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Khaksari M, Shahryari M, Raji-Amirhasani A, Soltani Z, Bibak B, Keshavarzi Z, Shakeri F. Aloe vera Leaf Extract Reduced BBB Permeability and Improved Neurological Results after Traumatic Brain Injury: The Role of Oxidative Stress. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2024; 2024:5586814. [PMID: 39040520 PMCID: PMC11262876 DOI: 10.1155/2024/5586814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 02/24/2024] [Accepted: 06/15/2024] [Indexed: 07/24/2024]
Abstract
Introduction Recognizing the importance of medicinal plants and the absence of specific medications for traumatic brain injury (TBI) treatment, this study was conducted to evaluate the effects of an aqueous extract of Aloe vera on oxidative stress, blood-brain barrier (BBB) permeability, and neurological scores following TBI. Materials and Methods Adult male rats were categorized into five groups: sham, TBI, vehicle, low-dose Aloe vera (LA), and high-dose Aloe vera (HA). We induced diffuse TBI using the Marmaro model and administered the aqueous Aloe vera leaf extract, as well as vehicle, via intraperitoneal injection half an hour after TBI. Neurological outcomes were assessed both before and several hours after TBI. Additionally, oxidative stress factors were measured 24 hr after TBI, and Evans blue content (a BBB permeability index) was determined 5 hr after TBI in both serum and brain. Results Both LA and HA reduced the increase in BBB permeability after TBI, with HA having a more pronounced effect than LA. Both Aloe vera doses decreased brain MDA levels, increased brain TAC, and lowered both serum and brain PC levels. The impact of Aloe vera on brain oxidative parameters was more significant than on serum. HA also counteracted the declining effects of TBI on neurological outcomes at 4 and 24 hr post-TBI. Conclusion This study suggests that Aloe vera extract may reduce BBB permeability and improve neurological outcomes after TBI by decreasing oxidative factors and increasing antioxidant factors.
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Affiliation(s)
- Mohammad Khaksari
- Endocrinology and Metabolism Research CenterKerman University of Medical Sciences, Kerman, Iran
- Department of Physiology and PharmacologyAfzalipour Faculty of MedicineKerman University of Medical Sciences, Kerman, Iran
| | - Marzieh Shahryari
- Endocrinology and Metabolism Research CenterKerman University of Medical Sciences, Kerman, Iran
- Department of PhysiologyNeuroscience Research CenterMedical FacultyGolestan University of Medical Sciences, Gorgan, Iran
| | - Alireza Raji-Amirhasani
- Endocrinology and Metabolism Research CenterKerman University of Medical Sciences, Kerman, Iran
- Department of Physiology and PharmacologyAfzalipour Faculty of MedicineKerman University of Medical Sciences, Kerman, Iran
| | - Zahra Soltani
- Physiology Research CenterInstitute of NeuropharmacologyKerman University of Medical Sciences, Kerman, Iran
| | - Bahram Bibak
- Natural Products and Medicinal Plants Research CenterNorth Khorasan University of Medical Sciences, Bojnurd, Iran
- Department of Physiology and PharmacologySchool of MedicineNorth Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Zakieh Keshavarzi
- Natural Products and Medicinal Plants Research CenterNorth Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Farzaneh Shakeri
- Department of Physiology and PharmacologySchool of MedicineNorth Khorasan University of Medical Sciences, Bojnurd, Iran
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Kim M, Jeon H, Chung Y, Lee SU, Park W, Park JC, Ahn JS, Lee S. Efficacy of Acetylcysteine and Selenium in Aneurysmal Subarachnoid Hemorrhage Patients: A Prospective, Multicenter, Single Blind Randomized Controlled Trial. J Korean Med Sci 2023; 38:e161. [PMID: 37270916 DOI: 10.3346/jkms.2023.38.e161] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 02/16/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Subarachnoid hemorrhage (SAH) patients have oxidative stress results in inflammation, tissue degeneration and neuronal damage. These deleterious effects cause aggravation of the perihematomal edema (PHE), vasospasm, and even hydrocephalus. We hypothesized that antioxidants may have a neuroprotective role in acute aneurysmal SAH (aSAH) patients. METHODS We conducted a prospective, multicenter randomized (single blind) trial between January 2017 and October 2019, investigating whether antioxidants (acetylcysteine and selenium) have the potential to improve the neurologic outcome in aSAH patients. The antioxidant patient group received antioxidants of acetylcysteine (2,000 mg/day) and selenium (1,600 µg/day) intravenously (IV) for 14 days. These drugs were administrated within 24 hours of admission. The non-antioxidant patient group received a placebo IV. RESULTS In total, 293 patients were enrolled with 103 patients remaining after applying the inclusion and exclusion criteria. No significant differences were observed in the baseline characteristics between the antioxidant (n = 53) and non-antioxidant (n = 50) groups. Among clinical factors, the duration of intensive care unit (ICU) stay was significantly shortened in patients who received antioxidants (11.2, 95% confidence interval [CI], 9.7-14.5 vs. 8.3, 95% CI, 6.2-10.2 days, P = 0.008). However, no beneficial effects were observed on radiological outcomes. CONCLUSION In conclusion, antioxidant treatment failed to show the reduction of PHE volume, mid-line shifting, vasospasm and hydrocephalus in acute SAH patients. A significant reduction in ICU stay was observed but need more optimal dosing schedule and precise outcome targets are required to clarify the clinical impacts of antioxidants in these patients. TRIAL REGISTRATION Clinical Research Information Service Identifier: KCT0004628.
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Affiliation(s)
- Moinay Kim
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hanwool Jeon
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- Department of Medical Science, Asan Medical Institute of Convergence Science and Technology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yeongu Chung
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Si Un Lee
- Department of Neurosurgery, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Wonhyoung Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Cheol Park
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Sung Ahn
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seungjoo Lee
- Department of Neurosurgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
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3
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Bulama I, Nasiru S, Bello A, Abbas AY, Nasiru JI, Saidu Y, Chiroma MS, Mohd Moklas MA, Mat Taib CN, Waziri A, Suleman BL. Antioxidant-based neuroprotective effect of dimethylsulfoxide against induced traumatic brain injury in a rats model. Front Pharmacol 2022; 13:998179. [PMID: 36353489 PMCID: PMC9638698 DOI: 10.3389/fphar.2022.998179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/17/2022] [Indexed: 08/03/2023] Open
Abstract
Traumatic brain injury (TBI) has been the result of neurological deficit and oxidative stress. This study evaluated the antioxidative neuroprotective property and learning and memory-enhancing effects of dimethyl sulfoxide (DMSO) in a rat model after the induction of TBI. 21 albino rats with 7 rats per group were used in this study. Group I was induced with TBI and treated with DMSO at 67.5 mg/kg orally once daily which started 30 min after the induction of TBI and lasted 21 days. Group II was induced with TBI but not treated while Group III was neither induced with TBI nor treated. Assessment of behavioral function (Learning and memory, anxiety and motor function), the level of an antioxidant enzymes and their gene expression (superoxide dismutase, catalase, glutathione peroxidase), the biomarkers of oxidative stress (malondialdehyde) and S100B levels as well as brain tissues histological studies were conducted. Administration of DMSO to rats with induced TBI has improved learning and memory, locomotor function and decreased anxiety in Group I compared to Group II. Moreover, the level of S100B was significantly (p < 0.05) lower in Group I compared to Group II. Treatment with DMSO also decreased lipid peroxidation significantly (p < 0.05) compared to Group II. There exists a significant (p < 0.05) increase in CAT, SOD, and GPX activities in Group I compared to Group II. Therefore, DMSO has demonstrated a potential antioxidative neuroprotective effect through its ability to increase the level of antioxidant enzymes which they quench and inhibit the formation of ROS, thereby improving cognitive functions.
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Affiliation(s)
- Ibrahim Bulama
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Nigeria
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Suleiman Nasiru
- Department of Veterinary Physiology and Biochemistry, Faculty of Veterinary Medicine, Usman Danfodiyo University, Sokoto, Nigeria
| | - Abubakar Bello
- Department of Pharmacology and Toxicology, Faculty of Veterinary Medicine, Wroclaw University of Environmental and Life Sciences, Wroclaw, Poland
| | - Abdullahi Yahaya Abbas
- Department of Biochemistry, Faculty of Chemical and Life Sciences, Usman Danfodiyo University, Sokoto, Nigeria
| | - Jinjiri Ismail Nasiru
- Department of Surgery, Faculty of Clinical Sciences, Usman Danfodiyo University Teaching Hospital, Sokoto, Nigeria
| | - Yusuf Saidu
- Department of Biochemistry, Faculty of Chemical and Life Sciences, Usman Danfodiyo University, Sokoto, Nigeria
| | - Musa Samaila Chiroma
- Department of Human Anatomy, Faculty of Basic Clinical Sciences, University of Maiduguri, Maiduguri, Nigeria
| | - Mohamad Aris Mohd Moklas
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Che Norma Mat Taib
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Ali Waziri
- Department of Veterinary Pathology, Faculty of Veterinary Medicine, University of Maiduguri, Maiduguri, Nigeria
| | - Bilbis Lawal Suleman
- Department of Biochemistry, Faculty of Chemical and Life Sciences, Usman Danfodiyo University, Sokoto, Nigeria
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Wen J, Chen J, Chang J, Wei J. Pulmonary complications and respiratory management in neurocritical care: a narrative review. Chin Med J (Engl) 2022; 135:779-789. [PMID: 35671179 PMCID: PMC9276382 DOI: 10.1097/cm9.0000000000001930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Neurocritical care (NCC) is not only generally guided by principles of general intensive care, but also directed by specific goals and methods. This review summarizes the common pulmonary diseases and pathophysiology affecting NCC patients and the progress made in strategies of respiratory support in NCC. This review highlights the possible interactions and pathways that have been revealed between neurological injuries and respiratory diseases, including the catecholamine pathway, systemic inflammatory reactions, adrenergic hypersensitivity, and dopaminergic signaling. Pulmonary complications of neurocritical patients include pneumonia, neurological pulmonary edema, and respiratory distress. Specific aspects of respiratory management include prioritizing the protection of the brain, and the goal of respiratory management is to avoid inappropriate blood gas composition levels and intracranial hypertension. Compared with the traditional mode of protective mechanical ventilation with low tidal volume (Vt), high positive end-expiratory pressure (PEEP), and recruitment maneuvers, low PEEP might yield a potential benefit in closing and protecting the lung tissue. Multimodal neuromonitoring can ensure the safety of respiratory maneuvers in clinical and scientific practice. Future studies are required to develop guidelines for respiratory management in NCC.
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Affiliation(s)
- Junxian Wen
- Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Dongcheng District, Beijing 100730, China
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5
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Kangisser L, Tan E, Bellomo R, Deane AM, Plummer MP. Neuroprotective Properties of Vitamin C: A Scoping Review of Pre-Clinical and Clinical Studies. J Neurotrauma 2021; 38:2194-2205. [PMID: 33544035 DOI: 10.1089/neu.2020.7443] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
There is a need for novel neuroprotective therapies. We aimed to review the evidence for exogenous vitamin C as a neuroprotective agent. MEDLINE, Embase, and Cochrane library databases were searched from inception to May 2020. Pre-clinical and clinical reports evaluating vitamin C for acute neurological injury were included. Twenty-two pre-clinical and 11 clinical studies were eligible for inclusion. Pre-clinical studies included models of traumatic and hypoxic brain injury, subarachnoid and intracerebral hemorrhage, and ischemic stroke. The median [IQR] maximum daily dose of vitamin C in animal studies was 120 [50-500] mg/kg. Twenty-one animal studies reported improvements in biomarkers, functional outcome, or both. Clinical studies included single reports in neonatal hypoxic encephalopathy, traumatic brain injury, and subarachnoid hemorrhage and eight studies in ischemic stroke. The median maximum daily dose of vitamin C was 750 [500-1000] mg, or ∼10 mg/kg for an average-size adult male. Apart from one case series of intracisternal vitamin C administration in subarachnoid hemorrhage, clinical studies reported no patient-centered benefit. Although pre-clinical trials suggest that exogenous vitamin C improves biomarkers of neuroprotection, functional outcome, and mortality, these results have not translated to humans. However, clinical trials used approximately one tenth of the vitamin C dose of animal studies.
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Affiliation(s)
- Lauren Kangisser
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Elinor Tan
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Rinaldo Bellomo
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Adam M Deane
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, University of Melbourne, Melbourne, Victoria, Australia
| | - Mark P Plummer
- Department of Intensive Care, Royal Melbourne Hospital, Parkville, Victoria, Australia.,Centre for Integrated Critical Care, Department of Medicine and Radiology, University of Melbourne, Melbourne, Victoria, Australia
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Kim M, Byun J, Chung Y, Lee SU, Park JE, Park W, Park JC, Ahn JS, Lee S. Reactive Oxygen Species Scavenger in Acute Intracerebral Hemorrhage Patients: A Multicenter, Randomized Controlled Trial. Stroke 2021; 52:1172-1181. [PMID: 33626901 DOI: 10.1161/strokeaha.120.032266] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Moinay Kim
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Joonho Byun
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Yeongu Chung
- Department of Neurosurgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (Y.C.)
| | - Si Un Lee
- Department of Neurosurgery, Seoul National University Bundang Hospital, Republic of Korea (S.U.L.)
| | - Ji Eun Park
- Department of Radiology (J.E.P.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Wonhyoung Park
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jung Cheol Park
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Jae Sung Ahn
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Seungjoo Lee
- Department of Neurosurgery (M.K., J.B., W.P., J.C.P., J.S.A., S.L.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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7
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Sharma HS, Sahib S, Tian ZR, Muresanu DF, Nozari A, Castellani RJ, Lafuente JV, Wiklund L, Sharma A. Protein kinase inhibitors in traumatic brain injury and repair: New roles of nanomedicine. PROGRESS IN BRAIN RESEARCH 2020; 258:233-283. [PMID: 33223036 DOI: 10.1016/bs.pbr.2020.09.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Traumatic brain injury (TBI) causes physical injury to the cell membranes of neurons, glial and axons causing the release of several neurochemicals including glutamate and cytokines altering cell-signaling pathways. Upregulation of mitogen associated protein kinase (MAPK) and extracellular signal-regulated kinase (ERK) occurs that is largely responsible for cell death. The pharmacological blockade of these pathways results in cell survival. In this review role of several protein kinase inhibitors on TBI induced oxidative stress, blood-brain barrier breakdown, brain edema formation, and resulting brain pathology is discussed in the light of current literature.
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Affiliation(s)
- Hari Shanker Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden.
| | - Seaab Sahib
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Z Ryan Tian
- Department of Chemistry & Biochemistry, University of Arkansas, Fayetteville, AR, United States
| | - Dafin F Muresanu
- Department of Clinical Neurosciences, University of Medicine & Pharmacy, Cluj-Napoca, Romania; "RoNeuro" Institute for Neurological Research and Diagnostic, Cluj-Napoca, Romania
| | - Ala Nozari
- Anesthesiology & Intensive Care, Massachusetts General Hospital, Boston, MA, United States
| | - Rudy J Castellani
- Department of Pathology, University of Maryland, Baltimore, MD, United States
| | - José Vicente Lafuente
- LaNCE, Department of Neuroscience, University of the Basque Country (UPV/EHU), Leioa, Bilbao, Spain
| | - Lars Wiklund
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
| | - Aruna Sharma
- International Experimental Central Nervous System Injury & Repair (IECNSIR), Department of Surgical Sciences, Anesthesiology & Intensive Care Medicine, Uppsala University Hospital, Uppsala University, Uppsala, Sweden
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8
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Tabrizi R, Borhani-Haghighi A, Mirhosseini N, Lankarani KB, Naghibzadeh-Tahami A, Akbari M, Heydari ST, Sangari M, Kolahdooz F, Raygan F, Asemi Z. The effects of alpha-lipoic acid supplementation on fasting glucose and lipid profiles among patients with stroke: a systematic review and meta-analysis of randomized controlled trials. J Diabetes Metab Disord 2019; 18:585-595. [PMID: 31890685 DOI: 10.1007/s40200-019-00423-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 07/05/2019] [Indexed: 02/05/2023]
Abstract
Background and objective Stroke is a devastating condition with long-term comorbidities including metabolic abnormalities. Alpha lipoic acid (ALA), with its antioxidant properties, might improve metabolic status of patients, though current evidence is still inclusive. This systematic review of randomized controlled trials (RCTs) was conducted to summarize the existing evidence regarding the effects of ALA supplementation on fasting glucose and lipid profiles among patients with stroke. Methods We searched Cochrane Library, EMBASE, MEDLINE, and Web of Science from 1990 until April 5th, 2018. The relevant randomized-controlled articles, based on defined key words, were included in the analyses. Two independent researchers investigated study eligibility, extracted data, and assessed the risk of bias for included studies. Heterogeneity among included studies was tested using Q-test and I2 statistics. Random-effects models were applied to pool the data and standardized mean differences (WMD) were considered as summary effect size. Results A total of five studies (140 patients in each intervention group) were included in our meta-analysis. The findings showed that ALA supplementation significantly decreased fasting glucose levels (WMD -36.93 mg/dL; 95% CI, -65.58, -8.28; P = 0.01; I2 = 85.0%) in patients with stroke. We found no significant effect of ALA supplementation on triglycerides (WMD -7.45 mg/dL; 95% CI, -51.35, 36.45; P = 0.739; I2 = 83.9%), total cholesterol (WMD -23.23 mg/dL; 95% CI, -48.07, 1.62; P = 0.067; I2 = 80.5%), LDL-cholesterol (WMD -10.46 mg/dL; 95% CI, -21.01, 0.09; P = 0.052; I2 = 47.4%) and HDL-cholesterol levels (WMD -3.02 mg/dL; 95% CI, -20.18, 14.14; P = 0.730; I2 = 85.8%). Conclusions This meta-analysis suggested the beneficial impacts of ALA supplementation in improving fasting glucose of patients diagnosed with stroke.
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Affiliation(s)
- Reza Tabrizi
- 1Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | | | - Kamran B Lankarani
- 4Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Naghibzadeh-Tahami
- 5Physiology Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Maryam Akbari
- 1Health Policy Research Center, Institute of Health, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Taghi Heydari
- 4Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojgan Sangari
- 6Endocrinology and Metabolism Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran
| | - Fariba Kolahdooz
- 7Indigenous and Global Health Research, Department of Medicine, University of Alberta, Edmonton, Canada
| | - Fariba Raygan
- 8Department of Cardiology, School of Medicine, Kashan University of Medical Sciences, Kashan, I.R. Iran
| | - Zatollah Asemi
- 9Research Center for Biochemistry and Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, I.R. Iran
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Zhang L, Wang H. Long Non-coding RNA in CNS Injuries: A New Target for Therapeutic Intervention. MOLECULAR THERAPY-NUCLEIC ACIDS 2019; 17:754-766. [PMID: 31437654 PMCID: PMC6709344 DOI: 10.1016/j.omtn.2019.07.013] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 12/15/2022]
Abstract
CNS injuries, such as traumatic brain injury (TBI), subarachnoid hemorrhage (SAH), intracerebral hemorrhage (ICH), and cerebral ischemic stroke, are important causes of death and long-term disability worldwide. As an important class of pervasive genes involved in many pathophysiological processes, long non-coding RNAs (lncRNAs) have received attention in the past decades. Multiple studies indicate that lncRNAs are abundant in the CNS and have a key role in brain function as well as many neurological disorders, especially in CNS injuries. Several investigations have deciphered that regulation of lncRNAs exert pro-angiogenesis, anti-apoptosis, and anti-inflammation effects in CNS injury via different molecules and pathways, including microRNA (miRNA), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), phosphatidylinositol-4,5-bisphosphate 3-kinase/protein kinase B (PI3K/AKT), Notch, and p53. Thus, lncRNAs show great promise as molecular targets in CNS injuries. In this article, we provide an updated review of the current state of our knowledge about the relationship between lncRNAs and CNS injuries, highlighting the specific roles of lncRNAs in CNS injuries.
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Affiliation(s)
- Li Zhang
- Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, China
| | - Handong Wang
- Department of Neurosurgery, Jinling Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, China.
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11
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Boujraf S, Belaïch R, Housni A, Maaroufi M, Tizniti S, Sqalli T, Benzagmout M. Blood Oxygenation Level-Dependent Functional MRI of Early Evidences of Brain Plasticity after Hemodialysis Session by Helixone Membrane of Patients with Indices of Adrenal Deficiency. Ann Neurosci 2017; 24:82-89. [PMID: 28588363 DOI: 10.1159/000475897] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/05/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Various alterations of hypothalamic-pituitary-adrenal axis function have been described in patients with chronic renal failure. Nevertheless, controversial evidences were stated about the association between adrenal function deficiency (AD) and hemodialysis (HD). PURPOSE The goal of this paper was to estimate indirect indices of the adrenal gland dysfunction which is potentially influenced by oxidative stress (OS) that still generates brain plasticity and reorganization of the functional control. METHODS Two male patients undergoing HD by the synthetic Helixone membrane for more than 6 months at the HD Center of the University Hospital of Fez, Fez, Morocco, were recruited. They underwent identical assessment immediately before and after the full HD session; this consisted of a blood ionogram revealing rates of sodium and calcium, and brain blood oxygenation level-dependent functional MRI (BOLD-fMRI) using a motor paradigm in block design. RESULTS The blood ionogram revealed hypercalcemia and hyponatremia in both patients. Both biological assessment and BOLD-fMRI study results revealed a high level of OS that induced activation of a significantly large brain volume area suggesting the occurrence of possible brain plasticity and functional control reorganization induced by free radicals and enhanced by AD. CONCLUSION The occurrence of brain plasticity and functional control reorganization was demonstrated in both patients studied who were undergoing HD by BOLD-fMRI with a notable sensitivity; this plasticity is induced by elevated OS occasioned by HD technique itself and probably amplified by AD. Similar results were found in a previous study performed on the same patients undergoing HD by a polysulfone membrane.
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Affiliation(s)
- Saïd Boujraf
- Department of Biophysics and Clinical MRI Methods, University Hospital of Fez, Fez, Morocco.,The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco
| | - Rachida Belaïch
- Department of Biophysics and Clinical MRI Methods, University Hospital of Fez, Fez, Morocco.,The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco
| | - Abdelkhalek Housni
- The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco
| | - Mustapha Maaroufi
- The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco.,Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - Siham Tizniti
- The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco.,Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - Tarik Sqalli
- Department of Nephrology, University Hospital of Fez, Fez, Morocco
| | - Mohammed Benzagmout
- The Clinical Neuroscience Laboratory, Faculty of Medicine of Fez, University Hospital of Fez, Fez, Morocco
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12
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Targeting the NF-E2-Related Factor 2 Pathway: a Novel Strategy for Traumatic Brain Injury. Mol Neurobiol 2017; 55:1773-1785. [PMID: 28224478 DOI: 10.1007/s12035-017-0456-z] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Accepted: 02/13/2017] [Indexed: 12/30/2022]
Abstract
As an essential component of cellular defense against a variety of endogenous and exogenous stresses, nuclear factor erythroid 2-related factor 2 (Nrf2) has received increased attention in the past decades. Multiple studies indicate that Nrf2 acts not only as an important protective factor in injury models but also as a downstream target of therapeutic agents. Activation of Nrf2 has increasingly been linked to many human diseases, especially in central nervous system (CNS) injury such as traumatic brain injury (TBI). Several researches have deciphered that activation of Nrf2 exerts antioxidative stress, antiapoptosis, and antiinflammation influence in TBI via different molecules and pathways including heme oxygenase-1 (HO-1), NADPH:quinine oxidoreductase-1 (NQO-1), nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), and nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2). Hence, Nrf2 shows great promise as a molecular target in TBI. In the present article, we provide an updated review of the current state of our knowledge about relationship between Nrf2 and TBI, highlighting the specific roles of Nrf2 in TBI.
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Intracerebral Hemorrhage, Oxidative Stress, and Antioxidant Therapy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2016; 2016:1203285. [PMID: 27190572 PMCID: PMC4848452 DOI: 10.1155/2016/1203285] [Citation(s) in RCA: 199] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 11/20/2015] [Accepted: 03/28/2016] [Indexed: 12/20/2022]
Abstract
Hemorrhagic stroke is a common and severe neurological disorder and is associated with high rates of mortality and morbidity, especially for intracerebral hemorrhage (ICH). Increasing evidence demonstrates that oxidative stress responses participate in the pathophysiological processes of secondary brain injury (SBI) following ICH. The mechanisms involved in interoperable systems include endoplasmic reticulum (ER) stress, neuronal apoptosis and necrosis, inflammation, and autophagy. In this review, we summarized some promising advances in the field of oxidative stress and ICH, including contained animal and human investigations. We also discussed the role of oxidative stress, systemic oxidative stress responses, and some research of potential therapeutic options aimed at reducing oxidative stress to protect the neuronal function after ICH, focusing on the challenges of translation between preclinical and clinical studies, and potential post-ICH antioxidative therapeutic approaches.
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What are the progesterone-induced changes of the outcome and the serum markers of injury, oxidant activity and inflammation in diffuse axonal injury patients? Int Immunopharmacol 2016; 32:103-110. [DOI: 10.1016/j.intimp.2016.01.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Revised: 01/10/2016] [Accepted: 01/14/2016] [Indexed: 02/06/2023]
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Ehsaei M, Khajavi M, Arjmand MH, Abuee MA, Ghayour-Mobarhan M, Hamidi Alamdari D. Prooxidant-antioxidant balance in patients with traumatic brain injury. Acta Neurol Belg 2015; 115:69-73. [PMID: 25027161 DOI: 10.1007/s13760-014-0300-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 04/08/2014] [Indexed: 10/25/2022]
Abstract
Brain trauma is an important cause of mortality and disability among young people worldwide. One of the mechanisms of post-traumatic secondary brain damage is related to free radical release and oxidative stress (OS). OS is the consequence of an imbalance between pro-oxidants and antioxidants in favor of pro-oxidants. This imbalance may lead to macromolecule damage including lipid peroxidation, protein crosslinking, DNA damage and changes in growth and function of cells in brain. Free radical release and subsequent lipid peroxidation are early events following neural tissues injury and are associated with hypo-perfusion, edema, and disruption of axonal guidance. In this study, we determined the prooxidant-antioxidant balance (PAB) in patients with brain injury, and its correlation with number of demographic and clinical parameters. Sera from 98 patients with traumatic brain and 100 healthy subjects were collected. The serum PAB was measured. Age, sex, GCS (Glasgow coma scale), mechanism of injury, brain lesions found on CT scan and lesions in other parts of the body, caused by trauma, were determined. A significantly higher PAB value was observed in the patient group (138.97 ± 15.9 HK unit) compared to the controls (60.82 ± 12.6 HK) (P = 0.001). In the patient group, there was no significant correlation of PAB with GCS, brain lesion characteristic, mechanism of injury, other accompanying traumatic injury, age and gender. When patients were classified into three groups according to GCS: group 1 (GCS>13, n = 28, PAB serum value = 138.51 ± 62.66 HK), group 2 (GCS between 8 and 12, n = 29, PAB serum value = 162.7 ± 50.6 HK) and group 3 (GCS <8, n = 41, PAB serum value = 155.56 ± 58.21 HK); there was no significant difference between groups. The serum PAB values were higher in patients with traumatic brain injury, although this was not associated with the extent of injury.
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Belaïch R, Boujraf S, Housni A, Maaroufi M, Batta F, Magoul R, Sqalli T, Errasfa M, Tizniti S. Assessment of hemodialysis impact by Polysulfone membrane on brain plasticity using BOLD-fMRI. Neuroscience 2014; 288:94-104. [PMID: 25522721 DOI: 10.1016/j.neuroscience.2014.11.064] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 10/21/2014] [Accepted: 11/23/2014] [Indexed: 11/26/2022]
Abstract
PURPOSE Hemodialysis (HD) is considered the most common alternative for overcoming renal failure. Studies have shown the involvement of HD membrane in the genesis of oxidative stress (OS) which has a direct impact on the brain tissue and is expected to be involved in brain plasticity and also reorganization of brain function control. The goal of this paper was to demonstrate the sensitivity of the blood oxygenation level-dependent functional magnetic resonance imaging (BOLD-fMRI) to characterize the OS before and after the HD session. PATIENTS, MATERIALS AND METHODS Twelve male patient-volunteers following chronic HD for more than 6months were recruited among 86 HD-patients. All patients underwent identical assessment immediately before and after the full HD-session. This consisted of full biological assessment, including malondialdehyde (MDA) and total antioxidant activity (TAOA); and brain BOLD-fMRI using the motor paradigm in block-design. RESULTS Functional BOLD-fMRI maps of motor area M1 were obtained from the HD patient before and after the hemodialysis session, important decrease in the intensity of brain activation of the motor area after HD, and important increase of the size of the volume of brain activation were observed, these changes are reflecting brain plasticity that is well correlated to OS levels. Individual patients MDA and TAOA before and after the hemodialysis sessions demonstrated a clear and systematic increase of the OS after HD (P-value=0.03). Correlation of BOLD-fMRI maximal signal intensity and volume of activated cortical brain area behaviors to MDA and total TAOA were close to 1. CONCLUSION OS is systematically increased in HD-patients after the HD-process. Indeed, the BOLD-fMRI shows a remarkable sensitivity to brain plasticity studied cortical areas. Our results confirm the superiority of the BOLD-fMRI quantities compared to the biological method used for assessing the OS while not being specific, and reflect the increase in OS generated by the HD. BOLD-fMRI is expected to be a suitable tool for evaluating the plasticity process evolution in hemodialysis brain patients.
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Affiliation(s)
- R Belaïch
- Department of Biophysics and Clinical MRI Methods, Faculty of Medicine, Fez, Morocco; The Clinical Neuroscience Laboratory, Faculty of Medicine, Fez, Morocco
| | - S Boujraf
- Department of Biophysics and Clinical MRI Methods, Faculty of Medicine, Fez, Morocco; The Clinical Neuroscience Laboratory, Faculty of Medicine, Fez, Morocco.
| | - A Housni
- The Clinical Neuroscience Laboratory, Faculty of Medicine, Fez, Morocco; Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - M Maaroufi
- The Clinical Neuroscience Laboratory, Faculty of Medicine, Fez, Morocco; Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
| | - F Batta
- The Clinical Neuroscience Laboratory, Faculty of Medicine, Fez, Morocco; Department of Nephrology, University Hospital of Fez, Fez, Morocco
| | - R Magoul
- Laboratory of Neuroendocrinology and Nutritional and Climatic Environment, Faculty of Sciences Dhar El Mahraz, University Sidi Mohammed Ben Abdellah, Fez-Atlas, BP 1796, Fez, Morocco
| | - T Sqalli
- Department of Nephrology, University Hospital of Fez, Fez, Morocco
| | - M Errasfa
- Department of Pharmacology, Faculty of Medicine, University of Fez, Fez, Morocco; The Laboratory of Molecular Basis in Human Pathology and Therapeutical Tools, Faculty of Medicine, University of Fez, Fez, Morocco
| | - S Tizniti
- The Clinical Neuroscience Laboratory, Faculty of Medicine, Fez, Morocco; Department of Radiology and Clinical Imaging, University Hospital of Fez, Fez, Morocco
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Evidence to support mitochondrial neuroprotection, in severe traumatic brain injury. J Bioenerg Biomembr 2014; 47:133-48. [PMID: 25358440 DOI: 10.1007/s10863-014-9589-1] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/13/2014] [Indexed: 12/22/2022]
Abstract
Traumatic brain injury (TBI) is still the leading cause of disability in young adults worldwide. The major mechanisms - diffuse axonal injury, cerebral contusion, ischemic neurological damage, and intracranial hematomas have all been shown to be associated with mitochondrial dysfunction in some form. Mitochondrial dysfunction in TBI patients is an active area of research, and attempts to manipulate neuronal/astrocytic metabolism to improve outcomes have been met with limited translational success. Previously, several preclinical and clinical studies on TBI induced mitochondrial dysfunction have focused on opening of the mitochondrial permeability transition pore (PTP), consequent neurodegeneration and attempts to mitigate this degeneration with cyclosporine A (CsA) or analogous drugs, and have been unsuccessful. Recent insights into normal mitochondrial dynamics and into diseases such as inherited mitochondrial neuropathies, sepsis and organ failure could provide novel opportunities to develop mitochondria-based neuroprotective treatments that could improve severe TBI outcomes. This review summarizes those aspects of mitochondrial dysfunction underlying TBI pathology with special attention to models of penetrating traumatic brain injury, an epidemic in modern American society.
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Tewari A, Mahendru V, Sinha A, Bilotta F. Antioxidants: The new frontier for translational research in cerebroprotection. J Anaesthesiol Clin Pharmacol 2014; 30:160-71. [PMID: 24803750 PMCID: PMC4009632 DOI: 10.4103/0970-9185.130001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
It is important for the anesthesiologist to understand the etiology of free radical damage and how free-radical scavengers attenuate this, so that this knowledge can be applied to diverse neuro-pathological conditions. This review will concentrate on the role of reactive species of oxygen in the pathophysiology of organ dysfunction, specifically sub arachnoid hemorrhage (SAH), traumatic brain injury (TBI) as well as global central nervous system (CNS) hypoxic, ischemic and reperfusion states. We enumerate potential therapeutic modalities that are been currently investigated and of interest for future trials. Antioxidants are perhaps the next frontier of translational research, especially in neuro-anesthesiology.
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Affiliation(s)
- Anurag Tewari
- Department of Anesthesiology, Dayanand Medical College, Ludhiana, Punjab, India
| | - Vidhi Mahendru
- Department of Anesthesiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashish Sinha
- Department of Anesthesiology and Perioperative Medicine, Drexel University College of Medicine, Philadelphia, USA
| | - Federico Bilotta
- Department of Anesthesiology, Critical Care and Pain Medicine, "Sapienza" University of Rome, Rome, Italy
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Mendes Arent A, de Souza LF, Walz R, Dafre AL. Perspectives on molecular biomarkers of oxidative stress and antioxidant strategies in traumatic brain injury. BIOMED RESEARCH INTERNATIONAL 2014; 2014:723060. [PMID: 24689052 PMCID: PMC3943200 DOI: 10.1155/2014/723060] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 12/04/2013] [Accepted: 12/09/2013] [Indexed: 11/23/2022]
Abstract
Traumatic brain injury (TBI) is frequently associated with abnormal blood-brain barrier function, resulting in the release of factors that can be used as molecular biomarkers of TBI, among them GFAP, UCH-L1, S100B, and NSE. Although many experimental studies have been conducted, clinical consolidation of these biomarkers is still needed to increase the predictive power and reduce the poor outcome of TBI. Interestingly, several of these TBI biomarkers are oxidatively modified to carbonyl groups, indicating that markers of oxidative stress could be of predictive value for the selection of therapeutic strategies. Some drugs such as corticosteroids and progesterone have already been investigated in TBI neuroprotection but failed to demonstrate clinical applicability in advanced phases of the studies. Dietary antioxidants, such as curcumin, resveratrol, and sulforaphane, have been shown to attenuate TBI-induced damage in preclinical studies. These dietary antioxidants can increase antioxidant defenses via transcriptional activation of NRF2 and are also known as carbonyl scavengers, two potential mechanisms for neuroprotection. This paper reviews the relevance of redox biology in TBI, highlighting perspectives for future studies.
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Affiliation(s)
- André Mendes Arent
- Department of Biochemistry, Federal University of Santa Catarina, Biological Sciences Centre, 88040-900 Florianópolis, SC, Brazil
- Faculty of Medicine, University of South Santa Catarina (Unisul), 88137-270 Palhoça, SC, Brazil
- Neurosurgery Service, São José Regional Hospital (HRSJ-HMG), 88103-901 São José, SC, Brazil
| | - Luiz Felipe de Souza
- Department of Biochemistry, Federal University of Santa Catarina, Biological Sciences Centre, 88040-900 Florianópolis, SC, Brazil
| | - Roger Walz
- Applied Neurosciences Centre (CeNAp) and Department of Medical Clinics, University Hospital, Federal University of Santa Catarina, 88040-900 Florianópolis, SC, Brazil
| | - Alcir Luiz Dafre
- Department of Biochemistry, Federal University of Santa Catarina, Biological Sciences Centre, 88040-900 Florianópolis, SC, Brazil
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