Changes in the permeability of blood brain barrier and endothelial cell damage after cerebral ischemia

OBJECTIVE： To investigate the effect of endothelial cells on the permeability of blood brain barrier （BBB） after brain injury and its effect mechanism. DATA SOURCES： We searched for the articles of permeability of BBB and endothelial cell injury after brain is- chemia, which were published between January 1982 and December 2005, with the key words of ＂cerebral ischemia damage,blood brain barrier （ BBB）,permeability,effect of endothelial cell （EC） and its variation mechanism＂in English. STUDY SELECTION： The materials were primarily selected. The articles related to the changes in the permeability of BBB and the effect of endothelial cells as well as the change mechanism after cerebral ischemia damage were chosen. Repetitive studies or review articles were excluded. DATA EXTRACTION： Totally 55 related articles were collected, and 35 were excluded due to repetitive or review articles, finally 20 articles were involved. DATA SYNTHESIS： The content or viewpoints of involved literatures were analyzed. Cerebral ischemia had damage for endothelial cells, such as the inflow of a lot of Ca2^＋, the production of nitrogen monoxide and oxygen free radical, and aggravated destruction of BBB. After acceptors of inflammatory mediators on cerebrovascular endothelial cell membrane, such as histamine, bradykinin , 5-hydroxytryptamine and so on are activated, endothelial cells shrink and the permeability of BBB increases. Its mechanism involves in the inflow of extracellular Ca^＋2and the release of intracellular Ca^2＋ in the cells. Glycocalyx molecule on the surface of endothelial cell, having structural polytropy, is the determinative factor of the permeability of BBB. VEGF, intensively increasing the vasopermeability and mainly effecting on postcapillary vein and veinlet, is the strongest known blood vessel permeation reagent. Its chronic overexpression in the brain can lead the destruction of BBB. CONCLUSION： The injury of endothelial cell participants in the pathological mechanism of BBB destruction after cerebral ischemla.

Transfusion of CXCR4-priming endothelial progenitor cells reduces cerebral ischemic damage and promotes angiogenesis and neurogenesis in db/db diabetic mice

Previous studies suggest that reduction and dysfunction of circulating endothelial progenitor cells(EPCs),and dysregulation in stromal cell derived factor-1/CXC-chemokine receptor 4(SDF-1/ CXCR4) axis in diabetes could be therapeutic targets for diabetic ischemic stroke.This study investigated the efficacy of CXCR4-priming EPCs on cerebral repair following ischemic stroke in db/db diabetic mice.Bone marrow derived EPCs from db/+ control mice were transfected with adenovirus(1×10~7 IU) carrying CXCR4(Ad-CXCR4-EPCs)or null(Ad- null-EPCs).The db/db mice were divided into three groups for EPCs injection(2×10~5 cells/100μl): Ad-CXCR4-EPCs,Ad-null-EPCs or saline(vehicle), via tail vein 2 hrs after middle cerebral artery occlusion (MCAO) surgery.Cerebral blood flow(CBF) was measured with laser Doppler flowmeter.Mice were sacrificed at 2 or 7 days thereafter.Level of circulating EPCs was measured by flow cytometry. Ischemic damage,cerebral microvascular density (MVD),angiogenesis and neurogenesis were determined by histological staining with Fluoro-J,CD31, CD31 +BrdU,NeuN +BrdU,GFAP+BrdU,respectively. Results(table) showed:1) Levels of CXCR4 expression were reduced in the brain and EPCs of db/db mice as measured by real-time RT-PCR and western blot analyses(data not shown);2) The level of circulating EPCs was more in the mice treated with Ad-CXCR4-EPCs;3)EPC transfusion improved CBF,increased MVD,angiogenesis and neurogenesis in peri-infarct area,and decreased ischemic damage.The efficacies were better in Ad-CXCR4 -EPCs group.Data suggest that transfusion of Ad-CXCR4-EPCs could be a therapeutic avenue for ischemia stroke in diabetes.

Neuroprotection and antioxidants

Ischemia as a serious neurodegenerative disorder causes together with reperfusion injury many changes in nervous tissue. Most of the neuronal damage is caused by complex of biochemical reactions and substantial processes, such as protein agregation, reactions of free radicals, insufficient blood supply, glutamate excitotoxicity, and oxidative stress. The result of these processes can be apoptotic or necrotic cell death and it can lead to an irreversible damage. Therefore, neuroprotection and prevention of the neurodegeneration are highly important topics to study. There are several approaches to prevent the ischemic damage. Use of many modern therapeutical methods and the incorporation of several substances into the diet of patients is possible to stimulate the endogenous protective mechanisms and improve the life quality.

Experimental Study of Protective Effect of Qingkailing(清开灵) on Brain Damage Induced by Glutamate

Objective： To observe the effect of Qingkailing (QKL) on brain damage induced by glutamate, in order to seek for effective drugs for antagonizing neurotoxicity of glutamate. Methods：The number and morphological metrology of neurocytes in cerebral cortex and hippocampus were detected by MIAS-300 image analyser, electron microscope and immunohistochemical methods. Results：QKL could alleviate the glutamate induced accumulation of water and sodium in brain tissue，relieve the metrological and structural damage of cerebral cells in cortex and hippocampus, reduce the percentage of c-fos positive cell in brain. Conclusion： QKL could protect brain damage induced by glutamate, which might be related to the inhibition of QKL on the enhancement of c-fos gene expression induced by glutamate.

Basic research and clinical progress of sepsis-associated encephalopathy

Sepsis-associated encephalopathy(SAE),a major cerebral complication of sepsis,occurs in 70%of patients admitted to the intensive care unit(ICU).This condition can cause serious impairment of consciousness and is associated with a high mortality rate.Thus far,several experimental screenings and radiological techniques(e.g.,electroencephalography)have been used for the non-invasive assessment of the structure and function of the brain in patients with SAE.Nevertheless,the pathogenesis of SAE is complicated and remains unclear.In the present article,we reviewed the currently available literature on the epidemiology,clinical manifestations,pathology,diagnosis,and management of SAE.However,currently,there is no ideal pharmacological treatment for SAE.Treatment targeting mitochondrial dysfunction may be useful in the management of SAE.