The Dynamic Changes And Role HIF-1α And Bcl-2in Peripheral Blood From Patients With Acute Cerebral Infarction

Ischemic cerebrovascular disease has now been one of seriousproblems that threatens health of old and middle-aged people with anincreasing trend in young.It roughly accounts for43-65%of all thecerebrovascular disease, and the case fatality rate is15-25%.With arelatively heavier disability and fatality rate, which badly influentspatients’ livings and creates a huge burden on their families and society,the case is getting a higher profile. According to the pathologicalmechanism to focal cerebral ischemia and clinical research, we found thatthe death of ischemic central area neurons is based on necrosis andperipheral neurons is on secondary death or apoptosis. Occurring most inpenumbra (region)-a treatment target of cerebral ischemia, a variety ofgenes involve in the apoptosis process where HIF-1α and Bcl-2are twoimportant factors to keep the nerves work that can promote theregeneration of the nerve and prevent it from apoptosis.The research aimsto discuss HIF-1α and Bcl-2’s function and meaning in the course ofcerebral infarction through clinical data and analysis of related expressionand changes of HIF-1α and Bcl-2in peripheral blood from patients withAcute Cerebral Infarction(ACI).Objective: To investigate the expression of Bcl-2(B-cell lymphoma or leukemia-2gene) and hypoxia-inducible factor-1α (HIF-1α) at everytimepiece in acute phrase of ACI patients; discuss their meaning andexpression during cerebral infarction and relationship with each.Method:1) Research Subject:Cerebral Infarction Group contains30hospitalizations (18of male and12of female),aged between47-80yearswith an average age of (62.20±9.05), from neurology department inSichuan Academy of Medical Science&Sichuan Provincial People’sHospital, during October2012to February2013. While the control groupcontains30healthy subjects and volunteers (16of male and14offemale)in our hospital during the same time,with the age from45to78,averaged (60.98±8.77) years of age.All patients and controlled onesmet the inclusion criteria and exclusion criteria.We had compared basicindexes of two groups, such as age, gender, smoking and alcohol drinkinghistory, blood pressure, blood sugar, LDL, triglyceride, liver and kidneyfunction and so on, getting to know whether there exists differences.2)For ACI group, we drew3ml of venous blood with at antecubital regionat seven points in time respectively:0.5d,1d,2d,3d,5d,7d,10d afterACI develops; for the control, we took only once.3) Apply with ELISA todetect HIF-1and Bcl-2expression levels at different time points andconcentration changes in peripheral blood within two groups.4) Tocalculate volume of cerebral infarct through MRI of skull: A×B×C×slicethickness×π/6.(A equals to the maximum diameter of infarction, B equals to the diameter perpendicular to the maximum, C equals to numberof positive layers getting from MRI. equals to circumference ratio).5)Evaluate neurological function of chosen ACI patients through NIHSS.6)Statistical Method: Use SPSS17.0to take data processing. All themeasurement data was expressed as mean and standard deviation (x±s).To evaluate differences in general information between normal groupand infarction group by/through independent sample t-test; analyzeexpression of HIF-1α and Bcl-2at different time points during acuteperiod; and evaluate differences among infarction groups of theirexpression of HIF-1α and Bcl-2at different time points. discusscorrelation between results from NIHSS and the factors-HIF-1α andBcl-2, and the intrafactor correlation.Results:1)Expression of HIF-1α: Expression of HIF-1α of ACI patientsis positive,comparing with control group, after ACI development days of0.5d,1d,2d,3d,5d,7d with a particular increase at1d,2d,3d,5d(P<0.01).The difference between groups was statistically significant. Anapparent difference exists on the1d, contracting with other time points(P<0.01), no such case for2d (P=0.140). No correlation has been foundbetween HIF-1α expression and NIHSS results (P>0.05). Significantdifferences have been found among normal group and infarction groupswhich have different infarct volumes in HIF-1α expression (P<0.05).After compared in pairs, significant differences have been found between groups with small volumes of the infarction and the large, the middle andthe large, but no statistic difference between the small and the middle(P>0.05).2)Expression of Bcl-2: Concentration expressions of Bcl-2fromACI patients is positive,comparing with control group, after ACIdevelopment days of0.5d,1d,2d,3d,5d,7d with a particular increase at1d,2d,3d,5d (P<0.01).The difference between groups was alsostatistically significant.An apparent difference exists on the1d,contracting with other time points (P<0.01). No correlation has beenfound between Bcl-2expression and NIHSS results (P>0.05). Significantdifferences have been found among normal group and infarction groupswhich have different infarct volumes in Bcl-2expression (P<0.05).Compared in pairs, three groups are different in statistics (P<0.05).3)Relationship between HIF-1α and Bcl-2: The linear relationship wasconfirmed. With coefficient being0.45(P<0.01), a strong correlation isthere.Conclusion:1) Concentration expression of HIF-1α shows a dynamicchanging rule at acute phrase of cerebral infarction. It starts to increase atthe day AVI occurs, rapidly reaches to peak on the1d and graduallydecreases during the2d to10d, although, the concentration level is still alittle higher than control group on the10d. These points a cue for us thatHIF-1α probably involves in the pathophysiological procedure of acutecerebral infarction, as a result from its function to protect nerves when cerebral ischemia and anoxia happens.2) Bcl-2expression improves atthe day ACI comes, rapidly raises to its peak on the1d, and lowers tonormal basically on the10d. As an important anti-apoptotic cytokine, itmay take part in neurons’ protection when cerebral ischemia and anoxiahappens.3) HIF-1α and Bcl-2begin to function on the day of onset ofillness, to their peak on the1d, then experience a down trend to normallevel till the10d. They can positively adjust functions of each other.4)HIF-1α and Bcl-2also have impact on damage degree caused by cerebralinfarction. The relationship is of some importance to judge severity.