Geçici orta serebral arter oklüzyonu ile oluşturulan serebral iskemi modeli

Beynimiz ortalama 1500 g ağırlığında olup toplam vücut ağırlığımızın yaklaşık %2’sine karşılık gelmesine rağmen kardiyak debinin yaklaşık olarak %20’sini kullanmaktadır. Serebral kan akımı beynin beslenmesinde en önemli yeri oluşturmakta ve seçilmiş bir beyin bölgesinde veya tüm beyinde oluşan serebral kan akımındaki azalma sonucu beyin iskemisi gerçekleşmektedir. Serebral iskemi, beyni besleyen damarlarda veya kanın özelliklerine bağlı olarak damarların tıkanması ya da kanaması sonucu oluşmaktadır. Dünyada yılda yaklaşık olarak 17 milyon inme vakası görülmekte ve ülkemizde ise yılda yaklaşık 132.000 vaka görülmektedir. İnme vakaları her geçen yıl daha da arttığından dolayı gelecekte sağlıkla ve ekonomiyle ilgili sorunlara neden olacağı tahmin edilmekte, inmenin önlenmesi ve etkin tedavilerin uygulanması büyük önem arz etmektedir. Serebral iskemi tedavisi araştırmalarında yeni ajanların keşfedilmesi ve yeni tedavi protokollerinin geliştirilmesi için deneysel hayvan modelleri tercih edilmektedir. İnsanlardaki serebral iskemik hastalıkların fizyopatolojisinin araştırılmasında sıklıkla sıçan ve fare gibi kemirgenler üzerinde yapılan geçici global serebral iskemi, geçici fokal serebral iskemi ve geçici ön beyin iskemi modellerikullanılmaktadır. Klinikte en fazla karşılaşılan iskemi tipi, fokal serebral iskemi olup en önemli nedenleri internal karotis arter veya onun en büyük dalı olan orta serebral arterin oklüzyonudur. Geçici serebral iskemi hayvan modelleri karotis ve/veya vertebral arter oklüzyonu ile insanlarda oluşan iskemiyi çok güzel taklit etmektedir. Geçici orta serebral arter oklüzyonu ile oluşturulan iskemi modeli, inmenin patofizyolojisini araştırmada en yaygın kullanılan modellerden biridir. Bu derlemede; serebral iskeminin epidemiyolojisi, patofizyolojisi ve deneysel serebral iskemi hayvan modelleri arasında en çok kullanılan orta serebral arter oklüzyon yöntemi ile ilgili bilgiler sunulmuştur. Bu bilgiler ışığında, serebral iskemi tedavisi çalışmalarında sıklıkla tercih edilen geçici orta serebral iskemi modeli oluşturulmasında dikkat edilmesi gereken konular hakkında önemli bilgiler edinilmiş olunacaktır.

Cerebral ischemia model created by transient middle cerebral artery occlusion

Our brain weighs an average of 1500 g and uses approximately 20% of the cardiac output, although it corresponds to approximately 2% of our total body weight. Cerebral blood flow constitutes the most important place in the nutrition of the brain and cerebral ischemia occurs as a result of a decrease in cerebral blood flow in a selected brain region or the whole brain. Cerebral ischemia occurs as a result of blockage or bleeding in the vessels feeding the brain or depending on the characteristics of the blood. There are approximately 17 million stroke cases per year in the world, and approximately 132.000 cases are seen annually in our country. Since stroke cases are increasing every year, it is predicted that it will cause health and economic problems in the future, and the prevention of stroke and the application of effective treatments are of great importance. Experimental animal models are preferred for discovering new agents and developing new treatment protocols in cerebral ischemia treatment research. Transient global cerebral ischemia, transient focal cerebral ischemia and transient forebrain ischemia models are mostly used in rodents such as rats and mice to investigate the pathophysiology of cerebral ischemic diseases in humans. The most common type of ischemia encountered in the clinic is focal cerebral ischemia and the most important causes are occlusion of the internal carotid artery or its largest branch, the middle cerebral artery. Transient cerebral ischemia animal models (with carotid and / or vertebral artery occlusion) mimic very well human ischemia. The ischemia model created by transient middle cerebral artery occlusion is one of the most widely used models in investigating the pathophysiology of stroke. In this review; information on the epidemiology, pathophysiology of cerebral ischemia and middle cerebral artery occlusion method, which is the most used animal models of experimental cerebral ischemia, are presented. In light of this information, cerebral ischemia treatment studies often preferred model of transient middle cerebral ischemia important information about the issues to be considered in the creation will be acquired.

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