Human albumin aggravates cerebral edema by disrupting the blood‑brain barrier in a rat model of ischemic stroke

Abstract

Cerebral edema and elevated intracranial pressure (ICP) are common complications observed following ischemic stroke. Osmotherapy has been used as a foundation to manage ICP induced by cerebral edema, and albumin is one of the most commonly used osmotic agents. The present study aimed to explore whether albumin lowered ICP by reducing cerebral edema when albumin elevated the colloid osmotic pressure (COP) of plasma. Sprague‑Dawley rats that underwent middle cerebral artery occlusion were used to assess COP and ICP. Magnetic resonance imaging measurements were performed to evaluate the cerebral edema and infarct size. Evans blue was used to assess the blood‑brain barrier (BBB) permeability. Western blotting was used to determine the expression levels of the tight junction proteins in cerebral vascular endothelial cells. The results showed that 25% albumin treatment (1.25 g/kg) by intravenous injection elevated the COP of plasma but did not reduce the ICP in rats that had undergone ischemic stroke. Additionally, albumin did not reduce the infarct size and instead aggravated the cerebral edema. Furthermore, the BBB permeability was increased by albumin. Concomitantly, albumin treatment significantly downregulated the expression of tight junction proteins (ZO‑1, occludin and claudin‑5) in cerebral vascular endothelial cells. Tight junction protein expression was significantly upregulated when the cells were treated with an MMP‑9 inhibitor (GM6001). These results suggest that albumin aggravates cerebral edema in rats with ischemic stroke by increasing BBB permeability.