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血清 miR-130a 水平升高与急性脑出血严重的血肿周围水肿相关,并可预测不良预后。

High Serum MiR-130a Levels Are Associated with Severe Perihematomal Edema and Predict Adverse Outcome in Acute ICH.

作者信息

Wang Meng-Die, Wang Yong, Xia Yuan-Peng, Dai Jing-Wen, Gao Lin, Wang Si-Qi, Wang Hai-Jun, Mao Ling, Li Man, Yu Shi-Meng, Tu Yan, He Quan-Wei, Zhang Guo-Peng, Wang Lei, Xu Guo-Zheng, Xu Hai-Bo, Zhu Ling-Qiang, Hu Bo

机构信息

Department of Neurology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan, 430022, People's Republic of China.

Department of Radiology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Avenue, Wuhan, 430022, People's Republic of China.

出版信息

Mol Neurobiol. 2016 Mar;53(2):1310-1321. doi: 10.1007/s12035-015-9099-0. Epub 2015 Jan 29.

Abstract

The development and/or progression of perihematomal edema (PHE) in patients with acute spontaneous intracerebral hemorrhage (ICH) vary substantially with different individuals. Although hematoma volume is a useful indicator for predicting PHE, its predictive power was not good at the early stage of ICH. Better predictors are urgently needed. In this study, we found that miR-130a was elevated in the serum of ICH patients and was an independent indicator positively associated with PHE volume within the first 3 days after onset. The R (2) was further evaluated when it is used in combination with hematoma mass. Serum miR-130a levels were associated with clinical outcome (National Institute of Health Stroke Scale (NIHSS) scores at day 14 and modified Rankin Scale (mRS) scores at day 90) only in patients with deep hematoma. Moreover, miR-130a was significantly increased in rat serum and perihematomal tissues and was in line with the change in brain edema. MiR-130a inhibitors reduced brain edema, blood-brain barrier (BBB) permeability, and increased neurological deficit scores, and miR-130a mimics increased monolayer permeability. Thrombin-stimulated brain microvascular endothelial cells (BMECs) were a main source of miR-130a under ICH. In the experimental model, the elevated miR-130a level was accompanied by the decreased caveolin-1 and increased matrix metalloproleinase (MMP)-2/9. Meanwhile, caveolin-1 (cav-1) was reduced by miR-130a mimics, accompanied by an increase in MMP-2/9 expression. The upregulated MMP-2/9 was then downregulated by cavtratin, a cav-1 scaffolding domain peptide. This regulation mechanism was authenticated in a thrombin-induced cellular ICH model. Our results suggest that serum miR-130a may serve as a useful early biomarker for monitoring post-ICH PHE and predicting prognosis and may be helpful in the decision-making of individualized therapy.

摘要

急性自发性脑出血(ICH)患者血肿周围水肿(PHE)的发展和/或进展在不同个体之间差异很大。尽管血肿体积是预测PHE的一个有用指标,但其在ICH早期的预测能力并不理想。因此迫切需要更好的预测指标。在本研究中,我们发现miR-130a在ICH患者血清中升高,并且是发病后前3天内与PHE体积呈正相关的独立指标。当它与血肿量联合使用时,进一步评估了R(2)。血清miR-130a水平仅在深部血肿患者中与临床结局(第14天的美国国立卫生研究院卒中量表(NIHSS)评分和第90天的改良Rankin量表(mRS)评分)相关。此外,miR-130a在大鼠血清和血肿周围组织中显著升高,并且与脑水肿的变化一致。miR-130a抑制剂可减轻脑水肿、血脑屏障(BBB)通透性,并增加神经功能缺损评分,而miR-130a模拟物则增加单层通透性。凝血酶刺激的脑微血管内皮细胞(BMECs)是ICH情况下miR-130a的主要来源。在实验模型中,miR-130a水平升高伴随着小窝蛋白-1减少和基质金属蛋白酶(MMP)-2/9增加。同时,miR-130a模拟物使小窝蛋白-1(cav-1)减少,同时伴随着MMP-2/9表达增加。上调的MMP-2/9随后被cavtratin(一种cav-1支架结构域肽)下调。这种调节机制在凝血酶诱导的细胞ICH模型中得到了验证。我们的结果表明,血清miR-130a可能作为监测ICH后PHE和预测预后的有用早期生物标志物,并且可能有助于个体化治疗的决策。

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