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Evidence of inflammatory cell involvement in brain arteriovenous malformations

Yongmei Chen1, Wei Zhu, Andrew W Bollen

  • 1Center for Cerebrovascular Research, Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, California, USA.

Neurosurgery
|October 1, 2008
PubMed
Abstract

Insights

Inflammatory cells, including neutrophils and macrophages, are present in brain arteriovenous malformation (AVM) tissue. This finding supports the role of inflammation in AVM disease progression and rupture risk.

Area of Science:

  • Neuroscience
  • Immunology
  • Pathology

Background:

  • Brain arteriovenous malformations (AVMs) are associated with high expression of inflammatory markers like matrix metalloproteinase-9 and myeloperoxidase (MPO).
  • Genetic variations in inflammatory genes correlate with an increased risk of AVM hemorrhage.

Purpose of the Study:

  • To investigate the presence and types of inflammatory cells within brain arteriovenous malformation (AVM) lesional tissue.
  • To correlate inflammatory cell presence with AVM characteristics and potential rupture risk.

Main Methods:

  • Immunohistochemistry was employed to identify neutrophils (MPO+), macrophages/microglia (CD68+), T lymphocytes (CD3+), and B lymphocytes (CD20+) in AVM specimens.
  • Endothelial cell (EC) mass was assessed using CD31 staining to normalize inflammatory cell counts.
  • Enzyme-linked immunosorbent assay (ELISA) was used to quantify MPO and matrix metalloproteinase-9 levels.

Main Results:

  • Neutrophils and macrophages were frequently detected in the vascular walls of AVM tissues, unlike T and B lymphocytes which were rare.
  • AVM tissues showed significantly higher neutrophil and macrophage/microglia marker expression compared to epilepsy control tissues.
  • Ex vivo analysis revealed a strong linear correlation between neutrophil quantity, MPO levels, and matrix metalloproteinase-9.

Conclusions:

  • The study confirms the presence of inflammatory cells within brain AVM tissue.
  • These findings, combined with prior research, suggest a significant role for inflammation in the progression and potential rupture of AVMs.
  • Inflammation may represent a novel therapeutic target for managing AVM disease.

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