RESUMEN
Objective To investigate the therapeutic effect of human urinary kallidinogenase in patients with acute cerebral infarction and explore the mechanism by blood oxygen level dependent functional magnetic resonance imaging (BOLD-fMRI). Methods twenty-three patients with acute cerebral infarction were randomized into control group (n=11) and treatment group (n=12) to receive conventional treatment and additional human urinary kallidinogenase treatment for 12 to 14 days, respectively. BOLD-fMRI was performed, and the affected forefinger muscle strength and NIHSS score were recorded before and after the treatment. Results In the treatment group, the activated frequency and volume in the sensorimotor cortex (SMC) ipsilateral to the infarct increased significantly after the treatment (11/12 vs 4/12; 99.58±169.41 vs 105.17±197.23, P<0.05). The inerernent in the activated volume in the SMC was significantly greater in the treatment group than in the control group (94.42±51.57 vs 16.09±106.61, P<0.05). The forefinger muscle strength and NIHSS score in the treatment group improved significantly after treatment (2.67±1.44 vs 1.25±1.48; 4.92±2.94 vs 10.42±3.80, P<0.05), and the improvement in NIHSS score was significantly greater in the treatment group than in the control group (5.50±1.31 vs 3.18±2.48, P<0.05). Conclusion The therapeutic effect of human urinary kallidinogenase on acute cerebral infarction is mediated essentially by promoting the activation in the SMC in the functional area of the brain.
RESUMEN
Objective To explore the relationship between the long-term presence of hypoxic tissue and astrocyte activation after cerebral infarction in rats. Methods Middle cerebral artery occlusion was performed in rats to induce permanent brain ischemia (PI group) or transient isehemia for 1.5 h followed by reperfusion (1.5 h IR group). Double immunofluorescence staining with EF5 and gliai fibrillary acidic protein (GFAP) antibodies was used to observe the hypoxic tissue and status of astrocyte activation, respectively. On days 1, 3, 7 and 14 after the operation, GFAP fluorescence intensity and the presence of hypoxic tissue in the ischemic cortex were observed. Results The hypoxic tissues were present from day 3 to day 14 after the operation in 1.5 h IR group, but disappeared after day 3 in PI group. GFAP fluorescence intensity in the hypoxic tissue was significantly higher than that in the surrounding tissues at all the observation time points (P<0.05). GFAP fluorescence intensity increased progressive in both groups with the lapse of time (P<0.05), reaching the peak level on day 7 followed then by gradual declination. On each of the time points for observation, GFAP fluorescence intensity in 1.5 h IR group was significantly higher than that in PI group (P<0.05). Conclusion Astrocyte activation is especially obvious in the hypoxic brain tissues after cerebral infarction, which is closely associated with the long-term existence of hypoxic tissues.