Cerebrovascular glycocalyx damage and microcirculation impairment in patients with temporal lobe epilepsy.

Autor:	van Lanen RH; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands., Haeren RH; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands., Staals J; Department of Neurology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Centre, Maastricht, The Netherlands., Dings JT; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.; Academic Centre for Epileptology, Maastricht University Medical Centre and Kempenhaeghe, Maastricht/Heeze, The Netherlands., Schijns OE; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands.; Academic Centre for Epileptology, Maastricht University Medical Centre and Kempenhaeghe, Maastricht/Heeze, The Netherlands., Hoogland G; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands., van Kuijk SM; Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Centre, Maastricht, The Netherlands., Kapsokalyvas D; Department of Genetics & Cell Biology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.; Interdisciplinary Center for Clinical Research (IZKF), University Hospital RWTH Aachen, Aachen, Germany., van Zandvoort MA; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands.; Department of Genetics & Cell Biology, CARIM School for Cardiovascular Diseases, Maastricht University, Maastricht, The Netherlands.; Institute for Molecular Cardiovascular Research IMCAR, Universitätsklinikum, Aachen University, Aachen, Germany., Vink H; Department of Physiology, Maastricht University, Maastricht, The Netherlands., Rijkers K; Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, The Netherlands.; School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands.; Academic Centre for Epileptology, Maastricht University Medical Centre and Kempenhaeghe, Maastricht/Heeze, The Netherlands.
Jazyk:	angličtina
Zdroj:	Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism [J Cereb Blood Flow Metab] 2023 Oct; Vol. 43 (10), pp. 1737-1751. Date of Electronic Publication: 2023 May 26.
DOI:	10.1177/0271678X231179413
Abstrakt:	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. Competing Interests: Declaration of conflicting interestsThe author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: HV is the Chief Science Officer at GlycoCheck & Microvascular Health Solutions. The authors declare that this manuscript has not been or currently is under review by any other journal.
Databáze:	MEDLINE
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