title: The pathologic cascade of cerebrovascular lesions in SHRSP: is erythrocyte accumulation an early phase?
abstract: Cerebral small vessel disease (CSVD) is associated with vessel wall changes, microbleeds, blood-brain barrier (BBB) disturbances, and reduced cerebral blood flow (CBF). As spontaneously hypertensive stroke-prone rats (SHRSP) may be a valid model of some aspects of human CSVD, we aimed to identify whether those changes occur in definite temporal stages and whether there is an initial phenomenon beyond those common vascular alterations. Groups of 51 SHRSP were examined simultaneously by histologic (Hematoxylin-Eosin, IgG-Immunohistochemistry, vessel diameter measurement) and imaging methods (Magnetic Resonance Imaging, 201-Thallium-Diethyldithiocarbamate/99m-Technetium-HMPAO Single Photon Emission Computed Tomography conducted as pilot study) at different stages of age. Vascular pathology in SHRSP proceeds in definite stages, whereas an age-dependent accumulation of erythrocytes in capillaries and arterioles represents the homogeneous initial step of the disease. Erythrocyte accumulations are followed by BBB disturbances and microbleeds, both also increasing with age. Microthromboses, tissue infarctions with CBF reduction, and disturbed potassium uptake represent the final stage of vascular pathology in SHRSP. Erythrocyte accumulations--we parsimoniously interpreted as stases--without cerebral tissue damage represent the first step of vascular pathology in SHRSP. If that initial phenomenon could be identified in patients, these erythrocyte accumulations might be a promising target for implementing prophylactic and therapeutic strategies in human CSVD.
authors: Klinik für Neurologie, Otto-von-Guericke Universität, Magdeburg, Germany. stefanie.schreiber@med.ovgu.de
authors: Stefanie
authors: S
authors: Schreiber
authors: Celine Z
authors: CZ
authors: Bueche
authors: Cornelia
authors: C
authors: Garz
authors: Siegfried
authors: S
authors: Kropf
authors: Frank
authors: F
authors: Angenstein
authors: Juergen
authors: J
authors: Goldschmidt
authors: Jens
authors: J
authors: Neumann
authors: Hans-Jochen
authors: HJ
authors: Heinze
authors: Michael
authors: M
authors: Goertler
authors: Klaus G
authors: KG
authors: Reymann
authors: Holger
authors: H
authors: Braun
mesh_terms: D000818:Animals; D001812:Blood-Brain Barrier / Q000473:pathology; D001921:Brain / Q000098:blood supply* / Q000473:pathology*; D059345:Cerebral Small Vessel Diseases / Q000473:pathology*; D004912:Erythrocytes / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D055806:Microvessels / Q000473:pathology*; D051381:Rats; D011918:Rats, Inbred SHR; D017208:Rats, Wistar; D015899:Tomography, Emission-Computed, Single-Photon