Document Detail


Impairment of the blood-brain barrier: a potential surrogate delineating the determinants of cerebral bleeding caused by fibrinolytic drugs.
MedLine Citation:
PMID:  10474793     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Intracranial bleeding is encountered in some patients with acute myocardial infarction treated with fibrinolytic drugs, and especially in patients with occult cerebral vasculopathy. In order to determine whether pharmacologically induced plasminemia is a determinant, and whether impairment of the blood-brain barrier can serve as a marker of risk, we studied spontaneously hypertensive stroke-prone rats (SHRSP) genetically disposed to cerebral vasculopathy. METHODS: In order to simulate the induction of plasminemia in patients treated with fibrinolytic drugs for acute myocardial infarction, three intravenous injections of human plasminogen and human tissue-type plasminogen activator (t-PA) were administered to the rats at 2-h intervals (12 mg plasminogen plus 60 micrograms t-PA, 6 mg plus 30 micrograms t-PA, and 0.5 mg plus 2.5 micrograms t-PA), and serial blood samples were assayed for plasmin. One hour after the final intravenous injection, the brain was perfusion-fixed with 4% formaldehyde, and the blood-brain barrier integrity was assessed by localization of immunoglobulin G (IgG) using fluorescein-conjugated goat anti-rat IgG and confocal microscopy. RESULTS: Transient plasminemia followed each injection of plasminogen and t-PA. Intracranial extravasation of IgG was observed in nine of 11 SHRSP treated with t-PA and plasminogen. None of seven SHRSP injected with vehicle alone exhibited extravasation (chi 2 = 6.37, P = 0.01). CONCLUSIONS: The results indicate that the blood-brain barrier in SHRSP is susceptible to impairment secondary to pharmacologically induced plasminemia and is predisposed to bleeding. The preparation developed may facilitate the delineation of relative risk of injury to cerebral vessels with thrombolytic therapy.
Authors:
P M Absher; E Hendley; D M Jaworski; D J Taatjes; B E Sobel
Related Documents :
14516413 - Protective effects of alpha-tocopherol and mannitol in both circulatory shock and cereb...
7916503 - Evaluation of delayed treatment of focal cerebral ischemia with three selective kappa-o...
14516413 - Protective effects of alpha-tocopherol and mannitol in both circulatory shock and cereb...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Coronary artery disease     Volume:  10     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-21     Completed Date:  1999-10-21     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  413-20     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Vermont 05446-2500, USA. pabsher@zoo.uvm.edu
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Animals
Blood-Brain Barrier*
Brain / drug effects*,  metabolism,  physiopathology
Cerebral Hemorrhage / chemically induced,  metabolism,  physiopathology*
Extravasation of Diagnostic and Therapeutic Materials
Female
Fibrinolysin / metabolism
Fibrinolytic Agents / pharmacology*
Hypertension / metabolism,  physiopathology*
Immunoglobulin G / metabolism
Male
Microscopy, Confocal
Plasminogen / pharmacology
Random Allocation
Rats
Rats, Inbred SHR
Rats, Inbred WKY
Tissue Plasminogen Activator / pharmacology
Chemical
Reg. No./Substance:
0/Fibrinolytic Agents; 0/Immunoglobulin G; 9001-91-6/Plasminogen; EC 3.4.21.68/Tissue Plasminogen Activator; EC 3.4.21.7/Fibrinolysin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Carotid intima-media thickness of young coronary patients.
Next Document:  One-year clinical follow-up with the serpentine balloon expandable stent: report of the first 100 pa...