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Palikov VA, Pavlov NB, Amirov RR, Ismailova AM, Borozdina NA, Palikova YA, Dyachenko IA, Khokhlova ON, Ponomareva TI, Rykov VA, Logunov AT, Murashev AN, Baranov VM. Effect of a helium and oxygen mixture on physiological parameters of rats with cerebral arterial air embolism. Front Physiol 2024; 15:1388331. [PMID: 38803366 PMCID: PMC11128824 DOI: 10.3389/fphys.2024.1388331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 04/17/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction: Cerebral arterial air embolism (CAE) is a serious and potentially dangerous condition that can interrupt the blood supply to the brain and cause stroke. One of the promising gas mixtures for emergency treatment of air embolism is an oxygen-helium mixture. Methods: We modeled CAE in awake rats by injecting air into the common carotid artery. Immediately after CAE, animals were either untreated or underwent hyperbaria, oxygen inhalation, heated air inhalation, or helium-oxygen mixture inhalation. Body temperature, locomotor activity, respiratory and cardiovascular parameters were monitored in the animals before CAE modeling, and 3 and 24 h after CAE modeling. Results: After 3 hours of CAE modeling in awake rats, depression of the nervous, cardiovascular and respiratory systems, as well as decreased body temperature were observed. 24 h after CAE modeling multifocal cerebral ischemia was observed. Normobaric helium-oxygen mixture inhalation, on par with hyperbaric treatment, restored body temperature, locomotor activity, respiratory volume, respiratory rate, and blood pressure 3 hours after CAE, and prevented the formation of ischemic brain damage lesions 24 h after CAE. Discussion: Thus, inhalation of a heated oxygen-helium gas mixture (O2 30% and He 70%) immediately after CAE improves the physiological condition of the animals and prevents the foci of ischemic brain damage formation.
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Affiliation(s)
- V. A. Palikov
- Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - N. B. Pavlov
- Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - R. R. Amirov
- Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
| | - A. M. Ismailova
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - N. A. Borozdina
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - Yu. A. Palikova
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - I. A. Dyachenko
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - O. N. Khokhlova
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - T. I. Ponomareva
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - V. A. Rykov
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - A. T. Logunov
- Closed Joint Stock Company «Specialized Design Bureau of Experimental Equipment at the Institute of Medical and Biological Problems of the Russian Academy of Sciences», Khimki, Russia
| | - A. N. Murashev
- Branch of the Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Pushchino, Russia
| | - V. M. Baranov
- Institute of Biomedical Problems of the Russian Academy of Sciences, Moscow, Russia
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2
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Zhong W, Cheng J, Yang X, Liu W, Li Y. Heliox Preconditioning Exerts Neuroprotective Effects on Neonatal Ischemia/Hypoxia Injury by Inhibiting Necroptosis Induced by Ca 2+ Elevation. Transl Stroke Res 2022; 14:409-424. [PMID: 35445968 DOI: 10.1007/s12975-022-01021-8] [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: 02/05/2022] [Revised: 03/11/2022] [Accepted: 04/09/2022] [Indexed: 10/18/2022]
Abstract
Our previous studies have indicated that heliox preconditioning (HePC) may exert neuroprotective effects on neonatal hypoxic-ischemic encephalopathy (HIE). The present study was to investigate whether HePC alleviates neonatal HIE by inhibiting necroptosis and explore the potential mechanism. Seven-day-old rat pups were randomly divided into Sham group, HIE group, HIE + HePC group, HIE + Dantrolene (DAN) group, and HIE + Necrostatin-1 (Nec-1) group. HIE was induced by common carotid artery ligation and subsequent hypoxia exposure. The neurological function, brain injury, and molecular mechanism were evaluated by histological staining, neurobehavioral test, Western blotting, Ca2+, immunofluorescence staining, co-immunoprecipitation (Co-IP), and transmission electron microscopy (TEM). Results supported that the expression of necroptosis markers and p-RyR2 in the brain increased significantly after HIE. HePC, DAN, or Nec-1 was found to improve the neurological deficits after H/I and inhibit neuronal necroptosis. Interestingly, both HePC and DAN inhibited the increases in cytoplasmic Ca2+ and CaMK-II phosphorylation in the brain secondary to HIE, but Nec-1 failed to affect Ca2+. In conclusion, our results suggest HePC may alleviate cytoplasmic Ca2+ overload by regulating p-RyR2, which inhibits the necroptosis in the brain, exerting neuroprotective effects on HIE.
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Affiliation(s)
- Weijie Zhong
- Department of Neurosurgery, Ninth People Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Juan Cheng
- Department of Ultrasound, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xiaosheng Yang
- Department of Neurosurgery, Ninth People Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China
| | - Wenwu Liu
- Naval Characteristic Medical Center Diving and Hyperbaric Medicine Research Laboratory, Shanghai, 200433, People's Republic of China.
| | - Yi Li
- Department of Neurosurgery, Ninth People Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, People's Republic of China.
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3
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Chen Y, Yang B, Xu L, Shi Z, Han R, Yuan F, Ouyang J, Yan X, Ostrikov KK. Inhalation of Atmospheric-Pressure Gas Plasma Attenuates Brain Infarction in Rats With Experimental Ischemic Stroke. Front Neurosci 2022; 16:875053. [PMID: 35516812 PMCID: PMC9063166 DOI: 10.3389/fnins.2022.875053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Previous studies suggest the potential efficacy of neuroprotective effects of gaseous atmospheric-pressure plasma (APP) treatment on neuronal cells. However, it remains unclear if the neuroprotective properties of the gas plasmas benefit the ischemic stroke treatment, and how to use the plasmas in the in vivo ischemic stroke models. Rats were subjected to 90 min middle cerebral artery occlusion (MCAO) to establish the ischemic stroke model and then intermittently inhaled the plasma for 2 min at 60 min MCAO. The regional cerebral blood flow (CBF) was monitored. Animal behavior scoring, magnetic resonance imaging (MRI), 2,3,5-triphenyltetrazolium chloride (TTC) staining, and hematoxylin and eosin (HE) staining were performed to evaluate the therapeutic efficacy of the gas plasma inhalation on MCAO rats. Intermittent gas plasma inhalation by rats with experimental ischemic stroke could improve neurological function, increase regional CBF, and decrease brain infarction. Further MRI tests showed that the gas plasma inhalation could limit the ischemic lesion progression, which was beneficial to improve the outcomes of the MCAO rats. Post-stroke treatment with intermittent gas plasma inhalation could reduce the ischemic lesion progression and decrease cerebral infarction volume, which might provide a new promising strategy for ischemic stroke treatment.
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Affiliation(s)
- Ye Chen
- Department of Pathophysiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Bingyan Yang
- School of Physics, Beijing Institute of Technology, Beijing, China
| | - Lixin Xu
- Department of Pathophysiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhongfang Shi
- Department of Pathophysiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruoyu Han
- School of Physics, Beijing Institute of Technology, Beijing, China
| | - Fang Yuan
- Department of Pathophysiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiting Ouyang
- School of Physics, Beijing Institute of Technology, Beijing, China
- *Correspondence: Jiting Ouyang,
| | - Xu Yan
- Department of Pathophysiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Xu Yan,
| | - Kostya Ken Ostrikov
- School of Chemistry and Physics and Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, QLD, Australia
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4
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How to Survive 33 min after the Umbilical of a Saturation Diver Severed at a Depth of 90 msw? Healthcare (Basel) 2022; 10:healthcare10030453. [PMID: 35326931 PMCID: PMC8956028 DOI: 10.3390/healthcare10030453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 02/11/2022] [Accepted: 02/21/2022] [Indexed: 01/27/2023] Open
Abstract
In 2012, a severe accident happened during the mission of a professional saturation diver working at a depth of 90 m in the North Sea. The dynamic positioning system of the diver support vessel crashed, and the ship drifted away from the working place, while one diver’s umbilical became snagged on a steel platform and was severed. After 33 min, he was rescued into the diving bell, without exhibiting any obvious neurological injury. In 2019, the media and a later ‘documentary’ film suggested that a miracle had happened to permit survival of the diver once his breathing gas supply was limited to only 5 min. Based on the existing data and phone calls with the diver concerned (Dc), the present case report tries to reconstruct, on rational grounds, how Dc could have survived after he was cut off from breathing gas, hot water, light and communication while 90 m deep at the bottom of the sea. Dc carried bail-out heliox (86/14) within two bottles (2 × 12 L × 300 bar: 7200 L). Calculating Dc’s varying per-minute breathing gas consumption over time, both the decreased viscosity of the helium mix and the pressure-related increase in viscosity did not exhibit a breathing gas gap. Based on the considerable respiratory heat loss, the core temperature was calculated to be as low as 28.8 °C to 27.2 °C after recovery in the diving bell. In accordance with the literature, such values would be associated with impaired or lost consciousness, respectively. Relocating Dc on the drilling template by using a remotely operated vehicle (ROV), the transport of the victim to the bell and subsequent care in the hyperbaric chamber must be regarded as exemplary. We conclude that, based on rational arguments and available literature data, Dc’s healthy survival is not a miracle, as it can be convincingly explained by means of reliable data. Remaining with a breathing gas supply sufficient for five minutes only would not have ended in a miracle but would have ended in death by suffocation. Nevertheless, survival of such an accident may appear surprising, and probably the limit for a healthy outcome was very close. We conclude, in addition, that highly effective occupational safety measures, in particular the considerable bail-out heliox reserve, secured the healthy survival. Nevertheless, the victim’s survival is likely to be due to his excellent diving training, together with many years of diving routine. The rescue action of the second diver and Dc’s retrieval by the ROV operator are also suggestive of the behavior of carefully selected crew members with the high degree of professional qualification needed to correctly function in a hostile environment.
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Weber NC, Preckel B. Gaseous mediators: an updated review on the effects of helium beyond blowing up balloons. Intensive Care Med Exp 2019; 7:73. [PMID: 31858285 PMCID: PMC6923303 DOI: 10.1186/s40635-019-0288-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 12/09/2019] [Indexed: 12/20/2022] Open
Abstract
Noble gases, although supposed to be chemically inert, mediate numerous physiological and cellular effects, leading to protection against ischaemia-reperfusion injury in different organs. Clinically, the noble gas helium is used in treatment of airway obstruction and ventilation disorders in children and adults. In addition, studies from recent years in cells, isolated tissues, animals and finally humans show that helium has profound biological effects: helium applied before, during or after an ischaemic event reduced cellular damage, known as "organ conditioning", in some tissue, e.g. the myocardium. Although extensive research has been performed, the exact molecular mechanisms behind these organ-protective effects of helium are yet not completely understood. In addition, there are significant differences of protective effects in different organs and animal models. A translation of experimental findings to the clinical situation has yet not been shown.
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Affiliation(s)
- Nina C Weber
- Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Benedikt Preckel
- Amsterdam University Medical Centers, location AMC, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.
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6
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Zhao CS, Li H, Wang Z, Chen G. Potential application value of xenon in stroke treatment. Med Gas Res 2018; 8:116-120. [PMID: 30319767 PMCID: PMC6178644 DOI: 10.4103/2045-9912.241077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 08/03/2018] [Indexed: 11/04/2022] Open
Abstract
Stroke is an acute disease with extremely high mortality and disability, including ischemic stroke and hemorrhagic stroke. Currently only limited drugs and treatments have been shown to have neuroprotective effects in stroke. As a medical gas, xenon has been proven to have neuroprotective effect in considerable amount of previous study. Its unique properties are different from other neuroprotective agents, making it is promising to play a special therapeutic role in stroke, either alone or in combination with other treatments. In this article, we aim to review the role of xenon in the treatment of stroke, and summarize the mechanism of using xenon to produce therapeutic effects after stroke according to the existing research. Moreover, we intend to explore and demonstrate the feasibility and safety of xenon for clinical treatment of stroke. Despite the disadvantages of difficulty in obtaining and being expensive, as long as the use of reasonable methods, xenon can play an important role in the treatment of stroke.
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Affiliation(s)
- Chong-Shun Zhao
- Department of Neurosurgery & Brain and Nerve Research Laboratory, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Hao Li
- Department of Neurology, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Zhong Wang
- Department of Neurosurgery & Brain and Nerve Research Laboratory, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Gang Chen
- Department of Neurosurgery & Brain and Nerve Research Laboratory, the First Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
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7
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Aehling C, Weber NC, Zuurbier CJ, Preckel B, Galmbacher R, Stefan K, Hollmann MW, Popp E, Knapp J. Effects of combined helium pre/post-conditioning on the brain and heart in a rat resuscitation model. Acta Anaesthesiol Scand 2018; 62:63-74. [PMID: 29159800 DOI: 10.1111/aas.13041] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 10/20/2017] [Accepted: 11/01/2017] [Indexed: 01/05/2023]
Abstract
BACKGROUND The noble gas helium induces cardio- and neuroprotection by pre- and post-conditioning. We investigated the effects of helium pre- and post-conditioning on the brain and heart in a rat resuscitation model. METHODS After approval by the Animal Care Committee, 96 Wistar rats underwent cardiac arrest for 6 min induced by ventricular fibrillation. Animals received 70% helium and 30% oxygen for 5 min before cardiac arrest and for 30 min after restoration of spontaneous circulation (ROSC). Control animals received 70% nitrogen and 30% oxygen. Hearts and brains were excised after 2, 4 h or 7 days. Neurological degeneration was evaluated using TUNEL and Nissl staining in the hippocampal CA-1 sector. Cognitive function after 7 days was detected with the tape removal test. Molecular targets were measured by infrared western blot. Data are shown as median [Interquartile range]. RESULTS Helium treatment resulted in significantly less apoptosis (TUNEL positive cells/100 pixel 73.5 [60.3-78.6] vs.78.2 [70.4-92.9] P = 0.023). Changes in Caveolin-3 expression in the membrane fraction and Hexokinase-II in the mitochondrial fraction were observed in the heart. Caveolin-1 expression of treated animals significantly differed from control animals in the membrane fraction of the heart and brain after ROSC. CONCLUSION Treatment with helium reduced apoptosis in our resuscitation model. Differential expression levels of Caveolin-1, Caveolin-3 and Hexokinase II in the heart were found after helium pre- and post-conditioning. No beneficial effects were seen on neurofunctional outcome.
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Affiliation(s)
- C. Aehling
- Department of Anesthesiology; Laboratory of Experimental Anesthesiology and Intensive Care; Academic Medical Center; Amsterdam The Netherlands
- Department of Anesthesiology; University Hospital of Heidelberg; Heidelberg Germany
| | - N. C. Weber
- Department of Anesthesiology; Laboratory of Experimental Anesthesiology and Intensive Care; Academic Medical Center; Amsterdam The Netherlands
| | - C. J. Zuurbier
- Department of Anesthesiology; Laboratory of Experimental Anesthesiology and Intensive Care; Academic Medical Center; Amsterdam The Netherlands
| | - B. Preckel
- Department of Anesthesiology; Laboratory of Experimental Anesthesiology and Intensive Care; Academic Medical Center; Amsterdam The Netherlands
| | - R. Galmbacher
- Department of Anesthesiology; University Hospital of Heidelberg; Heidelberg Germany
| | - K. Stefan
- Department of Anesthesiology; University Hospital of Heidelberg; Heidelberg Germany
| | - M. W. Hollmann
- Department of Anesthesiology; Laboratory of Experimental Anesthesiology and Intensive Care; Academic Medical Center; Amsterdam The Netherlands
| | - E. Popp
- Department of Anesthesiology; University Hospital of Heidelberg; Heidelberg Germany
| | - J. Knapp
- Department of Anesthesiology; University Hospital of Heidelberg; Heidelberg Germany
- Department of Anesthesiology and Pain Medicine; University Hospital of Bern; Bern Switzerland
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8
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David HN, Haelewyn B, Blatteau JÉ, Risso JJ, Vallée N, Abraini JH. Xenon-helium gas mixture at equimolar concentration of 37.5% protects against oxygen and glucose deprivation-induced injury and inhibits tissue plasminogen activator. Med Gas Res 2017; 7:181-185. [PMID: 29152211 PMCID: PMC5674656 DOI: 10.4103/2045-9912.215747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Xenon (Xe) is considered to be the golden standard neuroprotective gas. However, Xe has a higher molecular weight and lower thermal conductivity and specific heat than those of nitrogen, the main diluent of oxygen in air. These physical characteristics could impair or at least reduce the intrinsic neuroprotective action of Xe by increasing the patient's respiratory workload and body temperature. In contrast, helium (He) is a cost-efficient gas with a lower molecular weight and higher thermal conductivity and specific heat than those of nitrogen, but is far less potent than Xe. In this study, we hypothesized that mixing Xe and He could allow obtaining a neuroprotective gas mixture with advantageously reduced molecular weight and increased thermal conductivity. We found that Xe and He at the equimolar concentration of 37.5% reduced oxygen-glucose deprivation-induced increase in lactate dehydrogenase in brain slices, an ex vivo model of acute ischemic stroke. These results together with the effects of Xe-He on the thrombolytic efficiency of tissue plasminogen activator are discussed.
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Affiliation(s)
| | | | - Jean-Éric Blatteau
- Hôpital d'Instruction des Armées (HIA) Sainte-Anne, Service de Médecine Hyperbare et Expertise Plongée (SMHEP), Toulon, France
| | - Jean-Jacques Risso
- Institut de Recherche Biomédicale des Armées, Équipe Résidente de Recherche, Subaquatique Opérationnelle, Toulon, France
| | - Nicolas Vallée
- Institut de Recherche Biomédicale des Armées, Équipe Résidente de Recherche, Subaquatique Opérationnelle, Toulon, France
| | - Jacques H Abraini
- Institut de Recherche Biomédicale des Armées, Équipe Résidente de Recherche, Subaquatique Opérationnelle, Toulon, France.,Université Laval, Faculté de Médecine, Département d'Anesthesiologie, Québec, QC, Canada.,Université de Caen-Normandie, Caen, France
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9
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Abraini JH, David HN, Blatteau JÉ, Risso JJ, Vallée N. A method for calculating the gas volume proportions and inhalation temperature of inert gas mixtures allowing reaching normothermic or hypothermic target body temperature in the awake rat. Med Gas Res 2017; 7:175-180. [PMID: 29152210 PMCID: PMC5674655 DOI: 10.4103/2045-9912.215746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The noble gases xenon (Xe) and helium (He) are known to possess neuroprotective properties. Xe is considered the golden standard neuroprotective gas. However, Xe has a higher molecular weight and lower thermal conductivity and specific heat than those of nitrogen, the main diluent of oxygen (O2) in air, conditions that could impair or at least reduce the intrinsic neuroprotective properties of Xe by increasing the critical care patient's respiratory workload and body temperature. In contrast, He has a lower molecular weight and higher thermal conductivity and specific heat than those of nitrogen, but is unfortunately far less potent than Xe at providing neuroprotection. Therefore, combining Xe with He could allow obtaining, depending on the gas inhalation temperature and composition, gas mixtures with neutral or hypothermic properties, the latter being advantageous in term of neuroprotection. However, calculating the thermal properties of a mixture, whatever the substances - gases, metals, rubbers, etc. - is not trivial. To answer this question, we provide a graphical method to assess the volume proportions of Xe, He and O2 that a gas mixture should contain, and the inhalation temperature to which it should be administered to allow a clinician to maintain the patient at a target body temperature.
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Affiliation(s)
- Jacques H Abraini
- Institut de Recherche Biomédicale des Armées, Équipe Résidente de Recherche Subaquatique Opérationnelle, Toulon, France.,Université Laval, Faculté de Médecine, Département d'Anesthesiologie, Québec, QC, Canada
| | - Hélène N David
- Université Laval, Faculté de Médecine, Département d'Anesthesiologie, Québec, QC, Canada
| | - Jean-Éric Blatteau
- Hôpital d'Instruction des Armées Sainte-Anne, Service de Médecine Hyperbare et Expertise Plongée, Toulon, France
| | - Jean Jacques Risso
- Institut de Recherche Biomédicale des Armées, Équipe Résidente de Recherche Subaquatique Opérationnelle, Toulon, France
| | - Nicolas Vallée
- Institut de Recherche Biomédicale des Armées, Équipe Résidente de Recherche Subaquatique Opérationnelle, Toulon, France
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10
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Modulation by the Noble Gas Helium of Tissue Plasminogen Activator: Effects in a Rat Model of Thromboembolic Stroke. Crit Care Med 2017; 44:e383-9. [PMID: 26646461 DOI: 10.1097/ccm.0000000000001424] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
INTERVENTIONS Helium has been shown to provide neuroprotection in mechanical model of acute ischemic stroke by inducing hypothermia, a condition shown by itself to reduce the thrombolytic and proteolytic properties of tissue plasminogen activator. However, whether or not helium interacts with the thrombolytic drug tissue plasminogen activator, the only approved therapy of acute ischemic stroke still remains unknown. This point is not trivial since previous data have shown the critical importance of the time at which the neuroprotective noble gases xenon and argon should be administered, during or after ischemia, in order not to block tissue plasminogen activator-induced thrombolysis and to obtain neuroprotection and inhibition of tissue plasminogen activator-induced brain hemorrhages. MEASUREMENTS AND MAIN RESULTS We show that helium of 25-75 vol% inhibits in a concentration-dependent fashion the catalytic and thrombolytic activity of tissue plasminogen activator in vitro and ex vivo. In vivo, in rats subjected to thromboembolic brain ischemia, we found that intraischemic helium at 75 vol% inhibits tissue plasminogen activator-induced thrombolysis and subsequent reduction of ischemic brain damage and that postischemic helium at 75 vol% reduces ischemic brain damage and brain hemorrhages. CONCLUSIONS In a clinical perspective for the treatment of acute ischemic stroke, these data suggest that helium 1) should not be administered before or together with tissue plasminogen activator therapy due to the risk of inhibiting the benefit of tissue plasminogen activator-induced thrombolysis; and 2) could be an efficient neuroprotective agent if given after tissue plasminogen activator-induced reperfusion.
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11
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Liu K, Khan H, Geng X, Zhang J, Ding Y. Pharmacological hypothermia: a potential for future stroke therapy? Neurol Res 2017; 38:478-90. [PMID: 27320243 DOI: 10.1080/01616412.2016.1187826] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Mild physical hypothermia after stroke has been associated with positive outcomes. Despite the well-studied beneficial effects of hypothermia in the treatment of stroke, lack of precise temperature control, intolerance for the patient, and immunosuppression are some of the reasons which limit its clinical translation. Pharmacologically induced hypothermia has been explored as a possible treatment option following stroke in animal models. Currently, there are eight classes of pharmacological agents/agonists with hypothermic effects affecting a multitude of systems including cannabinoid, opioid, transient receptor potential vanilloid 1 (TRPV1), neurotensin, thyroxine derivatives, dopamine, gas, and adenosine derivatives. Interestingly, drugs in the TRPV1, neurotensin, and thyroxine families have been shown to have effects in thermoregulatory control in decreasing the compensatory hypothermic response during cooling. This review will briefly present drugs in the eight classes by summarizing their proposed mechanisms of action as well as side effects. Reported thermoregulatory effects of the drugs will also be presented. This review offers the opinion that these agents may be useful in combination therapies with physical hypothermia to achieve faster and more stable temperature control in hypothermia.
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Affiliation(s)
- Kaiyin Liu
- a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA
| | - Hajra Khan
- a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA
| | - Xiaokun Geng
- a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA.,b Department of Neurology, Beijing Luhe Hospital , Capital Medical University , Beijing , China
| | - Jun Zhang
- c China-America Institute of Neuroscience, Xuanwu Hospital , Capital Medical University , Beijing , China
| | - Yuchuan Ding
- a Department of Neurological Surgery , Wayne State University School of Medicine , Detroit , MI , USA.,b Department of Neurology, Beijing Luhe Hospital , Capital Medical University , Beijing , China
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13
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Fahlenkamp AV, Rossaint R, Coburn M. [Neuroprotection by noble gases: New developments and insights]. Anaesthesist 2016; 64:855-8. [PMID: 26329914 DOI: 10.1007/s00101-015-0079-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Noble gases are chemically inert elements, some of which exert biological activity. Experimental neuroprotection in particular has been widely shown for xenon, argon and helium. The underlying mechanisms of action are not yet fully understood. Besides an interference with neuronal ion-gated channels and cellular signaling pathways as well as anti-apoptotic effects, the modulation of neuroinflammation seems to play a crucial role. This review presents the current knowledge on neuroprotection by noble gases with a focus on interactions with the neuronal-glial network and neuroinflammation and the perspectives on clinical applications.
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Affiliation(s)
- A V Fahlenkamp
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland.
| | - R Rossaint
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
| | - M Coburn
- Klinik für Anästhesiologie, Universitätsklinikum Aachen, RWTH Aachen, Pauwelsstr. 30, 52074, Aachen, Deutschland
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Li Y, Zhang P, Liu Y, Liu W, Yin N. Helium preconditioning protects the brain against hypoxia/ischemia injury via improving the neurovascular niche in a neonatal rat model. Behav Brain Res 2016; 314:165-72. [PMID: 27515290 DOI: 10.1016/j.bbr.2016.08.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 08/03/2016] [Accepted: 08/07/2016] [Indexed: 11/25/2022]
Abstract
This study aimed to investigate whether helium preconditioning (He-PC) is able to exert neuroprotective effects via improving focal neurovascular niche in a neonatal rat hypoxia/ischemia (HI) brain injury model. Seven day old rat pups were divided into control group, HI group and He-PC group. HI was induced by exposure to 8% oxygen for 90min one day after preconditioning with 70% helium-30% oxygen for three 5-min periods. At 3 and 7 days, the brain was collected for the detection of inflammation related factors (tumor necrosis factor α [TNF-α], interleukin-1β [IL-1β], IL-10) and growth/neurotrophic factors (brain-derived neurotrophic factor [BDNF], basic fibroblast growth factor [bFGF] and nerve growth factor [NGF]); at 7 days, neurobehaviors were evaluated, and the brain was collected for the detection of mRNA expression of vascular endothelial growth factor (VEGF) and angiopoietin-1 (Ang-1) by PCR, protein expression of angiogenesis related molecules (VEGF, Ang-1, Tie-2 and Flt-1) by Western blotting and microvessel density (MCD) by immunohistochemistry for vWF. Results showed He-PC was able to reduce TNF-α and IL-1β, further increase IL-10, BDNF, bFGF and NGF, elevate the mRNA expression of VEGF and Ang-1, increase the protein expression of VEGF, Ang-1, Tie-2 and Flt-1, promote angiogenesis and improve neurobehaviors as compared to HI group. These findings suggest that He-PC may improve the post-stroke neurovascular niche to exert neuroprotective effects on neonatal HI brain injury.
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Affiliation(s)
- Yi Li
- Department of Neurosurgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, No 1665 Kongjiang Road, Yangpu District, Shanghai 200092, China
| | - Peixi Zhang
- Department of Cardiothoracic Surgery, The First Hospital of Jining City, No 6, Jiankang Road, Jining City, Shandong 272011, China
| | - Ying Liu
- Department of Pathology, Yantaishan Hospital, No 91, Jiefang Road, Zhifu District, Yantai City, Shandong 264001, China
| | - Wenwu Liu
- Department of Diving and Hyperbaric Medicine, The Second Military Medical University, Shanghai, China.
| | - Na Yin
- Department of Anesthesiology & Critical Care Medicine, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
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Brevoord D, Beurskens CJP, van den Bergh WM, Lagrand WK, Juffermans NP, Binnekade JM, Preckel B, Horn J. Helium ventilation for treatment of post-cardiac arrest syndrome: A safety and feasibility study. Resuscitation 2016; 107:145-9. [PMID: 27473390 DOI: 10.1016/j.resuscitation.2016.07.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 06/22/2016] [Accepted: 07/14/2016] [Indexed: 11/29/2022]
Abstract
AIM Besides supportive care, the only recommended treatment for comatose patients after cardiac arrest is target temperature management. Helium reduces ischaemic injury in animal models, and might ameliorate neurological injury in patients after cardiac arrest. As no studies exist on the use of helium in patients after cardiac arrest we investigated whether this is safe and feasible. METHODS The study was an open-label single arm intervention study in a mixed-bed academic intensive care unit. We included 25 patients admitted after circulatory arrest, with a presenting rhythm of ventricular fibrillation or pulseless tachycardia, return of spontaneous circulation within 30min and who were treated with hypothermia. Helium was administrated in a 1:1 mix with oxygen for 3h. A safety committee reviewed all ventilation problems, complications and causes of mortality. RESULTS Helium ventilation was started 4:59±0:52 (mean±SD)h after circulatory arrest. In one patient, helium ventilation was discontinued prematurely due to oxygenation problems. This was caused by pre-existing pulmonary oedema, and imposed limitations to PEEP and FiO2 by the study protocol, rather than the use of helium ventilation. Sixteen (64%) patients had a favourable neurological outcome. CONCLUSIONS We found that helium ventilation is feasible and can be used safely in patients treated with hypothermia after cardiac arrest. No adverse events related to the use of helium occurred during the three hours of administration.
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Affiliation(s)
- Daniel Brevoord
- Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Netherlands; Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, Netherlands.
| | - Charlotte J P Beurskens
- Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Netherlands; Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, Netherlands
| | - Walter M van den Bergh
- Department of Intensive Care, University Medical Center Groningen, University of Groningen, Netherlands; Department of Critical Care of the University Medical Center Groningen, University of Groningen
| | - Wim K Lagrand
- Department of Intensive Care, Academic Medical Center, University of Amsterdam, Netherlands
| | - Nicole P Juffermans
- Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, Netherlands; Department of Intensive Care, Academic Medical Center, University of Amsterdam, Netherlands
| | - Jan M Binnekade
- Department of Intensive Care, Academic Medical Center, University of Amsterdam, Netherlands
| | - Benedikt Preckel
- Department of Anaesthesiology, Academic Medical Center, University of Amsterdam, Netherlands; Laboratory of Experimental Intensive Care and Anesthesiology, Academic Medical Center, University of Amsterdam, Netherlands
| | - Janneke Horn
- Department of Intensive Care, Academic Medical Center, University of Amsterdam, Netherlands
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Zuercher P, Springe D, Grandgirard D, Leib SL, Grossholz M, Jakob S, Takala J, Haenggi M. A randomized trial of the effects of the noble gases helium and argon on neuroprotection in a rodent cardiac arrest model. BMC Neurol 2016; 16:43. [PMID: 27044425 PMCID: PMC4820914 DOI: 10.1186/s12883-016-0565-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/24/2016] [Indexed: 12/18/2022] Open
Abstract
Background The noble gas xenon is considered as a neuroprotective agent, but availability of the gas is limited. Studies on neuroprotection with the abundant noble gases helium and argon demonstrated mixed results, and data regarding neuroprotection after cardiac arrest are scant. We tested the hypothesis that administration of 50 % helium or 50 % argon for 24 h after resuscitation from cardiac arrest improves clinical and histological outcome in our 8 min rat cardiac arrest model. Methods Forty animals had cardiac arrest induced with intravenous potassium/esmolol and were randomized to post-resuscitation ventilation with either helium/oxygen, argon/oxygen or air/oxygen for 24 h. Eight additional animals without cardiac arrest served as reference, these animals were not randomized and not included into the statistical analysis. Primary outcome was assessment of neuronal damage in histology of the region I of hippocampus proper (CA1) from those animals surviving until day 5. Secondary outcome was evaluation of neurobehavior by daily testing of a Neurodeficit Score (NDS), the Tape Removal Test (TRT), a simple vertical pole test (VPT) and the Open Field Test (OFT). Because of the non-parametric distribution of the data, the histological assessments were compared with the Kruskal–Wallis test. Treatment effect in repeated measured assessments was estimated with a linear regression with clustered robust standard errors (SE), where normality is less important. Results Twenty-nine out of 40 rats survived until day 5 with significant initial deficits in neurobehavioral, but rapid improvement within all groups randomized to cardiac arrest. There were no statistical significant differences between groups neither in the histological nor in neurobehavioral assessment. Conclusions The replacement of air with either helium or argon in a 50:50 air/oxygen mixture for 24 h did not improve histological or clinical outcome in rats subjected to 8 min of cardiac arrest.
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Affiliation(s)
- Patrick Zuercher
- Department of Intensive Care Medicine, University Hospital - Inselspital and University of Bern, Freiburgstrasse, CH 3010, Bern, Switzerland
| | - Dirk Springe
- Department of Intensive Care Medicine, University Hospital - Inselspital and University of Bern, Freiburgstrasse, CH 3010, Bern, Switzerland
| | - Denis Grandgirard
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH 3010, Bern, Switzerland
| | - Stephen L Leib
- Neuroinfection Laboratory, Institute for Infectious Diseases, University of Bern, Friedbühlstrasse 51, CH 3010, Bern, Switzerland
| | - Marius Grossholz
- Department of Intensive Care Medicine, University Hospital - Inselspital and University of Bern, Freiburgstrasse, CH 3010, Bern, Switzerland
| | - Stephan Jakob
- Department of Intensive Care Medicine, University Hospital - Inselspital and University of Bern, Freiburgstrasse, CH 3010, Bern, Switzerland
| | - Jukka Takala
- Department of Intensive Care Medicine, University Hospital - Inselspital and University of Bern, Freiburgstrasse, CH 3010, Bern, Switzerland
| | - Matthias Haenggi
- Department of Intensive Care Medicine, University Hospital - Inselspital and University of Bern, Freiburgstrasse, CH 3010, Bern, Switzerland.
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17
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Li Y, Liu K, Kang ZM, Sun XJ, Liu WW, Mao YF. Helium preconditioning protects against neonatal hypoxia-ischemia via nitric oxide mediated up-regulation of antioxidases in a rat model. Behav Brain Res 2015; 300:31-7. [PMID: 26675888 DOI: 10.1016/j.bbr.2015.12.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 11/29/2015] [Accepted: 12/03/2015] [Indexed: 10/22/2022]
Abstract
This study aimed to investigate the role of nitric oxide (NO) in the neuroprotective effects of helium preconditioning (He-PC) in a neonatal hypoxia/ischemia (HI) rat model. Seven-day old rat pups were divided into normal control group, He-PC group, HI group, He-PC+HI group, L-NAME+HI group and L-NAME+He-PC+HI group. HI was induced by exposure to 80% oxygen for 90 min. He-PC was conducted with 70% helium-30% oxygen for three 5-min periods. Three hours after He-PC, animals in control group and He-PC group were sacrificed, and the brain was collected for the detection of NO content. At 24h after HI, animals in control group, HI group, He-PC+HI group, and L-NAME+He-PC+HI group were sacrificed, and the brain was collected for detection of infarct ratio, antioxidases (SOD, HO-1 and Nrf2), DNA binding activity of Nrf2 and TUNEL staining. Three weeks later, the neurological function and brain atrophy were determined. Results showed pretreatment with L-NAME alone failed to exert protective effect on HI. He-PC significantly increased NO content, reduced the brain infarct area, increased anti-oxidases expression and DNA binding activity of Nrf2, decreased the apoptotic cells, and improved the neurological function and brain atrophy. In addition, this protection was markedly inhibited by L-NAME (a non-selective NOS inhibitor). These findings suggest that the He-PC may induce NO production to activate Nrf2, exerting neuroprotective effect on neonatal HI.
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Affiliation(s)
- Y Li
- Department of Neurosurgery, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, No 1665 Kongjiang Road, Yangpu District, Shanghai 200092, China
| | - K Liu
- Department of Diving and Hyperbaric Medicine, Secondary Military Medical University, No 800, Xiangyin Road, Yangpu District, Shanghai 200433, China
| | - Z M Kang
- Department of Diving and Hyperbaric Medicine, Secondary Military Medical University, No 800, Xiangyin Road, Yangpu District, Shanghai 200433, China
| | - X J Sun
- Department of Diving and Hyperbaric Medicine, Secondary Military Medical University, No 800, Xiangyin Road, Yangpu District, Shanghai 200433, China
| | - W W Liu
- Department of Diving and Hyperbaric Medicine, Secondary Military Medical University, No 800, Xiangyin Road, Yangpu District, Shanghai 200433, China.
| | - Y F Mao
- Department of Anesthesiology and Surgical Intensive Care Unit, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, No 1665 Kongjiang Road, Yangpu District, Shanghai 200092, China.
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18
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Zhang M, Wang H, Zhao J, Chen C, Leak RK, Xu Y, Vosler P, Chen J, Gao Y, Zhang F. Drug-induced hypothermia in stroke models: does it always protect? CNS & NEUROLOGICAL DISORDERS-DRUG TARGETS 2014; 12:371-80. [PMID: 23469851 DOI: 10.2174/1871527311312030010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Revised: 11/06/2012] [Accepted: 11/11/2012] [Indexed: 12/19/2022]
Abstract
Ischemic stroke is a common neurological disorder lacking a cure. Recent studies show that therapeutic hypothermia is a promising neuroprotective strategy against ischemic brain injury. Several methods to induce therapeutic hypothermia have been established; however, most of them are not clinically feasible for stroke patients. Therefore, pharmacological cooling is drawing increasing attention as a neuroprotective alternative worthy of further clinical development. We begin this review with a brief introduction to the commonly used methods for inducing hypothermia; we then focus on the hypothermic effects of eight classes of hypothermia-inducing drugs: the cannabinoids, opioid receptor activators, transient receptor potential vanilloid, neurotensins, thyroxine derivatives, dopamine receptor activators, hypothermia-inducing gases, adenosine, and adenine nucleotides. Their neuroprotective effects as well as the complications associated with their use are both considered. This article provides guidance for future clinical trials and animal studies on pharmacological cooling in the setting of acute stroke.
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Affiliation(s)
- Meijuan Zhang
- Department of Neurology, University of Pittsburgh School of Medicine, 3500 Terrace Street, Pittsburgh, PA 15213, USA
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Deng J, Lei C, Chen Y, Fang Z, Yang Q, Zhang H, Cai M, Shi L, Dong H, Xiong L. Neuroprotective gases – Fantasy or reality for clinical use? Prog Neurobiol 2014; 115:210-45. [DOI: 10.1016/j.pneurobio.2014.01.001] [Citation(s) in RCA: 88] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 01/03/2014] [Accepted: 01/03/2014] [Indexed: 12/17/2022]
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Chen F, Qi Z, Luo Y, Hinchliffe T, Ding G, Xia Y, Ji X. Non-pharmaceutical therapies for stroke: mechanisms and clinical implications. Prog Neurobiol 2014; 115:246-69. [PMID: 24407111 PMCID: PMC3969942 DOI: 10.1016/j.pneurobio.2013.12.007] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2013] [Revised: 12/19/2013] [Accepted: 12/27/2013] [Indexed: 12/14/2022]
Abstract
Stroke is deemed a worldwide leading cause of neurological disability and death, however, there is currently no promising pharmacotherapy for acute ischemic stroke aside from intravenous or intra-arterial thrombolysis. Yet because of the narrow therapeutic time window involved, thrombolytic application is very restricted in clinical settings. Accumulating data suggest that non-pharmaceutical therapies for stroke might provide new opportunities for stroke treatment. Here we review recent research progress in the mechanisms and clinical implications of non-pharmaceutical therapies, mainly including neuroprotective approaches such as hypothermia, ischemic/hypoxic conditioning, acupuncture, medical gases and transcranial laser therapy. In addition, we briefly summarize mechanical endovascular recanalization devices and recovery devices for the treatment of the chronic phase of stroke and discuss the relative merits of these devices.
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Affiliation(s)
- Fan Chen
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Zhifeng Qi
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Yuming Luo
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China
| | - Taylor Hinchliffe
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA
| | - Guanghong Ding
- Shanghai Research Center for Acupuncture and Meridian, Shanghai 201203, China
| | - Ying Xia
- The Vivian L. Smith Department of Neurosurgery, The University of Texas Medical School at Houston, Houston, TX 77030, USA.
| | - Xunming Ji
- Cerebrovascular Diseases Research Institute, Xuanwu Hospital of Capital Medical University, Beijing, Beijing 100053, China.
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21
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Hale SL, Vanderipe DR, Kloner RA. Continuous heliox breathing and the extent of anatomic zone of noreflow and necrosis following ischemia/reperfusion in the rabbit heart. Open Cardiovasc Med J 2014; 8:1-5. [PMID: 24587834 PMCID: PMC3937439 DOI: 10.2174/1874192401408010001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 01/01/2014] [Accepted: 01/05/2014] [Indexed: 12/23/2022] Open
Abstract
Background: Nitrogen may contribute to reperfusion injury. Some studies have shown that helium as a replacement for nitrogen in breathing gas (heliox) reduces cell necrosis after ischemia/reperfusion when used in a preconditioning fashion (intermittent heliox exposure). Our aim was to test whether heliox, breathed continuously throughout the ischemic and reperfusion periods, reduced necrosis and a marker of reperfusion injury, the no-reflow phenomenon. Methods and Results: Anesthetized, open-chest rabbits received 30 min coronary artery occlusion/3 hrs reperfusion. Before CAO rabbits were randomized to heliox (30% oxygen + 70% helium, n=8) or air supplemented with oxygen to achieve blood gas values within physiologic range (n = 8). Rabbits received the appropriate mix during ischemic and reperfusion periods. Infarct size (% risk zone) and no-reflow defect were measured at the end of the reperfusion period. The ischemic risk zone was similar in both groups (28% of left ventricle in heliox and 29% in control). Heliox breathing did not reduce necrosis; infarct size, expressed as a percentage of the risk region was 44±4% in the heliox group and 49±5% in controls, p = 0.68. The extent of the no-reflow defect was not altered by heliox, either expressed as a percent of the risk region (29±4% in heliox and 28±3% in control) or as a percent of the necrotic zone (65±5% in heliox and 59±8% in control).Heliox treatment had no effect on hemodynamic parameters or arterial blood gas values. Conclusion: Continuous heliox breathing does not appear to be cardioprotective in the setting of acute myocardial infarction in the rabbit model. Heliox respiration administered during 30 minutes of ischemia and 180 minutes of reperfusion did not alter infarct size or the extent of no-reflow.
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Affiliation(s)
- Sharon L Hale
- The Heart Institute of Good Samaritan Hospital, Los Angeles, CA, USA
| | | | - Robert A Kloner
- The Heart Institute of Good Samaritan Hospital, Los Angeles, CA, USA ; Keck School of Medicine, Division of Cardiovascular Medicine, University of Southern California, Los Angeles, CA, USA
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22
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Chhor V, Canini F, De Rudnicki S, Dahmani S, Gressens P, Constantin P. [Hyperbaric oxygen therapy and inert gases in cerebral ischemia and traumatic brain injury]. ACTA ACUST UNITED AC 2013; 32:863-71. [PMID: 24169200 DOI: 10.1016/j.annfar.2013.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 09/10/2013] [Indexed: 10/26/2022]
Abstract
Cerebral ischemia is a common thread of acute cerebral lesions, whether vascular or traumatic origin. Hyperbaric oxygen (HBO) improves tissue oxygenation and may prevent impairment of reversible lesions. In experimental models of cerebral ischemia or traumatic brain injury, HBO has neuroprotective effects which are related to various mechanisms such as modulation of oxidative stress, neuro-inflammation or cerebral and mitochondrial metabolism. However, results of clinical trials failed to prove any neuroprotective effects for cerebral ischemia and remained to be confirmed for traumatic brain injury despite preliminary encouraging results. The addition of inert gases to HBO sessions, especially argon or xenon which show neuroprotective experimental effects, may provide an additional improvement of cerebral lesions. Further multicentric studies with a strict methodology and a better targeted definition are required before drawing definitive conclusions about the efficiency of combined therapy with HBO and inert gases in acute cerebral lesions.
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Affiliation(s)
- V Chhor
- Fédération d'anesthésiologie-réanimation et de médecine hyperbare, hôpital d'instruction des armées du Val-de-Grâce, 75005 Paris, France; Inserm U676, hôpital Robert-Debré, 48, boulevard Sérurier, 75019 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, UMRS 676, 75013 Paris, France; Centre for the Developing Brain, Department of Perinatal Imaging and Health, King's College London, London, Royaume-Uni.
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Ström JO, Ingberg E, Theodorsson A, Theodorsson E. Method parameters' impact on mortality and variability in rat stroke experiments: a meta-analysis. BMC Neurosci 2013; 14:41. [PMID: 23548160 PMCID: PMC3637133 DOI: 10.1186/1471-2202-14-41] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2012] [Accepted: 03/22/2013] [Indexed: 12/14/2022] Open
Abstract
Background Even though more than 600 stroke treatments have been shown effective in preclinical studies, clinically proven treatment alternatives for cerebral infarction remain scarce. Amongst the reasons for the discrepancy may be methodological shortcomings, such as high mortality and outcome variability, in the preclinical studies. A common approach in animal stroke experiments is that A) focal cerebral ischemia is inflicted, B) some type of treatment is administered and C) the infarct sizes are assessed. However, within this paradigm, the researcher has to make numerous methodological decisions, including choosing rat strain and type of surgical procedure. Even though a few studies have attempted to address the questions experimentally, a lack of consensus regarding the optimal methodology remains. Methods We therefore meta-analyzed data from 502 control groups described in 346 articles to find out how rat strain, procedure for causing focal cerebral ischemia and the type of filament coating affected mortality and infarct size variability. Results The Wistar strain and intraluminal filament procedure using a silicone coated filament was found optimal in lowering infarct size variability. The direct and endothelin methods rendered lower mortality rate, whereas the embolus method increased it compared to the filament method. Conclusions The current article provides means for researchers to adjust their middle cerebral artery occlusion (MCAo) protocols to minimize infarct size variability and mortality.
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Affiliation(s)
- Jakob O Ström
- Department of Clinical and Experimental Medicine, Clinical Chemistry, Faculty of Health Sciences, Linköping University, County Council of Östergötland, Linköping, Sweden.
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Sabir H, Scull-Brown E, Liu X, Thoresen M. Immediate Hypothermia Is Not Neuroprotective After Severe Hypoxia-Ischemia and Is Deleterious When Delayed by 12 Hours in Neonatal Rats. Stroke 2012; 43:3364-70. [DOI: 10.1161/strokeaha.112.674481] [Citation(s) in RCA: 101] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Hemmen Sabir
- From the School of Clinical Sciences, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom (H.S., E.S.-B., X.L., M.T.); Department of Physiology, University of Oslo, Institute of Basic Medical Sciences, Oslo, Norway (M.T.)
| | - Emma Scull-Brown
- From the School of Clinical Sciences, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom (H.S., E.S.-B., X.L., M.T.); Department of Physiology, University of Oslo, Institute of Basic Medical Sciences, Oslo, Norway (M.T.)
| | - Xun Liu
- From the School of Clinical Sciences, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom (H.S., E.S.-B., X.L., M.T.); Department of Physiology, University of Oslo, Institute of Basic Medical Sciences, Oslo, Norway (M.T.)
| | - Marianne Thoresen
- From the School of Clinical Sciences, University of Bristol, St Michael’s Hospital, Bristol, United Kingdom (H.S., E.S.-B., X.L., M.T.); Department of Physiology, University of Oslo, Institute of Basic Medical Sciences, Oslo, Norway (M.T.)
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