국소 허혈성 뇌졸중 후 조직 플라즈미노겐 활성제를 투여한 당뇨쥐에서의 미세혈관반응
Microvascular Response Following Focal Cerebral Ischemia in Diabetic Rats Treated with Tissue Plasminogen Activator
0
조회
0
다운로드
0
인용
0
참고문헌
초록
Background: Diabetes mellitus (DM) or hyperglycemia is known to be associated with increased risk of intracranial hemor-rhage in acute stroke patients who are treated with IV tissue-type plasminogen activator (tPA). However, the underlying mechanism remains unknown. We tested the hypothesis that different expression of matrix metalloproteinase (MMP) and occludin in DM play a role in increased risk of hemorrhages in DM by using a diabetic rat model. Methods: DM was induc-ed in Spargue Dawley rats by using injection of streptozotocin (60 mg/kg) and harvesting for 20 weeks. Focal cerebral ischemia was induced by occlusion of the middle cerebral artery occlusion (MCAO) for 2 hours and then reperfusion for 18 hours by using a nylon thread. tPA (10 mg/kg) or normal saline was infused via the femoral vein. Spectrophotometry, western blot and zymography were performed to measure the amount of hemorrhages, levels of occludin (tight junction protein) and activity of matrix metalloproteinase (MMP)-2 and MMP-9, respectively. Results: Mortality was significantly higher in diabetic rats. In surviving rats, hemorrhagic amounts and levels of cerebral occludin were not different between diabetic and nondiabetic rats, and tPA-infused and normal saline-infused rats. Although MMP-9 were higher in ischemic groups (P=0.001), their activities were not changed in diabetic or tPA-treated rats. Conclusion: Occludin and MMP may not play a major role in increasing the risk of hemorrhage in diabetic rats. (Korean J Stroke 2009;11:82-87)
Abstract
Background: Diabetes mellitus (DM) or hyperglycemia is known to be associated with increased risk of intracranial hemor-rhage in acute stroke patients who are treated with IV tissue-type plasminogen activator (tPA). However, the underlying mechanism remains unknown. We tested the hypothesis that different expression of matrix metalloproteinase (MMP) and occludin in DM play a role in increased risk of hemorrhages in DM by using a diabetic rat model. Methods: DM was induc-ed in Spargue Dawley rats by using injection of streptozotocin (60 mg/kg) and harvesting for 20 weeks. Focal cerebral ischemia was induced by occlusion of the middle cerebral artery occlusion (MCAO) for 2 hours and then reperfusion for 18 hours by using a nylon thread. tPA (10 mg/kg) or normal saline was infused via the femoral vein. Spectrophotometry, western blot and zymography were performed to measure the amount of hemorrhages, levels of occludin (tight junction protein) and activity of matrix metalloproteinase (MMP)-2 and MMP-9, respectively. Results: Mortality was significantly higher in diabetic rats. In surviving rats, hemorrhagic amounts and levels of cerebral occludin were not different between diabetic and nondiabetic rats, and tPA-infused and normal saline-infused rats. Although MMP-9 were higher in ischemic groups (P=0.001), their activities were not changed in diabetic or tPA-treated rats. Conclusion: Occludin and MMP may not play a major role in increasing the risk of hemorrhage in diabetic rats. (Korean J Stroke 2009;11:82-87)
참고문헌 (27)
- "Tissue plasminogen activator for acute ischemic stroke. The National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group", N Engl J Med, 333, pp.1581~1587 (1995)
- Lee KY, "Sequential combination of intravenous recombinant tissue plasminogen activator and intra-arterial urokinase in acute ischemic stroke", AJNR Am J Neuroradiol, 25, pp.1470~1475 (2004)
- Hacke W, "Intravenous thrombolysis with recombinant tissue plasminogen activator for acute hemispheric stroke. The European Cooperative Acute Stroke Study (ECASS)", JAMA, 274, pp.1017~1025 (1995)
- "Intracerebral hemorrhage after intravenous t-PA therapy for ischemic stroke. The NINDS t-PA Stroke Study Group", Stroke, 28, pp.2109~2118 (1997)
- Larrue V, "Hemorrhagic transformation in acute ischemic stroke. Potential contributing factors in the European Cooperative Acute Stroke Study", Stroke, 28, pp.957~960 (1997)
- Capes SE, "Stress hyperglycemia and prognosis of stroke in nondiabetic and diabetic patients: a systematic overview", Stroke, 32, pp.2426~2432 (2001)
- Bruno A, "Acute blood glucose level and outcome from ischemic stroke. Trial of ORG 10172 in Acute Stroke Treatment (TOAST) Investigators", Neurology, 52, pp.280~284 (1999)
- Kent TA, "Fabian RH. Heterogeneity affecting outcome from acute stroke therapy: making reperfusion worse", Stroke, 32, pp.2318~2327 (2001)
- Demchuk AM, "Serum glucose level and diabetes predict tissue plasminogen activator-related intracerebral hemorrhage in acute ischemic stroke", Stroke, 30, pp.34~39 (1999)
- Els T, "Hyperglycemia in patients with focal cerebral ischemia after intravenous thrombolysis: influence on clinical outcome and infarct size", Cerebrovasc Dis, 13, pp.89~94 (2002)
- Hamann GF, "Hemorrhagic transformation and microvascular integrity during focal cerebral ischemia", reperfusion, 1996, pp.16, 1373~1378
- Heo JH, "Matrix metalloproteinases increase very early during experimental focal cerebral ischemia", J Cereb Blood Flow Metab, 19, pp.624~633 (1999)
- Heo JH, "Increase in plasma matrix metalloproteinase-9 in acute stroke patients with thrombolysis failure", Stroke, 34, pp.48~50 (2003)
- Korninger C, "Studies on the specific fibrinolytic effect of human extrinsic (tissue-type) plasminogen activator in human blood and in various animal species in vitro", Thromb Haemost, 46, pp.561~565 (1981)
- Choudhri TF, "Use of a spectrophotometric hemoglobin assay to objectively quantify intracerebral hemorrhage in mice", Stroke, 28, pp.2296~2302 (1997)
- Asahi M, "Reduction of tissue plasminogen activator-induced hemorrhage and brain injury by free radical spin trapping after embolic focal cerebral ischemia in rats", J Cereb Blood Flow Metab, 20, pp.452~457 (2000)
- Latour LL, "Early blood-brain barrier disruption in human focal brain ischemia", Ann Neurol, 56, pp.468~477 (2004)
- del Zoppo GJ, "Ischaemic damage of brain microvessels: inherent risks for thrombolytic treatment in stroke", J Neurol Neurosurg Psychiatry, 65, pp.1~9 (1998)
- Rosenberg GA, "Proteolytic cascade enzymes increase in focal cerebral ischemia in rat", J Cereb Blood Flow Metab, 16, pp.360~366 (1996)
- Lapchak PA, "Metalloproteinase inhibition reduces thrombolytic (tissue plasminogen activator)-induced hemorrhage after thromboembolic stroke", Stroke, 31, pp.3034~3040 (2000)
- Sumii T, "Involvement of matrix metalloproteinase in thrombolysis- associated hemorrhagic transformation after embolic focal ischemia in rats", Stroke, 33, pp.831~836 (2002)
- Montaner J, "Matrix metalloproteinase expression is related to hemorrhagic transformation after cardioembolic stroke", Stroke, 32, pp.2762~2767 (2001)
- Montaner J, "Matrix metalloproteinase-9 pretreatment level predicts intracranial hemorrhagic complications after thrombolysis in human stroke", Circulation, 107, pp.598~603 (2003)
- Jin M, "Matrix metalloproteinases in human diabetic and nondiabetic vitreous", Retina, 21, pp.28~33 (2001)
- Uemura S, "Diabetes mellitus enhances vascular matrix metalloproteinase activity: role of oxidative stress", Circ Res, 88, pp.1291~1298 (2001)
- Nedergaard M, "Transient focal ischemia in hyperglycemic rats is associated with increased cerebral infarction", Brain Res, 408, pp.79~85 (1987)
- Cellek S, "Nitrergic neurodegeneration in cerebral arteries of streptozotocin-induced diabetic rats: a new insight into diabetic stroke", Diabetes, 54, pp.212~219 (2005)
