Brooks Steven D, DeVallance Evan, d'Audiffret Alexandre C, Frisbee Stephanie J, Tabone Lawrence E, Shrader Carl D, Frisbee Jefferson C, Chantler Paul D
Department of Physiology and Pharmacology, West Virginia University Health Sciences Center, Morgantown, West Virginia; Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia.
Division of Exercise Physiology, West Virginia University Health Sciences Center, Morgantown, West Virginia; Center for Cardiovascular and Respiratory Sciences, West Virginia University Health Sciences Center, Morgantown, West Virginia.
Am J Physiol Heart Circ Physiol. 2015 Dec 1;309(11):H1846-59. doi: 10.1152/ajpheart.00691.2015. Epub 2015 Oct 16.
The metabolic syndrome (MetS) is highly prevalent in the North American population and is associated with increased risk for development of cerebrovascular disease. This study determined the structural and functional changes in the middle cerebral arteries (MCA) during the progression of MetS and the effects of chronic pharmacological interventions on mitigating vascular alterations in obese Zucker rats (OZR), a translationally relevant model of MetS. The reactivity and wall mechanics of ex vivo pressurized MCA from lean Zucker rats (LZR) and OZR were determined at 7-8, 12-13, and 16-17 wk of age under control conditions and following chronic treatment with pharmacological agents targeting specific systemic pathologies. With increasing age, control OZR demonstrated reduced nitric oxide bioavailability, impaired dilator (acetylcholine) reactivity, elevated myogenic properties, structural narrowing, and wall stiffening compared with LZR. Antihypertensive therapy (e.g., captopril or hydralazine) starting at 7-8 wk of age blunted the progression of arterial stiffening compared with OZR controls, while treatments that reduced inflammation and oxidative stress (e.g., atorvastatin, rosiglitazone, and captopril) improved NO bioavailability and vascular reactivity compared with OZR controls and had mixed effects on structural remodeling. These data identify specific functional and structural cerebral adaptations that limit cerebrovascular blood flow in MetS patients, contributing to increased risk of cognitive decline, cerebral hypoperfusion, and ischemic stroke; however, these pathological adaptations could potentially be blunted if treated early in the progression of MetS.
代谢综合征(MetS)在北美人群中高度流行,并且与脑血管疾病发生风险增加相关。本研究确定了在MetS进展过程中大脑中动脉(MCA)的结构和功能变化,以及慢性药物干预对减轻肥胖Zucker大鼠(OZR,一种与MetS相关的转化模型)血管改变的影响。在对照条件下以及在用针对特定全身病理的药物进行慢性治疗后,测定了7 - 8周龄、12 - 13周龄和16 - 17周龄的瘦Zucker大鼠(LZR)和OZR离体加压MCA的反应性和血管壁力学特性。随着年龄增长,与LZR相比,对照OZR表现出一氧化氮生物利用度降低、舒张剂(乙酰胆碱)反应性受损、肌源性特性升高、结构变窄和血管壁硬化。与OZR对照组相比,7 - 8周龄开始的抗高血压治疗(如卡托普利或肼屈嗪)减弱了动脉僵硬的进展,而与OZR对照组相比,降低炎症和氧化应激的治疗(如阿托伐他汀、罗格列酮和卡托普利)改善了一氧化氮生物利用度和血管反应性,并且对结构重塑有混合效应。这些数据确定了特定的功能性和结构性脑适应性变化,这些变化限制了MetS患者的脑血管血流量,导致认知能力下降、脑灌注不足和缺血性中风风险增加;然而,如果在MetS进展早期进行治疗,这些病理适应性变化可能会得到缓解。