[1]申学明,韩秀鹏,何超,等.急性脑出血患者脑组织中小胶质细胞/巨噬细胞极化状态与血肿周围水肿的关系[J].新乡医学院学报,2023,40(12):1161-1166.[doi:10.7683/xxyxyxb.2023.12.012]
　SHEN Xueming,HAN Xiupeng,HE Chao,et al.Association between polarization status of microglia/macrophage in brain tissue and edema around hematoma in patients with acute cerebral hemorrhage[J].Journal of Xinxiang Medical University,2023,40(12):1161-1166.[doi:10.7683/xxyxyxb.2023.12.012]
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急性脑出血患者脑组织中小胶质细胞/巨噬细胞极化状态与血肿周围水肿的关系
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《新乡医学院学报》[ISSN:1004-7239/CN:41-1186/R]

卷:
40卷
期数:
2023年12
页码:
1161-1166
栏目:
临床研究
出版日期:
2023-12-05

文章信息/Info

Title:
Association between polarization status of microglia/macrophage in brain tissue and edema around hematoma in patients with acute cerebral hemorrhage
作者:
申学明1; 韩秀鹏1; 何超1; 唐艳军2; 韩松3; 闫长祥3
（1.安阳市人民医院神经外科，河南　安阳　455000；2.安阳市人民医院放射科，河南　安阳　455000；3.首都医科大学三博脑科医院神经外科，北京　100000）
Author(s):
SHEN Xueming1; HAN Xiupeng1; HE Chao1; TANG Yanjun2; HAN Song3; YAN Changxiang3
(1.Department of Neurosurgery，Anyang People′s Hospital,Anyang 455000,Henan Province，China； 2.Department of Radiology，Anyang People′s Hospital,Anyang 455000,Henan Province，China;3.Department of Neurosurgery，Sanbo Brain Hospital,Capital Medical University,Beijing 100000，China)
关键词:
急性脑出血; 小胶质细胞; 巨噬细胞; 极化状态; 血肿周围水肿
Keywords:
acute intracerebral hemorrhage; microglia; macrophages; polarization; perihematomal edema
分类号:
R743.3
DOI:
10.7683/xxyxyxb.2023.12.012
文献标志码:
A
摘要:
目的　探讨急性脑出血患者脑组织中小胶质细胞/巨噬细胞(MG/MP)极化状态与血肿周围水肿的相关性。
方法　选择2020年12月至2022年11月安阳市人民医院收治的急性脑出血患者52例为研究对象。所有患者行骨瓣开颅血肿清除术，获取手术通道上未受血肿侵犯的皮质区正常脑组织和血肿周围的破碎脑组织（血肿周围脑组织），采用Western blot法检测脑组织中炎症因子白细胞介素（IL）-1β、IL-6、肿瘤坏死因子-α（TNF-α）、IL-10、转化生长因子-β（TGF-β）的蛋白表达水平，采用荧光定量聚合酶链反应检测脑组织中IL-1β、IL-6、TNF-α、IL-10、TGF-β的mRNA表达水平，采用免疫荧光共聚焦技术检测脑组织中M1型、M2型MG/MP水平。收集患者手术前的CT影像资料，计算血肿周围相对水肿体积（r-PHE），根据r-PHE将患者分为高r-PHE组（2.0≤r-PHE<2.5）和低r-PHE 组（1.5<r-PHE<2.0）。比较高r-PHE组与低r-PHE组患者血肿周围脑组织中IL-1β、IL-6、TNF-α、IL-10和TGF-β的mRNA相对表达量。
结果　血肿周围脑组织中IL-1β、IL-6、TNF-α蛋白和mRNA相对表达量显著高于正常脑组织（P<0.05）；血肿周围脑组织与正常脑组织中IL-10、TGF-β蛋白和mRNA相对表达量比较差异无统计学意义（P>0.05）。 血肿周围脑组织中M1型MG/MP和M2型MG/MP水平均显著高于正常脑组织（P<0.05）。高r-PHE组患者血肿周围脑组织中IL-1β、IL-6、TNF-α的mRNA相对表达量显著高于低r-PHE组（P<0.05）；2组患者血肿周围脑组织中TGF-β、IL-10的mRNA相对表达量比较差异无统计学意义（P>0.05）。
结论　急性脑出血患者血肿周围脑组织中促炎因子及M1型MG/MP水平升高，且M1型MG/MP的极化水平与脑出血后血肿周围水肿程度具有一致性。
Abstract:
Objective　To explore the correlation between polarization status of microglia/macrophages(MG/MP) in brain tissue and edema around hematoma in patients with acute cerebral hemorrhage.
Methods　A total of 52 patients with acute intracerebral hemorrhage admitted to Anyang People′s Hospital from December 2020 to November 2022 were selected as the research subjects.All patients underwent craniotomy to remove hematoma,and the normal brain tissue in the cortical area that was not invaded by the hematoma and the fragmented brain tissue around the hematoma (brain tissue around the hematoma) on the surgical pathway were obtained.The expression levels of inflammatory factors such as interleukin (IL)-1β,IL-6,tumor necrosis factor-α (TNF-α),IL-10 and transforming growth factor-β (TGF-β) protein in brain tissue were detected by Western blot.The expression levels of IL-1β,IL-6,TNF-α,IL-10 and TGF-β mRNA in brain tissue were detected by fluorescence quantitative polymerase chain reaction.The levels of M1-type and M2-type MG/MP in brain tissue was detected by immunofluorescence confocal technique.CT images data of patients before operation were collected and the relative-erihematomal edema (r-PHE) was calculated.The patients were divided into high r-PHE group (2.0≤r-PHE<2.5) and low r-PHE group (1.5<r-PHE<2.0) according to r-PHE.The relative expression of IL-1β,IL-6,TNF-α,IL-10 and TGF-β mRNA in brain tissue around the hematoma of patients between the high r-PHE group and the low r-PHE group was compared.
Results　The relative expressions of IL-1β,IL-6,TNF-α protein and mRNA in brain tissue around the hematoma were significantly higher than those in the normal brain tissues(P<0.05),but there was no significant difference in the relative expressions of IL-10 and TGF-β protein and mRNA between the brain tissue around the hematoma and the normal brain tissue (P>0.05).The levels of M1 type and M2 type MG/MP in the brain tissue around the hematoma were significantly higher than those in normal brain tissue (P<0.05).The relative expressions of IL-1β,IL-6 and TNF-α mRNA in the brain tissue around the hematoma of patients in the high r-PHE group were significantly higher than those in the low r-PHE group (P<0.05),and there was no significant difference in the relative expressions of TGF-β and IL-10 mRNA in the brain tissue around the hematoma of patients between the two groups (P>0.05).
Conclusion　The levels of pro-inflammatory factors and M1-type MG/MP are increased in the brain tissue around the hematoma in patients with acute cerebral hemorrhage,and the degree of polarization of M1-type MG/MP is consistent with the degree of edema around hematoma after cerebral hemorrhage.

参考文献/References:

［1］　MARCOLINI E,STRETZ C,DEWITT K M.Intracranial hemorrhage and intracranial hypertension［J］.Emerg Med Clin North Am,2019,37(3):529-544.
［2］　马奎,张圣帮,郭西良.不同时间窗经额血肿穿刺引流高血压脑出血患者预后比较［J］.新乡医学院学报,2021,38(8):762-765.
MA K,ZHANG S B,GUO X L.Comparison of the prognosis of patients with hypertensive cerebral hemorrhage underwent transfrontal puncture and drainage at different time windows［J］.J Xinxiang Med Univ,2021,38(8):762-765.
［3］　GAO S,ZHOU L,LU J,et al.Cepharanthine attenuates early brain injury after subarachnoid hemorrhage in mice via inhibiting 15-lipoxygenase-1-mediated microglia and endothelial cell ferroptosis［J］.Oxid Med Cell Longev,2022,2022:4295208.
［4］　ZHU H,WANG Z,YU J,et al.Role and mechanisms of cytokines in the secondary brain injury after intracerebral hemorrhage［J］.Prog Neurobiol,2019,178:101610.
［5］　ORIHUELA R,MCPHERSON C A,HARRY G J.Microglial M1/M2 polarization and metabolic states［J］.Br J Pharmacol,2016,173(4):649-665.
［6］　CHEN Y,CHEN S,CHANG J,et al.Perihematomal edema after intracerebral hemorrhage:an update on pathogenesis,risk factors,and therapeutic advances［J］.Front Immunol,2021,12:740632.
［7］　HU X,LEAK R K,SHI Y,et al.Microglial and macrophage polarization—new prospects for brain repair［J］.Nat Rev Neurol,2015,11(1):56-64.
［8］　WON S Y,ZAGORCIC A,DUBINSKI D,et al.Excellent accuracy of ABC/2 volume formula compared to computer-assisted volumetric analysis of subdural hematomas［J］.PLoS One,2018,13(6):e0199809.
［9］　PHILLIPS V L,ROY A K,RATCLIFF J,et al.Minimally invasive parafascicular surgery (MIPS) for spontaneous intracerebral hemorrhage compared to medical management:a case series comparison for a single institution［J］.Stroke Res Treat,2020,2020:6503038.
［10］　CHEN S,PENG J,SHERCHAN P,et al.TREM2 activation attenuates neuroinflammation and neuronal apoptosis via PI3K/Akt pathway after intracerebral hemorrhage in mice［J］.J Neuroinflammation,2020,17(1):168.
［11］　HU X,LI P,GUO Y,et al.Microglia/macrophage polarization dynamics reveal novel mechanism of injury expansion after focal cerebral ischemia［J］.Stroke,2012,43(11):3063-3070.
［12］　KANAZAWA M,NINOMIYA I,HATAKEYAMA M,et al.Microglia and monocytes/macrophages polarization reveal novel therapeutic mechanism against stroke［J］.Int J Mol Sci,2017,18(10):2135.
［13］　GELOSO M C,CORVINO V,MARCHESE E,et al.The dual role of microglia in ALS:mechanisms and therapeutic approaches［J］.Front Aging Neurosci,2017,9:242.
［14］　索森森,李爱琴,原玲玲,等.巨噬细胞缺氧/复氧及M2型极化对小鼠心肌细胞凋亡的影响及机制［J］.新乡医学院学报,2022,39(7):612-616+621.
SUO S S,LI A Q,YUAN L L,et al.Effect and mechanism of macrophage hypoxia/reoxygenation and M2 type polarization on cardiomyocyte apoptosis of mice［J］.J Xinxiang Med Univ,2022,39(7):612-616,621.
［15］　姚宁丰,佘仁夏,舒艺璇,等.白藜芦醇对脑出血后小胶质细胞功能的影响及其机制［J］.解放军医学杂志,2023,48(4):420-430.
YAO N F,SHE R X,SHU Y X,et al.Effect and mechnism of resveratrol on the functional of microglia after intracerebral hemorrhage［J］.Med J Chin PLA,2023,48(4):420-430.
［16］　SELIM M,NORTON C.Perihematomal edema:implications for intracerebral hemorrhage research and therapeutic advances［J］.J Neurosci Res,2020,98(1):212-218.
［17］　JOARDER M A,KARIM A,BARUA K K,et al.A study on-effect of hematoma and perihematomal edema volume on GCS at the time of admission in patients with spontaneous lobar and basal Ganglia hemorrhage［J］.Pulse,2015,7(1):22-28.
［18］　HARRISON S K,GARRETT J S,KOHMAN K N,et al.Comparison of outcomes in patients with intracranial hemorrhage on factor Xa inhibitors versus vitamin K antagonists treated with 4-factor prothrombin complex concentrate［J］.Proc (Bayl Univ Med Cent),2018,31(2):153-156.

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更新日期/Last Update: 2023-12-05