POLYMORPHONUCLEAR LEUKOCYTES OCCLUDE CAPILLARIES FOLLOWING MIDDLE CEREBRAL-ARTERY OCCLUSION AND REPERFUSION IN BABOONS

被引:638
作者
DELZOPPO, GJ
SCHMIDSCHONBEIN, GW
MORI, E
COPELAND, BR
CHANG, CM
机构
[1] SCRIPPS RES INST, DEPT NEUROSURG, LA JOLLA, CA 92037 USA
[2] UNIV CALIF SAN DIEGO, DEPT AMES BIOENGN, LA JOLLA, CA 92093 USA
[3] SCRIPPS CLIN & RES FDN, ELECTRON MICROSCOPY LAB, LA JOLLA, CA 92037 USA
关键词
NEUTROPHILS; REPERFUSION; BABOONS;
D O I
10.1161/01.STR.22.10.1276
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background and Purpose: Microvascular perfusion defects may accompany sustained occlusion and subsequent reperfusion of the middle cerebral artery; however, the nature of such "no-reflow" defects remains unclear. Methods: In the absence of antithrombotic pretreatment, we documented lenticulostriatal microvascular flow integrity following 3-hour middle cerebral artery occlusion and 1-hour reperfusion in a baboon occlusion/reperfusion model by two methods identifying 1) microvascular occlusion and 2) microvascular patency. Results: Microvascular "no-reflow" involved capillaries (vessels of 4.0-7.5-mu-m diameter) of the lenticulostriatal territory. Capillary reflow included 27-39% of all capillaries in two subjects, indicating a significant reduction of perfusion from normal (2p = 0.045). In identical experimental preparations, single polymorphonuclear leukocytes completely occluded 4.7% of microvessels of capillary diameter in randomly selected fields, partially occluded 3.5% of postcapillary venules, and occluded 40% (four of 10) of capillaries in linear reconstruction along a 110-mu-m length. Circumferential contact between polymorphonuclear leukocytes and the luminal endothelial cell membranes was documented, with an intercellular gap of, at most, 160 nm. Fibrin was found with degranulated platelets when the latter were associated with granulocytes, but not with polymorphonuclear leukocytes alone. Conclusions: The finding of capillary-obstructing polymorphonuclear leukocytes in the microvascular bed following middle cerebral artery reperfusion in focal ischemia in this model satisfies an essential requirement for postulating their role in early microvascular injury and the "no-reflow" phenomenon.
引用
收藏
页码:1276 / 1283
页数:8
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