Prado R, Watson B D, Zhao W, Yao H, Busto R, Dietrich W D, Ginsberg M D
Cerebral Vascular Disease Research Center, University of Miami School of Medicine, FL 33101, USA.
J Cereb Blood Flow Metab. 1996 Jul;16(4):612-22. doi: 10.1097/00004647-199607000-00011.
The potential of nitric oxide (NO) to influence positively or negatively the outcome of mechanically induced focal cerebral ischemia is still controversial. Recent evidence suggests that NO of vascular origin, whether synthesized from exogenously administered L-arginine (L-Arg) or from NO donor compounds, is beneficial but that of neuronal origin is not. However, the therapeutic potential of NO to ameliorate stroke induced by arterial thrombosis has not been reported. We assessed the therapeutic effect of L-Arg administration in spontaneously hypertensive rats (SHR) subjected to permanent photothrombotic occlusion of the distal middle cerebral artery (dMCA). The ipsilateral carotid artery was left unligated to enhance L-Arg delivery into the putative penumbral region. Local CBF (LCBF) was assessed at 30 min by the [14C]iodoantipyrine technique (n = 9), while histological infarct volumes and index of peripheral ischemic cell change were determined at 3 days (n = 7). Rats (n = 9) given 300 mg/kg L-Arg at 18 and 3 h before photothrombotic dMCA occlusion and at 5 min afterward displayed no significant differences in LCBF compared with animals (n = 8) injected with water (the carrier vehicle) and similarly irradiated. Infarct volumes were also similar, being 37.0 +/- 9.7 mm3 (SD) in the vehicle-treated and 49.1 +/- 17.2 mm3 (SD) in the L-Arg-treated groups (both n = 7), as were assessments of ischemic neuronal density in the penumbra. In contrast, L-Arg administered intravenously in a dose of 300 mg/kg to nonischemic SHR (n = 5) increased cortical CBF by approximately 75% during a 70-min observation period. We conclude that thrombotic processes superimposed upon cerebral ischemia may facilitate tissue reactions that offset the potentially beneficial effect of L-Arg, and this caveat must be considered when proposing L-Arg for clinical treatment of focal thrombotic stroke.
一氧化氮(NO)对机械性诱导的局灶性脑缺血结局产生正向或负向影响的可能性仍存在争议。最近的证据表明,血管源性的NO,无论是由外源性给予的L-精氨酸(L-Arg)合成还是由NO供体化合物合成,都是有益的,但神经元源性的NO则不然。然而,NO改善动脉血栓形成所致中风的治疗潜力尚未见报道。我们评估了给予L-Arg对自发性高血压大鼠(SHR)永久性光血栓闭塞大脑中动脉远端(dMCA)的治疗效果。同侧颈动脉不结扎,以增强L-Arg向假定半暗带区域的递送。在30分钟时通过[14C]碘代安替比林技术评估局部脑血流量(LCBF)(n = 9),而在3天时测定组织学梗死体积和外周缺血细胞变化指数(n = 7)。在光血栓性dMCA闭塞前18小时和3小时以及闭塞后5分钟给予300 mg/kg L-Arg的大鼠(n = 9),与注射水(载体)并同样接受照射的动物(n = 8)相比,LCBF无显著差异。梗死体积也相似,载体治疗组为37.0±9.7 mm3(标准差),L-Arg治疗组为49.1±17.2 mm3(标准差)(均为n = 7),半暗带缺血神经元密度评估结果也相似。相比之下,以300 mg/kg静脉给予非缺血SHR(n = 5),在70分钟观察期内皮质CBF增加约75%。我们得出结论,叠加在脑缺血上的血栓形成过程可能促进组织反应,抵消L-Arg的潜在有益作用,在提议将L-Arg用于局灶性血栓性中风的临床治疗时必须考虑这一注意事项。