The Expression Of Gene Associated With Retinoid-interferon Mortality-19 In Human Intracranial Aneurysms And Its Significance

bjective: 1. TO observe the morphological changes and tissue pathology in human intracranial aneurysms.2.To detect the expressive changes of gene associated with retinoid-interferon-induced mortality-19(GRIM-19) in intracranial aneurysm wall membrane expression of smooth muscle cells, investigate intracranial aneurysm wall to reduce smooth muscle cell membrane and its causes and possible mechanisms of intracranial aneurysms occur in the development of the role.Methods : Collected Sichuan Medical University Hospital Neurosurgery in January 2013 ~ April 2014 admitted to intracranial aneurysm cases of subarachnoid hemorrhage caused by cranial microsurgery select clipping of intracranial aneurysm neck after removal of the aneurysm sac 45 cases of pathological specimens obtained and classified as aneurysm group, including 16 males and 29 females. Group Sichuan Medical University Hospital Neurosurgery traumatic brain injury patients admitted to the same period, the intracranial hematoma or internal decompression collected 45 cases of normal intracranial arteries, including 27 males and 18 females. Two sets of samples are required to obtain in ensuring the safety of the surgery and the patient before surgery to sign the consent form. Two groups of specimens were generally observed visually; sections were prepared two sets of light microscopy specimens organizational structure; RT-PCR techniques, immunohistochemistry SP method GRIM-19 intracranial aneurysm wall and the normal vessel wall smooth muscle cells, the comparison between the two changes. Exclude all cases of hypertension, diabetes, a history.Results: 1. Macroscopic general observation: tumor specimens aneurysm group mostly dark red, tan, cystic or fusiform appearance, most quality and tough, cut the tumor, 12 cases of tumor specimens visible surface wall white or dark red flat, round or oval atherosclerotic plaques, 28 cases of specimens aneurysm mural thrombus soft texture. Its wall thickness from the aneurysm neck tumors began to thin, the thinnest tumors in only remaining top thin fibrous membrane, and even some of them have broken. Observation See all ruptured aneurysms, aneurysm rupture are at the top or near the top of the tumor. The control group sample was bright red blood vessels, lumen no significant atherosclerotic plaque and thrombus. 2. Light microscopy: HE staining: normal intracranial arteries sliced light microscope, the wall thickness uniformity, clear inner, middle and outer layer film anatomical structure intact without damage, layers of cells morphologically normal adjacent muscle cells films often have a tight connection, the middle layer of smooth muscle cells concentrically arranged structure, wall rare inflammatory cells. Aneurysm group sliced light microscope, the wall thickness of the uneven start to the tumor from the aneurysm neck top is gradually thinned, and some partial or full-thickness wall tumor bulging outward, three-layer film anatomical structure is unclear, the tumor cell wall section or total destruction, inflammatory cell infiltration and diffuse division, lipids and cholesterol crystals visible deposits, partially visible machine of the aneurysm wall thrombus or adhered to the inner wall of the capsule fresh thrombus, medial smooth muscle cells decreased. Immunohistochemical staining: GRIM-19 in 42 cases of intracranial aneurysm wall smooth muscle cells of positive expression rate of 93.33%(42/45), GRIM-19 expression was significantly thinner strong regional aneurysm wall. Expression site located in order to brown or tan characterized nucleus, cytoplasm in rare expression. The positive control group, the arterial wall smooth muscle cell membrane expression rate of 55.56%(25/45), mainly expressed in the cytoplasm. Intracranial aneurysm wall GRIM-19 expression was higher in medial smooth muscle cells(P = 0.0002 <0.05), the difference was statistically significant compared to both. 3.RT-PCR detection: aneurysm group at 380 bp at the strip brightness higher. Statistically, the expression level of the aneurysm group SMCs GRIM-19 m RNA of O.96 ± O.10, the control group was O.63 ± 0.11, t = 8.42, P = 0.0003 <0.05, a statistically significant difference significance, indicating aneurysm wall membrane GRIM-19 m RNA smooth muscle cells than normal level of expression of intracranial arteries was significantly higher.Conclusion: 1. Intracranial aneurysm is a major pathological changes anatomy of the aneurysm wall was destroyed, thrombosis and atherosclerosis are formed, inflammatory cell infiltration, endothelial cells and smooth muscle cells decrease or even disappear, degradation of collagen fibers. 2.GRIM-19 intracranial aneurysm wall membrane expression of smooth muscle cells, and the relatively low expression in the control group, GRIM-19 expression was significantly thinner strong regional aneurysm wall. It speculated that GRIM-19 may be involved in the apoptotic pathway by reducing the imbalances in the smooth muscle cells in the pathological process, and then associated with intracranial aneurysm formation and rupture. 3. The present study explored the genetic level of intracranial aneurysms possible mechanism for its prevention and control provides a new experimental basis.