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Stroke：血栓中性粒细胞胞外陷阱内容物不利于tPA诱导的急性缺血性卒中溶栓！

2018-02-09 xing.T MedSci原创

NETs血栓AIS溶栓
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由此可见，本研究提示血栓内NETs内容物可能是导致再灌注耐受的原因，包括机械或静脉注射tPA的药物方法，而不考虑其病因。应该在AIS患者中进一步探索除了tPA之外加用DNAse1这一策略的功效。

嗜中性粒细胞胞外陷阱（NETs）是由组蛋白和由活化的嗜中性粒细胞产生的颗粒状蛋白质装饰而成的DNA胞外网络。NETs已被确定为血栓形成的主要触发因素和结构性因素。最近的一项研究指出来自于NETs的细胞外DNA线条是改善急性冠脉综合征组织型纤溶酶原激活剂（tPA）诱导溶栓的潜在治疗靶点。近日，卒中领域权威杂志Stroke上发表了一篇研究文章，该研究的目的是评估急性缺血性卒中（AIS）患者血管内治疗期间血栓中NETs的存在情况及其对tPA诱导的血栓溶解的影响。

研究人员分析了108例接受血管内治疗的AIS患者的血栓。血栓通过苏木精/伊红染色、免疫染色和离体酶测定进行分析归纳特点。此外，研究人员还评估了体外脱氧核糖核酸酶1（DNAse 1）对AIS患者血栓溶解的影响。

组织学分析显示，NETs对所有AIS血栓的组成成分具有促进作用，特别是在其外层中起作用。血栓中NETs内容物的定量测量与患者临床结局或AIS发病机制无关，但与血管内治疗手术操作时间长短和装置通过次数显著相关。体外重组DNAse 1可以加速了tPA诱导的血栓溶解，而单独的DNAse 1则无效。

由此可见，本研究提示血栓内NETs内容物可能是导致再灌注耐受的原因，包括机械或静脉注射tPA的药物方法，而不考虑其病因。应该在AIS患者中进一步探索除了tPA之外加用DNAse1这一策略的功效。

原始出处：

Celina Ducroux,et al. Thrombus Neutrophil Extracellular Traps Content Impair tPA-Induced Thrombolysis in Acute Ischemic Stroke.Stroke. 2018.https://doi.org/10.1161/STROKEAHA.117.019896

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    2018-10-25 12435c7fm60暂无昵称

    好好学习

    0

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    2018-12-26 爆笑小医

    #缺血性卒#

    0

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    2018-09-12 循证小兵

    #tPA#

    0

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    2018-10-04 guihongzh

    #缺血性#

    0

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    2018-02-11 yykkxiaodou

    #中性粒细胞#

    0

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    2018-02-11 h.y200607_23674418

    #中性粒细胞胞外陷阱#

    0