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de Souza SNF, Machado HR, da Silva Lopes L, da Silva Beggiora Marques P, da Silva SC, Dutra M, Aragon DC, Santos MV. Evaluation of the behavioral, histopathological, and immunohistochemical effects resulting from ventriculosubcutaneous shunt obstruction in kaolin-induced hydrocephalus in rats. Childs Nerv Syst 2024; 40:1533-1539. [PMID: 38194082 DOI: 10.1007/s00381-023-06260-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 12/15/2023] [Indexed: 01/10/2024]
Abstract
PURPOSE Hydrocephalus is a brain disease prevalent in the pediatric population that presents complex pathophysiology and multiple etiologies. The best treatment is still ventricular shunting. Mechanical obstruction is the most frequent complication, but the resulting pathological effects are still unknown. OBJECTIVE Evaluation and comparison of clinical, histopathological, and immunohistochemical aspects in the acute phase of experimental hydrocephalus induced by kaolin, after treatment with adapted shunt, and after shunt obstruction and posterior disobstruction. METHODS Wistar rats aged 7 days were used and divided into 4 groups: control group without kaolin injection (n = 6), untreated hydrocephalic group (n = 5), hydrocephalic group treated with ventriculosubcutaneous shunt (DVSC) (n = 7), and hydrocephalic group treated with shunt, posteriorly obstructed and disobstructed (n = 5). The animals were submitted to memory and spatial learning evaluation through the Morris water maze test. The rats were sacrificed at 28 days of age and histological analysis of the brains was performed with luxol fast blue, in addition to immunohistochemical analysis in order to evaluate reactive astrocytosis, inflammation, neuronal labeling, and apoptotic activity. RESULTS The group with shunt obstruction had worse performance in memory tests. Reactive astrocytosis was more evident in this group, as was the inflammatory response. CONCLUSIONS Obstruction of the shunt results in impaired performance of behavioral tests and causes irreversible histopathological changes when compared to findings in the group with treated hydrocephalus, even after unblocking the system. The developed model is feasible and efficient in simulating the clinical context of shunt dysfunction.
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Affiliation(s)
- Stephanie Naomi Funo de Souza
- Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil.
| | - Helio Rubens Machado
- Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil
| | - Luisa da Silva Lopes
- Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Pamella da Silva Beggiora Marques
- Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Stephanya Covas da Silva
- Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Maurício Dutra
- Behavioral Neuropathology and Pediatric Neurosurgery Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Davi Casale Aragon
- Department of Pediatrics, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Marcelo Volpon Santos
- Division of Pediatric Neurosurgery, Department of Surgery and Anatomy, University Hospital, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, 14049-900, Brazil
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Dutra M, Covas da Silva S, da Silva Beggiora Marques P, Oliveira Amaral I, Funo de Souza SN, Dutra LA, Volpon Santos M, Machado HR, da Silva Lopes L. Celecoxib attenuates neuroinflammation, reactive astrogliosis and promotes neuroprotection in young rats with experimental hydrocephalus. J Chem Neuroanat 2023; 133:102344. [PMID: 37777093 DOI: 10.1016/j.jchemneu.2023.102344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 10/02/2023]
Abstract
Hydrocephalus is a neurological condition with altered cerebrospinal fluid flow (CSF). The treatment is surgical and the most commonly used procedure is ventricle-peritoneal shunt. However, not all patients can undergo immediate surgery or achieve complete lesion reversal. Neuroprotective measures are valuable in such cases. It was evaluated whether the use of celecoxib, a selective inhibitor of COX-2, associated or not with ventricular-subcutaneous derivation, could offer benefits to the brain structures affected by experimental hydrocephalus. Seven-day-old male Wistar Hannover rats induced by intracisternal injection of kaolin 15% were used, divided into five groups with ten animals each: intact control (C), untreated hydrocephalus (H), hydrocephalus treated with celecoxib 20 mg/kg intraperitoneal (HTC), hydrocephalus treated with shunt (HTS) and hydrocephalus treated with shunt and celecoxib 20 mg/kg intraperitoneal (HTCS). Celecoxib was administered for 21 consecutive days, starting the day after hydrocephalus induction and continuing until the end of the experimental period. The surgery was performed seven days after inducing hydrocephalus. Multiple assessment methods were used, such as behavioral tests (water maze and open field), histological analysis (hematoxylin and eosin), immunohistochemistry (caspase-3, COX-2, and GFAP), and ELISA analysis of GFAP. The results of the behavioral and memory tests indicated that celecoxib improves the neurobehavioral response. The improvement can be attributed to the reduced neuroinflammation (p < 0.05), and astrogliosis (p < 0.05) in different brain regions. In conclusion, the results suggest that celecoxib holds great potential as an adjuvant neuroprotective drug for the treatment of experimental hydrocephalus.
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Affiliation(s)
- Maurício Dutra
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil.
| | - Stephanya Covas da Silva
- Department of Morphology and Pathology, Division of Anatomy, Federal University of Sao Carlos, Washington Luiz Hig., Monjolinho, Sao Carlos, SP, Brazil.
| | - Pâmella da Silva Beggiora Marques
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil
| | - Izadora Oliveira Amaral
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil.
| | - Stephanie Naomi Funo de Souza
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil
| | - Luiz Antônio Dutra
- Nucleus of Bioassays, Biosynthesis, and Ecophysiology of Natural Products (NuBBE), Institute of Chemistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Marcelo Volpon Santos
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil.
| | - Hélio Rubens Machado
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil
| | - Luiza da Silva Lopes
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, Brazil.
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Moreira CAA, Murayama LHV, Martins TDC, Oliveira VT, Generoso D, Machado VMDV, Batah SS, Fabro AT, Bazan R, Zanini MA, Sciutto E, Fleury A, Hamamoto Filho PT. Sexual dimorphism in the murine model of extraparenchymal neurocysticercosis. Parasitol Res 2023; 122:2147-2154. [PMID: 37428312 DOI: 10.1007/s00436-023-07913-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
Neurocysticercosis is a heterogeneous disease, and the patient's sex seems to play a role in this heterogeneity. Hosts' sexual dimorphism in cysticercosis has been largely explored in the murine model of intraperitoneal Taenia crassiceps cysticercosis. In this study, we investigated the sexual dimorphism of inflammatory responses in a rat model of extraparenchymal neurocysticercosis caused by T. crassiceps. T. crassiceps cysticerci were inoculated in the subarachnoid space of Wistar rats (25 females, 22 males). Ninety days later, the rats were euthanized for histologic, immunohistochemistry, and cytokines studies. Ten animals also underwent a 7-T magnetic resonance imaging (MRI). Female rats presented a higher concentration of immune cells in the arachnoid-brain interface, reactive astrogliosis in the periventricular region, in situ pro-inflammatory cytokine (interleukin [IL]-6) and anti-inflammatory cytokine (IL-10), and more intense hydrocephalus on MRI than males. Intracranial hypertension signals were not observed during the observational period. Overall, these results suggest sexual dimorphism in the intracranial inflammatory response that accompanied T. crassiceps extraparenchymal neurocysticercosis.
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Affiliation(s)
- Carlos Alexandre Aguiar Moreira
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Luis Henrique Vallesquino Murayama
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Tatiane de Camargo Martins
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Vinicius Tadeu Oliveira
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Diego Generoso
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | | | | | | | - Rodrigo Bazan
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Marco Antônio Zanini
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil
| | - Edda Sciutto
- Institute of Biomedical Investigations, UNAM - National Autonomous University of Mexico, Mexico City, Mexico
| | - Agnès Fleury
- Institute of Biomedical Investigations, UNAM - National Autonomous University of Mexico, Mexico City, Mexico
- Instituto Nacional de Neurología y Neurocirurgía, Mexico City, Mexico
| | - Pedro Tadao Hamamoto Filho
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School. UNESP - São Paulo State University, Distrito de Rubião Jr, s/n, CEP 18606-986, Botucatu, São Paulo, Brazil.
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da Silva Beggiora P, da Silva SC, Rodrigues KP, Almeida TADL, Botelho GS, Silva GAPDM, Machado HR, da Silva Lopes L. Memantine associated with ventricular-subcutaneous shunt promotes behavioral improvement, reduces reactive astrogliosis and cell death in juvenile hydrocephalic rats. J Chem Neuroanat 2022; 125:102165. [PMID: 36152798 DOI: 10.1016/j.jchemneu.2022.102165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 09/19/2022] [Accepted: 09/19/2022] [Indexed: 11/28/2022]
Abstract
Hydrocephalus is defined as the accumulation of cerebrospinal fluid in the brain ventricles. The usual treatment of hydrocephalus is surgical (shunt), but not all patients can undergo treatment immediately after diagnosis. Thus, neuroprotective measures were tested to minimize the tissue damage involved. Memantine is a non-competitive antagonist of the N-methyl-D-aspartate (NMDA) receptor, which has shown a neuroprotective action in neurodegenerative diseases. This study aimed to evaluate the neuroprotective response of memantine in animals treated with or without a ventricular-subcutaneous shunt. Seven-day-old male Wistar rats induced by intracisternal injection of kaolin were used, divided into five groups: intact control (n=10), hydrocephalic (n=10), hydrocephalic treated with memantine (20mg/kg/day) (n=10), hydrocephalic treated with shunt (n=10), hydrocephalic treated with shunt and memantine (20mg/kg/day) (n=10). Memantine administration was started on the day after hydrocephalus induction and continued until the last day of the experimental period, totaling 21 consecutive days of drug application. The CSF shunt surgery was performed seven days after hydrocephalus induction. Behavioral tests (open field, and modified Morris water maze), histological, and immunohistochemical evaluations were performed. Treatment with memantine resulted in significant improvement (p<0.05) in sensorimotor development, preservation of spatial memory, reduction of astrocytic reaction in the corpus callosum, cortex, and germinal matrix. When associated with the shunt, it has also been shown to reduce the cell death cascade. It is concluded that memantine is a promising adjuvant drug with beneficial potential for the treatment of lesions secondary to hydrocephalus.
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Affiliation(s)
- Pâmella da Silva Beggiora
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, 14040-900, Brazil.
| | - Stephanya Covas da Silva
- Department of Morphology and Pathology, Federal University of São Carlos, Washington Luiz, Monjolinho, São Carlos - SP, 13565-905, Brazil.
| | - Karine Pereira Rodrigues
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, 14040-900, Brazil.
| | - Timóteo Abrantes de Lacerda Almeida
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, 14040-900, Brazil.
| | - Gustavo Sampaio Botelho
- Department of Pediatric Neurosurgery, Children's and Maternity Hospital of São José do Rio Preto. Jamil Ferreira Kfouri Av, 3355, São José do Rio Preto, SP, 15091-240, Brazil.
| | - Gabriel Aparecido Pinto de Moura Silva
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, 14040-900, Brazil.
| | - Hélio Rubens Machado
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, 14040-900, Brazil.
| | - Luiza da Silva Lopes
- Department of Surgery and Anatomy, Ribeirão Preto Medical School, University of São Paulo, Bandeirantes Av, 3900, Ribeirão Preto, SP, 14040-900, Brazil.
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da Silva SC, da Silva Beggiora P, Catalão CHR, Dutra M, Matias Júnior I, Santos MV, Machado HR, da Silva Lopes L. Hyperbaric oxygen therapy associated with ventricular-subcutaneous shunt promotes neuroprotection in young hydrocephalic rats. Neuroscience 2022; 488:77-95. [DOI: 10.1016/j.neuroscience.2022.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/20/2022] [Accepted: 02/08/2022] [Indexed: 12/31/2022]
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The association of Edaravone with shunt surgery improves behavioral performance, reduces astrocyte reaction and apoptosis, and promotes neuroprotection in young hydrocephalic rats. J Chem Neuroanat 2021; 119:102059. [PMID: 34896559 DOI: 10.1016/j.jchemneu.2021.102059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/24/2021] [Accepted: 12/06/2021] [Indexed: 11/22/2022]
Abstract
The neuroprotective effect of Edaravone in young hydrocephalic rats associated with a CSF derivation system was evaluated. The drug has already been shown to be beneficial in experimental hydrocephalus, but the combination of this drug with shunt surgery has not yet been investigated. Fifty-seven-day-old Wistar rats submitted to hydrocephalus by injection of kaolin in the cisterna magna were used and divided into five groups: control (n = 10), hydrocephalic (n = 10), hydrocephalic treated with Edaravone (20 mg/kg/day) (n = 10), hydrocephalic treated with shunt (n = 10) and hydrocephalic treated with shunt and Edaravone (n = 10). Administration of the Edaravone was started 24 h after hydrocephalus induction (P1) and continued until the experimental endpoint (P21). The CSF shunt surgery was performed seven days after hydrocephalus induction (P7). Open-field tests, histological evaluation by hematoxylin and eosin, immunohistochemistry by Caspase-3 and GFAP, and ELISA biochemistry by GFAP were performed. Edaravone reduced reactive astrogliosis in the corpus callosum and germinal matrix (p < 0.05). When used alone or associated with CSF shunt surgery, the drug decreased the cell death process (p < 0.0001) and improved the morphological aspect of the astroglia (p < 0.05). The results showed that Edaravone associated with CSF bypass surgery promotes neuroprotection in young hydrocephalic rats by reducing reactive astrogliosis and decreasing cell death.
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Campos-Ordonez T, Gonzalez-Perez O. Characterization of a mouse model of chronic hydrocephalus induced by partial occlusion of the aqueduct of Sylvius in the adult brain. J Neurosci Methods 2021; 362:109294. [PMID: 34293409 DOI: 10.1016/j.jneumeth.2021.109294] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/16/2021] [Accepted: 07/17/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hydrocephalus is a neurologic disturbance produced by the abnormal production, circulation, and absorption of cerebrospinal fluid (CSF). Late-onset idiopathic aqueductal stenosis induces normal pressure hydrocephalus (NPH) in adults. To date, no animal model replicating chronic NPH is available to study the pathophysiological changes observed in these subjects. NEW METHOD We performed and characterized a model that induces chronic hydrocephalus in the adult mouse brain by producing a pre-aqueductal semiobstruction using an acetate lamina inserted into the atrium of the aqueduct of Sylvius. After surgical procedure, we analyzed the hydrocephalus development on days 60 and 120 and sham-operated animals were used as controls. We included an additional group of hydrocephalus resolution in which we removed the obstruction and analyzed the morphological changes in the brain. RESULTS The hydrocephalus was fully established on day 60 after the obstruction and remained stable for 120 days. In all animals, the intracranial pressure remained ~4.08 mmHg and we did not find statistically significant differences between the hydrocephalus groups and controls. We did not find motor impairments and anxiety-like behaviors among groups and the analysis of microglia and astrogliosis revealed mild glial reactivity. COMPARISON WITH EXISTING METHODS This model generates a long-term ventricular enlargement with normal intracranial pressure and moderate glial reactivity. Importantly, this model allows the reversibility of ventricular enlargement after the removal of the obstructive film from the brain. CONCLUSIONS This mouse model may be useful to study the long-term cerebral alterations that occur during NPH or after its surgical resolution.
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Affiliation(s)
- Tania Campos-Ordonez
- Laboratory of Neuroscience, School of Psychology, University of Colima, Colima 28040, Mexico; Physiological Science PhD Program, School of Medicine, University of Colima, Colima 28040, Mexico
| | - Oscar Gonzalez-Perez
- Laboratory of Neuroscience, School of Psychology, University of Colima, Colima 28040, Mexico.
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Sampaio GB, Da Silva SC, Romeiro TH, Beggiora PDS, Machado HR, Lopes LDS. Evaluation of the effects of quercetin on brain lesions secondary to experimental hydrocephalus in rats. Childs Nerv Syst 2019; 35:2299-2306. [PMID: 31134338 DOI: 10.1007/s00381-019-04184-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 04/28/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hydrocephaly is a disease that affects not only the dynamics of the cerebrospinal fluid, but also other structures of the central nervous system. Although shunt is effective in reducing ventriculomegaly, many neurological damages are not reversed with surgery. Several studies demonstrate that oxidative stress is involved in the genesis of hydrocephalus lesions. OBJECTIVE Evaluate the neuroprotective response of quercetin in hydrocephalus. MATERIALS AND METHODS Male newborns rats were used, which received the 15% kaolin injection in the cisterna magna for induction of hydrocephalus. They were divided into control group (C), untreated hydrocephalic (HN), shunted hydrocephalic (HD), hydrocephalic treated with distilled water (HA), hydrocephalic treated with distilled water and shunt (HDA), hydrocephalic treated with quercetin peritoneal (HQp), hydrocephalic treated with quercetin peritoneal and shunt (HDQp), hydrocephalic treated with quercetin by gavage (HQg), and hydrocephalus treated with quercetin by gavage and shunt (HDQg). RESULTS Quercetin significantly improved the immunohistochemical markers, mainly caspase and GFAP. There were no significant changes in clinical/behavioral assessment. The use of isolated quercetin does not alter the volume and ventricular size, and the realization of ventriculo-subcutaneous shunt in newborn rats with hydrocephalus presents a high morbi-mortality. CONCLUSION The use of quercetin shows laboratory improvement of the effects of glial lesion and corpus callosum fibers and is therefore not justified by the use of the routine substance as neuroprotective.
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Affiliation(s)
- G B Sampaio
- Hospital da Criança e Maternidade, Av. Jamil Feres Kfouri, 60 - Jardim Panorama, São José do Rio Preto, SP, 15091-240, Brazil.
| | - S C Da Silva
- Developmental neuropathology laboratory - Faculdade de Medicina da Universidade de São Paulo, Campus Ribeirão Preto - SP, Av bandeirantes, 3900, Ribeirão Preto, São Paulo, 14040-900, Brazil
| | - T H Romeiro
- Developmental neuropathology laboratory - Faculdade de Medicina da Universidade de São Paulo, Campus Ribeirão Preto - SP, Av bandeirantes, 3900, Ribeirão Preto, São Paulo, 14040-900, Brazil
| | - P D S Beggiora
- Developmental neuropathology laboratory - Faculdade de Medicina da Universidade de São Paulo, Campus Ribeirão Preto - SP, Av bandeirantes, 3900, Ribeirão Preto, São Paulo, 14040-900, Brazil
| | - H R Machado
- Developmental neuropathology laboratory - Faculdade de Medicina da Universidade de São Paulo, Campus Ribeirão Preto - SP, Av bandeirantes, 3900, Ribeirão Preto, São Paulo, 14040-900, Brazil
| | - L D S Lopes
- Developmental neuropathology laboratory - Faculdade de Medicina da Universidade de São Paulo, Campus Ribeirão Preto - SP, Av bandeirantes, 3900, Ribeirão Preto, São Paulo, 14040-900, Brazil
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Emmert AS, Iwasawa E, Shula C, Schultz P, Lindquist D, Dunn RS, Fugate EM, Hu YC, Mangano FT, Goto J. Impaired neural differentiation and glymphatic CSF flow in the Ccdc39 rat model of neonatal hydrocephalus: genetic interaction with L1cam. Dis Model Mech 2019; 12:12/11/dmm040972. [PMID: 31771992 PMCID: PMC6898999 DOI: 10.1242/dmm.040972] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/14/2019] [Indexed: 01/07/2023] Open
Abstract
Neonatal hydrocephalus affects about one child per 1000 births and is a major congenital brain abnormality. We previously discovered a gene mutation within the coiled-coil domain-containing 39 (Ccdc39) gene, which causes the progressive hydrocephalus (prh) phenotype in mice due to lack of ependymal-cilia-mediated cerebrospinal fluid (CSF) flow. In this study, we used CRISPR/Cas9 to introduce the Ccdc39 gene mutation into rats, which are more suitable for imaging and surgical experiments. The Ccdc39prh/prh mutants exhibited mild ventriculomegaly at postnatal day (P)5 that progressed into severe hydrocephalus by P11 (P<0.001). After P11, macrophage and neutrophil invasion along with subarachnoid hemorrhage were observed in mutant brains showing reduced neurofilament density, hypomyelination and increased cell death signals compared with wild-type brains. Significantly more macrophages entered the brain parenchyma at P5 before hemorrhaging was noted and increased expression of a pro-inflammatory factor (monocyte chemoattractant protein-1) was found in the cortical neural and endothelial cells in the mutant brains at P11. Glymphatic-mediated CSF circulation was progressively impaired along the middle cerebral artery from P11 as mutants developed severe hydrocephalus (P<0.001). In addition, Ccdc39prh/prh mutants with L1 cell adhesion molecule (L1cam) gene mutation, which causes X-linked human congenital hydrocephalus, showed an accelerated early hydrocephalus phenotype (P<0.05-0.01). Our findings in Ccdc39prh/prh mutant rats demonstrate a possible causal role of neuroinflammation in neonatal hydrocephalus development, which involves impaired cortical development and glymphatic CSF flow. Improved understanding of inflammatory responses and the glymphatic system in neonatal hydrocephalus could lead to new therapeutic strategies for this condition. This article has an associated First Person interview with the joint first authors of the paper. Summary: Glymphatic CSF circulation and development of the cerebral cortex are impaired in our new genetic rat model of neonatal hydrocephalus with the onset of parenchymal inflammation and hemorrhage.
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Affiliation(s)
- A Scott Emmert
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Eri Iwasawa
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Crystal Shula
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Preston Schultz
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Diana Lindquist
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - R Scott Dunn
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Elizabeth M Fugate
- Division of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Yueh-Chiang Hu
- Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Francesco T Mangano
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - June Goto
- Division of Pediatric Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
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Litwinska M, Litwinska E, Czaj M, Polis B, Polis L, Szaflik K. Ventriculo-amniotic shunting for severe fetal ventriculomegaly. Acta Obstet Gynecol Scand 2019; 98:1172-1177. [PMID: 30977122 DOI: 10.1111/aogs.13622] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 12/30/2018] [Accepted: 04/04/2019] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Severe fetal cerebral ventriculomegaly, observed in about 1 in 1000 newborns, is associated with a high risk of perinatal death and neurodevelopmental delay in survivors. The objective of this study was to evaluate the efficiency of ventriculo-amniotic shunting for drainage of severe fetal cerebral ventriculomegaly and the neurodevelopment of survivors at the age of 2 years. MATERIAL AND METHODS This was a retrospective study of 44 fetuses with severe bilateral ventriculomegaly treated with ventriculo-amniotic shunting in a tertiary fetal therapy center between 2010 and 2015. RESULTS Shunt insertion was successfully carried out at a median gestational age of 25 weeks (range 20-33 weeks). There were three fetal deaths within 24 hours of the procedure and 41 live births at a median gestational age of 37 weeks (range 28-39 weeks). Neurodevelopment at 2 years of age was evaluated using the Bayley scale in the 38 survivors. In the 27 cases with isolated ventriculomegaly 19 (70.4%; 95% confidence interval [95% CI] 51.5%-84.2%) had normal or mild neurodevelopmental delay and 8 (29.6%; 95% CI 15.6%-48.5%) were moderately or severely delayed. In the 11 with non-isolated ventriculomegaly 2 (18.2%; 95% CI 5.1%-4.8%) had normal or mild neurodevelopmental delay and 9 (81.8%; 95% CI 52.3%-94.9%) babies were moderately or severely delayed. CONCLUSIONS Ventriculo-amniotic shunting is an option for the management of severe ventriculomegaly and results in normalization of the ventricular diameter. However, a high proportion of survivors have neurodevelopmental delay and the possible beneficial effect of ventriculo-amniotic shunting needs to be assessed by randomized studies.
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Affiliation(s)
- Magdalena Litwinska
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Ewelina Litwinska
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Marta Czaj
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Bartosz Polis
- Department of Neurosurgery, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Lech Polis
- Department of Neurosurgery, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Krzysztof Szaflik
- Department of Gynecology, Fertility and Fetal Therapy, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
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Volpon Santos M, da Silva Lopes L, Machado HR, Santos de Oliveira R. Behavioral and Biochemical Features of the Course and Surgical Treatment of Experimental Obstructive Hydrocephalus in Young Rats. Dev Neurosci 2019; 41:34-43. [PMID: 30999305 DOI: 10.1159/000497433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 02/01/2019] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Hydrocephalus is a multifactorial disease, affecting the dynamics of cerebrospinal fluid (CSF) and leading to severe neurological impairment in children; in spite of the recent advances in hydrocephalus research, it has many physiopathological aspects that still remain poorly understood, especially after treatment. OBJECTIVES To analyze the clinical, radiological, histopathological, and biochemical aspects of kaolin-induced hydrocephalus in an experimental model, both in the acute phase and after shunt treatment, by means of behavioral tests, magnetic resonance imaging (MRI) scans, histopathological studies, and level of inflammatory interleukins in the CSF. METHODS Seven-day-old Wistar rats were used and subdivided into three subgroups: treated hydrocephalic (n = 24), untreated hydrocephalic (n = 17), and controls (n = 5). The hydrocephalic groups underwent cisternal injection of 15% kaolin for induction of hydrocephalus at 7 days of age. The treated group was submitted to a ventricular-subcutaneous shunt (VSCS) 1 week after induction. All animals were euthanized at 21 days of age. They underwent motor function and memory testing as well as brain MRI scans. Histopathological analysis for glial fibrillary acidic protein and Ki-67 was done, and CSF was collected for measurement of IL-1β, IL-6, and TNF-α. RESULTS The average time to reach the water maze platform was highest in the untreated hydrocephalic group. The magnetization transfer rates were 37.21 and 33.76 before and after shunting, respectively. The mean astrocyte counts were 2.45, 1.36, and 90.5 for shunted, untreated, and control animals, respectively. The mean CSF IL-1β concentrations were 62.3 and 249.6 pg/mL, the average IL-6 levels were 104.2 and 364.7 pg/mL, and the average TNF-α values were 4.9 and 170.5 pg/mL for the treated hydrocephalic group and the untreated group, respectively. CONCLUSIONS Pups treated with a CSF shunt showed better performance on memory tests. VSCS did not revert demyelination caused by hydrocephalus. Likewise, reactive astrocytosis and cell proliferation over the germinal matrix were not reversed after shunting. Hydrocephalic animals had raised levels of inflammatory interleukins, which returned to normal after treatment.
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Affiliation(s)
- Marcelo Volpon Santos
- Division of Pediatric Neurosurgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil, .,Developmental Neuropathology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil,
| | - Luiza da Silva Lopes
- Developmental Neuropathology Laboratory, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Hélio Rubens Machado
- Division of Pediatric Neurosurgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Ricardo Santos de Oliveira
- Division of Pediatric Neurosurgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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12
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Morosanu CO, Filip GA, Nicolae L, Florian IS. From the heart to the bladder-particularities of ventricular shunt topography and the current status of cerebrospinal fluid diversion sites. Neurosurg Rev 2018; 43:847-860. [PMID: 30338415 DOI: 10.1007/s10143-018-1033-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 08/28/2018] [Accepted: 09/17/2018] [Indexed: 12/01/2022]
Abstract
Hydrocephalus represents the pathological elevation of cerebrospinal fluid (CSF) levels as a consequence of various embryological or acquired defects. Although the classic method of treatment is by means of diverting the CSF from the ventricular system towards the peritoneum, there are other sites of diversion that have proven their efficiency through time, in the context of complications related to the more common option of intraperitoneal insertion. The aim of the review is to assess and organize a database of all the types of shunt locations from the oldest shunt attempts until present, using Pubmed and Medline and to underline the particularities related to technique, indications, complications and associated epidemiological background. Current literature reveals up to 36 sites of diversion of CSF with a diverse topography varying from cephalic regions such as venous sinuses or mastoid bone, thoracic elements such as the heart or the pleura and abdominopelvic segments such as the peritoneum or the urinary bladder. Several atypical locations were studied such as the fallopian and intestinal shunts. Although ventriculoperitoneal and ventriculoatrial shunts are the most commonly used shunts today, there are some systems such as the ventriculosinusal and ventriculolymphatic shunts that prove to be equally as efficient. The successful treatment of hydrocephalus requires a complete comprehension of the indications and therapeutic options and a reliable evaluation of the risks and possible complications. The profile of cerebral ventricular shunts is highly dynamic and the spectrum of cerebrospinal fluid diversion offers multiple solutions in the benefit of the patient.
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Affiliation(s)
- Cezar Octavian Morosanu
- Department of Neurosurgery, North Bristol NHS Trust, Southmead Hospital, Southmead Rd, Westbury-on-Trym, Bristol, United Kingdom.
| | - Gabriela Adriana Filip
- Department of Physiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
| | - Liviu Nicolae
- Department of Neurosurgery, North Bristol NHS Trust, Southmead Hospital, Southmead Rd, Westbury-on-Trym, Bristol, United Kingdom
| | - Ioan Stefan Florian
- Department of Neurosurgery, Cluj County Emergency Hospital, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania
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