Carbohydrate and energy metabolism during the evolution of hypoxic-ischemic brain damage in the immature rat

Application of the accurate assessment of intracellular magnesium and pH from the 31P shifts of ATP to cerebral hypoxia-ischemia in neonatal rat

The authors present a high field in vivo demonstration of our 2-dimensional calibration methods for determining magnesium ion concentration ([Mg]), under conditions of fluctuating pH, from the three 31P NMR chemical shift differences of ATP. The effect of 3 h of hypoxic-ischemic insult (HI) on intracellular brain [Mg] was evaluated by using a well established 7-day-old rat model of cerebral HI. During the final hour of HI, there was a significant increase (P < 0.001) in free magnesium as well as in the ratio of total [Mg]/[ATP]. The normal, HI, and early (1-2 h) recovery values of free [Mg] were 0.336 +/- 0.015, 0.519 +/- 0.104, and 0.337 +/- 0.071 mM, respectively. These results are consistent with the temporal changes in [ATP]. Our assessment of [Mg] and pH for this high error measurement is general for most in vivo applications and may be routinely implemented.

Liposomes as in-vivo carriers for citicoline: effects on rat cerebral post-ischaemic reperfusion

Citicoline is a therapeutic agent widely used in the treatment of brain injury, for example in cerebrovascular disease or traumatic accidents. Unfortunately, the strong polar nature of this drug prevents it crossing the blood-brain barrier. In this paper, the possibility of efficiently trapping citicoline in liposomes to improve its therapeutic effects is reported. The citicoline-encapsulation efficiency, drug leakage and size analysis of various liposome systems were studied. The real therapeutic effectiveness of these citicoline liposome formulations was evaluated by biological assay. The effects of free and liposome encapsulated citicoline on survival rate of ischaemic reperfused male Wistar rats (80-100 g) were investigated. Of the phospholipid mixtures used in citicoline liposome formulation the best in terms of delivery and therapeutic effects was 1,2-dipalmitoyl-sn-glycero-phosphocholine: dipalmitoyl-DL-alpha-phosphatidyl-L-serine:cholesterol (7:4:7 molar ratio). This phospholipid mixture was also assayed for brain conjugated diene levels in rats, since this parameter is an index of lipid peroxidation in rat cerebral cortex during post-ischaemic reperfusion. A citicoline-loaded phospholipid mixture has produced an increase in rat survival rate of about 24% and a reduction in diene levels of 60%, compared to the free drug.

Glucose transport in developing rat brain: glucose transporter proteins, rate constants and cerebral glucose utilization

Developing rat brain undergoes a series of functional and anatomic changes which affect its rate of cerebral glucose utilization (CGU). These changes include increases in the levels of the glucose transporter proteins, GLUT1 and GLUT3, in the blood-brain barrier as well as in the neurons and glia. 55 kDa GLUT1 is concentrated in endothelial cells of the blood-brain barrier, whereas GLUT3 is the predominant neuronal transporter. 45 kDa GLUT1 is in non-vascular brain, probably glia. Studies of glucose utilization with the 2-14C-deoxyglucose method of Sokoloff et al., (1977), rely on glucose transport rate constants, k1 and k2, which have been determined in the adult rat brain. The determination of these constants directly in immature brain, in association with the measurement of GLUT1, GLUT3 and cerebral glucose utilization suggests that the observed increases in the rate constants for the transport of glucose into (ki) and out of (k2) brain correspond to the increases in 55 kDa GLUT1 in the blood-brain barrier. The maturational increases in cerebral glucose utilization, however, more closely relate to the pattern of expression of non-vascular GLUT1 (45 kDa), and more specifically GLUT3, suggesting that the cellular expression of the glucose transporter proteins is rate limiting for cerebral glucose utilization during early postnatal development in the rat.

High-energy phosphate metabolism in a neonatal model of hydrocephalus before and after shunting

The authors studied the effects of hydrocephalus on the high-energy phosphate metabolism of the brain and the impact of ventriculoperitoneal (VP) shunting on these changes in an experimental model of hydrocephalus. High-energy phosphate metabolism was analyzed using in vivo magnetic resonance (MR) imaging and 31P MR spectroscopy. Hydrocephalus was produced in 34 1-week-old kittens by cisternal injection of 0.05 ml of a 25% kaolin solution. Sixteen litter mates were used as controls. A VP shunt with a distal slit valve was implanted in 17 of the 34 hydrocephalic animals 10 days after induction of hydrocephalus. Both MR imaging and 31P MR spectroscopy were obtained 1 and 3 weeks after either kaolin or distilled water injection. Untreated hydrocephalic animals had marked dilatation of the lateral ventricles and periventricular edema. Magnetic resonance spectroscopy showed a significant decrease in the energy index ratio of phosphocreatine (PCR): inorganic phosphate (PI) and an increase in the PI:adenosine triphosphate (ATP) ratio. There was a direct correlation between the decrease in the energy index and ventricular size. Compared with preoperative scans, shunted animals showed no periventricular edema, and the ventricles decreased in size. Also, PCR:PI and PI:ATP ratios were within the levels of controls. This study suggests that neonatal hydrocephalus results in a mild hypoxic/ischemic insult that is treatable by VP shunting.

Deferoxamine posttreatment reduces ischemic brain injury in neonatal rats

BACKGROUND AND PURPOSE

Iron catalyzes the formation of damaging reactive species during cerebral reperfusion. Brain iron concentration is highest at birth, so the brain of the asphyxiated newborn may be at increased risk of iron-dependent injury. We investigated whether the ferric iron chelator deferoxamine could reduce hypoxic-ischemic brain injury in neonatal rats. Because deferoxamine has concentration-dependent activities other than iron chelation, we measured brain deferoxamine levels and calculated deferoxamine pharmacokinetic parameters.

METHODS

We produced hypoxic-ischemic injury to the right cerebral hemisphere of 7-day-old rats by right common carotid artery ligation followed by 2.25 hours of hypoxia in 8% oxygen. At 5 minutes of recovery from hypoxia the rats received 100 mg/kg deferoxamine mesylate or saline subcutaneously. Rats (saline, n = 33; deferoxamine, n = 38) were killed at 42 hours of recovery to assess early acute edema by measurement of hemispheric water content. Other rats (saline, n = 31; deferoxamine, n = 32) were killed at 30 days of age for morphometric determination of right hemisphere atrophy. In still other rats, we measured deferoxamine levels in blood and brain after hypoxia-ischemia.

RESULTS

Deferoxamine significantly reduced right hemisphere injury as measured by early water content (P < .01) and later atrophy (P = .019). Deferoxamine brain levels peaked between 100 and 200 mumol/L at 40 to 60 minutes after injection and exceeded serum levels by +/- 70%.

CONCLUSIONS

Deferoxamine administered after induction of cerebral hypoxia-ischemia reduces injury in 7-day-old rats. Deferoxamine concentrates in the brain at levels between 100 and 200 mumol/L. At the concentrations achieved, deferoxamine might protect the brain through mechanisms unrelated to its ability to chelate iron.

Cerebral energy metabolism during hypoxia-ischemia correlates with brain damage: a 31P NMR study in unanesthetized immature rats

The association between the ultimate brain damage resulting from unilateral hypoxic-ischemic insult (HI) and the changes in high-energy metabolites, measured by noninvasive phosphorus-31 nuclear magnetic resonance (31P NMR) spectroscopy during the insult, was evaluated in 7-day postnatal rats. When the NMR metabolite levels were integrated over the last 1.5 h out of 2.5 h of HI, there was a significant correlation of both the estimator of phosphorylation potential (P < 0.001) and ATP levels (P < 0.01) with histologic score of damage and area morphometry. In particular, the development of cerebral infarction could be predicted from the NMR evaluation (P < 0.005). These findings suggest that a large disturbance in cellular energy metabolism is a prerequisite for the subsequent neuropathological alterations in this model.

Cerebral glucose and energy utilization during the evolution of hypoxic-ischemic brain damage in the immature rat

The cerebral metabolic rate for glucose (CMRg1) and cerebral energy utilization (CEU) were assessed in immature rats during recovery from cerebral hypoxia-ischemia. CMRg1 was determined using a modification of the Sokoloff technique with 2-deoxy-[14C]glucose (2-DG) as the radioactive tracer. CEU was determined using the Lowry decapitation technique. Seven-day postnatal rats underwent unilateral common carotid artery ligation, followed 4 h thereafter by exposure to 8% oxygen at 37 degrees C for 3 h. At 1, 4, or 24 h of recovery, the rat pups underwent those procedures necessary for the measurement of either CMRg1 or CEU. At 1 h of recovery, the CMRg1 of the cerebral hemisphere ipsilateral to the carotid artery occlusion was 97% of the control rate (8.7 mumol 100 g-1 min-1) but was only 48% of the control in the contralateral hemisphere. At 4 h of recovery, the CMRg1 was increased 49% above baseline in the ipsilateral hemisphere, decreasing thereafter to 84% of the control at 24 h. The CMRg1 of the contralateral hemisphere normalized by 4 h of recovery. An inverse correlation between endogenous concentrations of ATP or phosphocreatine and CMRg1 in the ipsilateral hemisphere was apparent at 4 h of recovery. CEU in the ipsilateral cerebral hemisphere was 64 and 46% of the control (3.47 mmol approximately P/kg/min) at 1 and 24 h, respectively (p < 0.05) and 77% of the control at 4 h of recovery. CEU in the contralateral hemisphere was unchanged from the control at all measured intervals. Correlation of the alterations in CMRg1 with those in CEU at the same intervals indicated that substrate supply exceeds energy utilization during early recovery from hypoxia-ischemia. The discrepancy combined with a persistent disruption of the cerebral energy state implies the existence of an uncoupling of mitochondrial oxidative phosphorylation as one mechanism for the occurrence of perinatal hypoxic-ischemic brain damage.

Localization of c-fos, c-jun, and hsp70 mRNA expression in brain after neonatal hypoxia-ischemia

The sites of expression of early response mRNAs were determined in the brains of 7-day-old rat pups exposed to unilateral carotid artery ligation followed by 3 h of hypoxia. Pups were sacrificed after recovery periods ranging from 10 min to 24 h. In agreement with our previous northern blot analysis, in situ hybridization of coronal brain sections to probes for c-fos, c-jun, and heat-inducible hsp70 revealed a marked induction and subsequent disappearance of all three mRNAs during this time period. We observed co-localization of the 2 immediate early gene (IEG) mRNAs, c-fos and c-jun, which encode proteins that act in combination to regulate subsequent gene expression. These mRNAs were expressed in all regions known to be vulnerable to permanent injury in this model, such as the cortex, hippocampus, and striatum, as well as in other regions that are spared from permanent damage, such as contralateral cortex and lateral ventricular neuroepithelium. The temporal and regional co-localization of c-fos and c-jun suggests that the transcriptional regulatory activity of their protein products could play a role in plasticity associated with death or recovery from injury in the immature brain. Hsp70 mRNA expression was induced in nearly all of the animals that were positive for IEG mRNAs. Although the most frequent site of expression for all three mRNAs was the ipsilateral cerebral cortex, hsp70 expression was restricted to the ipsilateral hemisphere and absent from a number of structures that were positive for c-fos and c-jun. In addition, the patterns of expression of hsp70 within specific structures frequently differed from those of the IEGs, implying that although both cellular early response systems are activated in this model, their specific functions are carried out within different microenvironments.

Nature, time-course, and extent of cerebral edema in perinatal hypoxic-ischemic brain damage

To ascertain the nature, time-course, and extent of the cerebral edema that accompanies perinatal hypoxic-ischemic brain damage, 7-day postnatal rats were subjected to unilateral right common carotid artery ligation followed by exposure to hypoxia with 8% oxygen for up to 3 hours. Some rat pups were sacrificed during hypoxia-ischemia or recovery for determination of cerebral hemispheric water content and percentage of brain swelling. Other animals were sacrificed and their brains processed either for determination of cerebral cortical edema and infarct volume or for horseradish peroxidase staining. The results indicated that cerebral edema occurs even during the course of hypoxia-ischemia and that the extent and duration of edema formation during the recovery period is dependent upon the severity of tissue injury. The data also disclosed a direct, linear correlation between infarct volume and the extent of cerebral edema. Accordingly, the greater the severity of cerebral edema, the proportionately greater the extent of infarction. Horseradish peroxidase staining, a reflection of vasogenic edema, occurred in 17 of 19 brains in a distribution which corresponded closely to the distribution of neuropathologic alterations observed histologically. The findings indicate that cerebral edema can occur in the absence of consequent infarction and that when infarction does occur, the associated edema contributes little or nothing to the severity of the ultimate brain damage.

Regional expression of c-fos and heat shock protein-70 mRNA following hypoxia-ischemia in immature rat brain

Cerebral ischemia induces the expression of a number of proteins that may have an important influence on cellular injury. The purpose of this study was to compare the regional effects of hypoxia-ischemia on the expression of the proto-oncogene, c-fos, and the heat shock protein-70 (HSP-70) gene in developing brain. Unilateral hypoxia-ischemia was produced in the brain of immature rats (7, 15, and 23 days after birth) using a combination of carotid artery ligation and systemic hypoxia (8% O2). After recovery for 2 and 24 h, the regional expression of c-fos and HSP-70 mRNA was determined using in situ hybridization. Littermates were permitted to recover for 1 week for assessment of histologic injury. Hypoxia-ischemia increased the expression of both c-fos and HSP-70 mRNA, but the topography of expression varied with the age of the animal as well as the mRNA species. In the 7-day-old group, expression of c-fos at 2 h increased in multiple regions of the ipsilateral hemisphere in nearly one-half of the animals, while HSP-70 mRNA was not expressed until 24 h and, then, predominantly in the hippocampus. In 15- and 23-day-old rats, expression of c-fos was increased at 2 h in the entorhinal cortex and in the dendritic field of the upper blade of the hippocampal dentate gyrus, while HSP-70 mRNA was prominently expressed in neocortex and the cell layers of the hippocampus. Interestingly, the strong expression of HSP-70 mRNA in dentate granule cells did not occur in the innermost layer of cells.(ABSTRACT TRUNCATED AT 250 WORDS)

An experimental model of generalized seizures for the measurement of local cerebral glucose utilization in the immature rat. I. Behavioral characterization and determination of lumped constant

An experimental model of status epilepticus has been developed in the immature rat by administration of pentylenetetrazol (PTZ) using repetitive, timed intraperitoneal injections of subconvulsive doses. The pattern of behavioral signs has been well characterized in each age group, i.e. 10 (P10), 14 (P14), 17 (P17) and 21 postnatal days (P21). In this model, the dose of convulsant could be adjusted as a function of interindividual sensitivity and status epilepticus lated for quite a long duration to allow the measurement of local cerebral metabolic rates for glucose (LCMRglc) by means of the [14C]2-deoxyglucose method [J. Neurochem., 28 (1977) 897-916]. To estimate LCMRglc during status epilepticus, the lumped constant (LC) was re-calculated in controls and PTZ-treated rats. The control LC was 0.54 at P10 and 0.50-0.51 at the three older ages studied (P14, P17 and P21). During status epilepticus, it increased to 0.64 in P10 rats and decreased to 0.42 and 0.40, respectively, in P17 and P21 animals. At P14, LC was not affected by seizures. The measurements of brain lactate levels showed a large 4.5-10-fold increase in PTZ-treated rats as compared to controls at all ages. The results of the present study show that the immature brain responds to sustained seizure activity in a specific way according to its postnatal age. Moreover, our results underscore the necessity of re-calculation of LC to the quantification of LCMRglc in such pathological states, particularly in immature animals.

Allopurinol preserves cerebral energy metabolism during perinatal hypoxia-ischemia: a 31P NMR study in unanesthetized immature rats

The effects of high dose allopurinol (ALLOP) pretreatment on the cerebral energy metabolism of unanesthetized 7-day-postnatal rats during exposure to 3 h of cerebral hypoxia-ischemia were serially quantitated using non-invasive 31P NMR spectroscopy. Adenosine triphosphate, integrated over the last 2 h of hypoxia and expressed as a fraction of baseline, was 0.73 +/- 0.16 with ALLOP pretreatment (200 mg/kg s.c.) compared to 0.52 +/- 0.05 for saline pretreatment (P = 0.001). Inorganic phosphate/phosphocreatine (Pi/PCr), integrated over the same time interval, was 2.63 +/- 1.23 relative to baseline with ALLOP versus 5.13 +/- 1.45 for saline-treated pups (P less than 0.0005). We suggest that the neuroprotection achieved with high dose ALLOP pretreatment may be attributed in part to preservation of energy metabolites.

Cerebral Carbohydrate and Energy Metabolism in Perinatal Hypoxic-Ischemic Brain Damage

Cerebral hypoxia-ischemia remains a major cause of acute perinatal brain injury. Research in experimental animals over the past decade has greatly expanded our knowledge of those oxidative events which occur during a hypoxic-ischemic insult to the brain, as well as those metabolic alterations which evolve during the recovery period following resuscitation. The available evidence suggests that hypoxia alone does not lead to brain damage, but rather a combination of hypoxia-ischemia or isolated cerebral ischemia is a necessary prerequisite for tissue injury to occur. Furthermore, hypoxia-ischemia severe enough to produce irreversible tissue injury is always associated with major perturbations in the energy status of the perinatal brain which persists well into the recovery period. The lingering energy depletion sets in motion a cascade of biochemical alterations that are initiated during the course of the insult and proceed well into the recovery period to culminate in either neuronal necrosis or infarction. Unlike the adult, where glucose supplementation prior to or during hypoxia-ischemia accentuates tissue injury, glucose treatment of perinatal animals subjected to a similar insult substantially reduces the extent of tissue injury. The mechanism for the age-specific effect of glucose on hypoxic-ischemic brain damage is discussed in relation to pathogenetic mechanisms responsible for the occurrence of permanent brain damage.

Intra- and extracellular changes of amino acids in the cerebral cortex of the neonatal rat during hypoxic-ischemia

Excitatory amino acids (EAAs) have been implicated to play a part in the development of hypoxic-ischemic brain injury in the neonate. The aim of the present study was to follow changes of intra- and extracellular (microdialysis) amino acids in the cerebral cortex in a model where cortical hypoxic-ischemic damage is produced consistently. Hypoxic-ischemia (unilateral ligation of the carotid artery + 2 h of exposure to 7.8% oxygen) caused a depletion of tissue ATP, phosphocreatine and glucose with a concomittant accumulation of AMP and lactic acid in cortical tissue. These changes were accompanied by a decrease of tissue aspartate and glutamine whereas the contents of gamma-aminobutyric acid (GABA), phenylalanine, leucine, isoleucine, valine and alanine increased. In the extracellular fluid GABA, glutamate, aspartate, taurine, glycine and alanine all increased multi-fold during hypoxic-ischemia. Aspartate and glutamate returned to near initial levels 2 h after the end of the insult, whereas the elevation of glycine persisted during recovery. In conclusion, the high extracellular levels of EAAs and glycine may exert injurious effects during and after hypoxic-ischemia.

Mechanisms of asphyxial brain damage, and possible pharmacologic interventions, in the fetus

An examination of the cellular and molecular mechanisms of neuronal cell damage may lead to the design of pharmacologic interventions during presumed or actual fetal asphyxia. Hypoxia-ischemia in its severest form results in insufficient adenosine 5'-triphosphate production. The most important effect of this is failure of adenosine 5'-triphosphate-dependent membrane functions, which maintain ionic homeostasis, that is, ionic pumping. There is K+ efflux and Na+ influx across the cell membrane, depolarization of the cell membrane, opening of the voltage-dependent calcium channels, and entrance of Ca++ into the cell. Cytosolic Ca++ is also increased by Ca++ efflux from the mitochondria and the sarcoplasmic reticulum. Ca++ is a toxin in high cytosolic concentrations; it activates phospholipases A and C, which cause membrane breakdown and release of free fatty acids, including arachidonic acid. The membrane is damaged, lysis occurs, and the neuron dies. High cytosolic Ca++ also causes release of excitatory amino acids (especially glutamate), which overwhelm the suppressant neurotransmitters, causing seizures, increased metabolism, and aggravation of the insufficient adenosine 5'-triphosphate availability. Thromboxane A2 is generated from arachidonic acid, increasing smooth muscle tone and thereby worsening the ischemia. Cyclooxygenase activity also results in formation of oxygen-free radicals that contribute to cell membrane damage, lysis, and death. Possibilities for pharmacologic interventions include (1) calcium channel blockers and antagonists, (2) excitatory neurotransmitter blockers, (3) oxygen-free radical scavengers (e.g., superoxide dismutase), (4) cyclooxygenase or prostaglandin synthesis inhibitors, and (5) seizure suppressants (e.g., phenobarbital). Some of these treatments have been shown experimentally to limit neuronal death in the adult and fetus, and after more investigative work they may be applicable to clinical practice.