Marzatico F, Gaetani P, Tartara F, Bertorelli L, Feletti F, Adinolfi D, Tancioni F, Rodriguez y Baena R
Institute of Pharmacology, IRCCS Policlinico S. Matteo, University of Pavia, Italy.
Life Sci. 1998;63(10):821-6. doi: 10.1016/s0024-3205(98)00338-5.
The antiproteasic activity of alpha1-antitrypsin (alpha1-AT) is reduced in cases of subarachnoid hemorrhage from ruptured intracranial aneurysm and particularly in patients currently smoking; alpha1-AT is very sensitive to oxidant agents. About 50% of physiological anti-oxidant systemic capacity is represented by Vitamin A, E and C. Plasmatic amounts of alpha1-AT, alpha1-AT Collagenase Inhibitory Capacity (CIC) and levels of vitamin A, vitamin E and vitamin C were analyzed in 39 patients, 26 women and 13 men, operated for intracranial aneurysm; 11 patients with unruptured intracranial aneurysm were considered as controls while 28 patients were included within 12 hours from subarachnoid hemorrhage (SAH). Plasmatic levels of vitamin A and vitamin E were significantly lower (p=0.038 and p=0.0158) in patients suffering SAH than in controls, while no statistically significant differences were found in mean plasmatic vitamin C levels. Level of alpha1-AT was not statistically different in controls and in patients with SAH; however, the activity of alpha1-AT, evaluated as CIC, is significantly reduced in patients with SAH (p=0.019). We have observed that systemic plasmatic levels of vitamins did not significantly differ in relation to smoking habit. Vitamin A and E represent an important defensive system against free radicals reactions. Particularly, vitamin E acts as an antioxidant by scavenging free-radicals. A reduced anti-oxidant status might be related to the higher sensibility of alpha1-AT to oxidative reactions and the activity of alpha1-AT is dependent on the antioxidant capacity of liposoluble vitamins. We can speculate that an acute systemic oxidative stress condition might influence the rupture of intracranial aneurysms.
在颅内动脉瘤破裂引起的蛛网膜下腔出血病例中，尤其是目前仍在吸烟的患者，α1-抗胰蛋白酶（α1-AT）的抗蛋白酶活性降低；α1-AT对氧化剂非常敏感。维生素A、E和C代表了约50%的生理抗氧化系统能力。对39例颅内动脉瘤手术患者（26例女性和13例男性）的血浆α1-AT、α1-AT胶原酶抑制能力（CIC）以及维生素A、维生素E和维生素C水平进行了分析；11例未破裂颅内动脉瘤患者作为对照，28例蛛网膜下腔出血（SAH）患者在出血后12小时内纳入研究。SAH患者的血浆维生素A和维生素E水平显著低于对照组（p = 0.038和p = 0.0158），而血浆维生素C平均水平未发现统计学显著差异。对照组和SAH患者的α1-AT水平无统计学差异；然而，以CIC评估的α1-AT活性在SAH患者中显著降低（p = 0.019）。我们观察到，维生素的全身血浆水平与吸烟习惯无显著差异。维生素A和E代表了对抗自由基反应的重要防御系统。特别是，维生素E通过清除自由基起到抗氧化作用。抗氧化状态降低可能与α1-AT对氧化反应的更高敏感性有关，且α1-AT的活性取决于脂溶性维生素的抗氧化能力。我们可以推测，急性全身氧化应激状态可能会影响颅内动脉瘤的破裂。
