Does indirect bypass surgery combined with high mobility group box-1 administration improve cerebral perfusion in a chronic cerebral hypoperfusion model?

2020 Fiscal Year Final Research Report

• Project/Area Number: 18K16585
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 56010:Neurosurgery-related
• Research Institution: Okayama University
• Principal Investigator: Hiramatsu Masafumi 岡山大学, 大学病院, 助教 (50771953)
• Project Period (FY): 2018-04-01 – 2021-03-31
• Keywords: 慢性脳虚血モデル / 間接血行再建術 / HMGB1蛋白 / VEGF / 血管新生

Outline of Final Research Achievements

Moyamoya disease is an intractable disease in which cerebral blood flow is reduced due to progressive stenosis and occlusion of bilateral internal carotid arteries, resulting in cerebral infarction. One of the treatment methods is indirect revascularization, in which muscles are placed on the brain's surface to increase cerebral blood flow. We have focused on HMGB1 protein, an angiogenic factor, as drug therapy to increase cerebral blood flow further.
In the experiment, we occluded bilateral common carotid arteries of rats to reduce cerebral blood flow. We laid the unilateral temporal muscle on the brain surface to create a moyamoya disease surgical model. Furthermore, by administering HMGB1 protein to the temporal muscle used in the surgery, we were able to increase the number of blood vessels in the cerebral cortex and show that cerebral blood flow increased compared to when HMGB1 protein was not administered.

Free Research Field

脳神経外科学　脳血管障害

Academic Significance and Societal Importance of the Research Achievements

もやもや病手術モデルにおける薬物療法は、今までに報告されてきたものは遺伝子を用いたものだけでしたが、今回は蛋白製剤（HMGB1蛋白）を用いることで脳表の血管が増加していることを示すことができ、さらに脳血流評価によってその有効性を示すことができた点が、学術的意義があると考えられる点です。この結果により、もやもや病の間接血行再建術における薬物併用療法が、より臨床応用しやすくなったため、社会的意義があったと考えられます。