Department of Neuroscience, Mario Negri Institute for Pharmacological Research, Via G. La Masa 19, Milan, Italy.
Epilepsia. 2012 Nov;53(11):1887-97. doi: 10.1111/j.1528-1167.2012.03666.x. Epub 2012 Sep 17.
Dysfunction of the blood-brain barrier (BBB) is a common finding during seizures or following epileptogenic brain injuries, and experimentally induced BBB opening promotes seizures both in naive and epileptic animals. Brain albumin extravasation was reported to promote hyperexcitability by inducing astrocytes dysfunction. To provide in vivo evidence for a direct role of extravasated serum albumin in seizures independently on the pathologic context, we did the following: (1) quantified the amount of serum albumin extravasated in the rat brain parenchyma during status epilepticus (SE); (2) reproduced a similar concentration in the hippocampus by intracerebroventricular (i.c.v.) albumin injection in naive rats; (3) measured electroencephalography (EEG) activity in these rats, their susceptibility to kainic acid (KA)-induced seizures, and their hippocampal afterdischarge threshold (ADT).
Brain albumin concentration was measured in the rat hippocampus and other forebrain regions 2 and 24 h after SE by western blot analysis. Brain distribution of serum albumin or fluorescein isothiocyanate (FITC)-albumin was studied by immunohistochemistry and immunofluorescence, respectively. Naive rats were injected with rat albumin or FITC-albumin, i.c.v., to mimic the brain concentration attained after SE, or with dextran used as control. Inflammation was evaluated by immunohistochemistry by measuring glial induction of interleukin (IL)-1β. Western blot analysis was used to measure inward rectifying potassium channel subunit Kir4.1 protein levels in the hippocampus. Seizures were induced in rats by intrahippocampal injection of 80 ng KA and quantified by EEG analysis, 2 or 24 h after rat albumin or dextran administration. ADT was measured by electrical stimulation of the hippocampus 3 months after albumin injection. In these rats, EEG was continuously monitored for 2 weeks to search for spontaneous seizures.
The hippocampal serum albumin concentration 24 h post-SE was 0.76 ± 0.21 μm. Similar concentrations were measured in other forebrain regions, whereas no changes were found in cerebellum. The hippocampal albumin concentration was similarly reproduced in naive rats by i.c.v. administration of 500 μg/4 μl rat albumin: albumin was predominantly detected extracellularly 2 h after injection, whereas at 24 h it was visible inside pyramidal neurons and in only a few scattered chondroitin sulphate proteoglycan (NG2)-positive cells, but not in glial fibrillary acidic protein (GFAP)-positive astrocytes or CR-3 complement receptor (OX-42)-positive microglia. The presence of albumin in naive rat hippocampus was associated with induced IL-1β in GFAP-positive astrocytes and a concomitant tissue down-regulation of Kir4.1. Spiking activity was evoked by albumin in the hippocampus lasting for 2 h. When KA was intrahippocampally applied either 2 or 24 h after albumin injection, the number of total interictal spikes in 3 h EEG recording was significantly increased by twofold on average. Three months after albumin injection, neither albumin nor inflammation was detected in brain tissue; at this time, the ADT was reduced by 50% but no spontaneous seizures were observed.
Transient hippocampal exposure to albumin levels similar to those attained after prominent BBB breakdown resulted in increased seizure susceptibility and long-term reduction in seizure threshold, but it did not evoke spontaneous seizures. These effects may be mediated by albumin-induced astrocytes dysfunction and the associated induction of proinflammatory molecules.
血脑屏障(BBB)功能障碍是癫痫发作或致痫性脑损伤后常见的现象,实验性诱导的 BBB 开放可促进未受损和癫痫动物的癫痫发作。有报道称,脑白蛋白外渗通过诱导星形胶质细胞功能障碍而促进过度兴奋。为了在不依赖病理环境的情况下,提供血脑屏障外渗白蛋白在癫痫发作中直接作用的体内证据,我们进行了以下实验:(1)在癫痫持续状态(SE)期间定量测定大鼠脑实质中血清白蛋白的外渗量;(2)通过向正常大鼠脑室内注射白蛋白,在类似浓度下复制海马区的情况;(3)测量这些大鼠的脑电图(EEG)活动、对海人酸(KA)诱导的癫痫发作的易感性以及海马后放电阈值(ADT)。
通过 Western blot 分析,在 SE 后 2 和 24 小时测量大鼠海马和其他前脑区域的脑白蛋白浓度。通过免疫组织化学和免疫荧光分别研究血清白蛋白或异硫氰酸荧光素(FITC)-白蛋白的脑分布。通过向正常大鼠脑室内注射大鼠白蛋白或 FITC-白蛋白模拟 SE 后达到的脑浓度,或注射葡聚糖作为对照来进行实验。通过测量白细胞介素(IL)-1β诱导的小胶质细胞的诱导,通过免疫组织化学评估炎症。使用 Western blot 分析测量海马内内向整流钾通道亚基 Kir4.1 蛋白水平。通过在海马内注射 80ng KA 诱导大鼠癫痫发作,并在大鼠白蛋白或葡聚糖给药后 2 或 24 小时通过 EEG 分析进行量化。通过海马电刺激测量 ADT,在白蛋白注射 3 个月后进行。在这些大鼠中,连续监测 EEG 2 周以寻找自发性癫痫发作。
SE 后 24 小时海马的血清白蛋白浓度为 0.76±0.21μm。在其他前脑区域也发现了类似的浓度变化,而小脑则没有变化。通过脑室内给予 500μg/4μl 大鼠白蛋白,在正常大鼠中也可重现类似的海马白蛋白浓度:白蛋白在注射后 2 小时主要检测到细胞外,而在 24 小时时可在锥体神经元内和仅少数散在的软骨素硫酸盐蛋白聚糖(NG2)阳性细胞中检测到,但在胶质纤维酸性蛋白(GFAP)阳性星形胶质细胞或补体受体 3(OX-42)阳性小胶质细胞中则无法检测到。正常大鼠海马中白蛋白的存在与 GFAP 阳性星形胶质细胞中诱导的 IL-1β以及伴随的 Kir4.1 组织下调有关。白蛋白可在海马中诱发持续 2 小时的电活动。当 KA 在白蛋白注射后 2 或 24 小时内被海马内注射时,在 3 小时的 EEG 记录中,总间发性棘波的数量平均增加了两倍。白蛋白注射 3 个月后,脑组织中既未检测到白蛋白也未检测到炎症;此时,ADT 降低了 50%,但未观察到自发性癫痫发作。
短暂的海马暴露于类似于明显 BBB 破坏后达到的白蛋白水平会导致癫痫易感性增加和长期发作阈值降低,但不会引起自发性癫痫发作。这些影响可能是由白蛋白诱导的星形胶质细胞功能障碍和相关诱导的促炎分子介导的。