呂越昌 施德源姜曉幸 馮振洲 蔣 淳 陳子賢
(復(fù)旦大學(xué)附屬中山醫(yī)院骨科 上海 200032)
神經(jīng)絲氨酸蛋白酶抑制劑(NSP)對(duì)大鼠急性脊髓損傷(SCI)后神經(jīng)功能的修復(fù)作用
呂越昌 施德源△姜曉幸 馮振洲 蔣 淳 陳子賢
(復(fù)旦大學(xué)附屬中山醫(yī)院骨科 上海 200032)
目的通過檢測(cè)腦源性神經(jīng)生長(zhǎng)因子(brain-derived neurotrophic factor,BDNF)、膠質(zhì)細(xì)胞源性神經(jīng)生長(zhǎng)因子(glial cell line-derived neurotrophic factor,GDNF)和軸突生長(zhǎng)抑制因子(neurite outgrowth inhibitor A,Nogo-A)的表達(dá)情況,來評(píng)估神經(jīng)絲氨酸蛋白酶抑制劑(neuroserpin,NSP)對(duì)急性脊髓損傷(spinal cord injury,SCI)大鼠神經(jīng)功能的恢復(fù)情況并對(duì)其機(jī)制進(jìn)行初步探索。方法130只成年雄性SD大鼠隨機(jī)分成3組:SCI組(n=60),用改良Allen's重物打擊法制備SCI模型,鞘內(nèi)注射生理鹽水25μL。NSP組(n=60),大鼠SCI后立即鞘內(nèi)注射NSP 25μL。正常對(duì)照組(n=10),只去除椎板,暴露脊髓,不造成SCI。各組定期行為學(xué)觀察(BBB評(píng)分),Western blot檢測(cè)SCI局部GDNF和Nogo-A的表達(dá),real-time PCR檢測(cè)SCI局部BDNF、GDNF和Nogo-A的表達(dá)情況。結(jié)果隨時(shí)間延長(zhǎng),術(shù)后SCI組和NSP組大鼠BBB評(píng)分均逐漸升高,但是兩組并無明顯差異。Western blot和real-time PCR顯示:急性SCI后1天GDNF表達(dá)明顯升高,且隨時(shí)間延長(zhǎng)其表達(dá)量逐漸降低,同時(shí),在1、3、7和14天各時(shí)間點(diǎn)NSP組GDNF表達(dá)量均高于SCI組。急性SCI后Nogo-A表達(dá)成逐漸升高趨勢(shì),同時(shí),NSP組在各時(shí)間點(diǎn)的Nogo-A表達(dá)量均低于SCI組。real-time PCR顯示:SCI 1天后BDNF表達(dá)水平顯著提高,隨時(shí)間推移,表達(dá)水平逐漸下降;同時(shí),NSP組在1、3、7和14天各時(shí)間點(diǎn)BDNF水平均明顯低于SCI組。結(jié)論急性SCI后,大鼠內(nèi)源性BDNF、GDNF和Nogo-A的表達(dá)水平均升高。外源性給予NSP對(duì)大鼠急性SCI后的運(yùn)動(dòng)功能無明顯改善,但在基因和蛋白質(zhì)水平對(duì)大鼠的神經(jīng)功能恢復(fù)有一定的促進(jìn)作用。
神經(jīng)絲氨酸蛋白酶抑制劑(NSP); 脊髓損傷(SCI); 腦源性神經(jīng)生長(zhǎng)因子(BDNF); 膠質(zhì)細(xì)胞源性神經(jīng)生長(zhǎng)因子(GDNF); 軸突生長(zhǎng)抑制因子(Nogo-A); 大鼠
脊髓損傷(spinal cord injury,SCI)后的功能重建與恢復(fù)是醫(yī)學(xué)界面臨的難題,迄今仍缺乏確定性的治療方法。神經(jīng)絲氨酸蛋白酶抑制劑(neuroserpin,NSP)是一種軸突選擇性的神經(jīng)源性絲氨酸蛋白酶抑制劑,屬于serpins超家族[1],在成人中樞神經(jīng)系統(tǒng)(central nerves system,CNS)有廣泛表達(dá),主要存在于海馬、下丘腦、小腦、嗅球、杏仁核以及交感神經(jīng)系統(tǒng),脊髓內(nèi)及背根神經(jīng)節(jié)內(nèi)也有大量表達(dá)[2]。有研究表明NSP在腦缺血進(jìn)程中起著一定的腦保護(hù)作用,外源性應(yīng)用NSP可以降低腦缺血再灌注后梗死體積,同時(shí)缺血半暗帶區(qū)凋亡細(xì)胞的數(shù)量[3]。我們之前的研究發(fā)現(xiàn),在大鼠慢性脊髓壓迫損傷后1~2天NSP呈表達(dá)高峰,隨后進(jìn)行性下降,而神經(jīng)元凋亡在受壓后6周較2周時(shí)明顯升高,且具有統(tǒng)計(jì)學(xué)意義[4]。由此我們推測(cè)NSP對(duì)SCI后神經(jīng)功能修復(fù)可能具有促進(jìn)作用。因此,本實(shí)驗(yàn)觀察SCI用NSP干預(yù)后的神經(jīng)功能修復(fù)情況,并對(duì)其機(jī)制進(jìn)行初步研究。
大鼠急性SCI模型健康成年雄性SD大鼠130只,體質(zhì)量為250 g(±20 g),購自上海斯萊克實(shí)驗(yàn)動(dòng)物有限責(zé)任公司。10%水合氯醛腹腔麻醉(0.3~0.4 m L/100 g),將大鼠俯臥,在背部沿脊柱由上而下摸至突出最高處為第10胸椎棘突,以此為中心備皮,常規(guī)消毒,鋪無菌手術(shù)單,后正中線作約2 cm切口,暴露T10、T11椎體,用磨鉆將T11橫突與椎板連接處磨斷,然后用咬骨鉗去除棘突和椎板,充分暴露T11脊髓。用改良的Allen's撞擊器制備SCI動(dòng)物模型,打擊時(shí)用拉鉤拉開脊髓兩側(cè)軟組織,使脊柱穩(wěn)定,不受呼吸運(yùn)動(dòng)影響,致傷量5 g×6 cm。撞擊后發(fā)現(xiàn)脊髓組織水腫、出血,硬脊膜完整呈紫紅色,緊張、膨隆、大鼠尾巴出現(xiàn)痙攣性擺動(dòng),雙下肢軀體回縮樣撲動(dòng),呈遲緩性癱瘓,即造模成功。造模后NSP組立即鞘內(nèi)注射重組人NSP(Pepro Tech公司,20μg/m L)25μL,SCI組鞘內(nèi)注射生理鹽水25 μL。術(shù)后常規(guī)給予抗生素預(yù)防感染,維持3天。術(shù)后人工排尿,每天3次。
BBB評(píng)分法參照Basso等[5]提出的SCI大鼠功能恢復(fù)評(píng)判標(biāo)準(zhǔn)即BBB評(píng)分法,雙盲法對(duì)各組動(dòng)物后肢運(yùn)動(dòng)能力進(jìn)行評(píng)估。根據(jù)關(guān)節(jié)活動(dòng)、前后肢協(xié)調(diào)運(yùn)動(dòng)、身體支撐、軀干及尾的位置等情況打分(0~21分)。0分代表后肢無活動(dòng),21分表示后肢活動(dòng)正常。
Western hlot檢測(cè)GDNF和Nogo-A表達(dá)NSP組和SCI組分別在造模后1、3、7和14天各取6只大鼠,過量10%水合氯醛腹腔注射致死,嚴(yán)格無菌操作取出傷段脊髓組織,用冰凍生理鹽水沖洗后迅速置于液氮中保存,而后將標(biāo)本轉(zhuǎn)至-80℃保存。按每100 mg標(biāo)本加1m L預(yù)冷蛋白裂解液(RIPA),玻璃勻漿器勻漿,至充分裂解,4℃12 000×g離心10 min,取上清,即得組織總蛋白產(chǎn)物,然后進(jìn)行SDS-PAGE電泳,PVDF膜轉(zhuǎn)膜,5%脫脂奶粉封閉,加一抗(兔抗GDNF,1∶500,Abcam;兔抗 Nogo-A,1∶1 000,Abcam;鼠抗β-actin,1∶5 000,Abcam),4℃過夜,加 HRP標(biāo)記二抗(1∶5 000,abcam),室溫孵育1 h,ECL顯影。
real-time PCR檢測(cè)NSP組和SCI組分別在造模后1、3、7和14天各取6只大鼠,過量10%水合氯醛腹腔注射致死,嚴(yán)格無菌操作取出傷段脊髓組織。Trizol試劑盒提取總RNA,紫外分光光度法測(cè)RNA濃度,然后總RNA反轉(zhuǎn)錄為cDNA,進(jìn)行real-time PCR反應(yīng),以β-actin為內(nèi)參。引物序列由上海生工生物工程股份有限公司合成。β-actin:上游引物5'-AATCAAGATCATTGCTCCACCAG-3',下游引物5'-TTAGAAGCATTTGCGGTGGAC-3';BDNF:上游引物5'-GATGAGGACCAGAAGGTTCG-3',下游引物 5'-GATTGGGTAGTTCGGCATTG-3';GDNF:上游引物5'-CCACACCGTTTAGCGGAATGC-3',下游引 物 5'-CGGGACTCTAAGATGAAGTTATGGG-3';Nogo-A:上 游 引 物 5'-CCGATACAGAAAAAGAGGACAG-3',Nogo-A:下游引物5'-AGGCTGGCACCAAACACC-3'。PCR儀為QIAGEN Rotor-Gene Q。
統(tǒng)計(jì)學(xué)處理實(shí)驗(yàn)數(shù)據(jù)均以±s表示,采用SPSS 11.0軟件進(jìn)行單因素方差分析。
BBB評(píng)分正常大鼠在造模前評(píng)分均為21分。對(duì)照組因?yàn)槭中g(shù)去除椎板的影響,術(shù)后1天評(píng)分稍有下降,之后迅速恢復(fù)為21分并保持穩(wěn)定。SCI組和NSP組術(shù)后1天均表現(xiàn)為喪失所有后肢運(yùn)動(dòng),評(píng)分為0,但隨時(shí)間延長(zhǎng),兩組大鼠評(píng)分漸漸升高,至14天時(shí)均超過8分。然而,NSP組與SCI組同時(shí)間段進(jìn)行比較并無明顯差異(P>0.05,表1)。
表1 3組大鼠BBB評(píng)分Tah 1 BBB scores in the 3 groups of rats±s)
表1 3組大鼠BBB評(píng)分Tah 1 BBB scores in the 3 groups of rats±s)
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Western hlot結(jié)果Western blot顯示:在正常成年大鼠脊髓內(nèi)GDNF表達(dá)很少,急性SCI后1天GDNF表達(dá)明顯升高,隨時(shí)間延長(zhǎng),其表達(dá)量逐漸降低,14天時(shí)略高于正常對(duì)照組;同時(shí),在1、3、7和14天各時(shí)間點(diǎn)NSP組GDNF表達(dá)量均高于SCI組(圖1)。Nogo-A在正常成年大鼠脊髓內(nèi)的表達(dá)量也較少,急性SCI后其表達(dá)成逐漸升高趨勢(shì),14天時(shí)表達(dá)最強(qiáng);同時(shí),NSP組在各時(shí)間點(diǎn)的Nogo-A表達(dá)量均低于SCI組(圖2)。
圖1 3組大鼠不同時(shí)間GDNF蛋白表達(dá)量Fig 1 Expressions of GDNF protein in the 3 groups of rats at different time points
圖2 3組大鼠不同時(shí)間Nogo-A蛋白表達(dá)量Fig 2 Expressions of Nogo-A protein in the 3 groups of rats at different time points
real-time PCR檢測(cè)結(jié)果real-time PCR顯示:BDNF在正常對(duì)照組表達(dá)極少,造模后1天NSP組與SCI組BDNF表達(dá)水平均顯著升高,隨時(shí)間推移,表達(dá)水平逐漸下降,但總是高于正常對(duì)照組。同時(shí),NSP組在1、3、7和14天各時(shí)間點(diǎn)BDNF水平均明顯低于SCI組(圖3);GDNF在正常對(duì)照組表達(dá)極少,SCI后1天NSP組與SCI組GDNF表達(dá)水平均顯著升高,隨時(shí)間延長(zhǎng),其表達(dá)水平逐漸下降,但總是高于正常對(duì)照組。同時(shí),NSP組在1、3和7天時(shí)間點(diǎn)GDNF水平明顯高于SCI組(圖4)。Nogo-A在正常組少量表達(dá),SCI后表達(dá)水平緩慢升高,在14天時(shí)達(dá)到最高峰(只觀察到術(shù)后14天),同時(shí),NSP組在1、3、7和14天各時(shí)間點(diǎn)Nogo-A水平明顯低于SCI組(圖5)。
圖3 BDNF mRNA相對(duì)表達(dá)量Fig 3 Relative expression of BDNF mRNA(1)vs.SCI group,P<0.05;(2)vs.Control group,P<0.05.
圖4 GDNF mRNA相對(duì)表達(dá)量Fig 4 Relative expression of GDNF m RNA(1)vs.SCI group,P<0.05;(2)vs.Control group,P<0.05.
圖5 Nogo-A mRNA相對(duì)表達(dá)量Fig 5 Relative expression of Nogo-A mRNA(1)vs.NSP group,P <0.05;(2)vs.Control group,P<0.05.
NSP由神經(jīng)元的軸突分泌,在軸突生長(zhǎng)和對(duì)突觸連接的形成突觸可塑性方面起到重要作用[6]。同時(shí)NSP參與調(diào)控中樞神經(jīng)系統(tǒng)細(xì)胞外組織型纖溶酶原激活劑(tissue-type plasminogen activator,tPA)和纖維蛋白溶酶的蛋白水解的活性,兩者共同調(diào)節(jié)神經(jīng)元的遷移和突觸形成,在神經(jīng)元的重塑和維持上起重要作用[1,7]。tPA是一種絲氨酸蛋白酶,在中樞神經(jīng)系統(tǒng)神經(jīng)元中以m RNA和蛋白水平表達(dá)。在外周血中,tPA是體內(nèi)纖溶系統(tǒng)的生理性激動(dòng)劑,在人體纖溶和凝血的平衡調(diào)節(jié)中發(fā)揮著關(guān)鍵性的作用,是一種新型的血栓溶解劑。而在中樞神經(jīng)系統(tǒng)中,tPA能夠引發(fā)興奮性毒性和缺血性的神經(jīng)元死亡,可以加速腦缺血和癲過程中神經(jīng)細(xì)胞的死亡[8-10]。然而,NSP又是tPA的天然抑制劑[6],由此可推測(cè)NSP對(duì)興奮性毒性介導(dǎo)的神經(jīng)元死亡起抑制作用。
成熟哺乳動(dòng)物的中樞神經(jīng)系統(tǒng)再生能力極其微弱,主要與3個(gè)因素有關(guān):(1)CNS神經(jīng)元自身缺乏足夠的再生能力;(2)CNS缺乏足夠的神經(jīng)營養(yǎng)因子支持其再生;(3)CNS再生的微環(huán)境中主要受大量少突膠質(zhì)細(xì)胞(oligodendrocyte,Oligo)合成的髓磷脂(myelin)相關(guān)抑制物的影響[11]。由于機(jī)體客觀存在的不可改變的因素,我們?cè)囍深A(yù)后2個(gè)因素來探索NSP的神經(jīng)保護(hù)作用。神經(jīng)營養(yǎng)因子是機(jī)體產(chǎn)生的能夠促進(jìn)神經(jīng)細(xì)胞存活、生長(zhǎng)、分化的一類蛋白質(zhì)因子,且為神經(jīng)元生長(zhǎng)與存活所必需[12]。本實(shí)驗(yàn)所涉及的3種因子都與神經(jīng)元的生長(zhǎng)存活關(guān)系非常密切。腦源性神經(jīng)營養(yǎng)因子(brain derived neurotrophic factor,BDNF)能夠防止神經(jīng)元受損傷死亡、改善神經(jīng)元的病理狀態(tài)、促進(jìn)受損傷神經(jīng)元再生及分化,而且是成熟的中樞及周圍神經(jīng)系統(tǒng)的神經(jīng)元維持生存及正常生理功能所必需的一類神經(jīng)營養(yǎng)因子。膠質(zhì)細(xì)胞源性神經(jīng)營養(yǎng)因子(glial cell line-derived neurotrophic factor,GDNF)是已知的最重要的運(yùn)動(dòng)神經(jīng)元營養(yǎng)因子。髓磷脂相關(guān)抑制物包括軸突生長(zhǎng)抑制因子(neurite outgrowth inhibitor,Nogo)、髓 鞘 相 關(guān) 糖 蛋 白 (myelin associated glycoprotein,MAG)、少突膠質(zhì)細(xì)胞髓鞘糖 蛋 白 (oligodendrocyte myelin glycoprotein,OMgp)[13]。Nogo-A是Nogo的一種主要異構(gòu)體,是目前已知最強(qiáng)的神經(jīng)軸突生長(zhǎng)抑制因子,具有限制軸突的伸延及中樞系統(tǒng)損傷后軸突的再生能力[14]。Simonen等[15]證實(shí),Nogo-A基因敲除小鼠胸部脊髓背側(cè)半切2周后,與野生型小鼠相比,Nogo-A基因敲除鼠有更多的皮質(zhì)脊髓束纖維長(zhǎng)入損傷處。Kim等[16]也證明,成年Nogo-A/B基因敲除小鼠SCI后,皮質(zhì)脊髓內(nèi)的軸突可廣泛延伸至橫斷面,神經(jīng)纖維大量再生并進(jìn)入側(cè)索節(jié)段。我們?cè)O(shè)計(jì)本實(shí)驗(yàn)就是觀察NSP對(duì)SCI后的神經(jīng)系統(tǒng)功能修復(fù)機(jī)制是否與后2個(gè)因素有關(guān)。
在本實(shí)驗(yàn)中,急性SCI后SCI組和NSP組的BBB評(píng)分在1、3、7和14天各時(shí)間點(diǎn)呈逐漸升高趨勢(shì),但兩組之間在同時(shí)間點(diǎn)比較卻無明顯差異,說明NSP對(duì)SCI后大鼠的后肢運(yùn)動(dòng)功能改善無有效的促進(jìn)作用。同時(shí),Madani等[17]也發(fā)現(xiàn)NSP的缺乏和過表達(dá)均對(duì)小鼠的運(yùn)動(dòng)功能沒有任何影響,但是在異常環(huán)境中和焦慮情況下其反應(yīng)性會(huì)降低,如遇到新事物時(shí)所產(chǎn)生的心理上的恐懼。從這方面來看,NSP對(duì)急性SCI后大鼠的運(yùn)動(dòng)功能似乎無太大的改善作用。當(dāng)然,也可能與我們的觀察時(shí)間相對(duì)較短或者NSP的有效作用時(shí)間不夠長(zhǎng)有一定關(guān)系。
SCI后,BDNF和GDNF在基因和蛋白質(zhì)水平的表達(dá)均上調(diào),這與脊髓的自我修復(fù)功能有關(guān)。從GDNF和Nogo-A的Western blot及real-time PCR結(jié)果來看,NSP的神經(jīng)保護(hù)作用機(jī)制與GDNF和Nogo-A在體內(nèi)的表達(dá)量有一定關(guān)系。GDNF與Nogo-A在基因和蛋白質(zhì)水平上的表達(dá)基本一致,NSP組GDNF表達(dá)量高于SCI組,Nogo-A表達(dá)量低于SCI組,表明NSP可以促進(jìn)GDNF的釋放并抑制Nogo-A的產(chǎn)生,對(duì)SCI后神經(jīng)功能的修復(fù)具有積極作用。
然而,real-time PCR顯示BDNF mRNA表達(dá)量在SCI后1天達(dá)最高峰,之后逐漸下降,而NSP組在各時(shí)間點(diǎn)BDNF m RNA表達(dá)量明顯低于SCI組。從結(jié)果來看,NSP對(duì)SCI后神經(jīng)元的保護(hù)作用與BDNF呈負(fù)相關(guān)的關(guān)系,即NSP抑制了BDNF的表達(dá)。在正常機(jī)體內(nèi),纖維蛋白酶(plasmin)由纖維蛋白酶原(plasminogen)轉(zhuǎn)化而來的過程需要通過tPA的誘導(dǎo)才能進(jìn)行,而BDNF的前體proBDNF轉(zhuǎn)化為其成熟體BDNF又離不開plasmin的活化作用[18],而NSP又是tPA的天然抑制劑[6]。所以,NSP間接地阻斷了需要t PA才能完成proBDNF到BDNF轉(zhuǎn)變的正常生理過程。NSP可以抑制tPA介導(dǎo)的神經(jīng)元死亡,同時(shí)又阻斷了BDNF的生成,然而BDNF對(duì)SCI后神經(jīng)元的存活具有重要的積極作用,因此,NSP對(duì)SCI后神經(jīng)元的保護(hù)作用機(jī)制與BDNF無太大關(guān)系。
通過本研究,我們觀察到NSP對(duì)急性SCI后的神經(jīng)功能修復(fù)確實(shí)起到積極的促進(jìn)作用,這可能與內(nèi)源性GNDF、Nogo-A的表達(dá)量的高低有密切關(guān)系,NSP通過GNDF的上調(diào)和Nogo-A的下調(diào)來保護(hù)存活神經(jīng)元的正常功能,促進(jìn)受損傷神經(jīng)元的再生及分化,并修復(fù)脊髓損傷后軸突的再生能力和可塑性。同時(shí),NSP的神經(jīng)修復(fù)功能對(duì)大鼠的運(yùn)動(dòng)功能似乎沒有有效的作用。但是,NSP對(duì)其他神經(jīng)營養(yǎng)因子是否也有類似的作用,或者NSP修復(fù)損傷后中樞神經(jīng)系統(tǒng)功能的具體機(jī)制目前仍不清楚,甚至將來NSP應(yīng)用于臨床的問題,都需要進(jìn)一步研究和探討。
致謝中國科學(xué)院上海生命科學(xué)研究院的周嘉偉、尹延青及周嘉偉老師組的研究生提供了大力幫助和指導(dǎo)。
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Repair effects of neuroserpin(NSP)on neural function after acute spinal cord inJury(SCI)in rats
LüYue-chang,SHI De-yuan△,JIANG Xiao-xing,F(xiàn)ENG Zhen-zhou,JIANG Chun,CHEN Zi-xian
(Department of Orthopedics,Zhongshan Hospital,F(xiàn)udan University,Shanghai200032,China)
neuroserpin(NSP); spinal cord injury(SCI); brain-derived neurotrophic factor(BDNF);glial cell line-derived neurotrophic factor(GDNF); neurite outgrowth inhibitor A(Nogo-A); rat
R 683.2
A
10.3969/j.issn.1672-8467.2014.02.013
2013-02-20;編輯:沈玲)
△Corresponding author E-mail:shiaden@yahoo.com.cn
【Ahstract】 OhJectiveTo explore the expressions of brain-derived neurotrophic factor(BDNF),glial cell line-derived neurotrophic factor(GDNF)and neurite outgrowth inhibitor A(Nogo-A)in rat spinal cord tissues with acute spinal cord injury(SCI),and then to study whether neuroserpin(NSP)could change these expressions to protect the neural function.MethodsOne hundred and thirty SD rats were randomly divided into 3 groups:SCI group (n=60),NSP group (n=60)and control group(n=10).The acute SCI models were made according to the Allen's weight drop method.SCI group were injected with 25μL normal saline,and NSP group were treated with 25μL NSP by intrathecalinjection immediately after acute SCI.In control group,we only removed the vertebral plate and did not injure the spinal cord.Then we used Basso Beattie Bresnahan(BBB)scores to evaluate the functional deficits of the spinal cord.Western blot and real-time PCR were used to detect the expressions of BDNF,GDNF and Nogo-A.ResultsThere were no significant difference in BBB scores between SCI and NSP group.Western blot and real-time PCR both indicated that GDNF expressions increased significantly one day after acute SCI compared with control group,and declined thereafter.GDNF expressions of NSP group were higher than these of SCI group at 1,3,7 and 14 d respectively after acute SCI.Nogo-A expressions after acute SCI increased compared with control group,and NSP group was lower than SCI group in every time point respectively.Meanwhile,real-time PCR showed that BDNF expressions after acute SCI reached the highest at 1 day and declined thereafter.However,the BDNF expressions of NSP group were significantly lower than these of SCI group at 1,3,7 and 14 d after acute SCI respectively.ConclusionsThe expressions of BDNF,GDNF and Nogo-A after ASCI all increased compared with control group.There were no significant improvement in the motor function of ASCI rats with NSP by intrathecal injection,but NSP could promote the neural function repairment after acute SCI at the gene and protein level.