Article(id=1198558111163319242, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558106218230069, articleNumber=null, orderNo=null, doi=10.11855/j.issn.0577-7402.0848.2023.1227, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1687104000000, receivedDateStr=2023-06-19, revisedDate=null, revisedDateStr=null, acceptedDate=1690473600000, acceptedDateStr=2023-07-28, onlineDate=1763688121834, onlineDateStr=2025-11-21, pubDate=1727452800000, pubDateStr=2024-09-28, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763688121834, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763688121834, creator=13701087609, updateTime=1763688121834, updator=13701087609, issue=Issue{id=1198558106218230069, tenantId=1146029695717560320, journalId=1189873630562394117, year='2024', volume='49', issue='9', pageStart='977', pageEnd='1098', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=0, createTime=1763688120655, creator=13701087609, updateTime=1763689155065, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198562444915339352, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558106218230069, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198562444915339353, tenantId=1146029695717560320, journalId=1189873630562394117, issueId=1198558106218230069, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1055, endPage=1061, ext={EN=ArticleExt(id=1198558111394005969, articleId=1198558111163319242, tenantId=1146029695717560320, journalId=1189873630562394117, language=EN, title=Therapeutic effect and its mechanism of dexmedetomidine on the rat model of perioperative stroke, columnId=1190310110212751762, journalTitle=Medical Journal of Chinese People’s Liberation Army, columnName=Basic Research, runingTitle=null, highlight=null, articleAbstract=

Objective To investigate the effect of dexmedetomidine (Dex) on the rat model of perioperative stroke and its mechanism. Methods One hundred male rats were randomly divided into sham group , middle cerebral artery occlusion (MCAO) group, low dose Dex [Dex-L, 0.5 μg/(kg·h)] group, medium dose Dex [Dex-M, 2 μg/(kg·h)] group, high dose Dex [Dex-H, 10 μg/(kg·h)] group, 20 rats in each group. A rat model of perioperative stroke was established by middle cerebral artery occlusion. Dex was injected intravenously at different doses during ischemia. After 24 h, the neurological function of the rats was evaluated. Then, the rats were sacrificed and the peripheral blood and whole brain tissue were collected, ischemic core area tissue was separated from some brain tissues and the cerebral infarction area was observed by TTC staining. The inflammatory cytokine contents in serum and ischemic core area were measured by ELISA. In addition, the expressions of formyl peptide receptor 1 (FPR1), transmembrane protein 119 (TMEM119), CD31 and VE-cadherin proteins were assayed by immunofluorescence, and the expressions of FPR1, nuclear factor-κB (NF-κB) and NLRP3 proteins by Western blotting in the ischemic core area. Results Compared with sham group, the proportion of cerebral infarction area and neurological scores in the MCAO group were significantly increased, and the contents of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α in the serum and the ischemic core area were significantly increased, the expressions of FPR1, TMEM119, p-NF-κB, NLRP3, CD31 and VE-cadherin in the ischemic core were significantly increased(P<0.001), and there was obvious co-expression of FPR1 and TMEM119. Compared with MCAO group, the proportion of cerebral infarction area and neurological scores in the Dex-M and Dex-H groups were significantly decreased, and the contents of IL-1β, IL-6 and TNF-α in serum and brain ischemic core area were significantly decreased, the expressions of FPR1, TMEM119, p-NF-κB, NLRP3, CD31 and VE-cadherin in the ischemic core were significantly decreased (P<0.001). Conclusions Dex can significantly alleviate perioperative stroke injury. The mechanism may be due to inhibiting the expression of FPR1 protein, activation of microglia cells and cerebral collateral circulation angiogenesis.

, correspAuthors=Gang Ma, authorNote=null, correspAuthorsNote=
E-mail:
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目的 探讨右美托咪定(Dex)对大鼠围手术期脑卒中模型的治疗作用及其机制。方法 100只雄性SD大鼠随机分为假手术组、中动脉缺血(MCAO)组、右美托咪定低剂量组[Dex-L组,0.5 μg/(kg.h)]、右美托咪定中剂量组[Dex-M组,2 μg/(kg.h)]与右美托咪定高剂量组[Dex-H组,10 μg/(kg.h)],每组20只。通过中动脉栓塞手术构建围手术期脑卒中大鼠模型,缺血期间静脉输注不同剂量Dex。24 h后,参考改良后的神经功能评分方法评估大鼠神经功能;将大鼠处死,取外周血及全脑组织,部分脑组织中分选出缺血核心区组织,采用TTC染色观察脑梗死区域,ELISA法检测血清和缺血核心区炎性细胞因子含量,免疫荧光检测缺血核心区甲酰肽受体1(FPR1)、跨膜蛋白119(TMEM119)、CD31、血管内皮钙黏蛋白(VE-cadherin)的表达,Western blotting检测缺血核心区FPR1、核因子κB(NF-κB)、NLRP3蛋白的表达。结果 与假手术组比较,MCAO组大鼠脑梗死区域面积占比和神经功能损伤评分明显增高,血清和脑组织缺血核心区白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α含量明显增加,脑组织缺血核心区FPR1、TMEM119、p-NF-κB、NLRP3、CD31、VE-cadherin表达明显增加(P<0.001),且FPR1与TMEM119存在明显的共表达情况。与MCAO组比较,Dex-M组和Dex-H组大鼠脑梗死区域面积占比和神经功能损伤评分明显降低,血清和脑组织缺血核心区IL-1β、IL-6、TNF-α含量明显减少,脑组织缺血核心区FPR1、TMEM119、p-NF-κB、NLRP3、CD31、VE-cadherin表达明显降低(P<0.001)。结论 Dex具有减轻围手术期脑卒中损伤的作用,其机制可能与降低FPR1蛋白表达,以及发挥抗小胶质细胞活化、抑制侧支循环血管新生相关。

, correspAuthors=马刚, authorNote=null, correspAuthorsNote=
马刚,E-mail:
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李佩佩,主治医师,主要从事围手术期器官功能保护方面的研究

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李佩佩,主治医师,主要从事围手术期器官功能保护方面的研究

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李佩佩,主治医师,主要从事围手术期器官功能保护方面的研究

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MCAO. 中动脉缺血;Dex. 右美托咪定;A. 各组大鼠脑梗死区域染色图(n=4);B. 各组大鼠神经功能损伤评分(n=15);与假手术组比较,(1)P<0.001;与MCAO组比较,(2)P<0.001

, figureFileSmall=DyZ58aFk+ec5SG4IwNxZmw==, figureFileBig=JUCadO6G/QzIj/hEnPoOTw==, tableContent=null), ArticleFig(id=1198558117656101162, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558111163319242, language=EN, label=Fig.2, caption=Fluorescence staining and relative fluorescence intensity statistics of FPR1 and TMEM119 in the ischemic core of rats in each group (n=4), figureFileSmall=JVfmGbQcpdm9y3M+a+ENxg==, figureFileBig=fVG2+c/FswFeZhgjC53elw==, tableContent=null), ArticleFig(id=1198558117756764465, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558111163319242, language=CN, label=图2, caption=各组大鼠脑组织缺血核心区FPR1和TMEM119荧光染色及相对荧光强度(n=4)

MCAO. 中动脉缺血;Dex. 右美托咪定;FPR1. 甲酰肽受体1;TMEM119. 跨膜蛋白119;与假手术组比较,(1)P<0.01,(2)P<0.001;与MCAO组比较,(3)P<0.001

, figureFileSmall=JVfmGbQcpdm9y3M+a+ENxg==, figureFileBig=fVG2+c/FswFeZhgjC53elw==, tableContent=null), ArticleFig(id=1198558117886787898, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558111163319242, language=EN, label=Fig.3, caption=Contents of inflammatory cytokines like IL-1β, IL-6, and TNF-α in serum and ischemic core of rats in each group (n=6), figureFileSmall=/U7Grc6tFl6Tb/afLijTPg==, figureFileBig=qxO1Sc9rhn5mMLCsRDxZRw==, tableContent=null), ArticleFig(id=1198558117945508161, tenantId=1146029695717560320, journalId=1189873630562394117, articleId=1198558111163319242, language=CN, label=图3, caption=各组大鼠血清及脑组织缺血核心区炎性细胞因子IL-1β、IL-6与TNF-α含量(n=6)

MCAO. 中动脉缺血;Dex. 右美托咪定;IL-1β. 白细胞介素-1β;IL-6. 白细胞介素-6;TNF-α. 肿瘤坏死因子-α;A. 各组大鼠血清中炎性细胞因子IL-1β、IL-6与TNF-α含量;B. 各组大鼠脑组织缺血核心区炎性细胞因子IL-1β、IL-6与TNF-α含量;与假手术组比较,(1)P<0.001;与MCAO组比较,(2)P<0.001

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MCAO. 中动脉缺血;Dex. 右美托咪定;FPR1. 甲酰肽受体1;p-NF-κB. 磷酸化核因子κB;NLRP3. 炎性小体;与假手术组比较,(1)P<0.001;与MCAO组比较,(2)P<0.001

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MCAO. 中动脉缺血;Dex. 右美托咪定;与假手术组比较,(1)P<0.001;与MCAO组比较,(2)P<0.001

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右美托咪定对大鼠围手术期脑卒中模型的治疗作用及其机制
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李佩佩 1 , 马刚 1, * , 屈保福 2 , 张彩霞 2
解放军医学杂志 | 基础研究 2024,49(9): 1055-1061
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解放军医学杂志 | 基础研究 2024, 49(9): 1055-1061
右美托咪定对大鼠围手术期脑卒中模型的治疗作用及其机制
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李佩佩1, 马刚1, * , 屈保福2, 张彩霞2
作者信息
  • 1宁夏医科大学总医院麻醉与围术期医学科,宁夏银川 750001
  • 2宁夏医科大学第一临床医学院麻醉与围术期医学科,宁夏银川 750001
  • 李佩佩,主治医师,主要从事围手术期器官功能保护方面的研究

通讯作者:

马刚,E-mail:
Therapeutic effect and its mechanism of dexmedetomidine on the rat model of perioperative stroke
Pei-Pei Li1, Gang Ma1, * , Bao-Fu Qu2, Cai-Xia Zhang2
Affiliations
  • 1Department of Anesthesiology and Perioperative Medicine, General Hospital of Ningxia Medical University, Yinchuang, Ningxia 750001, China
  • 2Department of Anesthesiology and Perioperative Medicine, the First Clinical Medical School of Ningxia Medical University, Yinchuang, Ningxia 750001, China
出版时间: 2024-09-28 doi: 10.11855/j.issn.0577-7402.0848.2023.1227
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目的 探讨右美托咪定(Dex)对大鼠围手术期脑卒中模型的治疗作用及其机制。方法 100只雄性SD大鼠随机分为假手术组、中动脉缺血(MCAO)组、右美托咪定低剂量组[Dex-L组,0.5 μg/(kg.h)]、右美托咪定中剂量组[Dex-M组,2 μg/(kg.h)]与右美托咪定高剂量组[Dex-H组,10 μg/(kg.h)],每组20只。通过中动脉栓塞手术构建围手术期脑卒中大鼠模型,缺血期间静脉输注不同剂量Dex。24 h后,参考改良后的神经功能评分方法评估大鼠神经功能;将大鼠处死,取外周血及全脑组织,部分脑组织中分选出缺血核心区组织,采用TTC染色观察脑梗死区域,ELISA法检测血清和缺血核心区炎性细胞因子含量,免疫荧光检测缺血核心区甲酰肽受体1(FPR1)、跨膜蛋白119(TMEM119)、CD31、血管内皮钙黏蛋白(VE-cadherin)的表达,Western blotting检测缺血核心区FPR1、核因子κB(NF-κB)、NLRP3蛋白的表达。结果 与假手术组比较,MCAO组大鼠脑梗死区域面积占比和神经功能损伤评分明显增高,血清和脑组织缺血核心区白细胞介素(IL)-1β、IL-6、肿瘤坏死因子(TNF)-α含量明显增加,脑组织缺血核心区FPR1、TMEM119、p-NF-κB、NLRP3、CD31、VE-cadherin表达明显增加(P<0.001),且FPR1与TMEM119存在明显的共表达情况。与MCAO组比较,Dex-M组和Dex-H组大鼠脑梗死区域面积占比和神经功能损伤评分明显降低,血清和脑组织缺血核心区IL-1β、IL-6、TNF-α含量明显减少,脑组织缺血核心区FPR1、TMEM119、p-NF-κB、NLRP3、CD31、VE-cadherin表达明显降低(P<0.001)。结论 Dex具有减轻围手术期脑卒中损伤的作用,其机制可能与降低FPR1蛋白表达,以及发挥抗小胶质细胞活化、抑制侧支循环血管新生相关。

甲酰肽受体1  /  右美托咪定  /  围手术期脑卒中  /  小胶质细胞  /  血管新生

Objective To investigate the effect of dexmedetomidine (Dex) on the rat model of perioperative stroke and its mechanism. Methods One hundred male rats were randomly divided into sham group , middle cerebral artery occlusion (MCAO) group, low dose Dex [Dex-L, 0.5 μg/(kg·h)] group, medium dose Dex [Dex-M, 2 μg/(kg·h)] group, high dose Dex [Dex-H, 10 μg/(kg·h)] group, 20 rats in each group. A rat model of perioperative stroke was established by middle cerebral artery occlusion. Dex was injected intravenously at different doses during ischemia. After 24 h, the neurological function of the rats was evaluated. Then, the rats were sacrificed and the peripheral blood and whole brain tissue were collected, ischemic core area tissue was separated from some brain tissues and the cerebral infarction area was observed by TTC staining. The inflammatory cytokine contents in serum and ischemic core area were measured by ELISA. In addition, the expressions of formyl peptide receptor 1 (FPR1), transmembrane protein 119 (TMEM119), CD31 and VE-cadherin proteins were assayed by immunofluorescence, and the expressions of FPR1, nuclear factor-κB (NF-κB) and NLRP3 proteins by Western blotting in the ischemic core area. Results Compared with sham group, the proportion of cerebral infarction area and neurological scores in the MCAO group were significantly increased, and the contents of interleukin (IL)-1β, IL-6 and tumor necrosis factor (TNF)-α in the serum and the ischemic core area were significantly increased, the expressions of FPR1, TMEM119, p-NF-κB, NLRP3, CD31 and VE-cadherin in the ischemic core were significantly increased(P<0.001), and there was obvious co-expression of FPR1 and TMEM119. Compared with MCAO group, the proportion of cerebral infarction area and neurological scores in the Dex-M and Dex-H groups were significantly decreased, and the contents of IL-1β, IL-6 and TNF-α in serum and brain ischemic core area were significantly decreased, the expressions of FPR1, TMEM119, p-NF-κB, NLRP3, CD31 and VE-cadherin in the ischemic core were significantly decreased (P<0.001). Conclusions Dex can significantly alleviate perioperative stroke injury. The mechanism may be due to inhibiting the expression of FPR1 protein, activation of microglia cells and cerebral collateral circulation angiogenesis.

formyl peptide receptor 1  /  dexmedetomidine  /  ischemic stroke  /  microglia  /  angiogenesis
李佩佩, 马刚, 屈保福, 张彩霞. 右美托咪定对大鼠围手术期脑卒中模型的治疗作用及其机制. 解放军医学杂志, 2024 , 49 (9) : 1055 -1061 . DOI: 10.11855/j.issn.0577-7402.0848.2023.1227
Pei-Pei Li, Gang Ma, Bao-Fu Qu, Cai-Xia Zhang. Therapeutic effect and its mechanism of dexmedetomidine on the rat model of perioperative stroke[J]. Medical Journal of Chinese People’s Liberation Army, 2024 , 49 (9) : 1055 -1061 . DOI: 10.11855/j.issn.0577-7402.0848.2023.1227
右美托咪定(dexmedetomidine,Dex)是一种高选择性肾上腺素能α2受体激动剂,临床上被广泛用于术中辅助麻醉[1]。已有研究表明,Dex能够改善围手术期缺血性脑卒中大鼠的神经功能,缩小梗死区域面积[2-3],但其作用机制仍待继续探讨。甲酰肽受体1(formyl peptide receptor-1,FPR1)属于G蛋白偶联趋化因子受体家族,可介导免疫细胞活化、细胞因子释放、神经元增殖和血管增生等过程[4-5]。然而,关于FPR1在围手术期脑卒中中的变化及其对缺血核心区神经元的影响鲜有报道,此外,Dex对FPR1表达的影响仍待探索。本研究通过中动脉栓塞手术构建围手术期脑卒中大鼠模型,探索Dex对围手术期脑卒中的治疗作用及其对FPR1蛋白表达的影响。
100只SPF级雄性SD大鼠,7周龄,由宁夏医科大学动物实验中心生产、饲养、繁殖[实验动物生产许可证号:SCXK(宁)2020-0001]。由SPF级实验动物中心统一饲养、管理。饲养环境中室温为(24±3) ℃,湿度为60%±10%,12 h/12 h昼夜循环,每笼不超过3只。本研究获宁夏医科大学总医院医学科研伦理审查委员会批准(KYLL-2022-0139)。
盐酸右美托咪定注射液(规格1 ml/0.1 mg,批号:E223105;江苏恩华药业股份有限公司);L3600线栓(广州佳灵生物技术有限公司);2,3,5-三苯基氯化四氮唑(2,3,5-triphenyltetrazolium chloride,TTC;美国Sigma公司);白细胞介素(interleukin,IL)-1β、IL-6和肿瘤坏死因子(tumour necrosis factor,TNF)-α ELISA试剂盒(杭州联科生物技术公司);anti-CD31、anti-血管内皮钙黏蛋白(VE-cadherin)、anti-跨膜蛋白119(transmembrane protein 119,TMEM119)、anti-FPR1抗体及Alexa Fluor 488和Alex Fluor594标记的抗鼠/兔IgG(H+L)稀释液(英国Abcam公司);anti-磷酸化核因子κB(p-NF-κB)、anti-NF-κB、anti-炎性小体(NOD-like receptor thermal protein domain associated protein 3,NLRP3)、anti-β-actin抗体(北京博奥森生物技术有限公司);HRP标记的山羊抗兔/鼠IgG(H+L)(上海碧云天生物技术有限公司)。荧光倒置显微镜(美国赛默飞公司);SDS-PAGE凝胶电泳装置(美国Bio-Rad公司);化学发光成像仪(上海天能科技有限公司)。
100只SD大鼠随机分为假手术组、中动脉缺血(MCAO)组、右美托咪定低剂量组[Dex-L组,0.5 μg/(kg.h)]、右美托咪定中剂量组[Dex-M组,2 μg/(kg.h)]、右美托咪定高剂量组[Dex-H组,10 μg/(kg.h)],每组20只。MCAO组、Dex-L组、Dex-M组、Dex-H组大鼠通过中动脉栓塞手术构建围手术期脑卒中模型。以2%戊巴比妥钠(40 mg/kg)麻醉大鼠后,固定在手术台上,颈部皮肤消毒、开口。沿颈部肌肉向下分离出颈动脉,沿颈外动脉插入线栓,前进至颈内动脉,继续游离至中动脉阻断血流。血流阻断期间,各Dex组大鼠分别静脉输注不同剂量的Dex,共持续2 h。2 h后拔出线栓,恢复缺血区灌注。假手术组大鼠仅麻醉后打开颈总动脉,分离出颈内与颈外动脉,不作插线栓处理。
拔出线栓24 h后,参考改良后的神经功能评分方法[6],对各组大鼠运动功能、感觉功能、平衡能力、异常运动进行评估,每项分数为0~6分。将各项评分累积获得最终结果,最高分为18分,分值越高提示大鼠神经功能损伤越严重。
神经功能评分完成后,处死各组大鼠,取全脑组织置于冰箱中冷冻。将脑组织切成厚度均一的薄片,每片厚约2 mm,共6片,置于TTC溶液中,37 ℃孵育20 min。取出切片,用多聚甲醛溶液固定后拍照。采用ImageJ软件计算白色梗死区域面积及红色非梗死区域面积,并计算脑梗死区域面积占比。脑梗死区域面积占比(%)=白色染色面积/(白色染色面积+红色染色面积)×100%。
神经功能评分完成后,处死各组大鼠,灌注生理盐水除尽血液,取全脑组织,置于多聚甲醛溶液中固定24 h。取出脑组织,梯度乙醇脱水,使用冷冻液包埋并切成10 μm厚切片。取缺血核心区明显的脑组织切片,PBS洗涤,滴加山羊血清封闭。PBST清洗后,滴加anti-FPR1、anti-TMEM119、anti-CD31与anti-VE-cadherin抗体溶液(1:100),4 ℃孵育过夜。PBST清洗,加入Alexa Fluor 488和Alex Fluor 594标记的抗鼠/兔IgG(H+L)稀释液(1:200),室温孵育2 h。荧光显微镜下拍摄缺血核心区照片并保存,ImagePro Plus软件对荧光强度进行分析。以假手术组蛋白荧光强度为标准进行归一化统计。
神经功能评分完成后,处死各组大鼠,收集全血和缺血核心区组织。全血经12 000 r/min离心5 min,取血清。缺血核心区组织经RIPA裂解液匀浆裂解,12 000 r/min离心5 min,取上清液。取预包被的anti-TNF-α、anti-IL-6与anti-IL-1β等细胞因子样品板,分别加入稀释后的血清(5倍稀释)与缺血核心区组织上清液(5倍稀释),37 ℃培养箱中孵育2 h。PBST清洗后,加入anti-TNF-α、anti-IL-6与anti-IL-1β等一抗稀释液(1:1000),37 ℃培养箱中孵育1 h。PBST清洗后,加入HRP标记的二抗稀释液(1:1000),37 ℃培养箱中孵育0.5 h。PBST清洗后,加入100 μl显色底物,10 min后,每个样品孔中加入50 μl显色终止液。采用酶标仪检测450 nm处各孔吸光度值,根据标准品绘制标准曲线,计算各样品孔中细胞因子含量。
将大鼠处死,取缺血核心区组织,加入裂解液匀浆裂解,12 000 r/min离心5 min,取上清液,煮沸制备样品。上样行SDS-PAGE凝胶电泳,湿法转移至PVDF膜上,用牛血清封闭抗原。PBST清洗,滴加anti-FPR1、anti-p-NF-κB、anti-NF-κB、anti-NLRP3与anti-β-actin抗体稀释液(1:1000),4 ℃孵育过夜。PBST清洗,滴加HRP标记山羊抗兔/鼠IgG(H+L)抗体稀释(1:2000),室温孵育2 h。PBST清洗,滴加ECL发光液,化学发光成像仪下显影获得不同蛋白条带,使用ImageJ软件分析各组蛋白表达灰度值。将目的蛋白灰度值与β-actin灰度值进行比较,获得比值作为各组蛋白量化统计结果。
采用SPSS 22.0软件进行统计分析。所有实验数据均以$\bar{x}±s$表示,多组间比较采用单因素方差分析(One Way ANOVA),进一步两两比较采用Tukey检验。P<0.05为差异有统计学意义。
TTC染色和神经功能损伤评估结果显示,假手术组大鼠脑组织未出现梗死区域,神经功能正常;与假手术组比较,MCAO组大鼠脑组织出现明显梗死区域,脑梗死区域面积占比和神经功能损伤评分明显增高(P<0.001);与MCAO组比较,Dex-L组大鼠脑梗死区域面积占比和神经功能损伤评分差异无统计学意义(P>0.05),Dex-M组和Dex-H组大鼠脑梗死区域面积占比和神经功能损伤评分明显降低(P<0.001)(图1)。
免疫荧光检测结果显示,FPR1与TMEM119蛋白存在明显的共定位表达情况。与假手术组比较,MCAO组大鼠脑组织缺血核心区FPR1、TMEM119表达明显增加(P<0.001);与MCAO组比较,Dex-L组大鼠脑组织缺血核心区FPR1、TMEM119表达差异无统计学意义(P>0.05),而Dex-M组和Dex-H组大鼠脑组织缺血核心区FPR1、TMEM119表达明显降低(P<0.001) (图2)。
ELISA法检测结果显示,与假手术组比较,MCAO组大鼠血清和脑组织缺血核心区IL-1β、IL-6、TNF-α含量明显增加(P<0.001);与MCAO组比较,Dex-L组大鼠血清和脑组织缺血核心区IL-1β、IL-6、TNF-α含量差异无统计学意义(P>0.05),而Dex-M组和Dex-H组大鼠血清和脑组织缺血核心区IL-1β、IL-6、TNF-α含量明显减少(P<0.001,图3)。
Western blotting检测结果显示,与假手术组比较,MCAO组大鼠脑组织缺血核心区FPR1、p-NF-κB、NLRP3蛋白表达增加(P<0.001);与MCAO组比较,Dex-L组大鼠脑组织缺血核心区FPR1、p-NF-κB、NLRP3蛋白表达差异无统计学意义(P>0.05),Dex-M组和Dex-H组大鼠脑组织缺血核心区FPR1、p-NF-κB、NLRP3蛋白表达明显降低(P<0.001,图4)。
免疫荧光检测结果显示,与假手术组比较,MCAO组大鼠脑组织缺血核心区CD31、VE-cadherin表达明显增加(P<0.001);与MCAO组比较,Dex-L组大鼠脑组织缺血核心区CD31、VE-cadherin表达差异无统计学意义(P>0.05),而Dex-M和Dex-H组大鼠脑组织缺血核心区CD31、VE-cadherin表达明显降低(P<0.001,图5)。
缺血性卒中是我国常见的心脑血管疾病,发病人数正逐年增加[7-8]。临床上,手术患者在围手术期因自身基础疾病、感染、大量出血、麻醉诱发低血压等因素,易发生缺血性卒中[9-10]。有研究发现,心血管疾病患者围手术期脑卒中发生率达4.8%~7.0%[11]。围手术期脑卒中临床常见症状为口眼歪斜,运动能力受损甚至出现半身不遂的情况。临床诊断中,CT检查脑实质中存在明显的低密度区[12]。本研究结果显示,MCAO组大鼠的运动功能、感觉功能、平衡能力明显受损,且部分大鼠伴有癫痫、抽搐的异常运动。TTC染色结果也显示,MCAO组大鼠存在明显的梗死区域,提示围手术期脑卒中模型构建成功。
有研究显示,FPR1可转导小胶质细胞中趋化因子信号,对组织损伤相关趋化分子模式作出反应。FPR1可通过激活细胞内包括钙动员和丝裂原活化蛋白激酶(MAPK)、细胞外调节蛋白激酶(ERK)、磷脂酰肌醇-3-激酶(PI3K)、蛋白激酶B (Akt)、p38/MAPK等信号通路转导[13-15],介导细胞黏附、定向迁移、脱颗粒和超氧化物生成。因此,FPR1极可能参与围手术期脑卒中神经修复过程。本研究探索了FPR1在Dex治疗围手术期脑卒中的作用。临床上,Dex常用剂量为0.2~0.7 μg/(kg.h),根据大鼠与人之间体表面积等效换算(约10倍),众多研究Dex剂量设置为2~7 μg/(kg.h),且部分研究为了探究多剂量Dex对缺血性卒中的影响,最高剂量设置至10 μg/(kg.h)[16-17]。本研究中,多剂量Dex干预治疗结果显示,0.5 μg/(kg.h) Dex对围手术期脑卒中大鼠并未发挥任何改善作用,而2 μg/(kg.h)与10 μg/(kg.h) Dex则明显减轻了大鼠神经功能损伤,缩小了脑梗死区域面积,降低了FPR1的表达。
TMEM119是一种细胞表面膜蛋白,与离子钙结合衔接分子1(ionized calcium binding adapter molecule 1,Iba1)同属小胶质细胞特异性标志蛋白,在巨噬细胞和其他神经免疫细胞上并不表达。非临床研究显示,围手术期脑卒中可诱发小胶质细胞活化。小胶质细胞属于脑组织中固有免疫细胞,与外周巨噬细胞功能类似。生理状态下,小胶质细胞发挥清除老化细胞碎片、细胞毒性物质的功能;但在病理条件下,过度的小胶质细胞活化会引发神经炎症,加剧围手术期脑卒中而诱发损伤[18]。本研究为了确定FPR1在脑组织中的染色定位,通过免疫荧光检测了缺血核心区FPR1、TMEM119蛋白的表达情况,结果显示FPR1与TMEM119存在明显的共定位表达,提示FPR1蛋白属于小胶质细胞表面膜蛋白。FPR1作为模式识别受体,可被N-甲酰化肽激活,诱发小胶质细胞活化,造成炎症反应并产生神经毒性。已有研究显示,FPR1激动剂fMLF可通过激活NLRP3炎性小体,上调和分泌IL-1β、IL-6、TNF-α而诱导小胶质细胞活化[19]。本研究结果也显示,与假手术组比较,MCAO组大鼠脑组织缺血核心区FPR1、TMEM119表达明显升高,外周与中枢炎性细胞因子IL-6、IL-1β、TNF-α含量明显增加,且Dex治疗可明显抑制FPR1与TMEM119的表达,降低IL-6、IL-1β、TNF-α含量。提示小胶质细胞活化与FPR1相关,中动脉缺血可能通过提高FPR1蛋白的表达,诱发小胶质细胞活化;而Dex则通过抑制FPR1蛋白的表达,进而抑制小胶质细胞活化。
缺血核心区神经血管侧支循环新生对围手术期脑卒中的影响一直存在争议。部分研究认为,诱导大脑侧支循环血管新生可帮助恢复缺血核心区营养供给,促进神经元新生,有助于神经功能恢复[20]。但也有研究认为,围手术期脑卒中会破坏血脑屏障,侧支循环血管新生一方面会加剧血液灌注损伤,另一方面会导致外周炎性细胞因子涌入中枢系统,通过级联效应加剧中枢炎症反应,导致更多的神经元破坏[21]。本研究发现,与假手术组相比,中动脉缺血虽然会造成区域梗死,但也会提高缺血核心区CD31与VE-cadherin蛋白的表达。由于CD31与VE-cadherin属于血管新生常见标志蛋白,提示中动脉缺血会诱发侧支循环血管新生,而假手术组大鼠因为神经血管单元未受损伤,并没有侧支循环血管新生。已有研究显示,FPR1不仅参与小胶质细胞活化[22],与血管内皮细胞增殖也明显相关[23]。在肿瘤领域研究中,靶向抑制FPR1蛋白的表达能够明显抑制肿瘤微环境中血管生成,抑制免疫细胞浸润[24]。此外,也有研究显示,激活内皮细胞中FPR3可诱导血管新生[25]。本研究发现,Dex明显抑制了CD31、VE-cadherin的表达。结合Western blotting结果,提示Dex可能通过降低FPR1蛋白的表达,抑制大脑侧支循环血管新生,避免血脑屏障的过度损伤,减轻外周炎性细胞因子对中枢神经系统的破坏。
综上所述,本研究通过中动脉缺血模拟临床围手术期脑卒中患者常见发病情况,发现Dex治疗能够明显改善大鼠神经功能,减少大鼠缺血侧梗死区域面积,其机制可能是通过抑制FPR1蛋白的表达:一方面抑制小胶质细胞活化,避免炎症效应过度激活;另一方面抑制大脑侧支循环血管新生,减轻再灌注造成的损伤,避免外周炎性细胞因子的涌入。然而,本研究仅通过Western blotting检测FPR1蛋白的表达,并没有使用FPR1抑制剂或基因敲除小鼠来探索Dex的作用机制,存在一定局限性。未来研究可通过FPR1-/-小鼠构建中动脉缺血模型,采用Dex进行治疗,又可在Dex治疗的同时以FPR1抑制剂进行干预,探究小胶质细胞活化与神经血管单元的变化,将最终结果与本研究结果进行综合,帮助我们进一步了解FPR1在Dex改善围手术期脑卒中的作用。
  • 宁夏自然科学基金项目(2022AAC02061)
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2024年第49卷第9期
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doi: 10.11855/j.issn.0577-7402.0848.2023.1227
  • 接收时间:2023-06-19
  • 首发时间:2025-11-21
  • 出版时间:2024-09-28
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  • 收稿日期:2023-06-19
  • 录用日期:2023-07-28
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Natural Science Foundation of Ningxia(2022AAC02061)
宁夏自然科学基金项目(2022AAC02061)
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    1宁夏医科大学总医院麻醉与围术期医学科,宁夏银川 750001
    2宁夏医科大学第一临床医学院麻醉与围术期医学科,宁夏银川 750001

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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