Reductions in brain pericytes are associated with arteriovenous malformation vascular instability
| العنوان: | Reductions in brain pericytes are associated with arteriovenous malformation vascular instability |
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| المؤلفون: | Harjus Birk, Carlene Partow, Hua Su, Tarik Tihan, Xiaolin Chen, George F Lasker, John K. Yue, Jan-Karl Burkhardt, Ethan A. Winkler, Helen Kim, W. Caleb Rutledge, Brian P. Walcott, Michael T. Lawton, Diana E. Guo, Edward F. Chang |
| المصدر: | Journal of neurosurgery, vol 129, iss 6 |
| بيانات النشر: | Journal of Neurosurgery Publishing Group (JNSPG), 2018. |
| سنة النشر: | 2018 |
| مصطلحات موضوعية: | CD31 = platelet endothelial adhesion molecule 1, Male, 0301 basic medicine, Pathology, Angiogenesis, Hemodynamics, Cardiovascular, ROI = region of interest, 2.1 Biological and endogenous factors, Aetiology, Child, arteriovenous malformations, microhemorrhage, Brain, General Medicine, Middle Aged, stroke, Platelet-Derived Growth Factor beta, medicine.anatomical_structure, CD13 = aminopeptidase N, Blood-Brain Barrier, BBB = blood-brain barrier, Female, Pericyte, Receptor, Adult, Intracranial Arteriovenous Malformations, medicine.medical_specialty, Adolescent, Clinical Sciences, GFAP = glial fibrillary acidic protein, vascular disorders, Blood–brain barrier, pericytes, Article, Mural cell, Receptor, Platelet-Derived Growth Factor beta, Young Adult, 03 medical and health sciences, medicine, Humans, NVLC = nonvascular lesion control, Vascular Diseases, MTT = mean transit time, Intracerebral hemorrhage, PDGFRβ = platelet-derived growth factor receptor–beta, Neurology & Neurosurgery, business.industry, Neurosciences, Endothelial Cells, Blood flow, blood-brain barrier, bAVM = brain arteriovenous malformation, medicine.disease, intracerebral hemorrhage, 030104 developmental biology, Hemosiderin, Pericytes, business |
| الوصف: | OBJECTIVEBrain arteriovenous malformations (bAVMs) are rupture-prone tangles of blood vessels with direct shunting of blood flow between arterial and venous circulations. The molecular and/or cellular mechanisms contributing to bAVM pathogenesis and/or destabilization in sporadic lesions have remained elusive. Initial insights into AVM formation have been gained through models of genetic AVM syndromes. And while many studies have focused on endothelial cells, the contributions of other vascular cell types have yet to be systematically studied. Pericytes are multifunctional mural cells that regulate brain angiogenesis, blood-brain barrier integrity, and vascular stability. Here, the authors analyze the abundance of brain pericytes and their association with vascular changes in sporadic human AVMs.METHODSTissues from bAVMs and from temporal lobe specimens from patients with medically intractable epilepsy (nonvascular lesion controls [NVLCs]) were resected. Immunofluorescent staining with confocal microscopy was performed to quantify pericytes (platelet-derived growth factor receptor–beta [PDGFRβ] and aminopeptidase N [CD13]) and extravascular hemoglobin. Iron-positive hemosiderin deposits were quantified with Prussian blue staining. Syngo iFlow post–image processing was used to measure nidal blood flow on preintervention angiograms.RESULTSQuantitative immunofluorescent analysis demonstrated a 68% reduction in the vascular pericyte number in bAVMs compared with the number in NVLCs (p < 0.01). Additional analysis demonstrated 52% and 50% reductions in the vascular surface area covered by CD13- and PDGFRβ-positive pericyte cell processes, respectively, in bAVMs (p < 0.01). Reductions in pericyte coverage were statistically significantly greater in bAVMs with prior rupture (p < 0.05). Unruptured bAVMs had increased microhemorrhage, as evidenced by a 15.5-fold increase in extravascular hemoglobin compared with levels in NVLCs (p < 0.01). Within unruptured bAVM specimens, extravascular hemoglobin correlated negatively with pericyte coverage (CD13: r = −0.93, p < 0.01; PDGFRβ: r = −0.87, p < 0.01). A similar negative correlation was observed with pericyte coverage and Prussian blue–positive hemosiderin deposits (CD13: r = −0.90, p < 0.01; PDGFRβ: r = −0.86, p < 0.01). Pericyte coverage positively correlated with the mean transit time of blood flow or the time that circulating blood spends within the bAVM nidus (CD13: r = 0.60, p < 0.05; PDGFRβ: r = 0.63, p < 0.05). A greater reduction in pericyte coverage is therefore associated with a reduced mean transit time or faster rate of blood flow through the bAVM nidus. No correlations were observed with time to peak flow within feeding arteries or draining veins.CONCLUSIONSBrain pericyte number and coverage are reduced in sporadic bAVMs and are lowest in cases with prior rupture. In unruptured bAVMs, pericyte reductions correlate with the severity of microhemorrhage. A loss of pericytes also correlates with a faster rate of blood flow through the bAVM nidus. This suggests that pericytes are associated with and may contribute to vascular fragility and hemodynamic changes in bAVMs. Future studies in animal models are needed to better characterize the role of pericytes in AVM pathogenesis. |
| وصف الملف: | application/pdf |
| تدمد: | 1933-0693 0022-3085 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::335caf6878a9e21cd90e49e484cb7f52 https://doi.org/10.3171/2017.6.jns17860 |
| حقوق: | OPEN |
| رقم الأكسشن: | edsair.doi.dedup.....335caf6878a9e21cd90e49e484cb7f52 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 19330693 00223085 |
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