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理解缺血性卒中作为一种性别二态性疾病的意义:软脑膜侧支循环的作用。

Implications for understanding ischemic stroke as a sexually dimorphic disease: the role of pial collateral circulations.

机构信息

Department of Neurological Sciences, University of Vermont Robert Larner College of Medicine , Burlington, Vermont.

Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Vermont Robert Larner College of Medicine , Burlington, Vermont.

出版信息

Am J Physiol Heart Circ Physiol. 2018 Dec 1;315(6):H1703-H1712. doi: 10.1152/ajpheart.00402.2018. Epub 2018 Sep 21.

Abstract

We investigated structural and functional differences in primary and pial collateral circulations in adult normotensive male and female Wistar rats. Male ( n = 10) and female ( n = 7) rats were subjected to middle cerebral artery (MCA) occlusion and changes in relative cerebral blood flow in MCA and pial collateral territories were measured by multisite laser-Doppler flowmetry. Rats were then transcardially perfused with a mixture of carbon black and latex, perfusion fixed, and imaged to compare primary and pial collateral structure between male ( n = 4) and female ( n = 3) rats, including lumen diameters and number. To study pial collateral function, leptomeningeal anastomoses (LMAs) were isolated and pressurized from male ( n = 7) and female ( n = 6) rats. Myogenic tone and reactivity to pressure, vascular function to pharmacological activator, or inhibitor of ion channels was measured and compared. There was no difference between relative cerebral blood flow in both MCA and pial collateral territories during occlusion and reperfusion between groups. Compared with male LMAs, female LMAs had similar myogenic tone (24.0 ± 7.3% vs. 16.0 ± 3.7%, P > 0.05) and reactivity to increased pressure and similar vascular responses to vasoconstrictive and vasodilatory stimuli. Additionally, compared with female LMAs, male LMAs had similar numbers (21 ± 1 vs. 20 ± 2, P > 0.05) and diameters (30.5 ± 2.0 vs. 26.2 ± 0.6 μm, P > 0.05), and no sex difference was detected in the diameter of arterial segments of circle of Willis. Together, our data establish no sex difference of cerebral collateral structure or function, suggesting that the reduced severity of stroke outcome in female rats is not likely due to differences in the cerebral collateral circulation. NEW & NOTEWORTHY Our work compared the function of leptomeningeal anastomoses between male and female adult normotensive rats with no sex difference found. We also confirmed no sex difference in primary and pial collateral structure in Wistar rats. Our findings suggest that the reduced severity of stroke in premenopausal women and reproductively intact female rodents is not likely due to improved primary and pial collateral circulations.

摘要

我们研究了成年雄性和雌性 Wistar 大鼠的大脑中动脉(MCA)闭塞时初级和软脑膜侧支循环的结构和功能差异。雄性(n = 10)和雌性(n = 7)大鼠接受 MCA 闭塞,通过多点激光多普勒血流仪测量 MCA 和软脑膜侧支循环区的相对脑血流变化。然后,用碳黑和乳胶混合物对大鼠进行心脏灌注,灌注固定后,对雄性(n = 4)和雌性(n = 3)大鼠的初级和软脑膜侧支结构进行成像比较,包括管腔直径和数量。为了研究软脑膜侧支的功能,从雄性(n = 7)和雌性(n = 6)大鼠中分离并加压软脑膜吻合(LMAs)。测量并比较了它们的肌源性张力和对压力的反应性、血管对药理学激活剂或离子通道抑制剂的功能。在两组之间的闭塞和再灌注期间,MCA 和软脑膜侧支循环区的相对脑血流没有差异。与雄性 LMA 相比,雌性 LMA 具有相似的肌源性张力(24.0±7.3%比 16.0±3.7%,P>0.05)和对压力增加的反应性,以及对血管收缩和血管舒张刺激的相似血管反应。此外,与雌性 LMA 相比,雄性 LMA 的数量(21±1 比 20±2,P>0.05)和直径(30.5±2.0 比 26.2±0.6μm,P>0.05)相似,而且在 Willis 环的动脉段的直径也没有性别差异。综上所述,我们的数据表明,大脑侧支循环的结构或功能没有性别差异,这表明雌性大鼠中风严重程度降低并非由于大脑侧支循环的差异所致。

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