1. Department of Rehabilitation Medicine, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
2. Department of Neurology, Liuzhou Traditional Chinese Medicine Hospital, Liuzhou 545001, China;
3. Department of Neurology, Ningbo Beilun people Hospital, Ningbo 315806, China;
4. Department of Pathology, First Affiliated Hospital of General Hospital of PLA, Beijing 100048, China.
Objective: To investigate whether microvascular damage is involved in the pathogenesis of heroin induced spongiform leukoencephalopathy (HSLE).
Methods: The brain tissues were collected from 4 HSLE patients and 5 controls and then fixed in 4% paraformaldehyde. The frontal lobe, corpus callosum and cerebellum were separated. The expressions of myelin base protein (MBP) and CD34 were detected by immunohistochemistry. TUNEL staining was applied to detect cell apoptosis. The correlation between microvascular changes and pathological vacuoles was evaluated.
Results: No obvious abnormalities were found in the brain of controls. Immunohistochemistry for MBP showed the collapse and fracture of myelin sheath and vacuole formation in the subcortical white matter, corpus callosum, and cerebellar white matter of HSLE patients. TUNEL staining showed the number of apoptotic cells in the cerebellar white matter and corpus callosum of HSLE patients was significantly higher than that in controls (F=389.451, P<0.001). Masson's trichrome staining revealed vacuolar degeneration in the cerebral white matter of HSLE patients, and the vacuoles were distributed around the microvessels. Immunohistochemistry revealed CD34 positive cells were seldom found besides the vessels in the cerebellar white matter and corpus callosum of HSLE patients, but a variety of CD34 positive cells was found in the vascular wall of controls (F=838.500, P<0.001).
Conclusion: Apoptosis of oligodendrocytes may be related to the HSLE. Cerebral vascular injury and microcirculation dysfunction are involved in the pathogenesis of HSLE. The interrelation between apoptosis of oligodendrocytes and the microvascular damage are required to be studied in future investigations.
Keywords: heroin induced spongiform leukoencephalopathy, microvessel, apoptosis, demyelination, myelin base protein.