Indirect Revascularization In Moyamoya Disease And Athrosclerotic Cerebral Vascular Disease:Difference In Theraputic Effect And Mechanism Analysis

Objection Moyamoya disease is a complex chronic cerebrovascular disease,which has very active vascular angiogenesis.At present,surgical vascular reconstruction is widely used in the treatment of moyamoya disease.However,the same surgical procedures often get different effect in the two groups of patients with moyamoya disease and atherosclerotic cerebral vascular occlusion(ACVD).Many circulating factors’ expression has been turned ou to be connected with moyamoya disease.The purpose of this study is to find the key factors related to the occurrence and development of moyamoya disease by the use of new technology.Methods From February 2013 to May 2017,37 patients with moyamoya disease and 23 patients with atherosclerotic cerebral vascular disease(ACVD)were enrolled into this study.Among them,there were 17 hemorrhagic moyamoya disease patients and 20 ischemic moyamoya disease patients.We try to describe the distribution of angiogenesis related factors,and find out the key factors to go on further studies by the use of protein chip technology.Results Through DSA study,we found the curative effect of moyamoya disease was better than ACVD,and hemorrhagic MMD was better than ischemic MMD.The present study also showed that the serum levels of MMP-9 and MCP-1 in patients with moyamoya disease were significantly higher than those in ACVD through protect chip technology.And the serum MMP-9 and MCP-1 levels in patients with hemorrhagic moyamoya disease were higher than ischemic moyamoya disease.In addition,the results of preoperative and postoperative comparative studies showed that the content of VEGF and MCP-1 was positively related to the indirect compensation effect.And surgical treatments could reduce serum MMP-9 and VEGF in patients with moyamoya disease.Conclusion Moyamoya disease is different from ACDS because of its active angiogenesis.Angiogenesis related key factors and this very active,mainly may include matrix metalloproteinases(MMPs)and its inhibitor(TIMP),vascular endothelial growth factor(VEGF)and its receptors(Flt-1,Flk,1/KDR)and monocyte chemoattractant protein-1(MCP-1).we use the proteomics methods to describe the overall expression pattern of angiogenesis-related factors in Moyamoya disease,identified some key factors,such as matrix metalloproteinase(MMPs),tissue inhibitor of metalloproteinase(TIMP),vascular endothelial growth factor(VEGF)and its receptors,Flt-1 and Flk-1/KDR,and monocyte chemotactic protein 1(MCP-1).