中文摘要
脑卒中是致死致残的首要原因之一,目前缺乏有效的治疗手段。组织纤溶酶原激活剂(tPA)是美国FDA唯一批准用于急性期溶栓治疗的药物,但受制于易导致出血、治疗时间窗短等不利因素。随着纳米技术的发展,纳米磁珠(MNP)可共价结合tPA形成稳定的MNP-tPA,进而扩展tPA的应用。前期研究证明,MNP-tPA可促进体外血栓溶解,在外置旋转磁场作用下,其能在液体环境中发生旋转、前向运动并作用至血栓部位,同时有效释放所携带的tPA。为进一步研究其在动物体内溶栓作用及机制,本课题拟(1)构建缺血性脑卒中动物模型,探讨MNP-tPA靶向达到血栓部位;(2)研究磁场对MNP-tPA溶栓效果的影响,包括梗死体积、出血性转化和神经行为学评价等。该研究进一步明确MNP-tPA的体内溶栓作用,为扩展其临床应用奠定一定基础。
英文摘要
Brain stroke is a leading cause of morbidity and mortality of the world. The treatment of ischemic stroke remains a daunting task as few therapeutic strategies have proven to be effective. Systemic thrombolysis with intravenous tissue plasminogen activator (tPA) remains the only FDA (Food and Drug Administration) proved treatment to improve clinical outcome of patients. Intravenous injection of tPA within 3h of onset for acute ischemic stroke is now widely accepted. But the side effects like increased intracerebral hemorrhage, and short treatment time window hampered the clinical usage. With the development of nanotechnology, nanoparticle based delivery of tPA can accelerate the thrombolysis. Our previous study found that nanoparticle based transplantation of tPA can increase the lysis efficacy, especially under the rotated magnetic field. For extending the clinical application of thrombolysis, we use the polyacrylic acid coated nanoparticle covalent binding with tPA and design our experimental program for the treatment of acute ischemic stroke: (1) identify the MNP-tPA at the clot site in mouse brain ischemic model; (2) find out the cerebral blood flow restoring effect of MNP-tPA in magnetic field, test the infarct volume, hemorrhage transformation and animal behavior test. These results will open a new way of using tPA for thrombolysis.
结题摘要
世界范围内,脑卒中是致死致残的主要原因之一。在我国,全国死因回顾抽样调查发现脑卒中位居死亡原因的第一位,其治疗手段十分局限,重组组织纤溶酶原激活剂(rtPA)是美国食品及药物管理局唯一审批通过用于缺血性脑卒中急性期溶栓治疗的药物,但存在治疗时间窗短、再出血率高等问题。因此,脑血栓治疗迫切需要提高rtPA溶栓效果以及安全性。在体外实验中,用大鼠血清、凝血酶、氯化钙制备体外血栓,将体外血栓置于磁场中,加入游离rtPA、MNP、MNP-rtPA等。用氯化铁诱导小鼠脑血栓模型,24只C57/BL6小鼠随机分成4组,分别尾静脉置管注射生理盐水、MNP、游离rtPA和MNP-rtPA,同时置于旋转磁场中90min,24h后行TTC染色观察脑梗死体积。结果表明游离rtPA体外溶解血栓的最佳浓度为100µg/ml,最佳反应时间是90min。在体外溶栓时,在旋转磁场作用下MNP-rtPA的溶栓效率从27.3±1.3% 增加至 42.8±2.8%;动物实验中生理盐水、MNP、游离rtPA和MNP-rtPA组的脑梗死体积分别为20.09±6.07mm3, 18.28±2.69mm3, 8.65±3.63mm3和4.40±2.46mm3。研究发现用旋转磁场促进rtPA的溶栓效力,发现MNP-rtPA可以促进血栓溶解,改善脑血流供应,减少脑梗死体积。纳米材料给药系统的成功构建,为脑血栓治疗提供了新的途径。
