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Orthostatic hypotension and cerebral small vessel disease: A systematic review 直立性低血压与脑小血管疾病:系统回顾
Pub Date : 2024-09-17 DOI: 10.1177/0271678x241283226
Julia HI Wiersinga, Frank J Wolters, Mike JL Peters, Hanneke FM Rhodius-Meester, Marijke C Trappenburg, Majon Muller
Orthostatic hypotension(OH) is highly prevalent in ageing populations and may contribute to cognitive decline through cerebral small vessel disease(CSVD). Research on the association between OH and CSVD is fragmented and inconsistent. We systematically reviewed the literature for studies assessing the association between OH and CSVD, published until December 1st 2023 in MEDLINE, PubMed or Web of Science. We included studies with populations aged ≥60, that assessed OH in relation to CSVD including white matter hyperintensities(WMH), lacunes and cerebral microbleeds. Modified JBI checklist was used to assess risk of bias. A narrative synthesis of the results was presented. Of 3180 identified studies, eighteen were included. Fifteen studies reported on WMH, four on lacunes, seven on microbleeds. Six of fifteen studies on WMH found that OH was related to an increased burden of WMH, neither longitudinal studies found associations with WMH progression. Findings were inconsistent across studies concerning lacunes and microbleeds. Across outcomes, adequate adjustment for systolic blood pressure tended to coincide with smaller effect estimates. Current evidence on the OH-CSVD association originates mostly from cross-sectional studies, providing inconsistent and inconclusive results. Longitudinal studies using standardized and fine-grained assessment of OH and CSVD and adequate adjustment for supine blood pressure are warranted.
直立性低血压(OH)在老年人群中非常普遍,可能会通过脑小血管疾病(CSVD)导致认知能力下降。有关OH与CSVD之间关系的研究既零散又不一致。我们系统地查阅了MEDLINE、PubMed或Web of Science上截至2023年12月1日发表的评估OH与CSVD之间关系的研究文献。我们纳入了年龄≥60岁人群的研究,这些研究评估了OH与CSVD的关系,包括白质高密度(WMH)、脑裂和脑微出血。评估偏倚风险时使用了修改后的 JBI 检查表。对研究结果进行了叙述性综合。在 3180 项已确定的研究中,有 18 项被纳入。其中 15 项研究报告了 WMH,4 项报告了裂隙,7 项报告了微出血。在15项关于WMH的研究中,有6项发现OH与WMH负担的增加有关,纵向研究均未发现与WMH进展有关。关于裂隙和微出血的研究结果不一致。在所有结果中,对收缩压的充分调整往往与较小的效应估计值相吻合。目前有关OH-CSVD相关性的证据主要来自横断面研究,结果不一致,也不确定。有必要进行纵向研究,对OH和CSVD进行标准化的精细评估,并对仰卧位血压进行适当调整。
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引用次数: 0
The relative associations of aortic and carotid artery stiffness with CeVD and cognition 主动脉和颈动脉僵化与心血管疾病和认知的相对关系
Pub Date : 2024-09-10 DOI: 10.1177/0271678x241281137
Caroline Robert, Lieng-Hsi Ling, Eugene SJ Tan, Narayanaswamy Venketasubramanian, Shir Lynn Lim, Lingli Gong, Josephine Lunaria Berboso, Arthur Mark Richards, Christopher Chen, Saima Hilal
We examined the relative associations of aortic and carotid artery stiffness with cerebrovascular disease (CeVD), cognition, and dementia subtypes in a memory clinic cohort of 272 participants (mean age = 75.4, SD = 6.8). We hypothesized that carotid artery stiffness would have greater effects on outcomes, given its proximate relationship to the brain. Aortic and carotid artery stiffness were assessed with applanation tonometry and carotid ultrasonography, respectively. CeVD markers included white matter hyperintensities (WMH), lacunes, cerebral microbleeds, cortical infarcts, and intracranial stenosis. Cognition was assessed by the Mini Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and a neuropsychological battery. Multivariable linear regression was conducted to determine associations of arterial stiffness with WMH and cognition, while logistic regression analysed associations with CeVD markers and dementia subtypes. Carotid artery stiffness z-score was associated with WMH, cortical infarcts, vascular cognitive impairment, and MMSE, independent of age, sex, education, vascular risk factors, and aortic stiffness z-score. Although aortic stiffness z-score was independently associated with cortical infarcts, this became non-significant after further adjusting for carotid artery stiffness z-score. We found that carotid artery stiffness had greater effects on CeVD, cognitive function and impairment in memory clinic patients compared to aortic stiffness.
我们在一个由 272 名参与者(平均年龄 = 75.4 岁,标码 = 6.8)组成的记忆诊所队列中,研究了主动脉和颈动脉僵化与脑血管疾病(CeVD)、认知能力和痴呆亚型的相对关联。我们假设,鉴于颈动脉与大脑的密切关系,颈动脉僵硬度会对结果产生更大的影响。主动脉和颈动脉僵硬度分别通过眼压计和颈动脉超声波检查进行评估。脑血管疾病标志物包括白质高密度(WMH)、裂隙、脑微出血、皮质梗塞和颅内狭窄。认知能力通过迷你精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)和神经心理测试进行评估。通过多变量线性回归确定动脉僵化与 WMH 和认知能力的关系,同时通过逻辑回归分析与 CeVD 标记和痴呆亚型的关系。颈动脉僵硬度z-分数与WMH、皮质梗塞、血管性认知障碍和MMSE相关,与年龄、性别、教育程度、血管风险因素和主动脉僵硬度z-分数无关。虽然主动脉僵硬度z-score与皮质梗死独立相关,但在进一步调整颈动脉僵硬度z-score后,这一点变得不显著。我们发现,与主动脉僵硬度相比,颈动脉僵硬度对CeVD、认知功能和记忆门诊患者的损伤有更大的影响。
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引用次数: 0
Detectability of white matter cerebral blood flow using arterial spin labeling MRI in patients with sickle cell disease: Relevance of flow territory, bolus arrival time, and hematocrit 利用动脉自旋标记磁共振成像检测镰状细胞病患者的脑白质血流:血流区域、血栓到达时间和血细胞比容的相关性
Pub Date : 2024-09-10 DOI: 10.1177/0271678x241270283
Wesley T Richerson, Megan Aumann, Alexander K Song, Jarrod J Eisma, Samantha Davis, Lauren Milner, Maria Garza, L Taylor Davis, Dann Martin, Lori C Jordan, Manus J Donahue
Sickle cell disease (SCD) is the most common genetic blood disorder, characterized by red cell hemolysis, anemia, and corresponding increased compensatory cerebral blood flow (CBF). SCD patients are at high risk for cerebral infarcts and CBF quantification is likely critical to assess infarct risk. Infarcts primarily localize to white matter (WM), yet arterial spin labeling (ASL) MRI, the most common non-invasive CBF approach, has poor WM CBF sensitivity owing to low WM CBF and long WM bolus arrival time (BAT). We hypothesize that anemia, and associated cerebral hyperemia, in SCD leads to improved WM detection with ASL. We performed 3-Tesla multi-delay pulsed ASL in SCD (n = 35; age = 30.5 ± 8.3 years) and control (n = 15; age = 28.7 ± 4.5 years) participants and applied t-tests at each inversion time within different flow territories, and determined which regions were significantly above noise floor (criteria: one-sided p < 0.05). Total WM CBF-weighted signal was primarily detectable outside of borderzone regions in SCD (CBF = 17.7 [range = 12.9–25.0] mL/100 g/min), but was largely unphysiological in control (CBF = 8.1 [range = 7.6–9.9)] mL/100 g/min) participants. WM BAT was reduced in SCD versus control participants (ΔBAT = 37 [range = 46–70] ms) and BAT directly correlated with hematocrit (Spearman’s-ρ = 0.62; p < 0.001). Findings support the feasibility of WM CBF quantification using ASL in SCD participants for appropriately parameterized protocols.
镰状细胞病(SCD)是最常见的遗传性血液疾病,以红细胞溶血、贫血和相应的代偿性脑血流(CBF)增加为特征。SCD 患者发生脑梗塞的风险很高,而 CBF 定量可能是评估脑梗塞风险的关键。脑梗塞主要发生在白质(WM),但动脉自旋标记(ASL)磁共振成像是最常见的无创 CBF 方法,但由于 WM CBF 低和 WM 药栓到达时间(BAT)长,对 WM CBF 的敏感性较差。我们假设,SCD 中的贫血及相关的脑充血会导致 ASL 对 WM 的检测能力提高。我们对 SCD 患者(n = 35;年龄 = 30.5 ± 8.3 岁)和对照组患者(n = 15;年龄 = 28.7 ± 4.5 岁)进行了 3-Tesla 多延迟脉冲 ASL 检测,并在不同血流区域的每个反转时间应用 t 检验,确定哪些区域明显高于噪声底(标准:单侧 p <0.05)。在 SCD(CBF = 17.7 [range = 12.9-25.0] mL/100 g/min)患者中,WM CBF 加权总信号主要在边界区以外的区域可检测到,但在对照组(CBF = 8.1 [range = 7.6-9.9] mL/100 g/min)患者中,CBF 加权总信号基本不符合生理状态。与对照组相比,SCD 患者的 WM BAT 减少(ΔBAT = 37 [range = 46-70] ms),且 BAT 与血细胞比容直接相关(Spearman's-ρ = 0.62; p < 0.001)。研究结果支持使用 ASL 对 SCD 参与者的 WM CBF 定量进行适当参数化方案的可行性。
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引用次数: 0
Microglia contact cerebral vasculature through gaps between astrocyte endfeet 小胶质细胞通过星形胶质细胞端瓣之间的间隙与脑血管接触
Pub Date : 2024-09-10 DOI: 10.1177/0271678x241280775
Gary P Morris, Catherine G Foster, Brad A Sutherland, Søren Grubb
The close spatial relationship between microglia and cerebral blood vessels implicates microglia in vascular development, homeostasis and disease. In this study we used the publicly available Cortical MM^3 electron microscopy dataset to systematically investigate microglial interactions with the vasculature. Our analysis revealed that approximately 20% of microglia formed direct contacts with blood vessels through gaps between adjacent astrocyte endfeet. We termed these contact points “plugs”. Plug-forming microglia exhibited closer proximity to blood vessels than non-plug forming microglia and formed multiple plugs, predominantly near the soma, ranging in surface area from ∼0.01 μm2 to ∼15 μm2. Plugs were enriched at the venule end of the vascular tree and displayed a preference for contacting endothelial cells over pericytes at a ratio of 3:1. In summary, we provide novel insights into the ultrastructural relationship between microglia and the vasculature, laying a foundation for understanding how these contacts contribute to the functional cross-talk between microglia and cells of the vasculature in health and disease.
小胶质细胞与脑血管之间密切的空间关系表明,小胶质细胞与血管的发育、平衡和疾病有关。在这项研究中,我们利用公开的皮质 MM^3 电子显微镜数据集系统地研究了小胶质细胞与血管的相互作用。我们的分析表明,大约 20% 的小胶质细胞通过相邻星形胶质细胞内膜之间的间隙与血管形成直接接触。我们将这些接触点称为 "塞"。与未形成塞子的小胶质细胞相比,形成塞子的小胶质细胞更接近血管,并形成多个塞子,主要在体节附近,表面积从 0.01 μm2 到 15 μm2 不等。插头富集在血管树的静脉端,显示出与内皮细胞接触的偏好,而与周细胞接触的比例为 3:1。总之,我们对小胶质细胞与血管之间的超微结构关系提出了新的见解,为了解这些接触如何有助于小胶质细胞与血管细胞在健康和疾病中的功能性交叉对话奠定了基础。
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引用次数: 0
Refined movement analysis in the Staircase test reveals differential motor deficits in mouse models of stroke 阶梯测试中的精细运动分析表明中风小鼠模型存在不同的运动障碍
Pub Date : 2024-05-15 DOI: 10.1177/0271678x241254718
Matej Skrobot, Rafael De Sa, Josefine Walter, Arend Vogt, Raik Paulat, Janet Lips, Larissa Mosch, Susanne Mueller, Sina Dominiak, Robert Sachdev, Philipp Boehm-Sturm, Ulrich Dirnagl, Matthias Endres, Christoph Harms, Nikolaus Wenger
Accurate assessment of post-stroke deficits is crucial in translational research. Recent advances in machine learning offer precise quantification of rodent motor behavior post-stroke, yet detecting lesion-specific upper extremity deficits remains unclear. Employing proximal middle cerebral artery occlusion (MCAO) and cortical photothrombosis (PT) in mice, we assessed post-stroke impairments via the Staircase test. Lesion locations were identified using 7 T-MRI. Machine learning was applied to reconstruct forepaw kinematic trajectories and feature analysis was achieved with MouseReach, a new data-processing toolbox. Lesion reconstructions pinpointed ischemic centers in the striatum (MCAO) and sensorimotor cortex (PT). Pellet retrieval alterations were observed, but were unrelated to overall stroke volume. Instead, forepaw slips and relative reaching success correlated with increasing cortical lesion size in both models. Striatal lesion size after MCAO was associated with prolonged reach durations that occurred with delayed symptom onset. Further analysis on the impact of selective serotonin reuptake inhibitors in the PT model revealed no clear treatment effects but replicated strong effect sizes of slips for post-stroke deficit detection. In summary, refined movement analysis unveiled specific deficits in two widely-used mouse stroke models, emphasizing the value of deep behavioral profiling in preclinical stroke research to enhance model validity for clinical translation.
准确评估中风后的功能障碍对转化研究至关重要。机器学习的最新进展提供了对啮齿动物卒中后运动行为的精确量化,但检测病变特异性上肢功能障碍的方法仍不明确。利用小鼠近端大脑中动脉闭塞(MCAO)和皮层光栓形成(PT),我们通过阶梯测试评估了中风后的障碍。我们使用 7 T-MRI 确定了病变位置。应用机器学习重建前爪运动轨迹,并使用新型数据处理工具箱 MouseReach 进行特征分析。病变重建精确定位了纹状体(MCAO)和感觉运动皮层(PT)的缺血中心。观察到了颗粒回收的改变,但与总体中风量无关。相反,在这两种模型中,前爪滑动和相对到达成功率与皮层病变大小的增加相关。MCAO 后纹状体病变的大小与伸手持续时间的延长有关,而伸手持续时间的延长又与症状发作的延迟有关。在 PT 模型中进一步分析选择性血清素再摄取抑制剂的影响发现,治疗效果并不明显,但在卒中后缺损检测中重复了滑动的强烈效应大小。总之,精细的运动分析揭示了两种广泛使用的小鼠中风模型的特定缺陷,强调了临床前中风研究中深度行为分析的价值,以提高模型的有效性,促进临床转化。
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引用次数: 0
Enlarged perivascular spaces in alcohol-related brain damage induced by dyslipidemia 血脂异常诱发酒精相关脑损伤的血管周围空间扩大
Pub Date : 2024-05-03 DOI: 10.1177/0271678x241251570
Han Liu, Lin Meng, Jiuqi Wang, Chi Qin, Renyi Feng, Yongkang Chen, Pei Chen, Qingyong Zhu, Mingming Ma, Junfang Teng, Xuebing Ding
Perivascular spaces (PVSs) as the anatomical basis of the glymphatic system, are increasingly recognized as potential imaging biomarkers of neurological conditions. However, it is not clear whether enlarged PVSs are associated with alcohol-related brain damage (ARBD). We aimed to investigate the effect of long-term alcohol exposure on dyslipidemia and the glymphatic system in ARBD. We found that patients with ARBD exhibited significantly enlargement of PVSs in the frontal cortex and basal ganglia, as well as a notable increased levels of total cholesterol (TC) and triglycerides (TG). The anatomical changes of the glymphatic drainage system mentioned above were positively associated with TC and TG. To further explore whether enlarged PVSs affects the function of the glymphatic system in ARBD, we constructed long alcohol exposure and high fat diet mice models. The mouse model of long alcohol exposure exhibited increased levels of TC and TG, enlarged PVSs, the loss of aquaporin-4 polarity caused by reactive astrocytes and impaired glymphatic drainage function which ultimately caused cognitive deficits, in a similar way as high fat diet leading to impairment in glymphatic drainage. Our study highlights the contribution of dyslipidemia due to long-term alcohol abuse in the impairment of the glymphatic drainage system.
血管周围间隙(PVS)是脑灌注系统的解剖学基础,越来越被认为是神经系统疾病的潜在成像生物标志物。然而,目前尚不清楚血管周围间隙增大是否与酒精相关脑损伤(ARBD)有关。我们的目的是研究长期酒精暴露对 ARBD 患者血脂异常和甘油三酯系统的影响。我们发现,ARBD 患者额叶皮层和基底节的 PVS 明显增大,总胆固醇(TC)和甘油三酯(TG)水平显著升高。上述甘油排泄系统的解剖学变化与 TC 和 TG 呈正相关。为进一步探讨PVSs增大是否会影响ARBD小鼠的甘液引流系统功能,我们建立了长期酒精暴露和高脂饮食小鼠模型。长期暴露于酒精的小鼠表现出 TC 和 TG 水平升高、PVSs 增大、反应性星形胶质细胞导致水蒸发蛋白-4 极性丧失以及甘液引流功能受损,最终导致认知障碍,这与高脂饮食导致甘液引流功能受损的情况类似。我们的研究强调了长期酗酒导致的血脂异常对甘油排泄系统的损害。
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引用次数: 0
Time-domain methods for quantifying dynamic cerebral blood flow autoregulation: Review and recommendations. A white paper from the Cerebrovascular Research Network (CARNet) 量化动态脑血流自动调节的时域方法:回顾与建议。脑血管研究网络(CARNet)白皮书
Pub Date : 2024-05-01 DOI: 10.1177/0271678x241249276
Kyriaki Kostoglou, Felipe Bello-Robles, Patrice Brassard, Max Chacon, Jurgen AHR Claassen, Marek Czosnyka, Jan-Willem Elting, Kun Hu, Lawrence Labrecque, Jia Liu, Vasilis Z Marmarelis, Stephen J Payne, Dae Cheol Shin, David Simpson, Jonathan Smirl, Ronney B Panerai, Georgios D Mitsis
Cerebral Autoregulation (CA) is an important physiological mechanism stabilizing cerebral blood flow (CBF) in response to changes in cerebral perfusion pressure (CPP). By maintaining an adequate, relatively constant supply of blood flow, CA plays a critical role in brain function. Quantifying CA under different physiological and pathological states is crucial for understanding its implications. This knowledge may serve as a foundation for informed clinical decision-making, particularly in cases where CA may become impaired. The quantification of CA functionality typically involves constructing models that capture the relationship between CPP (or arterial blood pressure) and experimental measures of CBF. Besides describing normal CA function, these models provide a means to detect possible deviations from the latter. In this context, a recent white paper from the Cerebrovascular Research Network focused on Transfer Function Analysis (TFA), which obtains frequency domain estimates of dynamic CA. In the present paper, we consider the use of time-domain techniques as an alternative approach. Due to their increased flexibility, time-domain methods enable the mitigation of measurement/physiological noise and the incorporation of nonlinearities and time variations in CA dynamics. Here, we provide practical recommendations and guidelines to support researchers and clinicians in effectively utilizing these techniques to study CA.
脑自动调节(CA)是一种重要的生理机制,可稳定脑血流(CBF)以应对脑灌注压(CPP)的变化。通过维持充足、相对恒定的血流供应,CA 在大脑功能中发挥着至关重要的作用。量化不同生理和病理状态下的 CA 对了解其影响至关重要。这些知识可作为临床决策的基础,尤其是在 CA 可能受损的情况下。CA 功能的量化通常涉及构建模型,以捕捉 CPP(或动脉血压)与 CBF 实验测量值之间的关系。除了描述正常的 CA 功能外,这些模型还提供了一种检测后者可能出现的偏差的方法。在此背景下,脑血管研究网络(Cerebrovascular Research Network)最近发布的一份白皮书重点介绍了传递函数分析(TFA),该方法可获得动态 CA 的频域估计值。在本文中,我们考虑使用时域技术作为替代方法。时域方法具有更高的灵活性,可以减轻测量/生理噪音,并将非线性和时间变化纳入 CA 动态分析。在此,我们将提供实用的建议和指南,以支持研究人员和临床医生有效利用这些技术来研究 CA。
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引用次数: 0
Dynamic neuroreceptor positron emission tomography in non-anesthetized rats using point source based motion correction: A feasibility study with [11C]ABP688 使用基于点源的运动校正技术对非麻醉大鼠进行动态神经受体正电子发射断层扫描:使用[11C]ABP688的可行性研究
Pub Date : 2024-04-29 DOI: 10.1177/0271678x241239133
Tina Kroll, Alan Miranda, Alexandra Drechsel, Simone Beer, Markus Lang, Alexander Drzezga, Pedro Rosa-Neto, Jeroen Verhaeghe, David Elmenhorst, Andreas Bauer
To prevent motion artifacts in small animal positron emission tomography (PET), animals are routinely scanned under anesthesia or physical restraint. Both may potentially alter metabolism and neurochemistry. This study investigates the feasibility of fully awake acquisition and subsequent absolute quantification of dynamic brain PET data via pharmacokinetic modelling in moving rats using the glutamate 5 receptor radioligand [11C]ABP688 and point source based motion correction. Five male rats underwent three dynamic [11C]ABP688 PET scans: two test-retest awake PET scans and one scan under anesthesia for comparison. Specific radioligand binding was determined via the simplified reference tissue model (reference: cerebellum) and outcome parameters BPND and R1 were evaluated in terms of stability and reproducibility. Test-retest measurements in awake animals gave reliable results with high correlations of BPND (y = 1.08 × −0.2, r = 0.99, p < 0.01) and an acceptable variability (mean over all investigated regions 15.7 ± 2.4%). Regional [11C]ABP688 BPNDs under awake and anesthetized conditions were comparable although in awake scans, absolute radioactive peak uptakes were lower and relative blood flow in terms of R1 was higher. Awake small animal PET with absolute quantification of neuroreceptor availability is technically feasible and reproducible thereby providing a suitable alternative whenever effects of anesthesia are undesirable, e.g. in sleep research.
为防止小动物正电子发射断层扫描(PET)中出现运动伪影,动物通常在麻醉或身体束缚状态下进行扫描。这两种方法都有可能改变新陈代谢和神经化学。本研究利用谷氨酸 5 受体放射性配体 [11C]ABP688 和基于点源的运动校正,对移动大鼠进行完全清醒采集,并通过药代动力学模型对动态脑 PET 数据进行绝对量化。五只雄性大鼠接受了三次动态[11C]ABP688 PET 扫描:两次测试-重复清醒 PET 扫描和一次麻醉下扫描以进行比较。通过简化的参考组织模型(参考:小脑)确定了特定的放射性配体结合,并评估了结果参数 BPND 和 R1 的稳定性和可重复性。清醒动物的重测结果可靠,BPND 的相关性高(y = 1.08 × -0.2, r = 0.99, p < 0.01),变异性可接受(所有研究区域的平均值为 15.7 ± 2.4%)。清醒和麻醉条件下的区域[11C]ABP688 BPND 具有可比性,尽管在清醒扫描中,放射性峰值吸收的绝对值较低,R1 的相对血流量较高。对神经受体可用性进行绝对量化的清醒小动物正电子发射计算机断层扫描在技术上是可行的,而且具有可重复性,因此在不希望麻醉影响的情况下(如睡眠研究),它是一种合适的替代方法。
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引用次数: 0
Endothelial lincRNA-p21 alleviates cerebral ischemia/reperfusion injury by maintaining blood-brain barrier integrity 内皮细胞 lincRNA-p21 通过维持血脑屏障完整性减轻脑缺血再灌注损伤
Pub Date : 2024-04-25 DOI: 10.1177/0271678x241248907
Yun-Hua Zhao, Yu Liang, Kang-Ji Wang, Sheng-Nan Jin, Xiao-Meng Yu, Qian Zhang, Jia-Yi Wei, Hui Liu, Wen-Gang Fang, Wei-Dong Zhao, Yuan Li, Yu-Hua Chen
Blood-brain barrier (BBB) disruption is increasingly recognized as an early contributor to the pathophysiology of cerebral ischemia/reperfusion (I/R) injury, and is also a key event in triggering secondary damage to the central nervous system. Recently, long non-coding RNA (lncRNA) have been found to be associated with ischemic stroke. However, the roles of lncRNA in BBB homeostasis remain largely unknown. Here, we report that long intergenic non-coding RNA-p21 (lincRNA-p21) was the most significantly down-regulated lncRNA in human brain microvascular endothelial cells (HBMECs) after oxygen and glucose deprivation/reoxygenation (OGD/R) treatment among candidate lncRNA, which were both sensitive to hypoxia and involved in atherosclerosis. Exogenous brain-endothelium-specific overexpression of lincRNA-p21 could alleviate BBB disruption, diminish infarction volume and attenuate motor function deficits in middle cerebral artery occlusion/reperfusion (MCAO/R) mice. Further results showed that lincRNA-p21 was critical to maintain BBB integrity by inhibiting the degradation of junction proteins under MCAO/R and OGD/R conditions. Specifically, lincRNA-p21 could inhibit autophagy-dependent degradation of occludin by activating PI3K/AKT/mTOR signaling pathway. Besides, lincRNA-p21 could inhibit VE-cadherin degradation by binding with miR-101-3p. Together, we identify that lincRNA-p21 is critical for BBB integrity maintenance, and endothelial lincRNA-p21 overexpression could alleviate cerebral I/R injury in mice, pointing to a potential strategy to treat cerebral I/R injury.
人们越来越认识到,血脑屏障(BBB)破坏是脑缺血/再灌注(I/R)损伤病理生理学的早期因素,也是引发中枢神经系统继发性损伤的关键事件。最近,人们发现长非编码 RNA(lncRNA)与缺血性中风有关。然而,lncRNA 在 BBB 平衡中的作用在很大程度上仍然未知。在这里,我们报告了长基因间非编码RNA-p21(lincRNA-p21)是人脑微血管内皮细胞(HBMECs)在缺氧和葡萄糖/复氧(OGD/R)处理后最显著下调的lncRNA,这些lncRNA既对缺氧敏感,又参与动脉粥样硬化。外源性脑内皮特异性过表达lincRNA-p21可缓解大脑中动脉闭塞/再灌注(MCAO/R)小鼠的BBB破坏、缩小梗死体积并减轻运动功能障碍。进一步的研究结果表明,在MCAO/R和OGD/R条件下,lincRNA-p21通过抑制连接蛋白的降解来维持BBB的完整性。具体来说,lincRNA-p21可通过激活PI3K/AKT/mTOR信号通路抑制自噬依赖的闭塞素降解。此外,lincRNA-p21还能通过与miR-101-3p结合抑制VE-cadherin降解。综上所述,我们发现lincRNA-p21对维持BBB完整性至关重要,而内皮lincRNA-p21的过表达可以减轻小鼠的脑I/R损伤,这为治疗脑I/R损伤提供了一种潜在的策略。
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引用次数: 0
An update on stem cell therapy for stroke patients: Where are we now? 中风患者干细胞疗法的最新进展:我们现在在哪里?
Pub Date : 2024-04-19 DOI: 10.1177/0271678x241227022
Jonah Gordon, Cesar V Borlongan
With a foundation built upon initial work from the 1980s demonstrating graft viability in cerebral ischemia, stem cell transplantation has shown immense promise in promoting survival, enhancing neuroprotection and inducing neuroregeneration, while mitigating both histological and behavioral deficits that frequently accompany ischemic stroke. These findings have led to a number of clinical trials that have thoroughly supported a strong safety profile for stem cell therapy in patients but have generated variable efficacy. As preclinical evidence continues to expand through the investigation of new cell lines and optimization of stem cell delivery, it remains critical for translational models to adhere to the protocols established through basic scientific research. With the recent shift in approach towards utilization of stem cells as a conjunctive therapy alongside standard thrombolytic treatments, key issues including timing, route of administration, and stem cell type must each be appropriately translated from the laboratory in order to resolve the question of stem cell efficacy for cerebral ischemia that ultimately will enhance therapeutics for stroke patients towards improving quality of life.
干细胞移植建立在20世纪80年代最初的工作基础之上,证明了脑缺血时的移植物存活能力。干细胞移植在促进存活、加强神经保护和诱导神经再生,同时减轻经常伴随缺血性中风的组织学和行为缺陷方面显示出巨大的前景。这些发现促成了一系列临床试验,这些试验充分证明了干细胞疗法对患者的安全性,但产生的疗效却不尽相同。随着临床前证据通过研究新细胞系和优化干细胞输送不断扩大,转化模型坚持基础科学研究建立的方案仍然至关重要。最近,干细胞作为标准溶栓疗法的辅助疗法,其使用方法发生了转变。为了解决干细胞对脑缺血的疗效问题,包括给药时间、给药途径和干细胞类型在内的关键问题都必须从实验室进行适当的转化,最终加强对中风患者的治疗,提高生活质量。
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引用次数: 0
期刊
Journal of Cerebral Blood Flow & Metabolism
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