血脑屏障内皮细胞与细胞间粘附分子-1在鼠脑缺血性脑水肿发生机制中的作用  

The role of endothelium of blood-brain barrier and intercellular adhesion molecule-1 in the course of ischemic cerebral edema in rats

作　　者：郝延磊[1] 蒲传强[1] 朱克[1] 张凤英[1] 刘洁晓[1] 朱光明[1] 张曙光[1] 

机构地区：[1]解放军总医院神经内科,北京100853

出　　处：《中华神经科杂志》2000年第2期86-89,共4页Chinese Journal of Neurology

摘　　要：目的研究缺血性脑水肿病理过程中血脑屏障内皮细胞及其细胞间粘附分子－1（intercellularadhesionmolecule-1，ICAM-1）的表达与血脑屏障通透性的关系。方法用电镜技术和免疫组织化学方法观察脑缺血过程中大鼠血脑屏障内皮细胞超微结构及其ICAM-1的表达和对镧离子的通透性改变。结果脑缺血后1h，缺血区脑组织血脑屏障内皮细胞未见ICAM-1表达，但电镜下可见内皮细胞轻度肿胀。3h，ICAM-1开始表达，缺血区脑组织轻度水肿，内皮细胞肿胀。至12h，ICAM-1表达达到高峰，脑组织严重水肿，内皮细胞、神经细胞及胶质细胞明显肿胀；内皮细胞胞饮小泡包含有被吞噬的镧离子，有些镧离子进入紧密连接间隙。72h，ICAM-1表达已明显减少，脑组织水肿仍较重，内皮细胞严重破坏，大量镧离子漏出血管外，进入脑实质。结论脑缺血后血脑屏障的破坏与ICAM－1的表达密切相关，提示ICAM－1参与血脑屏障内皮细胞的破坏过程，而且这些改变在缺血性脑水肿的病理过程中起重要作用。Objective To study the relationship of the changes of endothelium, the expression of intercellular adhesion molecule-1 (ICAM-1) and the permeability of blood-brain barrier(BBB) during the pathologic course in ischemic cerebral edema. Methods Electron microscopy and immunohistochemistry were used to observe the ultrastructural changes of endothelial cells of BBB, the expression of ICAM-1 on endothelial cells and the permeability to lanthanum (La3+) in rat brain following permanent middle cerebral artery occlusion (PMCAO). Results It was found that there was no ICAM-1 expression on the endothelial cells of BBB in the ischemic hemispheres at 1 h in the SD rats following PMCAO. Meanwhile we found light swelling in the endothelial cells. At 3 h, ICAM-1 started to express, brain edema was observed in the ischemic areas, BBB endothelial cells were swelling. At 12 h, the expression of ICAM-1 reached its maximum, the brain edema became remarkable. The BBB endothelial cells, neurons and glial cells were all swelling, and La3+ was found in pinocytotic vesivles and tight junctions of endothelial cells of BBB in the ischemic areas. At 72 h, tha expression of ICAM-1 was not remarkable. But brain edema was still serious, the BBB endothelium was damaged, and La3+ emerged in the extracellular spaces through BBB. Conclusion The expreesion of ICAM-1 on the endothelial cells had a relevant relationship with the rupture of BBB following cerebral ischemia, suggesting that ICAM-1 played an important role in the pathological course of the ischemic cerebral edema.

关 键 词：脑水肿 血脑屏障 胞间粘附分子 脑缺血 

分 类 号：R741.02[医药卫生—神经病学与精神病学]