脳循環，とくにthrombomodulinを中心に

抄録

Thrombomodulin (TM) is a newly described endothelial cell-associated protein that functions as a potent natural anticoagulant by converting thrombin from a procoagulant protease to an anticoagulant. Vessels in the brain were characterized with immunoperoxidase staining using a polyclonal anti-TM IgG. The staining patterns of TM were compared with those of von Willebrand factor (vWF) and Ulex europaeus agglutinin (UEA-1). The results showed that the staining of TM in the small vessels and capillaries in brain was faint compared to the staining of vWF and UEA-1. On the contrary, staining of TM was strongly positive in the capillaries in chroid plexus, however that of vWF was weak. It was suggested that the decreased distribution of TM in the brain vasculature may have a role for the pathogenesis of cerbrovascular occlusive diseases.
Next we assayed bradykinin in cerebrospinal fluid (CSF) by radioimmunoassay. Content of kinin in the CSF from non-neurological diseases was less than 30 pg/ml, however it was markedly increased up to 1-2 ng/ml in CSF from subarachnoid hemorrhage, meningitis and tumors. The level of kinin showed good correlation to the severity of headache or meningeal irritation. Based on these findings we propose that once coagulation factors are leaked into CSF-space through damaged blood-CSF barrier, factor XII will be activated resulting the release of kinin. The increased kinin in CSF may have effect on CSF-circulation and cause meningeal irritation with intracranial hypertension.