ABSTRACT
Objective To study the changes of permeability of blood brain barrier (BBB) in rats after acute traumatic brain injury and explore its mechanism. Methods Ninety-six male Wistar rats were randomly divided into sham-operated group (S group) and traumatic brain injury group (TBI group).Each group was divided into 6 subgroups (3,6,12,24,48 and 72 h after trauma).Brain injury animal models were established according to Feeney' s method.Measurement of Evans Blue (EB) was performed at different time points after injury to measure the changes of BBB permeability.Brain water content was tested by wet-dry weighting method. Expression of tight junction protein Claudin-5 was detected by Western blotting. Results As compared with that in rats of the S group,the brain water content and content of EB in rats of the TBI group were significantly increased at each time point (P＜0.05); and in TBI subgroups,the brain water content and content of EB were begun to increase 3 h after TBI,reaching its peak level 24 h after TBI.As compared with that in rats of the S group,the expression of Claudin-5 in rats of the TBI group was significantly decreased at 12,24,48 and 72 h after TBI (P＜0.05); and in TBI subgroups,the expression of Claudin-5 was begun to decrease 6 h after TBI,reaching its lowest level 24 h after TBI. Negative correlations were noted between protein expression level of Claudin-5 and both the brain water content and content of EB (r=-0.994,P=0.000; r=-0.846,P=0.036); positive correlation was observed between the brain water content and content of EB (r=0.863,P=0.027). Conclusion The degree of brain injury and changes of permeability of BBB may be time dependent in rats after acute brain traumatic injury; and Claudin-5 may be correlated with the changes of BBB.
ABSTRACT
Objective To observe the expressions ofinterleukin-17A (IL-17A) and transforming growth factor β (TGF-β) in the peripheral brain tissue of nidus after microsurgical resection of brain arterivenous malformations (AVM),and their significance.Methods We prospectively chose 25 patients with AVM; 12 of them were performed endovascular embolization and then microsurgical removal (Group A),and the other 13 were performed microsurgical removal only (Group B).Another 6 patients with traumatic brain injury and hypertensive cerebral hemorrhage that needed internal decompression were used as controls.The expressions of IL-17A and TGF-β in these brain tissues were detected by immunohistochemistry and RT-PCR.Results The protein and mRNA expressions of IL-17A in Group A and B were significantly increased as compared with those in the controls (P＜0.05);the protein and mRNA expressions of IL-17A in Group A were significantly decreased as compared with those in Group B (P＜0.05).The protein and mRNA expressions of TGF-β in Group A and B were significantly decreased as compared with those in the controls (P＜0.05); the protein expression of IL-17A in Group A was not significantly increased as compared with that in Group B (P＞0.05); the mRNA expression of IL-17A in Group A was significantly increased as compared with that in Group B (P＜ 0.05).Conclusion The increased expression of IL-17A might be associated with the growth and pathologic process of AVM; the increased expression of TGF-β might inhibit the inflammatory reaction after embolization.
ABSTRACT
<p><b>OBJECTIVE</b>To observe the clinical and pathological characteristics of brain arteriovenous malformations (BAVM) embolized with the non-adhesive aqueous embolic agent Onyx and evaluate its application in comprehensive treatment of BAVM.</p><p><b>METHODS</b>Thirty-four patients underwent BAVM embolization using Onyx, and their clinical manifestations, architecture of the malformed vessels, emblization procedure, and complications associated with the procedures were recorded. The resected tissues after embolization with Onyx were observed with electron microscope, and the prognosis of the patients was estimated with modified Rankin Score (mRS).</p><p><b>RESULTS</b>These patients included 21 male and 13 female patients with a mean age of 30.45-/+11.81 years and an estimated mean size of the nidus of 3.98-/+1.43 cm. The patients received a total of 52 endovascular treatment procedures with Onyx to embolize 86 feeding pedicals, which resulted in an average estimated size reduction of the nidus of (72.35-/+21.26)%. Complications associated with the procedure occurred in 7 patients, and 23 patients received surgical resection or radiosurgery after embolization. Follow-up of the patients for 6 months to 4 years showed that the mRS was below 3 in 32 cases and > or =3 in 2 cases. Vasodilatation, brain tissue edema surrounding the nidus, and inflammatory cell infiltration were observed in the resected tissues after embolization. In some major feeding pedicals, thrombus recanalization was observed after embolization with Onyx (diameter> or =3 mm).</p><p><b>CONCLUSION</b>Endovascular treatment of BAVM with Onyx can achieve high occlusion rate, enhance the safety of operation and radiosurgery, and improve the clinical prognosis of the patients.</p>
