Dahl N A, Looney G A, Black W H
Acta Neuropathol. 1982;57(2-3):111-20. doi: 10.1007/BF00685378.
This paper examines the neuropathology of oxygen-glucose deprivation uncomplicated by stagnant conditions. Rabbit vagus nerves were pulled into a multi-compartment perfusion chamber, stimulated five times per second and deprived of energy by substituting nitrogen and deoxyglucose for oxygen and glucose in the Locke's perfusate. After incubation the compartments were perfused with gluteraldehyde solution, and the nerves were prepared for electron microscopy. Fixation in the compartments ensured precise cross and longitudinal sections which permitted quantitative comparisons. Although the action potentials ceased in 45 min, 1 h of energy deprivation did not significantly affect the ultrastructure. After 2 h of deprivation the axons were smaller and flattened and microtubules appeared packed together. In the smallest axons the microtubules were gone, the neurofilaments were compacted and the few mitochondria had a dense, homogenous appearance. By 4 h the shrinking was extreme, yet 8% were swollen much larger than any of the controls. Longitudinal views showed these ballooned areas were greatly expanded regions of the smallest axons. Both tiny and huge regions were devoid of microtubules and the swollen axons contained expanded mitochondria. Calcium is indirectly implicated in the pathogenesis by the concurrence of mitochondrial alteration as the microtubules disappear coupled with the known role of mitochondria in calcium regulation and the reported effect of high calcium on microtubual dissociation. It is suggested that axons first shrink as osmotically active molecules are used or washed out. After a time without energy the mitochondria can no longer regulate the intracellular calcium, microtubules dissociate, and calcium-activated phospholipases create osmotically active molecules. Finally, high-amplitude, disruptive swelling occurs.
本文研究了无血流停滞情况的氧糖剥夺的神经病理学。将兔迷走神经放入多室灌注室,每秒刺激5次,并通过在洛克氏灌注液中用氮气和脱氧葡萄糖替代氧气和葡萄糖来剥夺能量。孵育后,用戊二醛溶液灌注各室,并制备用于电子显微镜检查的神经样本。在各室中固定可确保获得精确的横切面和纵切面,从而进行定量比较。尽管动作电位在45分钟内停止,但1小时的能量剥夺并未显著影响超微结构。剥夺2小时后,轴突变小且扁平,微管似乎聚集在一起。在最小的轴突中,微管消失,神经丝紧密排列,少数线粒体呈现致密、均匀的外观。到4小时时,萎缩极为严重,但仍有8%的轴突肿胀得比任何对照都大得多。纵切面显示这些肿胀区域是最小轴突的极大扩张区域。微小区域和巨大区域均无微管,肿胀的轴突含有扩张的线粒体。随着微管消失,线粒体发生改变,同时已知线粒体在钙调节中的作用以及高钙对微管解离的报道效应,提示钙间接参与了发病机制。有人提出,轴突首先因渗透活性分子被消耗或被冲走而收缩。在一段时间没有能量供应后,线粒体无法再调节细胞内钙,微管解离,钙激活的磷脂酶产生渗透活性分子。最后,出现高幅度的、破坏性的肿胀。