皮质醇是缺血性脑卒中急性期大脑皮层神经元凋亡的调节因子(临床和病理研究)

S. P. Sergeeva, A. A. Savin, P. Litvitsky, L. Gorbacheva, A. Lyundup, I. D. Breslavich, L. A. Savin
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引用次数: 0

摘要

缺血性中风(IS)发生时,应激反应系统会自然激活。这种激活的特征会影响急性期的结果和康复的预后,并可加以调整。目的:研究外周血皮质醇浓度对 IS 急性期大脑皮层神经元凋亡调节的影响。进行了一项前瞻性临床和病理研究。研究对象包括9名左侧大脑中动脉区域的IS患者,这些患者入院后在IS的超急性期死亡,没有感染性并发症、过敏反应或肿瘤疾病,也没有接受溶栓治疗。对大脑皮层进行了检查。采用间接免疫过氧化物酶免疫组化染色法测定了切片上的神经元特异性烯醇化酶(NSE)、蛋白53(p53)、caspase 3、caspase 8、Fas受体(CD95)和Fas凋亡抑制分子2(FAIM2)。IS患者组共分析了567个显微视野,对照组(3人)分析了63个视野。死前,用酶免疫测定法测定血液中 sFas、sFasL、皮质醇、促肾上腺皮质激素、肾上腺素和去甲肾上腺素的浓度(对照组有 28 人)。在第 2 区(r=0.263;p<0.01)和第 3 区(r=0.383;p<0.01),casp3 阳性神经元的比例与外周血中皮质醇的浓度之间存在显著的相关性。在第 2 区,sFas(r=-0.177;p<0.05)和 sFasL(r=-0.164;p<0.05)的浓度呈显著负相关;在第 3 区,sFasL 和 sFas 的浓度比值呈显著正相关(r=0.240;p<0.01)。大脑皮层中 Fas 阳性神经元的比例与外周血中该分子可溶形式的浓度显著相关(第一区--r=0.222,第二区--r=0.438,第三区--r=0.289;p<0.01),与 sFasL 和 sFas 的浓度之比也显著相关(分别为:r=0.231,r=0.266 和 r=0.281;p<0.01)。结论:外周血皮质醇浓度是决定IS急性期大脑皮层神经元凋亡调节的一个因素。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cortisol as a cerebral cortex neurons apoptosis regulator in acute phase of ischemic stroke (clinical and pathological study)
In response to ischemic stroke (IS) a natural activation of the stress-realizing system occurs. The features of this activation influence the outcome of the acute period and the prognosis of recovery and can be adjusted. At the same time, the role of the stress-realizing system in the pathogenesis of IS is still unexplored.Objective: to investigate the effect of peripheral blood cortisol concentration on the regulation of apoptosis of neurons of the cerebral cortex in the acute phase of IS.Material and methods. A prospective clinical and pathological study was performed. It included 9 patients with IS in the left middle cerebral artery territory who were admitted to hospital and died in the hyperacute phase of IS and had no infectious complications, allergic reactions or oncological diseases and who did not undergo thrombolysis. The cerebral cortex was examined. Neuron-specific enolase (NSE), protein 53 (p53), caspase 3, caspase 8, Fas receptor (CD95), and Fas apoptotic inhibitory molecule 2 (FAIM2) were determined on the slices using an indirect immunoperoxidase immunohistochemical staining method. A total of 567 microscopic fields were analysed for the group of patients with IS and 63 fields for the control group (three people). Before death, the blood concentrations of sFas, sFasL, cortisol, adrenocorticotropic hormone, adrenaline and norepinephrine were determined by enzyme immunoassay (the control group consisted of 28 people).Results. Significant correlation was found between the proportion of casp3-positive neurons and the concentration of cortisol in peripheral blood in zones 2 (r=0.263; p<0.01) and 3 (r=0.383; p<0.01). In the 2nd zone, significant negative correlation was found with the concentrations of sFas (r=-0.177; p<0.05) and sFasL (r=-0.164; p<0.05); in the 3rd zone, significant positive correlation was found with the ratio of the concentrations of sFasL and sFas (r=0.240; p<0.01). The proportion of Fas-positive neurons in the cerebral cortex correlated significantly with the concentration of the soluble form of this molecule (for the 1st zone – r=0.222, for the 2nd zone – r=0.438, for the 3rd zone – r=0.289; p<0.01) and the ratio of the concentrations of sFasL and sFas (respectively: r=0.231, r=0.266 and r=0.281; p<0.01) in the peripheral blood.Conclusion. Peripheral blood cortisol concentration is a factor that determines the regulation of apoptosis of neurons in the cerebral cortex in the acute phase of IS.
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