颈交感神经干离断对局灶性脑缺血大鼠脑组织核因子-κB的影响
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摘要
研究目的是应用免疫组织化学染色观察核因子-κB (nuclear factor-kappa B, NF-κB)在局灶性脑缺血中的活性变化,并通过颈交感神经干离断(Transaction of cervical sympathetic trunk, TCST)作为干预手段,来探讨NF-κB和脑缺血损伤的关系,进一步明确TCST的作用机制。实验方法采用线栓法制作Wistar大鼠的永久性大脑中动脉闭塞(middle cerebral artery occlusion, MCAO)模型。以MCAO动物模型为基础,对其行TCST术来模拟人类的星状神经节阻滞(stellate ganglion block, SGB),观察TCST对实验动物一般状态及神经功能的影响;应用光镜观察各实验组大鼠术后各时间点(术后6h,12h,24h,48h)脑组织的形态学变化;采用免疫组织化学方法检测Wistar大鼠脑组织的海马CA1区NF-κB活化的情况。结果显示NF-κB在脑缺血后6小时核表达即开始增强,在24小时表达至高峰,之后下降;治疗组的NF-κB核表达明显低于模型组。颈交感神经干离断术可以显著改善局灶性脑缺血大鼠的一般状态,并且改善缺血病灶的病理学变化。得出结论:颈交感神经干离断可以明显改善缺血性脑卒中动物的一般状态,使缺血区的病理损伤得到改善,降低NF-κB的活化,减轻缺血及应激对脑组织的损伤,对局灶性脑缺血有保护作用,并提示TCST的这些作用可能是通过NF-κB介导的途径实现的。
Background and objective: As the development of Chinese economic and the improvement of living standards, the incidence of ischemic cerebrovascular disease has increased annually, has become the leading cause of death in Chinese population. It has became a serious threat to life and health of our people, and brought about many problems to patients, families and the society. Therefore, it is necessary to give treatment timely and effectively in the early stage of the disease. Given treatment timely and effectively has close relationship in reducing mortality and improving the prognosis of the disease.It has also been a hot issue. to domestic and foreign scholars
     Ischemic cerebrovascular disease is caused by various reasons: the disorder of blood supply to the brain vascular lead to hypoxia and necrosis occurred irreversible damage of the involved cerebral ischemia, and the corresponding signs and symptoms caused by neurological deficits. Clinical treatment methods are commonly used ,such as thrombolytic drugs, anticoagulation and interventional vascular expansion and so on. These methods are after long-term clinical application, has been confirmed that there is some scientific and use, but there are limitations. Therefore, domestic and foreign researchers have been exploring the onset of ischemic cerebrovascular disease a new treatment.
     Stellate ganglion block (SGB) is to inject of local anesthetic in the loose connective tissue nearby the stellate ganglion of the neck to block disposable head, face, neck, upper limbs and upper chest sympathetic approach. This method of sympathetic blockade in these areas inhibit the control of cardiovascular exercise, glandular secretion, muscle tension, bronchial contraction and the conduction of pain nerve fibers. Thus, stellate ganglion block can correct circulation disturbance, hyperalgesia, abnormal sweating and other changes of the organs, which are caused by the hyperexcitability of sympathetic nerve. In recent years, this method was multi used in clinical treatment of ischemic cerebrovascular disease. It can improve the blood vessel spasm or dilated abnormal activities notably, and make the vessel stable. It also can reduce the edema of the vessel, have the anti-inflammatory effect, block the pain transmission of the sympathetic nerve. The specific mechanisms of this method is also reported at internal and abroad, and it mainly focus on increasing the flow speed of brain blood faster, reducing stress reaction, regulating the immune system and so on.
     The purpose of this study is to research the activation of nuclear factor-kappa B (NF-κB) and the regularity of the activation after focal ischemic damage in rats, and investigate the effect of transection of cervical sympathetic trunk (TCST) that can simulate the way human SGB to the levels of NF-κB activation in focal cerebral ischemia in rats brain.
     Methods: In this study, male Wistar rats were selected randomly and divided into 3 groups: sham operation group (S group), MCAO model group (M group), TCST treatment group (T group). According the embolizated time the rats were divided into 4 different subgroups randomly.There were 6 hours, 12 hours, 24 hours, 48 hours.The animals of S group as a sham control group; the animals of M group as MCAO model; The rats of T group break away from the ipsilateral sympathetic trunk in the MCAO model produced at same time. Detected the activation of NF-κB in the hippocampus of rat brain after middle cerebral artery occlusion time course point M group and T group by immunohistochemistry Also, observed the general state of animals and brain morphological change of the rats which the cervical sympathetic trunk off.
     Results: The results showed that the general condition and neurological deficit score: S awake rats after general anesthesia in good condition, M rats, poor general state, T group, though not of the general state of S rats, but better than the M group in large good general state of rats. T group simultaneous ipsilateral ptosis, eye fission small, miosis and other typical signs of Horner's syndrome; S group showed no neurological deficit or signs of Horner's syndrome. M group and T group rats after consciousness from anesthetizing were showing neurological impairment. M group compared with the S group, p <0.01, significant difference between the two groups, M group of neurological deficit scores were significantly higher than the S group; T group compared with the M group, p> 0.05, between the two groups of nerve impairment scores showed no difference. under the light microscope observe the microtome section of the rat brain which dyeing by hematoxylin-eosin staining, the infarcted area locate in the caudate nucleus, putamen, anterior and lateral hypothalamus, hippocampus CA1, CA2, CA3 area mostly. The changes of hippocampal CA1 neurons showed: Neurons of S group are more closely arranged neatly, the cells complete; under the high-power lens, the nuclei are large and round, and the nucleoli are prominent. The neurons of S groups subgroups are similar. The neurons in 6h subgroups of M group became swelling. No significant change in the number of neurons. after cerebral ischemia 24h, the number of neurons began to decrease, and the cell became degenerating. The cells of T group have been changes in ischemic pathology in the corresponding point in time there, but comparing with the M group, the pathological manifestations is lighter. Observed the expression of NF-κB under light microscope by immunohistochemical staining, the cytoplasm of cells showed positive, the nucleus stained yellow; negative cells showed only cytoplasmic stained yellow. The expression of NF-κB began to increase in the nuclear after 6 hours of cerebral ischemia, the expression increase to peak after 24 hours, then gradually reduced. The nuclear expression of NF-κB in the T group was significantly lower than the M group.
     Conclusions: The experimental results show that the infarct region mainly in the caudate nucleus, putamen, anterior and lateral hypothalamus, hippocampus CA1, CA2, CA3 area. The activation of NF-κB enhance after focal cerebral ischemia, and reach the peak after 24 hours. According analysis and comparison the result between the TCST group and the MCAO group, we found that transection of cervical sympathetic trunk of ischemic stroke can significantly improve the general state of animals, improve the pathological ischemic injury, decrease activation of NF-κB and reduce the stress on the brain ischemia and tissue injury, protect the brain.
引文
[1]吴兆苏,姚崇华,赵冬.我国人群脑卒中发病率、死亡率的流行病学研究[J].中华流行病学杂志, 2003, 24(3): 236-239.
    [2] Shiraishi K, Otssuki M, Tase C, et al. The effects of cervical sympathectomy on the pituitary and pineal endocrine system [J]. Masui, 1998, 47(10): 1187-1192.
    [3] Sen R, Baltimore D. Multiple nuclear factors interact with the immunoglobulin enhancer sequences[J]. Cell, 1986, 6:705-716.
    [4] Lee J I, Burckart G J. Nuclear factor kappa B: important transcription factor and therapeutic target[J]. Clin Pharmacol, 1998, 38 (11): 981.
    [5] Lang V, Janzen J, Fischer GZ, et al. BetaTrCP-mediated proteolysis of NF-κB1 p105 requires phosphorylation of p105 serines 927 and 932[J]. Mol Cell Biol, 2003, 23: 402- 413.
    [6] Amir RE, Iwai K, Ciechanover A. The NEDD 8 pathway is essential for SCF (β- TrCP) -mediated ubiquitination and processing of the NF-κB precursor p105[J]. J Biol Chem, 2002, 277: 23253-23259.
    [7] Chen ZJ. Ubiquitin signalling in the NF-kappaB pathway[J]. Nat Cell Biol, 2005, 7: 758-765.
    [8] Schmitz ML, Bacher S, KrachtM. IκB-independent control ofNF-κB activity by modulatory phosphorylations[J]. Trends Biochem Sci, 2001, 26: 186-190.
    [9] Oneill LA, Kaltschmidt C. NF-κB, a crucial tran-scription factor for glial and neuronal cell function[J].Trends Neurosci, 1997, 20(6): 252-258.
    [10] Ghosh G.. NF-κB and Rel Proteins: Evolutionarily Conserved Mediators of the Immune Response [J]. Annu Rev Immunol, 2006, 16 (4): 225-260.
    [11] Hinz M, Krappmann D, Eichten A, et al. NF-κB function in growth control: regulation of cyclin Dl expression and G0/G1-to-S-phase transition[J]. Mol Cell Biol, 1999, 19(4): 2690-2698.
    [12]王拥军,何芳,李小玲.白藜芦醇对实验性脑缺血的保护作用[J].中华医学杂志, 2003, 83: 534-536.
    [13] Stephenson D, Yin T Smalstig EB, et al. Transcription factor nuclear factor-kappa B is activated in neurons after focal cerebbral ischemia[J]. Cereb Blood Flow Metab, 2000, 20(3): 592-603.
    [14] Nurmi A, Lindsberg PJ, Koistinaho M, et al. Nuclear factor-kappa B contributes to infarction after permanent focal ischemia[J]. Stroke, 2004, 35(4): 987-991.
    [15] Diane S, Stephenson DT, Smalsting EB, et al. Global ischemia activates nuclear factor-kappa B in forebrain neurons of rats[J]. Stroke, 1997, 28: 1073-1080.
    [16] Zhang W, Potrovita I, Tarabin V, et al. Neuronal activation of NF-κB contributes to cell death in cerebral ischemia[J]. Cereb Blood Flow Metab, 2005, 25: 30-40.
    [17] Schneider A, Martin-Villalba A, Weih F, et al. NF-κB is activated and promotes cell death in focal cerebral ischemia[J]. Nature Med, 1999, 5: 554-559.
    [18] Seegers H, Grillon E, Trioullier Y, et al. Nuclear factor-kappa B activation in permanent intraluminal focal cerebral ischemia in the rat[J]. Neurosci Lett, 2000, 288(3): 241-245.
    [19]邢雪松,吕威力,张国斌.降钙素基因相关肤和神经生长因子对脑缺血再灌注大鼠海马及顶叶皮质神经元凋亡及核因子-κB表达的调节[J].解剖学杂志, 2007, 30(3): 320-322.
    [20] Pereira MP, Hurtado O, Cardenas A, et al. The nonthiazolidinedione PPAR- gamma agonist L-796, 449 is neuroprot active in experimental stroke[J]. Neuropathol Exp Neurol, 2005, 64: 797-805.
    [21] Carroll JE, Howard EF, Hess DC, et al. Nuclear factor-kappa B activation during cerebral reperfusion effect of attenuation with N-acetylcysteine treatment [J]. Brain Res Mol Brain Res, 1998, 56(122): 186-191.
    [22] Howard E, Chen O, Cheng C, et al. NF-kappa B is activated and ICAM-1 gene expression is upregulated during reoxygenation ofhuman brain endot helial cells[J]. Neurosci Lett, 1998, 248(3): 199-203.
    [23] Shen WH, Zhang CY, Zhang GY, et al. Antioxidants attenuate reperfusion injury after global brain ischemia through inhibiting nuclear factor-kappa B activity in rats[J]. Acta Pharmacol Sin, 2003, 24: 1125-1130.
    [24] Dohlen G, Carlsen H, Blomhoff R, et al. Reoxygenation of hypoxic mice with 100% oxygen induces brain nuclear factor–kappa B[J]. Pediatr Res, 2005, 58: 941-945.
    [25]徐江,黄晓琳.高压氧对脑缺血再灌注大鼠核因子-κB及细胞间粘附分子-1表达的影响[J].中华物理医学与康复杂志, 2005, 27: 259-262.
    [26] Zhu Y, Culmsee C, Klumpp S, et al. Neuroprotection by transforming growth factor-beta1 involves activation of nuclear factor-kappa B through phosphatidy- linositol-3-OH kinase/ Akt and mitogen- activated protein kinase- extracellular signal regulated kinase1, 2 signaling pathways[J]. Neuroscience, 2004, 123(4): 897-906.
    [27] Schneider A, Martin-Villalba A. NF-kappa B is activated and promoes cell death in focal cerebral ischemia[J]. Nat Med, 1999, 5 (5): 554-559.
    [28] Yu ZF, Zhou D, Bruce AJ , et al .Lack of the p50 subunit of NF-κBincreases the vulnerability of hippocampal neurons to excitotoxic injury[J]. Neurosci, 1999, 19 (20): 8856-8865
    [29] Clemens JA, Stephenson DT, Yin T, et al. Drug-induced neuroprotection from global ischemia is associated with prevention of persistent but not transient activation of nuclear factor-κB in rats [J]. Stroke, 1998, 29: 677-682.
    [30] Zea Longa El, Weinstein PR, Carson S, et al. Reversible middle cerebral artery occlusion without craniectomy in rats[J]. Stroke, 1989, 20(1): 84-89.
    [31] Kuge Y, Minematsu K, Yamaguchi T, et al. Nylon monofilament for intraluminal middle cerebral artery occlusion in rats[J]. Stroke, 1995, 26 (9): 1655-1658.
    [32] Koizumi J, Minematsu K, Yamaguchi T, et al. Experimental studies of ischemic brain edema: A new experimental model of cerebral embolism in rats in which recirclation can be introduced in the ischemia area [J]. Stroke, 1986, 8: 1.
    [33] Belayev L, Alonso OF, Busto R, et. Middle cerebral artery occlusion in the rat by intraluminal suture. Neurological and pathological evaluation of an improved modle [J]. Stroke, 1996, 27(9): 1616-1622.
    [34]石丽宏,邓海峰,王海丽.星状神经节阻滞治疗脑梗死36例疗效观察[J].中国康复理论与实践, 2008, 14(12): 1168-1169.
    [35]邱继忠,温德伟,李艳娟,等.星状神经节阻滞治疗脑梗死后遗症32例[J].中国临床康复, 2003, 7(2): 283.
    [36]蔡明,楚敏,童玉玲,等.星状神经节阻滞加运动再学习对脑梗死患者功能康复的影响[J].中国康复医学杂志, 2007, 22(3): 217.
    [37]赵丽,李建霞,吴学英,等.星状神经节阻滞联合早期康复训练治疗脑卒中后吞咽障碍[J].现代中西医结合杂志, 2009, 18(9): 1006-1007.
    [38]韦立莲.水突穴注射合用星状神经节阻滞对脑卒中后吞咽障碍的影响[J].中国临床康复, 2005, 9(9): 106-107.
    [39]全守波,王清秀,杨光,等.星状神经节阻滞对全脑缺血再灌注家兔循环和呼吸的影响[J].卒中与神经疾病, 2002, 9(2): 89-92.
    [40]全守波,王清秀,刘菊英,等.星状神经节阻滞对全脑缺血再灌注损伤家兔血清白介素6含量的影响[J].郧阳医学院学报, 2003, 22(6): 321-323.
    [41]全守波,王清秀,刘菊英,等.星状神经节阻滞对全脑缺血再灌注损伤家兔海马及颞叶皮质热休克蛋白70表达的影响[J].中国麻醉学杂志, 2004, 24(2): 133-137.
    [42]熊良志,王清秀,周青山,等.星状神经节阻滞对兔脑缺血再灌注期血清白细胞介素8的影响[J].中国临床康复, 2005, 9(10): 98-99.
    [43]熊良志,王清秀,周青山,等.星状神经节阻滞对全脑缺血再灌注后家兔海马CA1区Bax及Bcl-2表达的影响[J].中国临床康复, 2006, 10(14): 105-107.
    [44]李兴志,董莹,任丽娟,等.颈交感干离断对局灶性脑缺血大鼠生存率影响的实验研究[J].中风与神经疾病杂志, 2006, 23(4): 436-438.
    [45]董莹.颈交感干离断对局灶性脑缺血大鼠脑组织病理学及HSP70的影响[D].长春:吉林大学第一临床医学院, 2007.
    [46]李兴志,张鉴栩,卢晓维,等.颈交感干离断对局灶性脑缺血大鼠血浆中降钙素基因相关肽的影响[J].中国康复医学杂志, 2008, 23(3): 216-218.
    [47]李兴志.颈交感干离断对局灶性脑缺血大鼠脑保护作用的机理研究[D].长春:吉林大学第一临床医学院, 2007.
    [48]熊良志,周青山,王燕,等.颈交感神经干离断对局灶性脑缺血再灌注后大鼠海马iNOS表达的影响[J].卒中与神经疾病, 2008, 15(3): 142-144.

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