Novosti
Khirurgii

 This journal is
indexed in Scopus
journal cover
android icon Android Applicaion

Year 2014 Vol. 22 No 2

GENERAL AND SPECIAL SURGERY

V.N. OCHKOLYAS 1, G.YU. SOKURENKO 2

THE EVALUATION OF EXPRESSION OF CEREBRAL ISCHEMIA AFTER SURGICAL TREATMENT OF THE INTERNAL CAROTID ARTERY PATHOLOGY BY DETERMINING THE AUTOANTIBODY LEVEL TO NR2A SUBUNIT OF NMDA GLUTAMATE RECEPTORS

FSEE HPE “First Saint-Petersburg I.P. Pavlov State Medical University” 1
FSBE “All-Russian Center of Emergency and Radiation Medicine named after A.M. Nikiforov” RMES 2 ,
Saint-Petersburg
The Russian Federation

Objectives. Study of the NMDA glutamate receptors reaction on the change of the cerebral blood flow in the internal carotid artery basin in patients with cerebral ischemic disease.
Methods. 92 patients with hemodynamically significant stenosis of the internal carotid artery have been examined. The patients were divided into 2 groups: patients with a sufficient structural and functional potential of the cerebral blood flow compensation and patients with a low structural and functional potential of the cerebral blood flow compensation. The determination of antibody level to NR2A was carried out before the operation (the 1st period of control), 30 minutes after ICA clamping (the 2nd period of control), 3 hours after the operation (the 3rd period of control), 3 days (the 4th period of control) and 14 days (the 5th period of control) and 4 weeks after the operation (the 6th period of control). The immunoassay method for the semiquantitative determination of the antibodies level to NR2A subunit of NMDA receptors of glutamate was applied.
Results. It has been established that the alteration of NMDA glutamate receptors prevailed in the group of patients with a low potential of structural and functional compensation of the cerebral blood flow. Deterioration of the cerebral blood flow during the period of carotid artery clamping is considered as a factor objectively aggravating the degree of hypoxia in the affected vascular pool and amplifying the degree of alteration of NMDA glutamate receptors. Wherein the longer the clamping of the ICA, the greater destructive effect on the NMDA glutamate receptors occurs via the implementation of excitotoxicity mechanisms.
Conclusions. Objective estimation of the cerebral ischemia degree as well as the evaluation of the adjuvant therapy efficacy is known as one of the primary conditions for the treatment of patients with ischemic brain. In this regard the level of AAT to NR2A subunit of NMDA glutamate receptors is considered as an objective criterion for the effectiveness of the cerebral blood flow and allows evaluating both the cerebral ischemic disease course and the effectiveness of the therapeutic measures.

Keywords: ischemic stroke, carotid endarterectomy, NMDA glutamate receptors
p. 171 – 178 of the original issue
References
  1. Gusev EI, Skvortsova VI. Ishemiia golovnogo mozga [Cerebral ischemia]. Moscow, RF: Meditsina; 2001. 328 p.
  2. Warlow C, van Gijn J, Dennis M, Wardlaw J, Bamford J, Hankey G, Peter AG,, Rinkel G, Langhorne P, Sudlow C, Rothwell P. Stroke – Practical Management, 3rd ed. Oxford, Blackwell, 2008, 1008 p.
  3. Dambinova SA, Skoromets AA, Skoromets AP. Biomarkery tserebral'noi ishemii (razrabotka, issledovanie i praktika) [Biomarkers of cerebral ischemia (development, research and practice)]. Saint-Petersburg, RF: Kosta, RF; 2013. 336 p.
  4. Hazell AS. Excitotoxic mechanisms in stroke: an update of concepts and treatment strategies. 2007 Jun;50(7-8):941-53.
  5. Roach ES, Bettermann K, Biler J. Toole’s Cerebrovascular Disorders 6th Edition. Cambridge University Press, Cambridge, UK: 2010.- 408 p.
  6. Hassel B, Dingledine R. Glutamate and glutamate receptors Basic Neurochemistry: Principles of molecular, cellular and medical neurobiology. Editors ST Brady, GJ Siegel, RW Albers & DL Price. Eighth edition, 2012, Academic Press, Academic Press; 2012. 1096 p.
  7. Bayir H, Kagan VE. Bench-to-bedside review: Mitochondrial injury, oxidative stress and apoptosis--there is nothing more practical than a good theory. Crit Care. 2008;12(1):206.
  8. Dambinova SA. Biomarkers for transient ischemic attack (TIA) and ischemic stroke. Clin Lab Int. 2008;32: 7–10.
  9. Dambinova SA, Bettermann K, Glynn T, Tews M, Olson D, Weissman JD, Sowell RL.Diagnostic potential of the NMDA receptor peptide assay for acute ischemic stroke. PLoS One. 2012;7(7):e42362.
  10. Weissman JD, Khunteev GA, Heath R, Dambinova SA. NR2 antibodies: risk assessment of transient ischemic attack (TIA)/stroke in patients with history of isolated and multiple cerebrovascular events. J Neurol Sci. 2011 Jan 15;300(1-2):97-102.
  11. Dambinova SA, Izykenova GA. Diagnosticheskii nabor reagentov "cis-test" dlia vyiavleniia ishemicheskoi bolezni golovnogo mozga mlekopitaiushchikh [Diagnostic reagent "cis-test" kit to detect the coronary artery disease of the mammalian brain]: pat. 2146826 Rossiiskaia Federatsiia, MPK 7 G01N33/68C07K2/00, C07K14/705, C07K16/28, C07K17/00, G01N33/535, G01N33/53, A61K39/00; zaiavitel' i patentoobladatel' Dambinova S.A. - ¹ 98107477/13; zaiavl. 24.04.1998; opubl. 20.03.2000, Biul. ¹ 16.
  12. Bamford J, Sandercock P, Dennis M, Burn J, Warlow C. Classification and natural history of clinically identifiable subtypes of cerebral infarction. Lancet. 1991 Jun 22;337(8756):1521-6.
  13. Mead GE, Lewis SC, Wardlaw JM, Dennis MS, Warlow CP.How well does the Oxfordshire community stroke project classification predict the site and size of the infarct on brain imaging? J Neurol Neurosurg Psychiatry. 2000 May;68(5):558-62.
  14. Gaidar BV, Dudanov IP, Parfenov VE, Svistov DV. Ul'trazvukovye metody issledovaniia v diagnostike porazhenii vetvei dugi aorty [Ultrasonic methods in the diagnosis of lesions of the aortic arch branches]. Petrozavodsk, RF; 1994. 71 p.
  15. Chevalier JM, Gayral M, Duchemin JF, Beck F, Streichenberger T, Reignier B, Enon B. Reverse endarterectomy of the internal carotid. J Mal Vasc. 1994;19 Suppl A:18–23.
Address for correspondence:
197022, Rossiiskaia Federatsiia, g. Sankt-Peterburg, ul. L. Tolstogo, d. 6-8, FGOU VPO «Pervyi Sankt-Peterburgskii meditsinskii universitet imeni akademika I.P.Pavlova», kafedra nevrologii i neirokhirurgii,
e-mail: ovn@ihb.spb.ru; dumpo@rambler.ru
Ochkolias Vladislav Nikolaevich
Information about the authors:
Ochkolyas V.N. PhD, an associate professor of the neurology and neurosurgery chair with the clinic, FSEE HPE “The First I.P. Pavlov State Medical University of St. Peterburg”.
Sokurenko G.Yu. MD, professor, Chief physician of the clinic ¹ 2 of FSBE “All-Russian Center of Emergency and Radiation Medicine named after A.M. Nikiforov”, MES of Russia, St. Petersburg
Contacts | ©Vitebsk State Medical University, 2007-2023