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脾脏相关免疫反应介导脑出血后的脑心交互作用。

Spleen associated immune-response mediates brain-heart interaction after intracerebral hemorrhage.

机构信息

Department of Neurology, Henry Ford Hospital, Detroit, MI 48202, USA.

Department of Neurology, Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin 300052, China.

出版信息

Exp Neurol. 2020 May;327:113209. doi: 10.1016/j.expneurol.2020.113209. Epub 2020 Jan 24.

Abstract

BACKGROUND AND PURPOSE

Intracerebral hemorrhage (ICH) patients frequently encounter cardiovascular complications which may contribute to increased mortality and poor long term outcome. ICH induces systemic oxidative stress and activates peripheral immune responses which are involved in the pathological cascade leading to cardiac dysfunction and heart failure after ICH. We have previously reported that ICH induces progressive cardiac dysfunction in mice without primary cardiac diseases. In this study, we have investigated the role of immune response in mediating cardiac dysfunction post ICH in mice.

METHODS

Adult male C57BL/6 J mice were randomly assigned to the following groups (n = 8/group): 1) sham control; 2) ICH; 3) splenectomy with ICH (ICH + Spx); 4) splenectomy alone (Spx). Echocardiography was performed at 7 and 28 days after ICH. A battery of neurological and cognitive tests were performed. Flow cytometry, western blot and immunostaining were used to test mechanisms of ICH induced cardiac dysfunction.

RESULTS

Compared to sham control mice, Spx alone does not induce acute (7 day) or chronic (28 day) cardiac dysfunction. ICH induces significant neurological and cognitive deficits, as well as acute and chronic cardiac dysfunction compared to sham control mice. Mice subjected to ICH + Spx exhibit significantly improved neurological and cognitive function compared to ICH mice. Mice with ICH + Spx also exhibit significantly improved acute and chronic cardiac function compared to ICH mice indicated by increased left ventricular ejection fraction (LVEF) and left ventricular fractional shortening (LVFS), decreased cardiac fibrosis, decreased cardiomyocyte hypertrophy, decreased cardiac infiltration of immune cells and decreased expression of inflammatory factor and oxidative stress in the heart.

CONCLUSIONS

Our study demonstrates that splenectomy attenuates ICH-induced neurological and cognitive impairment as well as ICH-induced cardiac dysfunction in mice. Inflammatory cell infiltration into heart and immune responses mediated by the spleen may contribute to ICH-induce acute and chronic cardiac dysfunction and pathological cardiac remodeling.

摘要

背景与目的

脑出血(ICH)患者常伴有心血管并发症,这可能导致死亡率增加和预后不良。ICH 诱导全身氧化应激,并激活外周免疫反应,这些反应参与导致 ICH 后心脏功能障碍和心力衰竭的病理级联反应。我们之前报道过,ICH 可在没有原发性心脏疾病的情况下导致小鼠进行性心脏功能障碍。在这项研究中,我们研究了免疫反应在介导 ICH 后小鼠心脏功能障碍中的作用。

方法

成年雄性 C57BL/6J 小鼠被随机分为以下几组(n=8/组):1)假手术对照;2)ICH;3)ICH 伴脾切除术(ICH+Spx);4)单纯脾切除术(Spx)。ICH 后 7 天和 28 天进行超声心动图检查。进行一系列神经和认知测试。使用流式细胞术、western blot 和免疫染色来检测 ICH 诱导心脏功能障碍的机制。

结果

与假手术对照小鼠相比,单纯脾切除术不会引起急性(7 天)或慢性(28 天)心脏功能障碍。与假手术对照小鼠相比,ICH 诱导明显的神经和认知功能障碍,以及急性和慢性心脏功能障碍。与 ICH 小鼠相比,接受 ICH+Spx 的小鼠表现出明显改善的神经和认知功能。与 ICH 小鼠相比,接受 ICH+Spx 的小鼠也表现出明显改善的急性和慢性心脏功能,表现为左心室射血分数(LVEF)和左心室短轴缩短率(LVFS)增加、心脏纤维化减少、心肌细胞肥大减少、心脏免疫细胞浸润减少以及心脏中炎症因子和氧化应激表达减少。

结论

我们的研究表明,脾切除术可减轻 ICH 诱导的神经和认知功能障碍以及 ICH 诱导的小鼠心脏功能障碍。心脏内炎症细胞浸润和脾脏介导的免疫反应可能导致 ICH 引起的急性和慢性心脏功能障碍和病理性心脏重构。

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