Brain:中风、疲劳、冷漠、痴呆……这些脑小血管病症状都与炎症有关!

2021-10-23 MedSci原创 MedSci原创

这些发现强调了血浆sTREM2作为小血管疾病相关的白质损伤的强大预测标记物的潜在效用,并在治疗这种疾病时对靶向先天免疫反应具有临床意义。

如果把供应大脑的颈动脉比作树冠,水分经过由粗到细的树枝,输送到每一片树叶,而最末梢的树杈就是“脑小血管”。

大脑中的小血管广义上是指直径<500μm的位于大脑皮层深部的血管,狭义上,是特指脑内直径<200μm的小血管,其粗细相当于几根头发丝。当这些小血管发生了病变,比如阻塞或破裂,就会引起相应的症状——这就是脑小血管病(CSVD)。

很多时候,CSVD并没有明显的症状,许多患者只是体检后发现头部MRI的报告上写了“脑白质高信号(WMH)”、“缺血性白质病变”、“陈旧腔隙性梗死”等描述。如果此时掉以轻心,随着疾病的进展,部分患者可能会出现多种多样的症状。

CSVD还是全球最常见的血管性痴呆的主要原因。虽然有证据确定了炎症和脑血管病变之间的关系,但其机理联系还没有被阐明。最近的研究表明,免疫介质的激活,包括骨髓细胞上表达的可溶性受体2(TREM2),可能是关键的调节因素。

在近期发表在Brain的研究中,来自我国台湾的专家比较了10名AD患者和66名自发性脑内出血伴脑淀粉样血管病或高血压小血管病(两种最常见的散发性CSVD)幸存者的sTREM2的血浆水平及其与神经影像标志物和脑Aβ负荷的相关性。研究人员对所有参与者进行了脑部MRI和11C-匹兹堡化合物B PET,以评估放射性CSVD标志物和大脑Aβ负担,并对一个亚组患者进行了18F-T807 PET,以评估皮质tau病理学。

结果显示,AD患者和CSVD患者的血浆sTREM2水平相当(P=0.690)。在CSVD患者中,血浆sTREM2与WMH显著相关(P<0.001),但与大脑Aβ负荷无关。在AD和脑淀粉样血管病患者中,血浆sTREM2与tau阳性扫描(P=0.001)和WMH(P=0.013)独立相关,但与Aβ(P=0.221)无关。

血浆sTREM2与白质病变、Tau负担和认知的关系

综上,血浆sTREM2与WMH有关,与Aβ和tau病理学无关。这些发现强调了血浆sTREM2作为小血管疾病相关的白质损伤的强大预测标记物的潜在效用,并在治疗这种疾病时对靶向先天免疫反应具有临床意义。

 

参考文献:

Plasma soluble TREM2 is associated with white matter lesions independent of amyloid and tau, Brain, 2021;, awab332, https://doi.org/10.1093/brain/awab332

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    2021-11-06 杨致

    感谢分享

    0

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    2021-10-25 tamgche
  5. [GetPortalCommentsPageByObjectIdResponse(id=1715864, encodeId=58181e15864e3, content=<a href='/topic/show?id=441b4e17253' target=_blank style='color:#2F92EE;'>#小血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=47172, encryptionId=441b4e17253, topicName=小血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=956e32082497, createdName=clmlylxy, createdTime=Wed Sep 07 08:45:44 CST 2022, time=2022-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1644920, encodeId=5f7a16449206b, content=<a href='/topic/show?id=e3eb89e17fb' target=_blank style='color:#2F92EE;'>#血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89717, encryptionId=e3eb89e17fb, topicName=血管病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=64bb23195917, createdName=Luyuxie_17, createdTime=Sun Mar 06 10:45:44 CST 2022, time=2022-03-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1067610, encodeId=63c8106e610c3, content=感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=801b5560292, createdName=杨致, createdTime=Sat Nov 06 16:04:28 CST 2021, time=2021-11-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1260944, encodeId=7c631260944e0, content=<a href='/topic/show?id=493ee0559a7' target=_blank style='color:#2F92EE;'>#疲劳#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70559, encryptionId=493ee0559a7, topicName=疲劳)], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=674961, createdName=tamgche, createdTime=Mon Oct 25 09:45:44 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304280, encodeId=64c2130428043, content=<a href='/topic/show?id=87068482845' target=_blank style='color:#2F92EE;'>#脑小血管病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=44, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84828, encryptionId=87068482845, topicName=脑小血管病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=68f2317, createdName=天堂的云, createdTime=Mon Oct 25 09:45:44 CST 2021, time=2021-10-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1063501, encodeId=696d10635010f, content=如果把**大脑的颈动脉比作树冠,水分经过由粗到细的树枝,输送到每一片树叶,而最末梢的树杈就是“脑小血管”。, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a54e5645039, createdName=ms9000000212834100, createdTime=Sun Oct 24 17:32:40 CST 2021, time=2021-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1246322, encodeId=96111246322d6, content=老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=neuro.Dr, createdTime=Sat Oct 23 21:45:44 CST 2021, time=2021-10-23, status=1, ipAttribution=)]
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    2021-10-24 ms9000000212834100

    如果把**大脑的颈动脉比作树冠,水分经过由粗到细的树枝,输送到每一片树叶,而最末梢的树杈就是“脑小血管”。

    0

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    2021-10-23 neuro.Dr

    老年性痴呆,未来还是希望借助神经电生理吧,也许更为有效!

    0

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