Department of Neurology and Neurosurgery, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
J Neuropathol Exp Neurol. 2023 Aug 21;82(9):798-805. doi: 10.1093/jnen/nlad050.
Neuroinflammation and microthrombosis may be underlying mechanisms of brain injury after aneurysmal subarachnoid hemorrhage (aSAH), but they have not been studied in relation to each other. In postmortem brain tissue, we investigated neuroinflammation by studying the microglial and astrocyte response in the frontal cortex of 11 aSAH and 10 control patients. In a second study, we investigated the correlation between microthrombosis and microglia by studying the microglial surface area around vessels with and without microthrombosis in the frontal cortex and hippocampus of 8 other aSAH patients. In comparison with controls, we found increased numbers of microglia (mean ± SEM 50 ± 8 vs 20 ± 5 per 0.0026 mm³, p < 0.01), an increased surface area (%) of microglia (mean ± SEM 4.2 ± 0.6 vs 2.2 ± 0.4, p < 0.05), a higher intensity of the astrocytic intermediate filament protein glial fibrillary acidic protein (GFAP) (mean ± SEM 184 ± 28 vs 92 ± 23 arbitrary units, p < 0.05), and an increased GFAP surface area (%) (mean ± SEM 21.2 ± 2.6 vs 10.7 ± 2.1, p < 0.01) in aSAH tissue. Microglia surface area was approximately 40% larger around vessels with microthrombosis than those without microthrombosis (estimated marginal means [95% CI]; 6.1 [5.4-6.9] vs 4.3 [3.6-5.0], p < 0.001). Our results show that the microglial and astrocyte surface areas increased after aSAH and that microthrombosis and microglia are interrelated.
神经炎症和微血栓形成可能是蛛网膜下腔出血（aSAH）后脑损伤的潜在机制，但它们之间的关系尚未得到研究。在尸检脑组织中，我们通过研究 11 例 aSAH 患者和 10 例对照患者额叶皮层中的小胶质细胞和星形胶质细胞反应来研究神经炎症。在第二项研究中，我们通过研究额叶和海马中存在和不存在微血栓的血管周围小胶质细胞表面积，研究微血栓形成与小胶质细胞之间的相关性。与对照组相比，我们发现小胶质细胞数量增加（平均值 ± SEM 50 ± 8 比 20 ± 5 个/0.0026 mm³，p < 0.01），小胶质细胞表面积百分比增加（平均值 ± SEM 4.2 ± 0.6 比 2.2 ± 0.4，p < 0.05），星形胶质细胞中间丝蛋白胶质纤维酸性蛋白（GFAP）的强度增加（平均值 ± SEM 184 ± 28 比 92 ± 23 任意单位，p < 0.05），GFAP 表面积百分比增加（平均值 ± SEM 21.2 ± 2.6 比 10.7 ± 2.1，p < 0.01）在 aSAH 组织中。与没有微血栓形成的血管相比，有微血栓形成的血管周围的小胶质细胞表面积大约增加了 40%（估计边缘均值[95%CI]；6.1 [5.4-6.9] 比 4.3 [3.6-5.0]，p < 0.001）。我们的结果表明，aSAH 后小胶质细胞和星形胶质细胞的表面积增加，并且微血栓形成和小胶质细胞相互关联。
