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Blood-Brain Barrier Dysfunction in Idiopathic Intracranial Hypertension

Artikel i vetenskaplig tidskrift
Författare M. M. Hasan-Olive
Hans-Arne Hansson
R. Enger
E. A. Nagelhus
P. K. Eide
Publicerad i Journal of Neuropathology and Experimental Neurology
Volym 78
Nummer/häfte 9
Sidor 808-818
ISSN 0022-3069
Publiceringsår 2019
Publicerad vid Institutionen för biomedicin
Sidor 808-818
Språk en
Länkar dx.doi.org/10.1093/jnen/nlz063
Ämneskategorier Neurovetenskap

Sammanfattning

Idiopathic intracranial hypertension (IIH) is traditionally considered benign and characterized by symptoms related to increased intracranial pressure, including headache and impaired vision. We have previously demonstrated that brains of IIH patients exhibit patchy astrogliosis, increased perivascular expression of the water channel aquaporin-4 (AQP4) as well as degenerating pericyte processes and capillary basement membranes. Given the established association between pericyte degeneration and blood-brain barrier (BBB) dysfunction, we investigated blood protein leakage by light microscopic immunohistochemistry. We also assessed perivascular AQP4 expression by immunogold transmission electron microscopy. The study included 14 IIH patients and 14 reference (REF) subjects undergoing neurosurgery for epilepsy, aneurysm, or tumor. Evidence of BBB dysfunction, measured as area extravasated fibrinogen/fibrin, was significantly more pronounced in IIH than REF individuals. The extent of extravasated fibrinogen was positively correlated with increasing degree of astrogliosis and vascular AQP4 immunoreactivity, determined by light microscopy. Immunogold transmission electron microscopy revealed no overall changes in AQP4 expression at astrocytic vascular endfeet in IIH (n = 8) compared to REF (n = 11) individuals. Our results provide evidence of BBB leakage in IIH, signifying that IIH is a more serious neurodegenerative disease than previously considered.

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