Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China; Department of Neurology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China.
Department of Neurology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Exp Neurol. 2020 Aug;330:113320. doi: 10.1016/j.expneurol.2020.113320. Epub 2020 Apr 16.
Blood brain barrier (BBB) hyperpermeability and brain edema contribute to increased seizure susceptibility and brain injury in status epilepticus (SE). The endothelial glycocalyx is the coating on luminal side of the endothelium and can be considered as the first barrier of BBB. Currently, little is known about the effects of endothelial glycocalyx in SE. We hypothesized glycocalyx degradation could be considered as a first step in the pathophysiology of SE. The study aimed to investigate the impacts of glycocalyx integrity loss on brain damage in a C57BL/6 mouse model of SE induced by lithium-pilocarpine and whether heparin, a competitive antagonist against heparinase, improves survival and neurological outcome. Compared to controls, glycocalyx was significantly degraded after SE, which was mitigated by heparin. The glycocalyx disruption was associated with higher BBB permeability and aggravated brain edema at 72 h after SE, as well as lower survival rate and poorer neurologic outcome. Conversely, preservation of glycocalyx by heparin could reduce SE-induced activation of glia cells, BBB leakage, brain edema, decrease the expressions of inflammatory factors and improve neurologic outcome. The study highlights the importance of glycocalyx degradation in cerebral edema and SE outcome, and indicates heparin treatment may be a new strategy for brain protection in SE.
血脑屏障(BBB)通透性增加和脑水肿导致癫痫持续状态(SE)时癫痫易感性和脑损伤增加。内皮糖萼是内皮细胞腔侧的涂层,可以被认为是 BBB 的第一道屏障。目前,对于 SE 中内皮糖萼的作用知之甚少。我们假设糖萼降解可能被认为是 SE 病理生理学的第一步。本研究旨在探讨糖萼完整性丧失对锂-匹罗卡品诱导的 C57BL/6 小鼠 SE 模型脑损伤的影响,以及肝素(一种肝素酶的竞争性拮抗剂)是否能提高存活率和神经功能结局。与对照组相比,SE 后糖萼明显降解,肝素可减轻糖萼的降解。糖萼破坏与 SE 后 72 小时 BBB 通透性增加和脑水肿加重相关,且存活率降低,神经功能结局较差。相反,肝素对糖萼的保护作用可减少 SE 诱导的神经胶质细胞激活、BBB 渗漏、脑水肿,降低炎症因子的表达,改善神经功能结局。本研究强调了糖萼降解在脑水肿和 SE 结局中的重要性,并表明肝素治疗可能是 SE 中脑保护的一种新策略。