国际麻醉学与复苏杂志   2022, Issue (11): 0-0
    
七氟醚通过抑制细胞焦亡减轻蛛网膜下腔出血后早期脑损伤
付瑶, 李林1()
1.北部战区总医院
Sevoflurane alleviates early brain injury after subarachnoid hemorrhage by inhibiting cell pyroptosis
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摘要:

目的 探讨七氟醚通过炎症类受体蛋白‑3(Nod‑like receptor associated protein 3, NLRP3)介导的细胞焦亡途径对蛛网膜下腔出血(subarachnoid hemorrhage, SAH)后早期脑损伤(early brain injury, EBI)的影响。 方法 108只10~12周雄性C57BL/6小鼠,按随机数字表法分为3组(每组36只),假手术组(A组)、模型组(B组)和模型+七氟醚组(C组)。B组和C组采用线穿法制作SAH模型,A组做相同的手术,但不刺破大脑中动脉。C组于SAH模型建立后1 h,持续吸入3%七氟醚和空气1 h。各组小鼠进行SAH分级和神经功能评分,测定脑水含量,伊文思蓝(evans blue, EB)染色法计算EB渗出量评判小鼠血脑屏障通透性;Western blot法检测与血脑屏障通透性密切相关的基质金属蛋白酶9(matrix metalloprotein 9, MMP‑9)和紧密连接蛋白[闭合小环蛋白‑1(zonula occludens‑1, ZO‑1)、咬合蛋白(occludin)、靠停蛋白‑5(claudin‑5)]及NLRP3、凋亡相关斑点样蛋白(apoptosis‑associated speck‑like protein containing CARD, ASC)、裂解半胱氨酸蛋白酶(caspase‑1)、IL‑18、IL‑1β的表达;实时荧光定量PCR检测NLRP3 mRNA、caspase‑1 mRNA的表达水平;caspase⁃1活性检测试剂盒检测caspase‑1的活性;TUNEL和NeuN双重染色检测神经细胞焦亡情况。 结果 SAH分级和神经功能评分显示:与A组比较,B组的SAH分级明显增高(P<0.05);与B组比较,C组SAH分级明显降低(P<0.05);与C组比较,B组的神经系统评分明显降低(P<0.05)。脑水含量及EB渗出量检测显示:与A组比较,B组的脑含水量与EB渗出量明显增加(P<0.05);与B组比较,C组的脑含水量与EB渗出量明显减少(P<0.05)。Western blot检测结果显示:与A组比较,B组中ZO‑1、occludin和claudin‑5蛋白表达水平明显降低(P<0.05),NLRP3、ASC、裂解caspase‑1、IL‑1β和IL‑18的蛋白表达水平明显增高(P<0.05);与B组比较,C组中ZO‑1、occludin和claudin‑5表达水平明显增高(P<0.05),NLRP3、ASC、裂解caspase‑1、IL‑1β和IL‑18表达水平明显降低(P<0.05);与A组比较,B组中MMP‑9表达水平明显增高;与B组比较,C组中MMP‑9表达水平明显降低(P<0.05)。实时荧光定量PCR实验显示:与A组比较,B组中NLRP3和caspase‑1的mRNA水平明显增加;与B组比较,C组中NLRP3和caspase‑1的mRNA水平明显降低(P<0.05)。与A组比较,B组的caspase‑1活性明显增加;与B组比较,C组的caspase‑1的活性明显减少(P<0.05)。TUNEL染色检测显示:与A组比较,B组的TUNEL阳性神经元细胞数量明显升高(P<0.05);与B组比较,C组TUNEL神经元细胞阳性数量明显降低(P<0.05)。 结论 七氟醚能够抑制SAH后NLRP3炎症小体介导的细胞焦亡,改善SAH后的EBI情况。

关键词: 七氟醚; 蛛网膜下腔出血; 脑损伤; 炎症类受体蛋白‑3; 焦亡
Abstract:

Objective To study the effect of sevoflurane on the early brain injury (EBI) after subarachnoid hemorrhage (SAH) through the focal death pathway mediated by the Nod‑like receptor associated protein 3 (NLRP3). Methods A total of 108 male C57BL/6 mice of 10−12 weeks were divided into three groups (36 mice in each group) according to the random number table method, namely the sham operation group (group A), the model group (group B) and the model+sevoflurane group (group C). The SAH model was made by the threading method in groups B and C, and the same operation was performed in group A, but the middle cerebral artery was not punctured. After establishing the SAH model, the mice in group C continued to inhale 3% sevoflurane and air for 1 h. The mouse in each group was evaluated by SAH grading and neurological function score, brain water content, and evans blue (EB) staining was used to calculate the amount of EB exudation to evaluate the permeability of blood brain barrier in mice. Western blot was used to detect matrix metalloprotein 9 (MMP‑9) and tight junction protein [zonula occludens‑1 (ZO‑1), accludin and claudin‑5] and inflammation‑related proteins NLRP3, apoptosis‑associated speck‑like protein containing CARD (ASC), cleaved caspase‑1, interleukin (IL)‑18, IL‑1β expression. Rreal‑time fluorescence quantitative polymerase chain reaction (PCR) detection of NLRP3 mRNA, caspase‑1 mRNA expression levels, detection of caspase‑1 activation. Terminal deoxynucleotidyl transferase‑mediated dUTP‑biotin nick end labeling (TUNEL) and NeuN double staining was used to detect neuronal pyroptosis. Results SAH bleeding grade and neurological function score showed that compared with group A, the SAH grade of group B was significantly increased (P<0.05), and compared with group B, the SAH grade of group C was significantly decreased (P<0.05). Compared with group C, the neurological score of group B was significantly reduced (P<0.05). Compared with group A, the brain water content and EB staining of group B increased significantly (P<0.05). Compared with group B, the brain water content and EB staining of group C decreased significantly (P<0.05). Compared with group A, the protein expression levels of ZO‑1, occludin and claudin‑5 of group B were significantly reduced (P<0.05), and the protein expression levels of NLRP3, ASC, cleaved caspase‑1, IL‑1β and IL‑18 of group B were significantly increased (P<0.05). Compared with group B, the expression levels of ZO‑1, occludin and claudin‑5 in group C were significantly increased (P<0.05), and the expression levels of NLRP3, ASC, cleaved caspase‑1, IL‑1β and IL‑18 were significantly decreased (P<0.05). Compared with group A, the expression level of MMP‑9 in group B was significantly increased. Compared with group B, the expression level of MMP‑9 in group C was significantly decreased (P<0.05). Real‑time quantitative PCR experiments showed that compared with group A, the mRNA levels of NLRP3 and caspase‑1 in group B were significantly increased; compared with group B, the mRNA levels of NLRP3 and caspase‑1 in group C were significantly decreased (P<0.05). Compared with group A, the activity of caspase‑1 in group B was greatly increased; compared with group B, the activity of caspase‑1 in group C was significantly decreased (P<0.05). TUNEL staining test showed that compared with group A, the number of TUNEL‑positive neurons in group B was significantly increased (P<0.05); compared with group B, the number of TUNEL‑positive neurons in group C was significantly decreased (P<0.05). Conclusions Sevoflurane can inhibit the NLRP3 inflammasome‑mediated pyroptosis after SAH and improve early brain injury after SAH.

Key words: Sevoflurane; Subarachnoid hemorrhage; Brain injury; Nod‑like receptor associated protein 3; Pyroptosis