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Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy
Temporal lobe epilepsy (TLE) is increasingly associated with blood-brain barrier dysfunction and microvascular alterations, yet the pathophysiological link is missing. An important barrier function is exerted by the glycocalyx, a gel-like layer coating the endothelium. To explore such associations,...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581235/ https://www.ncbi.nlm.nih.gov/pubmed/37231664 http://dx.doi.org/10.1177/0271678X231179413 |
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author | van Lanen, Rick HGJ Haeren, Roel HL Staals, Julie Dings, Jim TA Schijns, Olaf EMG Hoogland, Govert van Kuijk, Sander MJ Kapsokalyvas, Dimitris van Zandvoort, Marc AMJ Vink, Hans Rijkers, Kim |
author_facet | van Lanen, Rick HGJ Haeren, Roel HL Staals, Julie Dings, Jim TA Schijns, Olaf EMG Hoogland, Govert van Kuijk, Sander MJ Kapsokalyvas, Dimitris van Zandvoort, Marc AMJ Vink, Hans Rijkers, Kim |
author_sort | van Lanen, Rick HGJ |
collection | PubMed |
description | Temporal lobe epilepsy (TLE) is increasingly associated with blood-brain barrier dysfunction and microvascular alterations, yet the pathophysiological link is missing. An important barrier function is exerted by the glycocalyx, a gel-like layer coating the endothelium. To explore such associations, we used intraoperative videomicroscopy to quantify glycocalyx and microcirculation properties of the neocortex and hippocampus of 15 patients undergoing resective brain surgery as treatment for drug-resistant TLE, and 15 non-epileptic controls. Fluorescent lectin staining of neocortex and hippocampal tissue was used for blood vessel surface area quantification. Neocortical perfused boundary region, the thickness of the glycocalyx’ impaired layer, was higher in patients (2.64 ± 0.52 µm) compared to controls (1.31 ± 0.29 µm), P < 0.01, indicative of reduced glycocalyx integrity in patients. Moreover, erythrocyte flow velocity analysis revealed an impaired ability of TLE patients to (de-)recruit capillaries in response to changing metabolic demands (R(2) = 0.75, P < 0.01), indicating failure of neurovascular coupling mechanisms. Blood vessel quantification comparison between intraoperative measurements and resected tissue showed strong correlation (R(2) = 0.94, P < 0.01). This is the first report on in vivo assessment of glycocalyx and microcirculation properties in TLE patients, confirming the pivotal role of cerebrovascular changes. Further assessment of the cerebral microcirculation in relation to epileptogenesis might open avenues for new therapeutic targets for drug-resistant epilepsy. |
format | Online Article Text |
id | pubmed-10581235 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105812352023-10-18 Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy van Lanen, Rick HGJ Haeren, Roel HL Staals, Julie Dings, Jim TA Schijns, Olaf EMG Hoogland, Govert van Kuijk, Sander MJ Kapsokalyvas, Dimitris van Zandvoort, Marc AMJ Vink, Hans Rijkers, Kim J Cereb Blood Flow Metab Original Articles Temporal lobe epilepsy (TLE) is increasingly associated with blood-brain barrier dysfunction and microvascular alterations, yet the pathophysiological link is missing. An important barrier function is exerted by the glycocalyx, a gel-like layer coating the endothelium. To explore such associations, we used intraoperative videomicroscopy to quantify glycocalyx and microcirculation properties of the neocortex and hippocampus of 15 patients undergoing resective brain surgery as treatment for drug-resistant TLE, and 15 non-epileptic controls. Fluorescent lectin staining of neocortex and hippocampal tissue was used for blood vessel surface area quantification. Neocortical perfused boundary region, the thickness of the glycocalyx’ impaired layer, was higher in patients (2.64 ± 0.52 µm) compared to controls (1.31 ± 0.29 µm), P < 0.01, indicative of reduced glycocalyx integrity in patients. Moreover, erythrocyte flow velocity analysis revealed an impaired ability of TLE patients to (de-)recruit capillaries in response to changing metabolic demands (R(2) = 0.75, P < 0.01), indicating failure of neurovascular coupling mechanisms. Blood vessel quantification comparison between intraoperative measurements and resected tissue showed strong correlation (R(2) = 0.94, P < 0.01). This is the first report on in vivo assessment of glycocalyx and microcirculation properties in TLE patients, confirming the pivotal role of cerebrovascular changes. Further assessment of the cerebral microcirculation in relation to epileptogenesis might open avenues for new therapeutic targets for drug-resistant epilepsy. SAGE Publications 2023-05-26 2023-10 /pmc/articles/PMC10581235/ /pubmed/37231664 http://dx.doi.org/10.1177/0271678X231179413 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Articles van Lanen, Rick HGJ Haeren, Roel HL Staals, Julie Dings, Jim TA Schijns, Olaf EMG Hoogland, Govert van Kuijk, Sander MJ Kapsokalyvas, Dimitris van Zandvoort, Marc AMJ Vink, Hans Rijkers, Kim Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
title | Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
title_full | Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
title_fullStr | Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
title_full_unstemmed | Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
title_short | Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
title_sort | cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10581235/ https://www.ncbi.nlm.nih.gov/pubmed/37231664 http://dx.doi.org/10.1177/0271678X231179413 |
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