The receptor for advanced glycation end-products (RAGE) is expressed on human brain endothelial cells (HBEC) and is implicated in neuronal cell death after ischemia. We report that endogenous secretory RAGE (esRAGE) is a splicing variant form of RAGE that functions as a decoy against ischemia-induced neuronal cell damage. This study demonstrated that esRAGE was associated with heparan sulphate proteoglycans on HBEC. The parabiotic experiments between human esRAGE overexpressing transgenic (Tg), RAGE knockout (KO), and wild-type (WT) mice revealed a significant neuronal cell damage in the CA1 region of the WT side of parabiotic WT→WT mice, but not of Tg→WT mice, 7 days after bilateral common carotid artery occlusion. Human esRAGE was detected around the CA1 neurons in the WT side of the parabiotic Tg→WT pair, but not in the KO side of the Tg→KO pair. To elucidate the dynamic transfer of esRAGE into the brain, we used the blood-brain barrier (BBB) system (PharmaCo-Cell) with or without RAGE knockdown in endothelial cells. A RAGE-dependent transfer of esRAGE was demonstrated from the vascular to the brain side. These findings suggested that esRAGE is associated with heparan sulphate proteoglycans and is transferred into the brain via BBB to exert its neuroprotective effects in ischemia.
Headache in patients with pituitary adenomas associated with ISP elevation, results from compromised dural integrity at the sella and intratumoral hemorrhage. The increased stretch force of the sella dura may be a notable etiology of headache in patients with pituitary adenoma.
The major symptoms that are caused by Rathke's cleft cysts (RCCs) are visual disturbances, headaches, and endocrine insufficiencies. Among these symptoms, the endocrine insufficiencies are thought to result from the spreading of inflammation that is induced by the cyst contents onto the pituitary gland or the compression of the gland and the pituitary stalk by RCCs. Here, we present 2 rare cases with lymphocytic infundibulohypophysitis with the sudden onset of headaches and subsequent diabetes insipidus (DI). Magnetic resonance imaging revealed remarkable swelling of the pituitary gland with a small mass that was located between the anterior and the posterior lobe of the pituitary gland. Transsphenoidal surgery was performed to remove the mass, and pathological examinations of the cyst wall demonstrated that the epithelial tissue of the RCC and the posterior lobe were affected by massive lymphocytic infiltration. The clinical courses and pathological results of these patients strongly suggested that the rupture of the RCC onto the posterior lobe caused the lymphocytic hypophysitis. Postoperatively, the DI could be controlled with a smaller amount of anti-diuretic hormone replacement compared to that required preoperatively.
KEywoRds:Hypophysitis, Rathke's cleft cyst, Lymphocyte, Diabetes insipidus ÖZ Rathke yarığı kistlerinin (RCC'ler) neden olduğu ana belirtiler görme bozuklukları, baş ağrıları ve endokrin yetmezliklerdir. Bu belirtiler arasında endokrin yetmezliklerin, kist içeriğinin oluşturduğu enflamasyonun hipofize yayılması veya hipofizin ve hipofiz sapının RCC'ler ile kompresyonu sonucunda oluştuğu düşünülmektedir. Makalede, aniden baş ağrısı ve sonrasında diabetes insipidus (DI) gelişen 2 nadir lenfositik infundibulohipofizit olgusu sunuldu. Manyetik rezonans görüntüleme hipofizin anterior ve posterior lobu arasında küçük bir kitleyle birlikte hipofizde belirgin şişme göstermiştir. Kitleyi çıkarmak için transsfenoidal cerrahi yapılmış ve kist duvarının patoloji incelemeleri epitelyal RCC dokusu ve posterior lobda masif lenfositik infiltrasyon göstermiştir. Bu hastalarda klinik seyir ve patoloji sonuçları, lenfositik hipofizitin nedeninin RCC'nin posterior loba rüptürü olduğunu kuvvetle düşündürmüştür. Postoperatif olarak DI preoperatif olarak gerekenden daha az miktarda antidiüretik hormon replasmanıyla kontrol altına alınabilmiştir.
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