Bednar M M, Gross C E, Russell S R, Short D, Giclas P C
Department of Surgery, Vermont Center for Vascular Research, University of Vermont, Burlington, USA.
J Neurosurg. 1997 Jan;86(1):139-42. doi: 10.3171/jns.1997.86.1.0139.
Although complement activation is associated with tissue injury during inflammatory and ischemic states, complement activation in states of acute cerebral ischemia before and after administration of tissue plasminogen activator (TPA) has not yet been examined and is the focus of this investigation. Twenty-four New Zealand White rabbits weighing 3 to 3.5 kg were used for this study. Of these, 20 were subjected to intracranial autologous clot embolization via the internal carotid artery. Three hours postembolization, rabbits received an intravenous infusion of TPA (6.3 mg/kg, 20% bolus with the remainder infused over a 2-hour interval; 12 animals) or vehicle (eight animals). All animals were observed for a total of 7 or 8 hours postembolization. These two groups were compared to a cohort undergoing sham operation with subsequent TPA infusion (four animals). Plasma samples to quantify complement component C5 hemolytic activity (C5H5O) were obtained at the following time points: 30 minutes before and after clot embolization; 1 hour before and 1 hour after the initiation of therapy with TPA or vehicle and at the completion of the protocol; 7 to 8 hours after clot embolization. The C5 activation was not detected as the result of acute cerebral ischemia. However, animals receiving TPA with or without concomitant clot embolization exhibited C5 activation as assessed by a reduction in C5 hemolytic function, both 1 hour after initiation of TPA infusion (78.7 +/- 10.3% and 77.5 +/- 9.9% of baseline value, respectively; mean +/- standard error of the mean [SEM]) and at the end of the protocol, 2 hours after the completion of the TPA infusion (72.5 +/- 8.8% and 53.3 +/- 8.1%, respectively; mean +/- SEM, p < 0.05, each group). This study supports the conclusion that TPA, but not acute cerebral ischemia, may activate the complement cascade in this rabbit model of thromboembolic stroke.
尽管补体激活与炎症和缺血状态下的组织损伤相关,但在组织型纤溶酶原激活剂(TPA)给药前后的急性脑缺血状态下,补体激活情况尚未得到研究,而这正是本研究的重点。本研究使用了24只体重为3至3.5千克的新西兰白兔。其中,20只通过颈内动脉进行颅内自体血栓栓塞。栓塞后3小时,兔子接受静脉输注TPA(6.3毫克/千克,20%推注,其余在2小时间隔内输注;12只动物)或赋形剂(8只动物)。所有动物在栓塞后共观察7或8小时。将这两组与一组接受假手术并随后输注TPA的动物(4只)进行比较。在以下时间点采集血浆样本以定量补体成分C5溶血活性(C5H5O):血栓栓塞前后30分钟;开始用TPA或赋形剂治疗前1小时、治疗后1小时以及实验结束时;血栓栓塞后7至8小时。急性脑缺血未检测到C5激活。然而,接受TPA治疗(无论是否伴有血栓栓塞)的动物,在开始输注TPA后1小时(分别为基线值的78.7±10.3%和77.5±9.9%;平均值±平均标准误差[SEM])以及在TPA输注完成后2小时即实验结束时(分别为72.5±8.8%和53.3±8.1%;平均值±SEM,每组p<0.05),通过C5溶血功能降低评估显示出C5激活。本研究支持以下结论:在这个血栓栓塞性中风的兔子模型中,可能是TPA而非急性脑缺血激活了补体级联反应。