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安宫牛黄丸通过改善中风后低灌注、脑血管反应性和微循环障碍来调节脑血流量。

An-Gong-Niu-Huang-Wan (AGNHW) regulates cerebral blood flow by improving hypoperfusion, cerebrovascular reactivity and microcirculation disturbances after stroke.

作者信息

Zhang Xiao, Pei Jiamin, Xue Luping, Zhao Zhe, Xu Renhao, Zhang Cong, Zhang Cong, Fu Lijie, Zhang Xiangjian, Cui Lili

机构信息

Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, 050000, Hebei, China.

Hebei Key Laboratory of Vascular Homeostasis and Hebei Collaborative Innovation Center for Cardio-cerebrovascular Disease, Shijiazhuang, 050000, China.

出版信息

Chin Med. 2024 May 22;19(1):73. doi: 10.1186/s13020-024-00945-7.

Abstract

BACKGROUND

The restoration of cerebrovascular regulation and improvement of cerebral blood flow in ischaemic regions are crucial for improving the clinical prognosis after stroke. An-Gong-Niu-Huang-Wan (AGNHW) is a famous traditional compound Chinese medicine that has been used for over 220 years to treat acute ischaemic stroke; however, its role in the regulation of cerebral blood flow is still unclear. The aim of the present study was to investigate the regulatory effect of AGNHW on cerebral blood flow and microcirculation after ischaemic stroke and to elucidate the underlying mechanisms involved.

METHODS

Male C57BL/6 mice were subjected to distal middle cerebral artery occlusion (dMCAO) and randomly assigned to the sham, MCAO, or AGNHW groups. AGNHW was administered intragastrically 1 h after dMCAO. The rotarod test was utilized to evaluate behavioural function; TTC was used to determine the infarct volume; and ischaemic injury was assessed by detecting brain levels of SOD, MDA and NO. Then, cortical perfusion and acetazolamide-induced cerebrovascular reactivity were assessed using laser speckle contrast imaging, and the velocity and flux of red blood cells in cortical capillaries were detected using two-photon laser scanning microscopy. In addition, we employed RNA-Seq to identify variations in gene expression profiles and assessed endothelium-dependent changes in microcirculatory dysfunction by measuring vasoactive mediator levels.

RESULTS

AGNHW significantly increased cerebral blood flow, reduced the infarct volume, and promoted functional recovery after cerebral ischaemia. AGNHW increased the velocity and flux of red blood cells in capillaries and improved cerebrovascular reactivity in the ischaemic cortex. Furthermore, AGNHW regulated endothelium-dependent microcirculation, as evidenced by decreases in the expression of endothelins (Edn1, Edn3 and Ednrb) and the ratios of brain and serum TXB2/6-keto-PGF1α and ET-1/CGRP.

CONCLUSIONS

AGNHW improved cerebral hypoperfusion, regulated cerebrovascular reactivity and attenuated microcirculatory dysfunction within the ischaemic cortex after stroke. This outstanding effect was achieved by modulating the expression of genes related to vascular endothelial cell function and regulating endothelium-dependent vasoactive mediators.

摘要

背景

恢复脑血管调节功能并改善缺血区域的脑血流量对于改善中风后的临床预后至关重要。安宫牛黄丸(AGNHW)是一种著名的传统复方中药,已用于治疗急性缺血性中风220多年;然而,其在调节脑血流量中的作用仍不清楚。本研究的目的是探讨AGNHW对缺血性中风后脑血流量和微循环的调节作用,并阐明其潜在机制。

方法

雄性C57BL/6小鼠接受大脑中动脉远端闭塞(dMCAO),并随机分为假手术组、MCAO组或AGNHW组。dMCAO后1小时经胃给予AGNHW。利用转棒试验评估行为功能;用TTC测定梗死体积;通过检测脑内SOD、MDA和NO水平评估缺血损伤。然后,使用激光散斑对比成像评估皮质灌注和乙酰唑胺诱导的脑血管反应性,并使用双光子激光扫描显微镜检测皮质毛细血管中红细胞的速度和通量。此外,我们采用RNA-Seq鉴定基因表达谱的变化,并通过测量血管活性介质水平评估微循环功能障碍中内皮依赖性变化。

结果

AGNHW显著增加脑血流量,减少梗死体积,并促进脑缺血后的功能恢复。AGNHW增加了毛细血管中红细胞的速度和通量,并改善了缺血皮质中的脑血管反应性。此外,AGNHW调节内皮依赖性微循环,表现为内皮素(Edn1、Edn3和Ednrb)表达以及脑和血清TXB2/6-酮-PGF1α和ET-1/CGRP比值降低。

结论

AGNHW改善了脑灌注不足,调节了脑血管反应性,并减轻了中风后缺血皮质内的微循环功能障碍。这种显著效果是通过调节与血管内皮细胞功能相关的基因表达以及调节内皮依赖性血管活性介质实现的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/764f/11112936/e9fab9d095d9/13020_2024_945_Fig1_HTML.jpg

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