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Phillips KF, Deshpande LS, DeLorenzo RJ. Hypothermia Reduces Mortality, Prevents the Calcium Plateau, and Is Neuroprotective Following Status Epilepticus in Rats. Front Neurol 2018; 9:438. [PMID: 29942282 PMCID: PMC6005175 DOI: 10.3389/fneur.2018.00438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Accepted: 05/24/2018] [Indexed: 12/13/2022] Open
Abstract
Status Epilepticus (SE) is a major neurological emergency and is considered a leading cause of Acquired Epilepsy (AE). We have shown that SE produces neuronal injury and prolonged alterations in hippocampal calcium levels ([Ca2+]i) that may underlie the development of AE. Interventions preventing the SE-induced Ca2+ plateau could therefore prove to be beneficial in lowering the development of AE after SE. Hypothermia is used clinically to prevent neurological complications associated with Traumatic Brain Injury, cardiac arrest, and stroke. Here, we investigated whether hypothermia prevented the development of Ca2+ plateau following SE. SE was induced in hippocampal neuronal cultures (HNC) by exposing them to no added MgCl2 solution for 3 h. To terminate SE, low Mg2+ solution was washed off with 31°C (hypothermic) or 37°C (normothermic) physiological recording solution. [Ca2+]i was estimated with ratiometric Fura-2 imaging. HNCs washed with hypothermic solution exhibited [Ca2+]i ratios, which were significantly lower than ratios obtained from HNCs washed with normothermic solution. For in vivo SE, the rat pilocarpine (PILO) model was used. Moderate hypothermia (30–33°C) in rats was induced at 30-min post-SE using chilled ethanol spray in a cold room. Hypothermia following PILO-SE significantly reduced mortality. Hippocampal neurons isolated from hypothermia-treated PILO SE rats exhibited [Ca2+]i ratios which were significantly lower than ratios obtained from PILO SE rats. Hypothermia also provided significant neuroprotection against SE-induced delayed hippocampal injury as characterized by decreased FluoroJade C labeling in hypothermia-treated PILO SE rats. We previously demonstrated that hypothermia reduced Ca2+ entry via N-methyl-D-aspartate and ryanodine receptors in HNC. Together, our studies indicate that by targeting these two receptor systems hypothermia could interfere with epileptogenesis and prove to be an effective therapeutic intervention for reducing SE-induced AE.
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Affiliation(s)
- Kristin F Phillips
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States
| | - Laxmikant S Deshpande
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.,Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
| | - Robert J DeLorenzo
- Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.,Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, United States
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2
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Fei YX, Zhang TH, Zhao J, Ren H, Du YN, Yu CL, Wang Q, Li S, Ren TL, Jian Q, Fei SY, Zhang ZQ, Zhang Y. In vitro and in vivo evaluation of hypothermia on pharmacokinetics and pharmacodynamics of nimodipine in rabbits. J Int Med Res 2018; 46:335-347. [PMID: 28851258 PMCID: PMC6011315 DOI: 10.1177/0300060517720056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 06/20/2017] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the effect of hypothermia on the pharmacokinetics and pharmacodynamics of nimodipine in rabbits using in vivo and in vitro methods. Methods Five healthy New Zealand rabbits received a single dose of nimodipine (0.5 mg/kg) intravenously under normothermic and hypothermic conditions. Doppler ultrasound was used to monitor cerebral blood flow, vascular resistance, and heart rate. In vitro evaluations of protein binding, hepatocyte uptake and intrinsic clearance of liver microsomes at different temperatures were also conducted. Results Plasma concentrations of nimodipine were significantly higher in hypothermia than in normothermia. Nimodipine improved cerebral blood flow under both conditions, but had a longer effective duration during the hypothermic period. Low temperature decreased the intrinsic clearance of liver microsomes, with no change in protein binding or hepatocyte uptake of nimodipine. Conclusion Nimodipine is eliminated at a slower rate during hypothermia than during normothermia, mainly due to the decreased activity of cytochrome P450 enzymes. This results in elevated system exposure with little enhancement in pharmacological effect.
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Affiliation(s)
- Yu-xing Fei
- Department of Cardiology, Navy General Hospital of PLA, Beijing, PR China
| | - Tian-hong Zhang
- Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, PR China
| | - Jing Zhao
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
| | - He Ren
- Department of Ultrasound, Navy General Hospital of PLA, Beijing, PR China
| | - Ya-nan Du
- Department of Neurosurgery, Navy General Hospital of PLA, Beijing, PR China
| | - Chun-ling Yu
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
| | - Qiang Wang
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
| | - Shu Li
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
| | - Ting-lin Ren
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
| | - Qiang Jian
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
| | - Shu-yang Fei
- Grade 2013, Clinical Medical College, Capital Medical University, Beijing, PR China
| | - Zhen-qing Zhang
- Institute of Pharmacology and Toxicology, Academy of Military Medical Sciences, Beijing, PR China
| | - Yi Zhang
- Department of Pharmacy, Navy General Hospital of PLA, Beijing, PR China
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Wowk S, Fagan KJ, Ma Y, Nichol H, Colbourne F. Examining potential side effects of therapeutic hypothermia in experimental intracerebral hemorrhage. J Cereb Blood Flow Metab 2017; 37:2975-2986. [PMID: 27899766 PMCID: PMC5536807 DOI: 10.1177/0271678x16681312] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/27/2016] [Accepted: 10/30/2016] [Indexed: 11/16/2022]
Abstract
Studies treating intracerebral hemorrhage (ICH) with therapeutic hypothermia (TH) have shown inconsistent benefits. We hypothesized that TH's anti-inflammatory effects may be responsible as inflammatory cells are essential for removing degrading erythrocytes. Here, we subjected rats to a collagenase-induced striatal ICH followed by whole-body TH (∼33℃ for 11-72 h) or normothermia. We used X-ray fluorescence imaging to spatially quantify total and peri-hematoma iron three days post-injury. At three and seven days, we measured non-heme iron levels. Finally, hematoma volume was quantified on one, three, and seven days. In the injured hemisphere, total iron levels were elevated ( p < 0.001) with iron increasing in the peri-hematoma region ( p = 0.007). Non-heme iron increased from three to seven days (p < 0.001). TH had no effect on any measure of iron ( p ≥ 0.479). At one and three days, TH did not affect hematoma volume ( p ≥ 0.264); however, at seven days there was a four-fold increase in hematoma volume in 40% of treated animals ( p = 0.032). Thus, even when TH does not interfere with initial increases in total and non-heme iron or its containment, TH can cause re-bleeding post-treatment. This serious complication could partly account for the intermittent protection previously observed. This also raises serious concerns for clinical usage of TH for ICH.
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Affiliation(s)
- Shannon Wowk
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Kelly J Fagan
- Department of Biology, MacEwan University, Edmonton, Canada
| | - Yonglie Ma
- Department of Psychology, University of Alberta, Edmonton, Alberta, Canada
| | - Helen Nichol
- Department of Anatomy and Cell Biology, University of Saskatchewan, Saskatoon, Canada
| | - Frederick Colbourne
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Alberta, Canada
- Department of Psychology, University of Alberta, Edmonton, Alberta, Canada
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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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McCutcheon V, Park E, Liu E, Sobhebidari P, Tavakkoli J, Wen XY, Baker AJ. A Novel Model of Traumatic Brain Injury in Adult Zebrafish Demonstrates Response to Injury and Treatment Comparable with Mammalian Models. J Neurotrauma 2016; 34:1382-1393. [PMID: 27650063 DOI: 10.1089/neu.2016.4497] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Traumatic brain injury (TBI) is a leading cause of death and morbidity in industrialized countries with considerable associated health care costs. The cost and time associated with pre-clinical development of TBI therapeutics is lengthy and expensive with a poor track record of successful translation to the clinic. The zebrafish is an emerging model organism in research with unique technical and genomic strengths in the study of disease and development. Its high degree of genetic homology and cell signaling pathways relative to mammalian species and amenability to high and medium throughput assays has potential to accelerate the rate of therapeutic drug identification. Accordingly, we developed a novel closed-head model of TBI in adult zebrafish using a targeted, pulsed, high-intensity focused ultrasound (pHIFU) to induce mechanical injury of the brain. Western blot results indicated altered microtubule and neurofilament expression as well as increased expression of cleaved caspase-3 and beta APP (β-APP; p < 0.05). We used automated behavioral tracking software to evaluate locomotor deficits 24 and 48 h post-injury. Significant behavioral impairment included decreased swim distance and velocity (p < 0.05), as well as heightened anxiety and altered group social dynamics. Responses to injury were pHIFU dose-dependent and modifiable with MK-801, MDL-28170, or temperature modulation. Together, results indicate that the zebrafish exhibits responses to injury and intervention similar to mammalian TBI pathophysiology and suggest the potential for use to rapidly evaluate therapeutic compounds with high efficiency.
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Affiliation(s)
| | - Eugene Park
- 2 Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto, Ontario, Canada
| | - Elaine Liu
- 2 Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto, Ontario, Canada
| | - Pooya Sobhebidari
- 3 Department of Physics, Ryerson University , Toronto, Ontario, Canada
| | - Jahan Tavakkoli
- 2 Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto, Ontario, Canada .,3 Department of Physics, Ryerson University , Toronto, Ontario, Canada
| | - Xiao-Yan Wen
- 2 Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto, Ontario, Canada .,4 Departments of Medicine and Physiology, University of Toronto , Ontario, Canada
| | - Andrew J Baker
- 1 Institute of Medical Sciences, University of Toronto , Ontario, Canada .,2 Keenan Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital , Toronto, Ontario, Canada .,5 Departments of Anesthesia and Surgery, University of Toronto , Ontario, Canada
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Klahr AC, Nadeau CA, Colbourne F. Temperature Control in Rodent Neuroprotection Studies: Methods and Challenges. Ther Hypothermia Temp Manag 2016; 7:42-49. [PMID: 27327871 DOI: 10.1089/ther.2016.0018] [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] [Indexed: 12/29/2022] Open
Abstract
Extensive animal research facilitated the clinical translation of therapeutic hypothermia for cardiac arrest in adults and hypoxic-ischemic injury in infants. Similarly, clinical interest in hypothermia for other brain injuries, such as stroke, has been greatly supported by positive findings in preclinical work. The reliability, validity, and utility of animal models, among many research practices (blinding, randomization, etc.), are key to successful clinical translation. Here, we review methods used to induce and maintain hypothermia in animal models. These include physical and pharmacological methods. We emphasize the advantages and limitations of each approach, and the importance of using clinically relevant cooling protocols and appropriate monitoring and reporting approaches. Moreover, we performed a literature survey of ischemic stroke studies published in 2015 to highlight the continuing risk of temperature confounds in neuroprotection studies. For example, many still do not accurately monitor and report temperature during surgery (23.5%), even though almost half of these studies (46.0%) use pharmaceutical agents that likely influence temperature. We hope this review stimulates awareness and discussion of the importance of temperature in neuroprotective studies.
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Affiliation(s)
- Ana C Klahr
- 1 Neuroscience and Mental Health Institute, University of Alberta , Edmonton, Canada
| | - Colby A Nadeau
- 2 Department of Psychology, University of Alberta , Edmonton, Canada
| | - Frederick Colbourne
- 1 Neuroscience and Mental Health Institute, University of Alberta , Edmonton, Canada .,2 Department of Psychology, University of Alberta , Edmonton, Canada
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Cheshire WP. Thermoregulatory disorders and illness related to heat and cold stress. Auton Neurosci 2016; 196:91-104. [DOI: 10.1016/j.autneu.2016.01.001] [Citation(s) in RCA: 106] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Revised: 12/17/2015] [Accepted: 01/05/2016] [Indexed: 01/22/2023]
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Forreider B, Pozivilko D, Kawaji Q, Geng X, Ding Y. Hibernation-like neuroprotection in stroke by attenuating brain metabolic dysfunction. Prog Neurobiol 2016; 157:174-187. [PMID: 26965388 DOI: 10.1016/j.pneurobio.2016.03.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 03/02/2016] [Accepted: 03/03/2016] [Indexed: 11/24/2022]
Abstract
Many mammalian species naturally undergo hibernation, a process that is associated with drastic changes in metabolism and systemic physiology. Their ability to retain an undamaged central nervous system during severely reduced cerebral blood flow has been studied for possible therapeutic application in human ischemic stroke. By inducing a less extreme 'hibernation-like' state, it has been hypothesized that similar neuroprotective effects reduce ischemia-mediated tissue damage in stroke patients. This manuscript includes reviews and evaluations of: (1) true hibernation, (2) hibernation-like state and its neuroprotective characteristics, (3) the preclinical and clinical methods for induction of artificial hibernation (i.e., therapeutic hypothermia, phenothiazine drugs, and ethanol), and (4) the mechanisms by which cerebral ischemia leads to tissue damage and how the above-mentioned induction methods function to inhibit those processes.
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Affiliation(s)
- Brian Forreider
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - David Pozivilko
- Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Qingwen Kawaji
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Xiaokun Geng
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA; China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China.
| | - Yuchuan Ding
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA; China-America Institute of Neuroscience, Luhe Hospital, Capital Medical University, Beijing, China.
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Tracy B, Armola R, Micham J. The "cold cord": a review of therapeutic hypothermia for traumatic spinal cord injuries. Am J Crit Care 2015; 24:540-3. [PMID: 26523013 DOI: 10.4037/ajcc2015879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Brett Tracy
- Brett Tracy is a third-year general surgery resident at Memorial Health University Medical Center, Savannah, Georgia. Rochelle Armola is director of trauma and The Ochsner Institute for Injury Research and Prevention, Memorial Health University Medical Center, Savannah, Georgia. Jennifer Micham is the NICHE coordinator at ProMedica Toledo Hospital, Toledo, Ohio
| | - Rochelle Armola
- Brett Tracy is a third-year general surgery resident at Memorial Health University Medical Center, Savannah, Georgia. Rochelle Armola is director of trauma and The Ochsner Institute for Injury Research and Prevention, Memorial Health University Medical Center, Savannah, Georgia. Jennifer Micham is the NICHE coordinator at ProMedica Toledo Hospital, Toledo, Ohio
| | - Jennifer Micham
- Brett Tracy is a third-year general surgery resident at Memorial Health University Medical Center, Savannah, Georgia. Rochelle Armola is director of trauma and The Ochsner Institute for Injury Research and Prevention, Memorial Health University Medical Center, Savannah, Georgia. Jennifer Micham is the NICHE coordinator at ProMedica Toledo Hospital, Toledo, Ohio
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