中华脑科疾病与康复杂志(电子版) 2016年6月,6卷3期

综述

远隔缺血后适应与基因差异表达的研究进展

吴凌1 汪孟然2 石晶2 刘茜2 闫中瑞2 李好好1 邢怀美1

250012 济南,山东大学1;272000 山东省,济宁市第一人民医院神经内科2
闫中瑞,Email:zhongruiy@163.com

摘要:急性脑梗死严重威胁人类的健康,实施早期有效的溶栓治疗、恢复缺血脑组织的血流和功能是临床公认有效的治疗手段。但溶栓治疗有严格的时间窗限制,能在早期行溶栓治疗的患者仅有5%,且并发症较多,为了攻克这一难题,缺血后适应对缺血脑组织的保护作用逐渐进入了人们的视线。目前远隔缺血后适应(RIPC)已成为当今研究的热点,通过对非致死性器官如远端肢体进行短暂非致死性重复缺血-再灌注处理,可明显减轻已缺血器官的缺血-再灌注损伤,对于已缺血脑组织可减轻其炎症反应,改善脑水肿,减小梗死体积。对于这一结论,许多研究都已证实,然而其发生机制尚不明确,目前较为公认的假说有抗细胞凋亡、抗氧化、抑制炎症反应、抑制一氧化氮(NO)释放、增加细胞因子等。本文将就基因的差异性表达作一相关性探讨。

关键词: 脑梗死; 基因; 远隔缺血后适应; 差异表达

参考文献

1 Murry CE,Jennings RB,Reimer KA,et al.Preconditioning with ischemia:a lay of lethal cell injury in ischemicmyocaidium[J].Circulation,1986,74(5):1124-1136.
2 Zhao ZQ,Corvera JS,Halkos ME,et al.Inhibition of myocardial injury by ischemic postconditioning reperfusion comparison with ischemic preconditioning[J].Am J Physiol Heart Circ Physiol,2003,285(2):H579-H588.
3 Hoyte LC,Papadakis M,Barber PA,et al.Improved regional cerebral blood flow is important for the protection seen in a mouse model of late phase ischemic preconditioning[J].Brain Res,2006,1121(1):231-237.
4 Kerendi F,Kin H,Halkos ME,et al.Remote postconditioning.Brief renal ischemia and reperfusion applied before coronary artery reperfusion reduces myocardial infarct size via endogenous activation of adenosine receptors[J].Basic Res Cardiol,2005,100(5):404-412.
5 Zhang W,Miao Y,Zhou S,et al.Neuroprotective effects of ischemic postconditioning on global brain ischemia in rats through upregulation of hippocampal glutamine synthetase[J].J Clin Neurosci,2011,18(5):685-689.
6 Zhang W,Miao Y,Zhou S,et al.Involvement of glutamate transporter-1 in neuroprotection against global brain ischemia-reperfusion injury induced by postconditioning in rats[J].Int J Mol Sci,2010,11(11):4407-4416.
7 Nikkola E,Laiwalla A,Ko A,et al.Remote ischemic conditioning alters methylation and expression of cell cycle genes in aneurysmal subarachnoid hemorrhage[J].Stroke,2015,46(9):2445-2451.
8 董文帅,金巍,陈静,等.远隔缺血预处理诱导大鼠缺血脑保护的基因表达谱分析[J].Chin J Clin Neurosci,2015,23(1):1-8.
9 Wei D,Ren C,Chen X,et al.The chronic protective effects of limb remote preconditioning and the underlying mechanisms involved in inflammatory factors in rat stroke[J].PLoS One,2012,7(2):e30892.
10 Xu T,Gong Z,Zhu WZ,et al.Remote ischemic preconditioning protects neurocognitive function of rats following cerebral hypoperfusion[J].Med Sci Monit,2011,17(11):BR299-304.
11 Baudry M,Bi X,Aguirre C.Progesterone-estrogen interactions in synaptic plasticity and neuroprotection[J].Neuroscience,2013,239:280-294.
12 Wang X,Zhang J,Yang Y,et al.Progesterone attenuates cerebral edema in neonatal rats with hypoxic-ischemic brain damage by inhibiting the expression of matrix metalloproteinase-9 and aquaporin-4[J].Exp Ther Med,2013,6(1):263-267.
13 Yu L,Fan SJ,Liu L,et al.Effect of ischemic postconditioning on cerebral edema and the AQP4 expression following hypoxic-ischemic brain damage in neonatal rats[J].World J Pediatr,2015,11(2):165-170.
14 Li S,Hu X,Zhang M,et al.Remote ischemic post-conditioning improves neurological function by AQP4 down-regulation in astrocytes[J].Behav Brain Res,2015,289:1-8.
15 Han D,Sun M,He PP,et al.Ischemic postconditioning alleviates brain edema after focal cerebral ischemia reperfusion in rats through down-regulation of aquaporin-4[J].Mol Neurosci,2015,56(3):722-729.
16 Hu S,Dong H,Zhang H,et al.Noninvasive limb remote ischemic preconditioning contributes neuroprotective effects via activation of adenosine A1 receptor and redox status after transient focal cerebral ischemia in rats[J].Brain Res,2012,1459:81-90.
17 Gao Y,Song J,Chen H,et al.TRPV1 activation is involved in the cardioprotection of remote limb ischemic postconditioning in ischemia-reperfusion injury rats[J].Biochem Biophys Res Commun,2015,463(4):1034-1039.
18 Brandenburger T,Grievink H,Heinen N,et al.Effects of remote ischemic preconditioning and myocardial ischemia on microRNA-1 expression in the rat heart in vivo[J].Shock,2014,42(3):234-238.
19 Wu H,Yang SF,Dai J,et al.Combination of early and delayed ischemic postconditioning enhances brain-derived neurotrophic factor production by upregulating the ERK-CREB pathway in rats with focal[J].Mol Med Rep,2015,12(5):6427-6434.
20 Zhang J,Ohta T,Maruyama A,et al.BRG1 interacts with Nrf2 to selectively mediate HO-1 induction in response to oxidative stress[J].Mol Cell Biol,2006,26(21):7942-7952.
21 Li P,Su L,Li X,et al.Remote limb ischemic postconditioning protects mouse brain against cerebral ischemia/reperfusion injury via upregulating expression of Nrf2,HO-1 and NQO-1 in mice[J].Int J Neurosci, 2016,126(6):552-559.
22 Wu ZY, Wang ZW, Hu R,et al.Role of Nrf2 signal pathway in rats with deep hypothermia ischemia/reperfusion injury undergoing remotepostconditioning[J].Genet Mol Res,2015,14(1):492-499.
23 Chavez JC,LaManna JC.Activation of hypoxia-induced factor-1in the rat cerebral cortex after transient global ischemia:poten-tial role of insulin-like growth factor-1[J].J Neurosci,2002,22(20):8922-8931.
24 Zong Y,Jiang L,Zhang M,et al.Limb remote ischemic postconditioning protects cerebral ischemia from injury associated with expression of HIF-1α in rats[J].BMC Neurosci,2015,16:97.
25 Zhu T,Zhan L,Liang D,et al.Hypoxia-inducible factor 1α mediates neuroprotection of hypoxic postconditioning against global cerebral ischemia[J].Neuropathol Exp Neurol,2014,73(10):975-986.

(编辑:杨智华 收稿日期:2016-05-19)