1
|
A New Approach in the Treatment of Traumatic Brain Injury: The Effects of Levosimendan on Necrosis, Apoptosis, and Oxidative Stress. World Neurosurg 2022; 168:e432-e441. [PMID: 36152936 DOI: 10.1016/j.wneu.2022.09.067] [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: 05/07/2022] [Revised: 09/13/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Traumatic brain injury (TBI) is an essential and common health problem worldwide. Levosimendan is an inotropic and vasodilator drug used to treat heart failure. Moreover, it exerts pleiotropic effects and, thus, protective effects on many organs. The present study aimed to investigate the effect of levosimendan on necrosis, apoptosis, and reactive oxygen species in rats with TBI. METHODS The study included 28 female Wistar-Albino rats weighing 200-250 g. The rats were divided into 4 groups with 7 rats each as follows: Group 1: No trauma group (Control), Group 2: Traumatized, untreated group (T), Group 3: Levosimendan was administered at a dose of 12 μg/kg intraperitoneally 1 hour after the trauma (L1), Group 4: Levosimendan was administered at a dose of 12 μg/kg intraperitoneally 2 hours after the concussion (L2). After the experiment, the rats were decapitated, and the brain tissue was removed. Necrosis was assessed with Cresyl violet staining, apoptosis was assessed with immunohistochemical analysis, superoxide dismutase and catalase levels were measured with the spectrophotometric method, and malondialdehyde (MDA) levels were assessed by High-Performance Liquid Chromatography. RESULTS The number of necrotic cells in the L1 and L2 groups was significantly lower than in the K and T groups (P = 0.015 and P = 0.03, respectively). Although the active caspase-3 level was signified considerably in the T, L1, and L2 groups compared to the K group, no significant difference was found among these 3 groups (P > 0.05). The results of superoxide dismutase levels were similar to those of active caspase-3. catalase level was significantly higher in the K group than in the T and L2 groups (P = 0.045). Malondialdehyde activity was considerably higher in the L1 and L2 groups compared to the K group (P = 0.023). CONCLUSIONS Our results indicated that levosimendan may exert a neuroprotective effect by reducing necrosis in TBI and that levosimendan does not affect apoptosis and antioxidant levels in TBI. Comprehensive studies are needed to elucidate the effect of levosimendan on TBI fully.
Collapse
|
2
|
Honore PM, Redant S, Moorthamers S, Preseau T, Kaefer K, Barreto Gutierrez L, Attou R, Gallerani A, Boer W, De Bels D. What should clinicians know about the renal effect and the mechanism of action of levosimendan? Expert Opin Drug Saf 2021; 20:1459-1461. [PMID: 34612116 DOI: 10.1080/14740338.2021.1986483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Patrick M Honore
- ICU Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium.,Faculty of Medicine, ULB University, Bruxelle, Belgium
| | - Sebastien Redant
- ICU Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Sofie Moorthamers
- ED Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Thierry Preseau
- ED Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Keitiane Kaefer
- ICU Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | | | - Rachid Attou
- ICU Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Andrea Gallerani
- ICU Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| | - Willem Boer
- Intensive Care Dept, Ziekenhuis Oost Limburgh, Genk, Belgium
| | - David De Bels
- ICU Dept, Centre Hospitalier Universitaire Brugmann, Brussels, Belgium
| |
Collapse
|
3
|
Wu B, Peng YG, Zhao S, Bao N, Pan L, Dong J, Xu X, Wang Q. Supplement of levosimendan to epinephrine improves initial resuscitation outcomes from asphyxial cardiac arrest. BMC Anesthesiol 2017; 17:18. [PMID: 28148233 PMCID: PMC5289016 DOI: 10.1186/s12871-017-0309-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 01/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Levosimendan exerted favorable effects on the initial outcome in the treatment of ventricular fibrillation cardiac arrest. This study investigated the efficacy of levosimendan in the treatment of asphyxia-induced cardiac arrest in rats. METHODS Animals underwent asphyxial cardiac arrest/cardiopulmonary resuscitation, randomized to three treatment groups: epinephrine (10 μg/kg) supplemented with levosimendan (bolus 12 μg/kg and infusion for 1 h, EL group); epinephrine only (10 μg/kg, E group), or levosimendan only (bolus 12 μg/kg and infusion for 1 h, L group). The resuscitation success rate, wet-to-dry ratio of lung, and rate of alveolar and blood gas analysis were recorded. RESULTS 10 rats in the EL group, 8 in the E group, and 2 in the L group showed an initial return of spontaneous circulation (P < 0.001); among them, 10, 4, and 2 rats survived at the end of a 60-min observation period from each group, respectively (P = 0.001). The coronary perfusion pressure in the EL group was higher than that of either the E or L group (P < 0.05). The lung wet-to-dry weight ratio and rate of damaged alveoli were lower in the EL group than the E group (P < 0.05). CONCLUSIONS In the early stage of resuscitation for asphyxia-induced cardiac arrest in rats, levosimendan supplemented with epinephrine can significantly increase coronary perfusion pressure, reduce lung injury, and ultimately enhance the survival rate.
Collapse
Affiliation(s)
- Bingjing Wu
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Yong G Peng
- Department of Anesthesiology, College of Medicine, University of Florida Shands Hospital, Gainesville, FL, USA
| | - Shishi Zhao
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Nana Bao
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Linmin Pan
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Jiaojiao Dong
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China
| | - Xuzhong Xu
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China. .,The First Affiliated Hospital, Wenzhou Medical University, South Baixiang Rd, Wenzhou City, Zhejiang Province, 325000, China.
| | - Quanguang Wang
- Department of Anesthesiology, The First Affiliated Hospital, Wenzhou Medical University, Wenzhou City, Zhejiang Province, China. .,The First Affiliated Hospital, Wenzhou Medical University, South Baixiang Rd, Wenzhou City, Zhejiang Province, 325000, China.
| |
Collapse
|