Cai Jun, Pan Ruihuan, Jia Xiang, Li Yue, Hou Zijun, Huang Run-Yue, Chen Xin, Huang Shengping, Yang Guo-Yuan, Sun Jingbo, Huang Yan
Diagnosis and Treatment Center of Encephalopathy, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China; The Second Institute of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510120, China; Post-doctoral Research Center of Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
Diagnosis and Treatment Center of Encephalopathy, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou 510120, China.
J Ethnopharmacol. 2014 Dec 2;158 Pt A:301-9. doi: 10.1016/j.jep.2014.10.019. Epub 2014 Oct 30.
Haemorrhagic transformation is an asymptomatic event that frequently occurs after following ischaemic stroke, particularly when pharmaceutical thrombolysis is used. However, the mechanism responsible for haemorrhagic transformation remains unknown, and therapeutics have not been identified. In this study, we administered a combination of astragalus membranaceus and ligustrazine to rats with cerebral ischaemia that had undergone thrombolysis. We analysed the effect of this combination on the attenuation of haemorrhagic transformation and the maintenance of blood-brain barrier integrity.
A rat model of focal cerebral ischaemia was induced with autologous blood clot injections. Thrombolysis was performed via the intravenous injection of rt-PA. Astragalus membranaceus, ligustrazine or a combination of Astragalus membranaceus and ligustrazine was administered immediately after the clot injection. The cerebral infarct area, neurological deficits, blood-brain barrier integrity, and cerebral haemorrhage status were determined after 3, 6 and 24h of ischaemia. The ultrastructure of the blood-brain barrier was examined with a transmission electron microscope. The expression of tight junction proteins, including claudin-1, claudin-5, occludin, and zonula occludens-1, and matrix metallopeptidase-9 activation was further evaluated in terms of their roles in the protective effects of the combination drug on the integrity of the blood-brain barrier.
Ischaemia-induced Evans blue leakage and cerebral haemorrhage were markedly reduced in the combination drug-treated rats compared to the rats treated with either astragalus membranaceus or ligustrazine alone (p<0.05). The disruption of the ultrastructure of the blood-brain barrier and the neurological deficits were ameliorated by the combination treatment (p<0.05). The reductions in the expression of laudin-1, claudin-5, occludin, and ZO-1 were smaller in the rats that received the combination treatment. In addition, MMP-9 activity was suppressed in the combination-treated rats compared to the controls (p<0.05).
Treatment with a combination of astragalus membranaceus and ligustrazine alleviated ischaemia-induced micro-haemorrhage transformation by maintaining the integrity of the blood-brain barrier.
出血性转化是缺血性中风后经常发生的无症状事件,尤其是在使用药物溶栓时。然而,出血性转化的机制仍然未知,并且尚未确定治疗方法。在本研究中,我们对接受溶栓治疗的脑缺血大鼠给予黄芪和川芎嗪的组合。我们分析了这种组合对减轻出血性转化和维持血脑屏障完整性的作用。
通过自体血凝块注射诱导大鼠局灶性脑缺血模型。通过静脉注射rt-PA进行溶栓。在血凝块注射后立即给予黄芪、川芎嗪或黄芪与川芎嗪的组合。在缺血3、6和24小时后测定脑梗死面积、神经功能缺损、血脑屏障完整性和脑出血状态。用透射电子显微镜检查血脑屏障的超微结构。进一步评估紧密连接蛋白(包括claudin-1、claudin-5、occludin和小带闭合蛋白-1)的表达以及基质金属蛋白酶-9的激活在联合药物对血脑屏障完整性的保护作用中的作用。
与单独用黄芪或川芎嗪治疗的大鼠相比,联合药物治疗的大鼠缺血诱导的伊文思蓝渗漏和脑出血明显减少(p<0.05)。联合治疗改善了血脑屏障超微结构的破坏和神经功能缺损(p<0.05)。接受联合治疗的大鼠中,claudin-1、claudin-5、occludin和ZO-1表达的降低较小。此外,与对照组相比,联合治疗的大鼠中MMP-9活性受到抑制(p<o.05)。
黄芪和川芎嗪联合治疗通过维持血脑屏障的完整性减轻缺血诱导的微出血转化。