebral blood flow monitored in vivo by laser Doppler flowmetry. HBO treatment was performed in a pressure chamber with 100% O2, 3 arm for 1 h. Neurological deficits and infarct volumes were assessed at 24 hours after ischemia. The immunohistochemical changes of apoptosis in the penumbra were evaluated by detecting the expression of cleaved Caspase-3, cleaved Caspase-9, Bcl-2, Bax and TUNEL staining.

RESULTS

HBO therapy initiated at 3 and 6 hours after ischemia significantly improved the neurological function and reduced infarct volume. Meanwhile, it increased the expression of Bcl-2 protein and decreased the expression of activated Caspase-3, activated Caspase-9 and TUNEL-positive cells. However, HBO therapy administrated 12 hours after ischemia aggravated the neurological deficits and enlarged infarct volume, while it showed no significant reduction of apoptotic change compared with control.

CONCLUSION

There is a therapeutic window for the use of HBO in acute transient cerebral ischemia in rats. HBO-treatment is highly effective in reducing infarct volume when initiated up to 6h after the onset of ischemia. Inhibition of apoptotic cell death in the penumbra appears to be the underlying protective effect of early therapy.

摘要

目的

评估急性短暂性缺血后不同时间开始给予高压氧(HBO)的效果。进一步研究缺血半暗带中的细胞凋亡,以寻找可能的机制。

方法

将雄性SD大鼠随机分为以下几组:对照组、缺血后3小时开始HBO治疗组、缺血后6小时开始HBO治疗组、缺血后12小时开始HBO治疗组。所有动物均接受90分钟的大脑中动脉腔内闭塞(MCAO),并通过激光多普勒血流仪在体内监测局部脑血流量。在压力舱中用100%氧气进行HBO治疗,3个大气压,持续1小时。在缺血后24小时评估神经功能缺损和梗死体积。通过检测裂解的半胱天冬酶-3、裂解的半胱天冬酶-9、Bcl-2、Bax的表达以及TUNEL染色来评估半暗带中凋亡的免疫组化变化。

结果

缺血后3小时和6小时开始HBO治疗可显著改善神经功能并减少梗死体积。同时,它增加了Bcl-2蛋白的表达,降低了活化的半胱天冬酶-3、活化的半胱天冬酶-9的表达以及TUNEL阳性细胞的数量。然而,缺血后12小时进行HBO治疗会加重神经功能缺损并扩大梗死体积,与对照组相比,其凋亡变化没有显著减少。

结论

在大鼠急性短暂性脑缺血中使用HBO存在治疗窗。在缺血发作后6小时内开始HBO治疗对减少梗死体积非常有效。抑制半暗带中的凋亡细胞死亡似乎是早期治疗的潜在保护作用。

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