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Valerio E, Mardegan V, Stocchero M, Cavicchiolo ME, Pirillo P, Poloniato G, D’Onofrio G, Bonadies L, Giordano G, Baraldi E. Urinary metabotypes of newborns with perinatal asphyxia undergoing therapeutic hypothermia. PLoS One 2022; 17:e0273175. [PMID: 35972970 PMCID: PMC9380923 DOI: 10.1371/journal.pone.0273175] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 08/03/2022] [Indexed: 11/29/2022] Open
Abstract
Perinatal asphyxia (PA) still occurs in about three to five per 1,000 deliveries in developed countries; 20% of these infants show hypoxic-ischemic encephalopathy (HIE) on brain magnetic resonance imaging (MRI). The aim of our study was to apply metabolomic analysis to newborns undergoing therapeutic hypothermia (TH) after PA to identify a distinct metabotype associated with the development of HIE on brain MRI. We enrolled 53 infants born at >35 weeks of gestation with PA: 21 of them showed HIE on brain MRI (the “HIE” group), and 32 did not (the “no HIE” group). Urine samples were collected at 24, 48 and 72 hours of TH. Metabolomic data were acquired using high-resolution mass spectrometry and analyzed with univariate and multivariate methods. Considering the first urines collected during TH, untargeted analysis found 111 relevant predictors capable of discriminating between the two groups. Of 35 metabolites showing independent discriminatory power, four have been well characterized: L-alanine, Creatine, L-3-methylhistidine, and L-lysine. The first three relate to cellular energy metabolism; their involvement suggests a multimodal derangement of cellular energy metabolism during PA/HIE. In addition, seven other metabolites with a lower annotation level (proline betaine, L-prolyl-L-phenylalanine, 2-methyl-dodecanedioic acid, S-(2-methylpropionyl)-dihydrolipoamide-E, 2,6 dimethylheptanoyl carnitine, Octanoylglucuronide, 19-hydroxyandrost-4-ene-3,17-dione) showed biological consistency with the clinical picture of PA. Moreover, 4 annotated metabolites (L-lysine, L-3-methylhistidine, 2-methyl-dodecanedioic acid, S-(2-methylpropionyl)-dihydrolipoamide-E) retained a significant difference between the “HIE” and “no HIE” groups during all the TH treatment. Our analysis identified a distinct urinary metabotype associated with pathological findings on MRI, and discovered 2 putative markers (L-lysine, L-3-methylhistidine) which may be useful for identifying neonates at risk of developing HIE after PA.
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Affiliation(s)
- Enrico Valerio
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- * E-mail:
| | - Veronica Mardegan
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Matteo Stocchero
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Maria Elena Cavicchiolo
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Paola Pirillo
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Gabriele Poloniato
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Gianluca D’Onofrio
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Luca Bonadies
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
| | - Giuseppe Giordano
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Eugenio Baraldi
- Neonatal Intensive Care Unit, Department of Womens’ and Childrens’ Health, University Hospital of Padua, Padova, Italy
- Institute of Pediatric Research (IRP), Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
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Dietz RM, Orfila JE, Rodgers KM, Patsos OP, Deng G, Chalmers N, Quillinan N, Traystman RJ, Herson PS. Juvenile cerebral ischemia reveals age-dependent BDNF-TrkB signaling changes: Novel mechanism of recovery and therapeutic intervention. J Cereb Blood Flow Metab 2018; 38:2223-2235. [PMID: 29611441 PMCID: PMC6282214 DOI: 10.1177/0271678x18766421] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Global ischemia in childhood often leads to poor neurologic outcomes, including learning and memory deficits. Using our novel model of childhood cardiac arrest/cardiopulmonary resuscitation (CA/CPR), we investigate the mechanism of ischemia-induced cognitive deficits and recovery. Memory is impaired seven days after juvenile CA/CPR and completely recovers by 30 days. Consistent with this remarkable recovery not observed in adults, hippocampal long-term potentiation (LTP) is impaired 7-14 days after CA/CPR, recovering by 30 days. This recovery is not due to the replacement of dead neurons (neurogenesis), but rather correlates with brain-derived neurotrophic factor (BDNF) expression, implicating BDNF as the molecular mechanism underlying impairment and recovery. Importantly, delayed activation of TrkB receptor signaling reverses CA/CPR-induced LTP deficits and memory impairments. These data provide two new insights (1) endogenous recovery of memory and LTP through development may contribute to improved neurological outcome in children compared to adults and (2) BDNF-enhancing drugs speed recovery from pediatric cardiac arrest during the critical school ages.
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Affiliation(s)
- Robert M Dietz
- 1 Department of Pediatrics, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - James E Orfila
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Krista M Rodgers
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Olivia P Patsos
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Guiying Deng
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Nicholas Chalmers
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Nidia Quillinan
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,4 Department of Pharmacology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Richard J Traystman
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,4 Department of Pharmacology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
| | - Paco S Herson
- 2 Neuronal Injury Program, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,3 Department of Anesthesiology, 129263 University of Colorado School of Medicine, Aurora, CO, USA.,4 Department of Pharmacology, 129263 University of Colorado School of Medicine, Aurora, CO, USA
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Keilhoff G, Esser T, Titze M, Ebmeyer U, Schild L. High-potential defense mechanisms of neocortex in a rat model of transient asphyxia induced cardiac arrest. Brain Res 2017; 1674:42-54. [DOI: 10.1016/j.brainres.2017.08.018] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/24/2017] [Accepted: 08/14/2017] [Indexed: 01/14/2023]
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Keilhoff G, Esser T, Titze M, Ebmeyer U, Schild L. Gynostemma pentaphyllum is neuroprotective in a rat model of cardiopulmonary resuscitation. Exp Ther Med 2017; 14:6034-6046. [PMID: 29250141 PMCID: PMC5729372 DOI: 10.3892/etm.2017.5315] [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: 06/10/2017] [Accepted: 10/02/2017] [Indexed: 01/11/2023] Open
Abstract
Asphyxial cardiac arrest (ACA)-induced ischemia results in acute and delayed neuronal cell death. The early reperfusion phase is critical for the outcome. Intervention strategies directed to this period are promising to reduce ACA/resuscitation-dependent impairments. This study focused on the evaluation of the protective potential of an extract from Gynostemma pentaphyllum (GP), a plant used in traditional medicine with antioxidative, glucose lowering and neuroprotective activities, in an ACA rat model. We tested the following parameters: i) Basic systemic parameters such as pCO2 and blood glucose value within the first 30 min post-ACA; ii) mitochondrial response by determining activities of citrate synthase, respiratory chain complexes I + III and II + III, and the composition of cardiolipin 6 and 24 h post-ACA; iii) neuronal vitality of the CA1 hippocampal region by immunohistochemistry 24 h and 7 days post-ACA; and iv) cognitive function by a novel object recognition test 7 days post-ACA. GP, administered after reaching spontaneous circulation, counteracted the following: i) ACA-mediated increases in arterial CO2 tension and blood glucose values; ii) transient increase in the activity of the respiratory chain complexes II + III; iii) elevation in cardiolipin content; iv) hippocampal CA1 neurodegeneration, and v) loss of normal novelty-object seeking. The protective effects of GP were accompanied by side effects of the vehicle DMSO, such as the stimulation of citrate synthase activity in control animals, inhibition of cardiolipin synthesis in ACA animals and complex II + III activity in both control and ACA animals. The results emphasize the importance of the early post-resuscitation phase for the neurological outcome after ACA/resuscitation, and demonstrated the power of GP substitution as neuroprotective intervention. Moreover, the results underline the need of a careful handling of the popular vehicle DMSO.
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Affiliation(s)
- Gerburg Keilhoff
- Institute of Biochemistry and Cell Biology, Otto-von-Guericke University Magdeburg, Leipziger, D-39120 Magdeburg, Germany
| | - Torben Esser
- Department of Anesthesiology, Otto-von-Guericke University Magdeburg, Leipziger, D-39120 Magdeburg, Germany
| | - Maximilian Titze
- Institute of Biochemistry and Cell Biology, Otto-von-Guericke University Magdeburg, Leipziger, D-39120 Magdeburg, Germany
| | - Uwe Ebmeyer
- Department of Anesthesiology, Otto-von-Guericke University Magdeburg, Leipziger, D-39120 Magdeburg, Germany
| | - Lorenz Schild
- Department of Pathological Biochemistry, Otto-von-Guericke University Magdeburg, Leipziger, D-39120 Magdeburg, Germany
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Esser T, Keilhoff G, Ebmeyer U. Anesthesia specific differences in a cardio-pulmonary resuscitation rat model; halothane versus sevoflurane. Brain Res 2016; 1652:144-150. [PMID: 27725150 DOI: 10.1016/j.brainres.2016.10.003] [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: 07/03/2015] [Revised: 09/26/2016] [Accepted: 10/04/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Our asphyxia cardiac arrest (ACA) rat model is well established. The original model was designed in the 1990th using halothane and nitrous oxide for pre-insult anesthesia. Because of its hepato-toxicity and its potential to induce severe liver failures, halothane is no longer used in clinical anesthesia for several years. In order to minimize the health risk for our laboratory staff as well as to keep the experimental settings of our model on a clinically oriented basis we decided to replace halothane by sevoflurane. In this study we intended to determine if the change of the narcotic gas regiment causes changes in the neurological damage and how far our model had to be adjusted. METHODS Adult rats were subjected to 5min of ACA followed by resuscitation. There were four treatment groups: ACA - halothane, ACA - sevoflurane and with halothane or sevoflurane sham operated animals. Vital and blood parameters were monitored during the 45min post-resuscitation intensive care phase. After a survival time of 7 days histological evaluation of the hippocampus was performed. RESULTS We observed that resuscitated rats anesthetized prior by sevoflurane (i) have had a lower heart rate and a higher MAP compared to halothane anesthetized animals; (ii) The neurological damaged were significantly reduced in the hippocampal CA1 region in sevoflurane treated rats. CONCLUSION Using sevoflurane instead of halothane for anesthesia requires some physiological and experimental changes. However the model keeps its validity. Sevoflurane caused less pronounced neurodegeneration in the CA1 region of the hippocampus. This had to be considered in further resuscitation-studies containing sevoflurane as anesthetic. Institutional protocol number for animal studies: 42502-2-2-947 Uni MD.
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Affiliation(s)
- Torben Esser
- Department of Anaesthesiology, University of Magdeburg, Leipziger Strasse 44, Magdeburg, Germany.
| | - Gerburg Keilhoff
- Institute of Biochemistry and Cell Biology, University of Magdeburg, Leipziger Strasse 44, Magdeburg, Germany
| | - Uwe Ebmeyer
- Department of Anaesthesiology, University of Magdeburg, Leipziger Strasse 44, Magdeburg, Germany
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Khodanovich MY, Kisel' AA, Chernysheva GA, Smol'yakova VI, Savchenko RR, Plotnikov MB. Effect of Fluoxetine on Neurogenesis in Hippocampal Dentate Gyrus after Global Transient Cerebral Ischemia in Rats. Bull Exp Biol Med 2016; 161:351-4. [PMID: 27496030 DOI: 10.1007/s10517-016-3412-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Indexed: 11/30/2022]
Abstract
Changes in cerebral neurogenesis provoked by ischemia and the effect of fluoxetine on this process were studied using a three-vessel occlusion model of global transient cerebral ischemia. The global transient cerebral ischemia was modeled on male Wistar rats by transient occlusion of three major vessels originating from the aortic arch and supplying the brain (brachiocephalic trunk, left subclavian artery, and left common carotid artery). The cells expressing doublecortin (DCX, a marker of young neurons) were counted in the hippocampal dentate gyrus on day 31 after ischemia modeling. It was found that ischemia inhibited neurogenesis in the dentate gyrus in comparison with sham-operated controls (p<0.05), while fluoxetine (20 mg/kg/day) injected over 10 days after surgery restored neurogenesis to the control level (p<0.001).
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Affiliation(s)
- M Yu Khodanovich
- Department of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russia.
| | - A A Kisel'
- Department of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russia
| | - G A Chernysheva
- Department of Circulation Pharmacology, E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia
| | - V I Smol'yakova
- Department of Circulation Pharmacology, E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia
| | - R R Savchenko
- Department of Neurobiology, Research Institute of Biology and Biophysics, Tomsk State University, Tomsk, Russia
| | - M B Plotnikov
- Department of Circulation Pharmacology, E. D. Goldberg Research Institute of Pharmacology and Regenerative Medicine, Tomsk, Russia
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Keilhoff G, Titze M, Esser T, Langnaese K, Ebmeyer U. Constitutive and functional expression of YB-1 in microglial cells. Neuroscience 2015; 301:439-53. [DOI: 10.1016/j.neuroscience.2015.06.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 06/15/2015] [Accepted: 06/15/2015] [Indexed: 12/28/2022]
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Ebmeyer U, Esser T, Keilhoff G. Low-dose nitroglycerine improves outcome after cardiac arrest in rats. Resuscitation 2014; 85:276-83. [DOI: 10.1016/j.resuscitation.2013.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 08/02/2013] [Accepted: 10/09/2013] [Indexed: 02/07/2023]
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Environmental enrichment decreases asphyxia-induced neurobehavioral developmental delay in neonatal rats. Int J Mol Sci 2013; 14:22258-73. [PMID: 24232451 PMCID: PMC3856064 DOI: 10.3390/ijms141122258] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 10/18/2013] [Accepted: 10/28/2013] [Indexed: 01/01/2023] Open
Abstract
Perinatal asphyxia during delivery produces long-term disability and represents a major problem in neonatal and pediatric care. Numerous neuroprotective approaches have been described to decrease the effects of perinatal asphyxia. Enriched environment is a popular strategy to counteract nervous system injuries. The aim of the present study was to investigate whether enriched environment is able to decrease the asphyxia-induced neurobehavioral developmental delay in neonatal rats. Asphyxia was induced in ready-to-deliver mothers by removing the pups by caesarian section after 15 min of asphyxia. Somatic and neurobehavioral development was tested daily and motor coordination weekly. Our results show that rats undergoing perinatal asphyxia had a marked developmental delay and worse performance in motor coordination tests. However, pups kept in enriched environment showed a decrease in the developmental delay observed in control asphyctic pups. Rats growing up in enriched environment did not show decrease in weight gain after the first week and the delay in reflex appearance was not as marked as in control rats. In addition, the development of motor coordination was not as strikingly delayed as in the control group. Short-term neurofunctional outcome are known to correlate with long-term deficits. Our results thus show that enriched environment could be a powerful strategy to decrease the deleterious developmental effects of perinatal asphyxia.
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Voxel-based morphometry and histological analysis for evaluating hippocampal damage in a rat model of cardiopulmonary resuscitation. Neuroimage 2013; 77:215-21. [DOI: 10.1016/j.neuroimage.2013.03.042] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 02/16/2013] [Accepted: 03/14/2013] [Indexed: 01/21/2023] Open
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Effects of a single-dose hypertonic saline hydroxyethyl starch on cerebral blood flow, long-term outcome, neurogenesis, and neuronal survival after cardiac arrest and cardiopulmonary resuscitation in rats*. Crit Care Med 2012; 40:2149-56. [DOI: 10.1097/ccm.0b013e31824e6750] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Keilhoff G, Schweizer H, John R, Langnaese K, Ebmeyer U. Minocycline neuroprotection in a rat model of asphyxial cardiac arrest is limited. Resuscitation 2010; 82:341-9. [PMID: 21168947 DOI: 10.1016/j.resuscitation.2010.11.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Revised: 11/05/2010] [Accepted: 11/11/2010] [Indexed: 12/14/2022]
Abstract
OBJECTIVE The study investigated a possible neuroprotective potency of minocycline in an experimental asphyxial cardiac arrest (ACA) rat model. Clinically important survival times were evaluated thus broadening common experimental approaches. METHODS Adult rats were subjected to 5 min of ACA followed by resuscitation. There were two main treatment groups: ACA and sham operated. Relating to minocycline treatment each group consisted of three sub-groups: pre-, post-, and sans-mino, with three different survival times: 4, 7, and 21 days. Neurodegeneration and microgliosis were monitored by immunohistochemistry. Alterations of microglia-associated gene expression were analyzed by quantitative RT-PCR. RESULTS ACA induced massive nerve cell loss and activation of microglia/macrophages in hippocampal CA1 cell layer intensifying with survival time. After 7 days, minocycline significantly decreased both, neuronal degeneration and microglia response in dependence on the application pattern; application post ACA was most effective. After 21 days, neuroprotective effects of minocycline were lost. ACA significantly induced expression of the microglia-associated factors Ccl2, CD45, Mac-1, F4-80, and Tnfa. Independent on survival time, minocycline affected these parameters not significantly. Expression of iNOS was unaffected by both, ACA and minocycline. CONCLUSIONS In adult rat hippocampus microglia was significantly activated by ACA. Minocycline positive affected neuronal survival and microglial response temporary, even when applied up to 18 h after ACA, thus defining a therapeutically-relevant time window. As ACA-induced neuronal cell death involves acute and delayed events, longer minocycline intervention targeting also secondary injury cascades should manifest neuroprotective potency, a question to be answered by further experiments.
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Affiliation(s)
- Gerburg Keilhoff
- Institute of Biochemistry and Cell Biology, University of Magdeburg, Leipziger Strasse 44, Magdeburg, Germany.
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