1
|
Hu Q, Zhang R, Dong X, Yang D, Yu W, Du Q. Huperzine A ameliorates neurological deficits after spontaneous subarachnoid hemorrhage through endothelial cell pyroptosis inhibition. Acta Biochim Biophys Sin (Shanghai) 2024; 56:645-656. [PMID: 38529553 DOI: 10.3724/abbs.2024037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/27/2024] Open
Abstract
Spontaneous subarachnoid hemorrhage (SAH) is a kind of hemorrhagic stroke which causes neurological deficits in survivors. Huperzine A has a neuroprotective effect, but its role in SAH is unclear. Therefore, we explore the effect of Huperzine A on neurological deficits induced by SAH and the related mechanism. In this study, Evans blue assay, TUNEL staining, immunofluorescence, western blot analysis, and ELISA are conducted. We find that Huperzine A can improve neurological deficits and inhibit the apoptosis of nerve cells in SAH rats. Huperzine A treatment can improve the upregulation of brain water content, damage of blood-brain barrier, fibrinogen and matrix metalloprotein 9 expressions and the downregulation of ZO-1 and occludin expressions induced by SAH. Huperzine A inhibit the expressions of proteins involved in pyroptosis in endothelial cells in SAH rats. The increase in MDA content and decrease in SOD activity in SAH rats can be partly reversed by Huperzine A. The ROS inducer H 2O 2 can induce pyroptosis and inhibit the expressions of ZO-1 and occludin in endothelial cells, which can be blocked by Huperzine A. In addition, the increase in the entry of p65 into the nucleus in endothelial cells can be partly reversed by Huperzine A. Huperzine A may delay the damage of blood-brain barrier in SAH rats by inhibiting oxidative stress-mediated pyroptosis and tight junction protein expression downregulation through the NF-κB pathway. Overall, Huperzine A may have clinical value for treating SAH.
Collapse
Affiliation(s)
- Qiang Hu
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310000, China
- Department of Neurosurgery, Nanjing Medical University Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, Hangzhou 310000, China
| | - Rong Zhang
- Medical Examination Center, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310000, China
| | - Xiaoqiao Dong
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310000, China
- Department of Neurosurgery, Nanjing Medical University Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, Hangzhou 310000, China
| | - Dingbo Yang
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310000, China
- Department of Neurosurgery, Nanjing Medical University Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, Hangzhou 310000, China
| | - Wenhua Yu
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310000, China
- Department of Neurosurgery, Nanjing Medical University Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, Hangzhou 310000, China
| | - Quan Du
- Department of Neurosurgery, Affiliated Hangzhou First People's Hospital, Westlake University School of Medicine, Hangzhou 310000, China
- Department of Neurosurgery, Nanjing Medical University Affiliated Hangzhou Hospital, Hangzhou First People's Hospital, Hangzhou 310000, China
| |
Collapse
|
2
|
Wiśniewski K, Popęda M, Price B, Bieńkowski M, Fahlström A, Drummond K, Adamides AA. Glucose-6-phosphate dehydrogenase and 8-iso-prostaglandin F2α as potential predictors of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage. J Neurosurg 2023; 139:698-707. [PMID: 36640097 DOI: 10.3171/2022.12.jns222332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 12/07/2022] [Indexed: 01/15/2023]
Abstract
OBJECTIVE Delayed cerebral ischemia (DCI) is a serious complication of aneurysmal subarachnoid hemorrhage (aSAH), which is responsible for significant death and disability. The dynamic balance between the production and elimination of reactive oxygen species (ROS) in patients with DCI is suspected be shifted to favor ROS formation. The authors assessed the relationship between F2-isoprostanes (F2-IsoPs), oxidative stress biomarkers, and glucose-6-phosphate dehydrogenase (G6PD), which are responsible for nicotinamide adenine dinucleotide phosphate (NADPH) production for glutathione system function, with post-aSAH DCI. METHODS The authors assessed 45 aSAH patients for F2-IsoP and G6PD concentration using commercial ELISA on days 2, 4, and 6 after aSAH. The authors examined the correlation between plasma F2-IsoP and G6PD concentrations and clinical factors with DCI occurrence and aSAH outcome. RESULTS Expectedly, the most important clinical predictors of DCI were Hunt and Hess grade and modified Fisher (mFisher) grade. Plasma F2-IsoP and G6PD concentrations were greater in aSAH patients than the control group (p < 0.01). F2-IsoP concentrations were greater and G6PD concentrations were lower in patients with DCI than those without (p < 0.01). Plasma F2-IsoP and G6PD concentrations on day 2 were correlated with DCI occurrence (p < 0.01). Plasma F2-IsoP concentrations on days 2 and 6 were correlated with outcome at 1 and 12 months (p < 0.01). CONCLUSIONS Decreased G6PD indirectly informs the reduced antioxidant response, especially for the glutathione system. G6PD concentration was lower in patients with DCI than those without, which may explain the increased F2-IsoP concentrations. mFisher grade, plasma F2-IsoP concentration, and G6PD concentration on day 2 after aSAH, in combination, may serve as predictors of DCI. Further research is necessary to investigate the therapeutic utility of F2-IsoPs and antioxidants in clinical practice.
Collapse
Affiliation(s)
- Karol Wiśniewski
- 1Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- 2Department of Neurosurgery and Neurooncology, Medical University of Łódź, Łódzkie, Poland
| | - Marta Popęda
- 3Department of Pathomorphology, Medical University of Gdańsk, Pomorskie, Poland
| | - Benjamin Price
- 1Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Michał Bieńkowski
- 3Department of Pathomorphology, Medical University of Gdańsk, Pomorskie, Poland
| | - Andreas Fahlström
- 1Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- 4Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden; and
| | - Katharine Drummond
- 1Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- 5Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Victoria, Australia
| | - Alexios A Adamides
- 1Department of Neurosurgery, Royal Melbourne Hospital, Melbourne, Victoria, Australia
- 5Department of Surgery, Royal Melbourne Hospital, University of Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Nguyen A, Patel AB, Kioutchoukova IP, Diaz MJ, Lucke-Wold B. Mechanisms of Mitochondrial Oxidative Stress in Brain Injury: From Pathophysiology to Therapeutics. OXYGEN (BASEL, SWITZERLAND) 2023; 3:163-178. [PMID: 37082315 PMCID: PMC10111246 DOI: 10.3390/oxygen3020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
Mitochondrial oxidative stress has been implicated in various forms of brain injury, both traumatic and non-traumatic. Due to its oxidative demand, the brain is intimately dependent on its mitochondrial functioning. However, there remains appreciable heterogeneity in the development of these injuries regarding ROS and their effect on the sequelae. These include traumatic insults such as TBIs and intracranial hemorrhaging secondary to this. In a different vein, such injuries may be attributed to other etiologies such as infection, neoplasm, or spontaneous hemorrhage (strokes, aneurysms). Clinically, the manner of treatment may also be adjusted in relation to each injury and its unique progression in the context of ROS. In the current review, then, the authors highlight the role of mitochondrial ROS in various forms of brain injury, emphasizing both the collective and unique elements of each form. Lastly, these narratives are met with the current therapeutic landscape and the role of emerging therapies in treating reactive oxygen species in brain injuries.
Collapse
Affiliation(s)
- Andrew Nguyen
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Anjali B. Patel
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | | | - Michael J. Diaz
- College of Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Brandon Lucke-Wold
- Department of Neurosurgery, University of Florida, 1600 SW Archer Rd., Gainesville, FL 32610, USA
| |
Collapse
|
4
|
Santana D, Mosteiro A, Pedrosa L, Llull L, Torné R, Amaro S. Clinical relevance of glucose metrics during the early brain injury period after aneurysmal subarachnoid hemorrhage: An opportunity for continuous glucose monitoring. Front Neurol 2022; 13:977307. [PMID: 36172028 PMCID: PMC9512056 DOI: 10.3389/fneur.2022.977307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Hyperglycaemia, hypoglycaemia and higher glucose variability during the Early Brain Injury (EBI) period of aneurysmal subarachnoid hemorrhage (aSAH) have been associated with poor clinical outcome. However, it is unclear whether these associations are due to direct glucose-driven injury or if hyperglycaemia simply acts as a marker of initial severity. Actually, strict glucose control with intensive insulin therapy has not been demonstrated as an effective strategy for improving clinical outcomes after aSAH. Currently published studies describing an association between hyperglycaemia and prognosis in aSAH patients have been based on isolated glucose measurements and did not incorporate comprehensive dynamic evaluations, such as those derived from subcutaneous continuous glucose monitoring devices (CMG). Arguably, a more accurate knowledge on glycaemic patterns during the acute phase of aSAH could increase our understanding of the relevance of glycaemia as a prognostic factor in this disease as well as to underpin its contribution to secondary focal and diffuse brain injury. Herein, we have summarized the available evidence on the diagnostic and prognostic relevance of glucose metrics during the acute phase of cerebrovascular diseases, focusing in the EBI period after aSAH. Overall, obtaining a more precise scope of acute longitudinal glucose profiles could eventually be useful for improving glucose management protocols in the setting of acute aSAH and to advance toward a more personalized management of aSAH patients during the EBI phase.
Collapse
Affiliation(s)
- Daniel Santana
- Comprehensive Stroke Center, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Alejandra Mosteiro
- Neurosurgery Department, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
| | - Leire Pedrosa
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Laura Llull
- Comprehensive Stroke Center, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ramón Torné
- Neurosurgery Department, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- *Correspondence: Ramón Torné
| | - Sergi Amaro
- Comprehensive Stroke Center, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain
- Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain
- Department of Medicine, Faculty of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
- Sergi Amaro
| |
Collapse
|
5
|
Antioxidant therapies in traumatic brain injury. Neurochem Int 2021; 152:105255. [PMID: 34915062 DOI: 10.1016/j.neuint.2021.105255] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 12/07/2021] [Accepted: 12/10/2021] [Indexed: 12/24/2022]
Abstract
Oxidative stress plays a crucial role in traumatic brain injury (TBI) pathogenesis. Reactive oxygen species (ROS) and reactive nitrogen species (RNS) formed in excess after TBI synergistically contribute to secondary brain damage together with lipid peroxidation products (reactive aldehydes) and inflammatory mediators. Furthermore, oxidative stress, endoplasmic reticulum stress and inflammation potentiate each other. Following TBI, excessive oxidative stress overloads the endogenous cellular antioxidant system leading to cell death. To combat oxidative stress, several antioxidant therapies were tested in preclinical animal models of TBI. These include free radical scavengers, activators of antioxidant systems, Inhibitors of free radical generating enzymes and antioxidant enzymes. Many of these therapies showed promising outcomes including reduced edema, blood-brain barrier (BBB) protection, smaller contusion volume, and less inflammation. In addition, many antioxidant therapies also promoted better sensory, motor, and cognitive functional recovery after TBI. Overall, preventing oxidative stress is a viable therapeutic option to minimize the secondary damage and to improve the quality of life after TBI.
Collapse
|
6
|
Wu F, Liu Z, Li G, Zhou L, Huang K, Wu Z, Zhan R, Shen J. Inflammation and Oxidative Stress: Potential Targets for Improving Prognosis After Subarachnoid Hemorrhage. Front Cell Neurosci 2021; 15:739506. [PMID: 34630043 PMCID: PMC8497759 DOI: 10.3389/fncel.2021.739506] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/20/2021] [Indexed: 12/13/2022] Open
Abstract
Subarachnoid hemorrhage (SAH) has a high mortality rate and causes long-term disability in many patients, often associated with cognitive impairment. However, the pathogenesis of delayed brain dysfunction after SAH is not fully understood. A growing body of evidence suggests that neuroinflammation and oxidative stress play a negative role in neurofunctional deficits. Red blood cells and hemoglobin, immune cells, proinflammatory cytokines, and peroxidases are directly or indirectly involved in the regulation of neuroinflammation and oxidative stress in the central nervous system after SAH. This review explores the role of various cellular and acellular components in secondary inflammation and oxidative stress after SAH, and aims to provide new ideas for clinical treatment to improve the prognosis of SAH.
Collapse
Affiliation(s)
- Fan Wu
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zongchi Liu
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ganglei Li
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Lihui Zhou
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Kaiyuan Huang
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Zhanxiong Wu
- College of Electronics and Information, Hangzhou Dianzi University, Hangzhou, China
| | - Renya Zhan
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jian Shen
- First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.,Department of Neurosurgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| |
Collapse
|
7
|
Oguzoglu AS, Senol N, Asci H, Erzurumlu Y, Gulle K, Savran M, Sadef M, Acar BG, Goksel HM. Pregabalin Protects Brain Tissue from Subarachnoid Hemorrhage by Enhancing HIF-1α/eNOS Signaling and VEGF Production. World Neurosurg 2021; 152:e713-e720. [PMID: 34129987 DOI: 10.1016/j.wneu.2021.06.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 01/25/2023]
Abstract
OBJECTIVE We investigated the effects of different doses of pregabalin on the pathophysiologic changes in early brain injury after subarachnoid hemorrhage (SAH) in rats. METHODS Thirty-eight Wistar albino rats were divided into 4 groups: control (n = 8), SAH (n = 10), SAH plus 30 mg/kg/day of pregabalin (n = 10), and SAH plus 60 mg/kg/day of pregabalin (n = 10). SAH was induced with 0.3 mL of autologous blood injected to the cisterna magna of rats. Pregabalin was administered intraperitoneally. Oxidative stress markers, mRNA expression of endothelial nitric oxide synthase, hypoxia-inducible factor-1α, and vascular endothelial growth factor, and histopathological changes were evaluated. RESULTS Pregabalin increased mRNA expression of endothelial nitric oxide synthase, hypoxia-inducible factor-1α, and vascular endothelial growth factor in a dose-dependent manner. Significant improvement in the histopathological parameters was observed at 60 mg/kg, including a decrease in diffuse hemorrhagic areas, edema and apoptotic bodies in the associated cortical area, evident vacuolization in the hippocampal area, and apoptotic bodies. However, these improvements were not observed with the lower dose (30 mg/kg). In contrast, the antioxidant effect was greater with 30 mg/kg of pregabalin than with 60 mg/kg. CONCLUSIONS Although the antioxidant effect was significant with the lower dose of pregabalin, the anti-inflammatory effects via vasodilatation were more marked with the higher dose. Significant improvements in the histopathological changes were observed with the higher dose of pregabalin. The dose-dependent effects of pregabalin on SAH should be evaluated in animal studies as a function of time and in the acute and chronic phases.
Collapse
Affiliation(s)
- Ali Serdar Oguzoglu
- Department of Neurosurgery, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Nilgun Senol
- Department of Neurosurgery, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey.
| | - Halil Asci
- Department of Medical Pharmacology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Yalcin Erzurumlu
- Department of Biochemistry, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Kanat Gulle
- Departments of Histology and Embryology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Mehtap Savran
- Department of Medical Pharmacology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Mustafa Sadef
- Department of Neurosurgery, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Berivan Gunduru Acar
- Department of Medical Pharmacology, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| | - Hakan Murat Goksel
- Department of Neurosurgery, Suleyman Demirel University, Faculty of Medicine, Isparta, Turkey
| |
Collapse
|
8
|
Jayamanoharan S, Mangum JE, Stylli S, Ziogas J, Adamides AA. Association between elevated cerebrospinal fluid D-dimer levels and delayed cerebral ischaemia after aneurysmal subarachnoid haemorrhage. J Clin Neurosci 2020; 76:177-182. [PMID: 32321663 DOI: 10.1016/j.jocn.2020.04.041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 04/04/2020] [Indexed: 11/17/2022]
Abstract
Delayed cerebral ischaemia (DCI) after aneurysmal subarachnoid haemorrhage (aSAH) is a major contributor to morbidity and mortality. It is currently not possible to reliably predict patients at risk of DCI after aSAH. The aim of this study was to quantify cerebrospinal fluid (CSF) D-Dimer and plasminogen levels and to investigate any association with development of DCI. Cerebrospinal fluid (CSF) samples collected from 30 patients within 72 h post-aSAH (n = 13 DCI and n = 17 non-DCI patients) were analysed. DCI was diagnosed when angiographic vasospasm was detected in the presence of new onset neurological deficit. Enzyme-linked immunosorbent assays were used to quantify D-dimer concentrations while western blotting was used to quantify plasminogen levels. Significant differences in CSF proteins between DCI and non-DCI cohorts were verified using Mann-Whitney test. Sensitivity and specificity of these proteins for detecting DCI was examined using a ROC curve and verified with a Fischer's exact test. CSF levels of D-dimer within 72 h post aSAH were significantly elevated in DCI patients (54.29 ng/ml, 25.35-105.88 ng/ml) compared to non-DCI patients (26.75 ng/ml, 6.9-45.08 ng/ml) [p = 0.03]. In our sample population, D-dimer levels above 41.1 ng/ml had a sensitivity of 69.2% and specificity of 75% for predicting DCI. CSF levels of plasminogen (DCI: 0.50 signal-intensity/μl, 0.20-0.73 signal-intensity/μl, non-DCI: 0.28 signal-intensity/μl, 0.22-0.54 signal-intensity/μl) did not differ between the DCI and non-DCI cohort (p > 0.05). Our study suggests that elevated D-dimer in the first 72 h after aSAH may be a potential predictive biomarker for DCI.
Collapse
Affiliation(s)
| | - Jonathan E Mangum
- Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Stanley Stylli
- Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC 3050, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria 3010, Australia
| | - James Ziogas
- Department of Pharmacology and Therapeutics, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Alexios A Adamides
- Department of Neurosurgery, Royal Melbourne Hospital, 300 Grattan St, Parkville, VIC 3050, Australia; Department of Surgery, University of Melbourne, Parkville, Victoria 3010, Australia.
| |
Collapse
|
9
|
Muballe KD, Sewani-Rusike CR, Longo-Mbenza B, Iputo J. Predictors of recovery in moderate to severe traumatic brain injury. J Neurosurg 2019; 131:1648-1657. [PMID: 30497133 DOI: 10.3171/2018.4.jns172185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Accepted: 04/05/2018] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Traumatic brain injury (TBI) is a significant cause of morbidity and mortality worldwide. Clinical outcomes in TBI are determined by the severity of injury, which is dependent on the primary and secondary brain injury processes. Whereas primary brain injury lesions are related to the site of impact, secondary brain injury results from physiological changes caused by oxidative stress and inflammatory responses that occur after the primary insult. The aim of this study was to identify important clinical and biomarker profiles that were predictive of recovery after moderate to severe TBI. A good functional outcome was defined as a Glasgow Outcome Scale (GOS) score of ≥ 4. METHODS This was a prospective study of patients with moderate to severe TBI managed at the Nelson Mandela Academic Hospital during the period between March 2014 and March 2016. Following admission and initial management, the patient demographic data (sex, age) and admission Glasgow Coma Scale score were recorded. Oxidative stress and inflammatory biomarkers in blood and CSF were sampled on days 1-7. On day 14, only blood was sampled for the same biomarkers. The primary outcome was the GOS score-due to its simplicity, the GOS was used to assess clinical outcomes at day 90. Because of difficulty in performing regular follow-up due to the vastness of the region, difficult terrain, and long travel distances, a 3-month follow-up period was used to avoid default. RESULTS Sixty-four patients with Glasgow Coma Scale scores of ≤ 12 were seen and managed. Among the 56 patients who survived, 42 showed significant recovery (GOS score ≥ 4) at 3 months. Important predictors of recovery included antioxidant activity in the CSF (superoxide dismutase and total antioxidant capacity). CONCLUSIONS Recovery after TBI was dependent on the resolution of oxidative stress imbalance.
Collapse
Affiliation(s)
| | | | - Benjamin Longo-Mbenza
- 3Public Health, Walter Sisulu University, Mthatha, Eastern Cape Province, South Africa
| | | |
Collapse
|
10
|
Jeong HG, Cha BG, Kang DW, Kim DY, Ki SK, Kim SI, Han JH, Yang W, Kim CK, Kim J, Lee SH. Ceria Nanoparticles Synthesized With Aminocaproic Acid for the Treatment of Subarachnoid Hemorrhage. Stroke 2019; 49:3030-3038. [PMID: 30571409 DOI: 10.1161/strokeaha.118.022631] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Background and Purpose- Despite early aneurysm repair and aggressive management for complications, subarachnoid hemorrhage (SAH) results in at least 25% mortality rate and 50% persistent neurological deficit. We investigated whether ceria nanoparticles which have potent antioxidative activities can protect against subarachnoid hemorrhage via attenuating fatal brain injuries. Methods- Uniform, 3 nm, water-dispersed ceria nanoparticles were prepared from short sol-gel reaction of cerium (III) ions with aminocaproic acid in aqueous phase. SAH was induced by endovascular perforation of middle cerebral artery of rats. A single dose of ceria nanoparticles (0.5 mg Ce/kg) or saline control was randomly administered intravenously at an hour post-SAH. Neuronal death, macrophage infiltration, SAH grade, and brain edema were evaluated at 72 hours. Mortality and neurological function were assessed for 14 days. Results- The obtained ceria nanoparticles with high Ce3+ to Ce4+ ratio demonstrated potent antioxidative, cytoprotective, and anti-inflammatory activities in vitro. In rodent SAH models, the severity of hemorrhage was comparable between the ceria nanoparticles- and saline-treated groups. However, ceria nanoparticles significantly reduced neuronal death, macrophage infiltration, and brain edema after SAH. Ceria nanoparticles successfully improved survival rates (88.2% in the ceria nanoparticles group versus 21.1% in the control group; P<0.001) and neurological outcomes (modified Garcia score: 12.1±0.5 in the ceria nanoparticles group versus 4.4±0.5 in the control group; P<0.001) of the animals with SAH. Conclusions- Ceria nanoparticles, totally synthesized in aqueous phase using aminocaproic acid, demonstrated promising results against SAH via potent antioxidative, neuroprotective and anti-inflammatory activities. Given the obvious limitations of current therapies for SAH, ceria nanoparticles can be a potential therapeutic agent which might result in a paradigm shift in SAH treatment.
Collapse
Affiliation(s)
- Han-Gil Jeong
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Bong Geun Cha
- School of Chemical Engineering (B.G.C., J.K.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Dong-Wan Kang
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Do Yeon Kim
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Seul Ki Ki
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Song I Kim
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Ju Hee Han
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Wookjin Yang
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Chi Kyung Kim
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea.,Department of Neurology, Korea University Guro Hospital and Korea University College of Medicine, Seoul (C.K.K.)
| | - Jaeyun Kim
- School of Chemical Engineering (B.G.C., J.K.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea.,Department of Health Sciences and Technology, Samsung Advanced Institute for Health Science & Technology (SAIHST) (J.K.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea.,Biomedical Institute for Convergence (BICS) (J.K.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Seung-Hoon Lee
- From the Laboratory of Innovative Nanotechnology, Biomedical Research Institute and Department of Neurology, Seoul National University Hospital, Republic of Korea (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.).,Korean Cerebrovascular Research Institute, Seoul (H.-G.J., D.-W.K., D.Y.K., S.K.K., S.I.K., J.h.H., W.Y., C.K.K., S.-H.L.), Sungkyunkwan University (SKKU), Suwon, Republic of Korea.,Center for Nanoparticle Research, Institute for Basic Science (IBS), Seoul, Republic of Korea (S.-H.L.)
| |
Collapse
|
11
|
Mo J, Enkhjargal B, Travis ZD, Zhou K, Wu P, Zhang G, Zhu Q, Zhang T, Peng J, Xu W, Ocak U, Chen Y, Tang J, Zhang J, Zhang JH. AVE 0991 attenuates oxidative stress and neuronal apoptosis via Mas/PKA/CREB/UCP-2 pathway after subarachnoid hemorrhage in rats. Redox Biol 2019; 20:75-86. [PMID: 30296700 PMCID: PMC6174866 DOI: 10.1016/j.redox.2018.09.022] [Citation(s) in RCA: 117] [Impact Index Per Article: 23.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/21/2018] [Accepted: 09/27/2018] [Indexed: 01/13/2023] Open
Abstract
Oxidative stress and neuronal apoptosis have been demonstrated to be key features in early brain injury (EBI) after subarachnoid hemorrhage (SAH). Previous studies have indicated that Mas receptor activation initiates an anti-oxidative and anti-apoptotic role in the brain. However, whether Mas activation can attenuate oxidative stress and neuronal apoptosis after SAH remains unknown. To investigate the beneficial effect of Mas on oxidative stress injury and neuronal apoptosis induced by SAH, a total of 196 rats were subjected to an endovascular perforation model of SAH. AVE 0991 (AVE), a selective agonist of Mas, was administered intranasally 1 h after SAH induction. A779, a selective inhibitor of Mas, and small interfering ribonucleic acid (siRNA) for UCP-2 were administered by intracerebroventricular (i.c.v) injection at 1 h and 48 h before SAH induction respectively. Neurological tests, immunofluorescence, TUNEL, Fluoro-Jade C, DHE staining, and Western blot experiments were performed. We found that Mas activation with AVE significantly improved neurobehavioral scores and reduced oxidative stress and neuronal apoptosis in SAH+AVE group compared with SAH+vehicle group. Moreover, AVE treatment significantly promoted phosphorylation of CREB and the expression UCP-2, as well as upregulated expression of Bcl-2 and downregulation of Romo-1 and Bax. The protective effects of AVE were reversed by i.c.v injection of A779 and UCP-2 siRNA in SAH+AVE+A779 and SAH+AVE+UCP-2 siRNA groups, respectively. In conclusion, our data provides evidence that Mas activation with AVE reduces oxidative stress injury and neuronal apoptosis through Mas/PKA/p-CREB/UCP-2 pathway after SAH. Furthermore, our study indicates that Mas may be a novel therapeutic treatment target in early brain injury of SAH.
Collapse
Affiliation(s)
- Jun Mo
- Department of Neurosurgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang, China; Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA; Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Budbazar Enkhjargal
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Zachary D Travis
- Department of Earth and Biological Sciences, Loma Linda University, Loma Linda, CA 92350, USA
| | - Keren Zhou
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA; Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Pei Wu
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Guangyu Zhang
- Mass Spectrometry Core Facility, Loma Linda University, Loma Linda, CA 92350, USA
| | - Qiquan Zhu
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Tongyu Zhang
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Jianhua Peng
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Weilin Xu
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA; Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China
| | - Umut Ocak
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Yili Chen
- Department of Neurosurgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang, China
| | - Jiping Tang
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA
| | - Jianmin Zhang
- Department of Neurosurgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu 322000, Zhejiang, China; Department of Neurosurgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang, China; Brain Research Institute, Zhejiang University, Hangzhou 310000, Zhejiang, China.
| | - John H Zhang
- Department of Physiology and Pharmacology, Loma Linda University, Loma Linda, CA 92350, USA; Department of Anesthesiology, Loma Linda University, Loma Linda, CA 92350, USA; Department of Neurosurgery, Loma Linda University, Loma Linda, CA 92350, USA.
| |
Collapse
|
12
|
Traumatic brain injury and NADPH oxidase: a deep relationship. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2015; 2015:370312. [PMID: 25918580 PMCID: PMC4397034 DOI: 10.1155/2015/370312] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/15/2015] [Accepted: 03/18/2015] [Indexed: 12/21/2022]
Abstract
Traumatic brain injury (TBI) represents one of the major causes of mortality and disability in the world.
TBI is characterized by primary damage resulting from the mechanical forces applied to the head as a direct result of the trauma and by the subsequent secondary injury due to a complex cascade of biochemical events that eventually lead to neuronal cell death. Oxidative stress plays a pivotal role in the genesis of the delayed harmful effects contributing to permanent damage. NADPH oxidases (Nox), ubiquitary membrane multisubunit enzymes whose unique function is the production of reactive oxygen species (ROS), have been shown to be a major source of ROS in the brain and to be involved in several neurological diseases. Emerging evidence demonstrates that Nox is upregulated after TBI, suggesting Nox critical role in the onset and development of this pathology.
In this review, we summarize the current evidence about the role of Nox enzymes in the pathophysiology of TBI.
Collapse
|
13
|
Budohoski KP, Guilfoyle M, Helmy A, Huuskonen T, Czosnyka M, Kirollos R, Menon DK, Pickard JD, Kirkpatrick PJ. The pathophysiology and treatment of delayed cerebral ischaemia following subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry 2014; 85:1343-53. [PMID: 24847164 DOI: 10.1136/jnnp-2014-307711] [Citation(s) in RCA: 183] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Cerebral vasospasm has traditionally been regarded as an important cause of delayed cerebral ischaemia (DCI) which occurs after aneurysmal subarachnoid haemorrhage, and often leads to cerebral infarction and poor neurological outcome. However, data from recent studies argue against a pure focus on vasospasm as the cause of delayed ischaemic complications. Findings that marked reduction in the incidence of vasospasm does not translate to a reduction in DCI, or better outcomes has intensified research into other possible mechanisms which may promote ischaemic complications. Early brain injury and cell death, blood-brain barrier disruption and initiation of an inflammatory cascade, microvascular spasm, microthrombosis, cortical spreading depolarisations and failure of cerebral autoregulation, have all been implicated in the pathophysiology of DCI. This review summarises the current knowledge about the mechanisms underlying the development of DCI. Furthermore, it aims to describe and categorise the known pharmacological treatment options with respect to the presumed mechanism of action and its role in DCI.
Collapse
Affiliation(s)
- Karol P Budohoski
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Mathew Guilfoyle
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Adel Helmy
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Terhi Huuskonen
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK Department of Neurosurgery, Kuopio Neurocenter, Kuopio University Hospital, Kuopio, Finland
| | - Marek Czosnyka
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Ramez Kirollos
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - David K Menon
- Department of Anaesthesiology, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - John D Pickard
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| | - Peter J Kirkpatrick
- Division of Neurosurgery, Department of Clinical Neurosciences, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
| |
Collapse
|
14
|
Biomarkers of vasospasm development and outcome in aneurysmal subarachnoid hemorrhage. J Neurol Sci 2014; 341:119-27. [DOI: 10.1016/j.jns.2014.04.020] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Revised: 03/20/2014] [Accepted: 04/14/2014] [Indexed: 12/30/2022]
|
15
|
Chen S, Feng H, Sherchan P, Klebe D, Zhao G, Sun X, Zhang J, Tang J, Zhang JH. Controversies and evolving new mechanisms in subarachnoid hemorrhage. Prog Neurobiol 2014; 115:64-91. [PMID: 24076160 PMCID: PMC3961493 DOI: 10.1016/j.pneurobio.2013.09.002] [Citation(s) in RCA: 270] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 09/07/2013] [Accepted: 09/12/2013] [Indexed: 12/13/2022]
Abstract
Despite decades of study, subarachnoid hemorrhage (SAH) continues to be a serious and significant health problem in the United States and worldwide. The mechanisms contributing to brain injury after SAH remain unclear. Traditionally, most in vivo research has heavily emphasized the basic mechanisms of SAH over the pathophysiological or morphological changes of delayed cerebral vasospasm after SAH. Unfortunately, the results of clinical trials based on this premise have mostly been disappointing, implicating some other pathophysiological factors, independent of vasospasm, as contributors to poor clinical outcomes. Delayed cerebral vasospasm is no longer the only culprit. In this review, we summarize recent data from both experimental and clinical studies of SAH and discuss the vast array of physiological dysfunctions following SAH that ultimately lead to cell death. Based on the progress in neurobiological understanding of SAH, the terms "early brain injury" and "delayed brain injury" are used according to the temporal progression of SAH-induced brain injury. Additionally, a new concept of the vasculo-neuronal-glia triad model for SAH study is highlighted and presents the challenges and opportunities of this model for future SAH applications.
Collapse
Affiliation(s)
- Sheng Chen
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China; Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - Hua Feng
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Prativa Sherchan
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - Damon Klebe
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - Gang Zhao
- Department of Neurology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shanxi, China
| | - Xiaochuan Sun
- Department of Neurosurgery, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jianmin Zhang
- Department of Neurosurgery, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiping Tang
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA
| | - John H Zhang
- Department of Physiology & Pharmacology, Loma Linda University, Loma Linda, CA, USA; Department of Neurosurgery, Loma Linda University, Loma Linda, CA, USA.
| |
Collapse
|
16
|
Dong YS, Wang JL, Feng DY, Qin HZ, Wen H, Yin ZM, Gao GD, Li C. Protective effect of quercetin against oxidative stress and brain edema in an experimental rat model of subarachnoid hemorrhage. Int J Med Sci 2014; 11:282-90. [PMID: 24516353 PMCID: PMC3917118 DOI: 10.7150/ijms.7634] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 01/06/2014] [Indexed: 12/22/2022] Open
Abstract
Quercetin has been demonstrated to play an important role in altering the progression of ischemic brain injuries and neurodegenerative diseases by protecting against oxidative stress. The effects of quercetin on brain damage after subarachnoid hemorrhage (SAH), however, have not been investigated. This study was designed to explore the effects of quercetin on oxidative stress and brain edema after experimental SAH using four equal groups (n = 16) of adult male Sprague-Dawley (SD) rats, including a sham group, an SAH + vehicle group, an SAH + quercetin10 group, and an SAH + quercetin50 group. The rat SAH model was induced by injection of 0.3 ml of non-heparinised arterial blood into the prechiasmatic cistern. In the SAH + quercetin10 and SAH + quercetin50 groups, doses of 10 mg/kg and 50 mg/kg quercetin, respectively, were directly administered by intraperitoneal injection at 30 min, 12 h, and 24 h after SAH induction. Cerebral tissue samples were extracted for enzymatic antioxidant determination, lipid peroxidation assay, caspase-3 activity and water content testing 48 h after SAH. Treatment with a high dose (50 mg/kg) of quercetin markedly enhanced the activities of copper/zinc superoxide dismutase (CuZn-SOD) and glutathione peroxidase (GSH-Px), and treatment with this dose significantly reduced the level of malondialdehyde (MDA). Caspase-3 and brain edema was ameliorated and neurobehavioral deficits improved in rats that received the high dose of quercetin. The findings suggest that the early administration of optimal dose of quercetin may ameliorate brain damage and provide neuroprotection in the SAH model, potentially by enhancing the activity of endogenous antioxidant enzymes and inhibiting free radical generation.
Collapse
Affiliation(s)
- Yu-shu Dong
- 1. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710032, PR China. ; 2. Department of Neurosurgery, 463rd Hospital of PLA, Shenyang 110042, PR China
| | - Ju-lei Wang
- 1. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710032, PR China. ; 3. Department of Neurosurgery, Wuhan General Hospital of Guangzhou Military Command, Wuhan 430070, PR China
| | - Da-yun Feng
- 1. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710032, PR China
| | - Huai-zhou Qin
- 1. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710032, PR China
| | - Hua Wen
- 2. Department of Neurosurgery, 463rd Hospital of PLA, Shenyang 110042, PR China
| | - Zhong-min Yin
- 2. Department of Neurosurgery, 463rd Hospital of PLA, Shenyang 110042, PR China
| | - Guo-dong Gao
- 1. Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an 710032, PR China
| | - Chuan Li
- 4. Department of Medical Administration, General Hospital of Shenyang Military Command, Shenyang 110016, PR China
| |
Collapse
|
17
|
Abstract
Brain injury after subarachnoid hemorrhage (SAH) is a biphasic event with an acute ischemic insult at the time of the initial bleed and secondary events such as cerebral vasospasm 3 to 7 days later. Although much has been learned about the delayed effects of SAH, less is known about the mechanisms of acute SAH-induced injury. Distribution of blood in the subarachnoid space, elevation of intracranial pressure, reduced cerebral perfusion and cerebral blood flow (CBF) initiates the acute injury cascade. Together they lead to direct microvascular injury, plugging of vessels and release of vasoactive substances by platelet aggregates, alterations in the nitric oxide (NO)/nitric oxide synthase (NOS) pathways and lipid peroxidation. This review will summarize some of these mechanisms that contribute to acute cerebral injury after SAH.
Collapse
Affiliation(s)
- Fatima A Sehba
- Department of Neurosurgery, Mount Sinai School of Medicine, New York, NY 10029-6574, USA.
| | | |
Collapse
|
18
|
Sehba FA, Friedrich V. Cerebral microvasculature is an early target of subarachnoid hemorrhage. ACTA NEUROCHIRURGICA. SUPPLEMENT 2012; 115:199-205. [PMID: 22890669 DOI: 10.1007/978-3-7091-1192-5_37] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Most subarachnoid hemorrhage (SAH) patients exhibit clinical signs of cerebral ischemia at admission but no angiographic vasospasm. Consequently, the source of early cerebral ischemia is not understood. Parenchymal microvessels may contribute to early cerebral ischemia, but the low resolution of current imaging has prevented their analysis in SAH patients. Animal studies demonstrated that early after SAH structure and function of parenchymal vessels are compromised to the level that may very well contribute to early ischemia. We review these studies.
Collapse
Affiliation(s)
- Fatima A Sehba
- Department of Neurosurgery and Neurosciences, Mount Sinai School of Medicine, New York, NY 10029, USA.
| | | |
Collapse
|
19
|
Caner B, Hou J, Altay O, Fuj M, Zhang JH. Transition of research focus from vasospasm to early brain injury after subarachnoid hemorrhage. J Neurochem 2012; 123 Suppl 2:12-21. [DOI: 10.1111/j.1471-4159.2012.07939.x] [Citation(s) in RCA: 119] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Basak Caner
- Department of Physiology; Loma Linda University, School of Medicine; Loma Linda; California; USA
| | - Jack Hou
- Department of Physiology; Loma Linda University, School of Medicine; Loma Linda; California; USA
| | - Orhan Altay
- Department of Physiology; Loma Linda University, School of Medicine; Loma Linda; California; USA
| | - Mutsumi Fuj
- Department of Physiology; Loma Linda University, School of Medicine; Loma Linda; California; USA
| | | |
Collapse
|
20
|
Barry C, Turner RJ, Corrigan F, Vink R. New therapeutic approaches to subarachnoid hemorrhage. Expert Opin Investig Drugs 2012; 21:845-59. [DOI: 10.1517/13543784.2012.683113] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
21
|
Sehba FA, Hou J, Pluta RM, Zhang JH. The importance of early brain injury after subarachnoid hemorrhage. Prog Neurobiol 2012; 97:14-37. [PMID: 22414893 PMCID: PMC3327829 DOI: 10.1016/j.pneurobio.2012.02.003] [Citation(s) in RCA: 450] [Impact Index Per Article: 37.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Revised: 02/01/2012] [Accepted: 02/16/2012] [Indexed: 12/11/2022]
Abstract
Aneurysmal subarachnoid hemorrhage (aSAH) is a medical emergency that accounts for 5% of all stroke cases. Individuals affected are typically in the prime of their lives (mean age 50 years). Approximately 12% of patients die before receiving medical attention, 33% within 48 h and 50% within 30 days of aSAH. Of the survivors 50% suffer from permanent disability with an estimated lifetime cost more than double that of an ischemic stroke. Traditionally, spasm that develops in large cerebral arteries 3-7 days after aneurysm rupture is considered the most important determinant of brain injury and outcome after aSAH. However, recent studies show that prevention of delayed vasospasm does not improve outcome in aSAH patients. This finding has finally brought in focus the influence of early brain injury on outcome of aSAH. A substantial amount of evidence indicates that brain injury begins at the aneurysm rupture, evolves with time and plays an important role in patients' outcome. In this manuscript we review early brain injury after aSAH. Due to the early nature, most of the information on this injury comes from animals and few only from autopsy of patients who died within days after aSAH. Consequently, we began with a review of animal models of early brain injury, next we review the mechanisms of brain injury according to the sequence of their temporal appearance and finally we discuss the failure of clinical translation of therapies successful in animal models of aSAH.
Collapse
Affiliation(s)
- Fatima A Sehba
- The Departments of Neurosurgery and Neuroscience, Mount Sinai School of Medicine, New York, NY 10029, USA.
| | | | | | | |
Collapse
|
22
|
Hantson P. Physiopathologie des lésions cérébrales précoces et retardées dans l’hémorragie sous-arachnoïdienne : avancées récentes. MEDECINE INTENSIVE REANIMATION 2012. [DOI: 10.1007/s13546-011-0418-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
|
23
|
Nitric oxide related pathophysiological changes following subarachnoid haemorrhage. ACTA NEUROCHIRURGICA. SUPPLEMENT 2011; 110:105-9. [PMID: 21116924 DOI: 10.1007/978-3-7091-0353-1_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
Subarachnoid hemorrhage (SAH) comprises only about 7% of all strokes worldwide but is associated with severe mortality and morbidity. SAH is associated with a number of secondary pathologies, such as: transient cerebral vasospasm, delayed ischemic neuronal deficit (DIND), cortical spreading depression, microcirculatory modifications, microthrombosis and ischemic complications. Available data demonstrate that there are complex interactions among these secondary complications, and NO plays an important role among the interactions. NO has been implicated to be a crucial molecule in eliminating vasospasm, facilitating neuroprotection, anti-microthrombosis, cerebral ischemic tolerance and promoting endothelial cell function. Therefore, therapeutic agent targeting a key component in the pathopyhysiology of SAH such as NO and its related enzymes would be favorable for future development of SAH drugs. Alternatively, because of the complex nature of the secondary complications after SAH, agents with multiple efficacies on these complications, or the combination of several agents such as NO donors, oxide radical scavengers and neuroprotectants might be more desirable.
Collapse
|
24
|
Erşahin M, Toklu HZ, Akakin D, Yuksel M, Yeğen BC, Sener G. The effects of Nigella sativa against oxidative injury in a rat model of subarachnoid hemorrhage. Acta Neurochir (Wien) 2011; 153:333-41. [PMID: 21072672 DOI: 10.1007/s00701-010-0853-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Accepted: 10/23/2010] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim of the study was to investigate the putative neuroprotective effect of Nigella sativa oil (NSO) treatment against subarachnoid hemorrhage (SAH) in rats. METHODS To induce SAH, rats were injected with 0.3 ml blood into their cisterna magna. Male Wistar albino rats were divided as control, vehicle-treated SAH, and NSO-treated (0.2 ml/kg, intraperitoneally) SAH groups. Forty-eight hours after SAH induction, neurological examination scores were recorded and the rats were decapitated. Brain tissue samples were taken for blood brain barrier permeability, brain water content, or determination of malondialdehyde (MDA) and glutathione (GSH) levels, myeloperoxidase (MPO), and Na(+)-K(+)-ATPase activities. RESULTS AND DISCUSSION On the second day of SAH induction, neurological examination scores were increased in SAH groups, while SAH caused significant decreases in brain GSH content and Na(+)-K(+)-ATPase activity, which were accompanied with significant increases in MDA levels and MPO activity. The histological observation showed vasospasm of the basillary artery. On the other hand, NSO treatment markedly improved the neurological scores while all oxidant responses were prevented, implicating that NSO treatment may be of therapeutic use in preventing oxidative stress due to SAH.
Collapse
Affiliation(s)
- Mehmet Erşahin
- Department of Neurosurgery, Haydarpasa Numune Education and Research Hospital, Istanbul, Turkey
| | | | | | | | | | | |
Collapse
|
25
|
Sehba FA, Pluta RM, Zhang JH. Metamorphosis of subarachnoid hemorrhage research: from delayed vasospasm to early brain injury. Mol Neurobiol 2010; 43:27-40. [PMID: 21161614 PMCID: PMC3023855 DOI: 10.1007/s12035-010-8155-z] [Citation(s) in RCA: 231] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2010] [Accepted: 11/24/2010] [Indexed: 01/07/2023]
Abstract
Delayed vasospasm that develops 3–7 days after aneurysmal subarachnoid hemorrhage (SAH) has traditionally been considered the most important determinant of delayed ischemic injury and poor outcome. Consequently, most therapies against delayed ischemic injury are directed towards reducing the incidence of vasospasm. The clinical trials based on this strategy, however, have so far claimed limited success; the incidence of vasospasm is reduced without reduction in delayed ischemic injury or improvement in the long-term outcome. This fact has shifted research interest to the early brain injury (first 72 h) evoked by SAH. In recent years, several pathological mechanisms that activate within minutes after the initial bleed and lead to early brain injury are identified. In addition, it is found that many of these mechanisms evolve with time and participate in the pathogenesis of delayed ischemic injury and poor outcome. Therefore, a therapy or therapies focused on these early mechanisms may not only prevent the early brain injury but may also help reduce the intensity of later developing neurological complications. This manuscript reviews the pathological mechanisms of early brain injury after SAH and summarizes the status of current therapies.
Collapse
Affiliation(s)
- Fatima A Sehba
- Department of Neurosurgery, Mount Sinai School of Medicine, Box 1136, New York, NY 10029, USA.
| | | | | |
Collapse
|
26
|
Oxidative stress in subarachnoid haemorrhage: significance in acute brain injury and vasospasm. ACTA NEUROCHIRURGICA SUPPLEMENT 2008; 104:33-41. [DOI: 10.1007/978-3-211-75718-5_7] [Citation(s) in RCA: 169] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
|
27
|
Cosan TE, Demir TA, Yayla E, Cosan D, Berber A, Kaynak Z. Trace minerals in experimental subarachnoid haemorrhage: zinc, copper and manganese levels in rat brain tissue, blood and urine. Acta Neurochir (Wien) 2006; 148:443-8. [PMID: 16475018 DOI: 10.1007/s00701-006-0745-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2005] [Accepted: 12/20/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Zinc (Zn), copper (Cu) and manganese (Mn) are involved in regulatory systems in the cell. Their role in neuromodulator activities and redox reactions has been implicated in the pathogenesis of neurological disorders. The aim of this study was to determine changes of Zn, Cu and Mn levels in brain tissue, blood and urine after experimental subarachnoid haemorrhage (SAH). The possible importance of these trace minerals on the pathogenesis of SAH was also discussed. METHOD Rats were divided into three groups; namely a SAH group, a control group and a normal group. Blood samples in the SAH group and normal saline in the control group were injected into the cisterna magna. No surgical procedures were performed on the normal group. Brain tissue, blood and urine samples were measured for trace minerals by atomic absorption spectrophotometry. Measurements were taken on days 3, 7 and 10 after the onset in the control and SAH groups, and on the first day in the normal group. FINDINGS The reduced blood Zn levels and increased Zn urine loss observed in the SAH group were conspicuously significant. Furthermore, significant changes in Mn levels were also seen at different stages of the trial in the SAH group. However, differences found in the Cu levels between the groups were not significant enough to explain the results. INTERPRETATION These results suggest that the low blood Zn levels seen throughout the stages, the low brain tissue Mn levels seen during the latter part of the trial, and the low blood Mn levels observed during the early stages, may all be related to an increased risk in experimental SAH in rats. These differences may have possible role in the pathogenesis of SAH, and further investigations into the reduced blood Mn levels observed during the study may lead to new insight into the treatment of SAH.
Collapse
Affiliation(s)
- T E Cosan
- Department of Neurosurgery, Medical Faculty, Osmangazi University, Eskisehir, Turkey.
| | | | | | | | | | | |
Collapse
|
28
|
Ramanathan L, Gulyani S, Nienhuis R, Siegel JM. Sleep deprivation decreases superoxide dismutase activity in rat hippocampus and brainstem. Neuroreport 2002; 13:1387-90. [PMID: 12167758 PMCID: PMC8802885 DOI: 10.1097/00001756-200208070-00007] [Citation(s) in RCA: 164] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sleep deprivation by the disk-over-water technique results in a predictable syndrome of physiological changes in rats. It has been proposed that reactive oxygen species (ROS) may be responsible for some of these effects. A variety of antioxidative enzymes such as superoxide dismutase (SOD) and glutathione peroxidase (GPx) help to regulate the level of ROS. In this study we investigated the effects of prolonged (5-11 days) sleep deprivation on the activities of SOD and GPx as well as the metabolic activity of the mitochondria (using alamar blue) in several brain regions (cortex, hippocampus, hypothalamus, brainstem and cerebellum). We show that prolonged sleep deprivation significantly decreased Cu/Zn-SOD activity in the hippocampus and brainstem, suggesting an alteration in the metabolism of ROS resulting in oxidative stress.
Collapse
Affiliation(s)
- Lalini Ramanathan
- Department of Psychiatry, University of California at Los Angeles, Los Angeles, CA, USA
| | | | | | | |
Collapse
|
29
|
Gaetani P, Pasqualin A, Rodriguez y Baena R, Borasio E, Marzatico F. Oxidative stress in the human brain after subarachnoid hemorrhage. J Neurosurg 1998; 89:748-54. [PMID: 9817412 DOI: 10.3171/jns.1998.89.5.0748] [Citation(s) in RCA: 71] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT The aim of this study was to verify the patterns of antioxidant enzymatic activity of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) in the human brain after subarachnoid hemorrhage (SAH) to verify whether an "oxidative stress situation" characterizes the brain response to subarachnoid bleeding. METHODS Forty samples of gyrus rectus or temporal operculum that were obtained during a surgical approach to anterior circulation aneurysms were used for this study. The activity of total SOD, GSH-Px, and the SOD/GSH/Px ratio (which expresses the balance between the production of hydrogen peroxides by dismutation of superoxide radicals and the scavenging potential) were calculated in each case. Twelve samples were obtained from patients who underwent surgery for unruptured aneurysms (control group); 13 samples were obtained during surgical procedures performed within 72 hours of SAH; and 15 samples were obtained during delayed surgical procedures (> 10 days post-SAH). Ten patients presented with clinical deterioration caused by arterial vasospasm. In both SAH groups, the mean total SOD activity was significantly higher than in the control group (p=0.029). The mean activity of GSH-Px did not differ significantly between the SAH and control groups (p=0.731). There was a significant increase in the SOD/GSH-Px ratio in both SAH groups, as compared with controls (p < 0.05). There was a significant correlation between the enzymatic activity and the clinical severity of the hemorrhage, with findings of lower values of SOD and, mainly, of the SOD/GSH-Px ratio in the poor-grade patients. The SOD/GSH-Px ratio was 2.14+/-0.44 in patients who presented with clinical vasospasm and 1.24+/-0.2 in cases without vasospasm. CONCLUSIONS The results of this study show an imbalance of the antioxidant enzymatic activities in the human brain after SAH. which is linked to the severity of the initial bleeding and possibly modified by the development of arterial vasospasm.
Collapse
Affiliation(s)
- P Gaetani
- Department of Neurosurgery, Istituto Clinico Humanitas, Rozzano (Milan), Italy
| | | | | | | | | |
Collapse
|
30
|
Toyoda T, Kwan AL, Bavbek M, Kassell NF, Wanebo JE, Lee KS. Enhanced endogenous antioxidant activity and inhibition of cerebral vasospasm in rabbits by pretreatment with a nontoxic endotoxin analog, monophosphoryl lipid A. J Neurosurg 1998; 88:1082-7. [PMID: 9609304 DOI: 10.3171/jns.1998.88.6.1082] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECT Monophosphoryl lipid A (MPL) and diphosphoryl lipid (DPL) are derivatives of the lipopolysaccharide (endotoxin) of Salmonella minnesota strain R595. Monophosphoryl lipid A is relatively nontoxic and can stimulate the natural defense or immune system. Diphosphoryl lipid is relatively toxic; however, at higher concentrations, it can also stimulate an immune response. The purpose of the present study was to determine the effects of these endotoxin analogs on cerebral vasospasm after the onset of subarachnoid hemorrhage (SAH) in rabbits. METHODS Intrathecal administration of MPL or DPL (5 microg/kg) was performed immediately before and 24 hours after induction of SAH in New Zealand White rabbits. Forty-eight hours after induction of SAH, the animals were killed by perfusion fixation for morphometric analyses of vessels or perfused with saline and assayed for superoxide dismutase (SOD) activity. Additional rabbits were administered MPL or DPL and killed 24 hours later for assessment of SOD activity; no SAH was induced in these animals. Experimental SAH elicited spasm of the basilar arteries in each group. Vasospasm was markedly attenuated in animals treated with MPL (p < 0.01 compared with vehicle-treated animals), but not in animals treated with DPL. A substantial reduction in SOD activity in the basilar artery accompanied the vasospasm; this loss of activity was significantly blocked by treatment with MPL, but not DPL. In animals that were not subjected to experimental SAH, MPL elicited a significant increase in SOD activity over basal levels, whereas DPL was ineffective. CONCLUSIONS These data provide evidence of a marked protective effect of the endotoxin analog MPL against vasospasm. Although the mechanism(s) responsible for the protective effect of MPL remains to be verified, an enhancement of basal antioxidant activity and an inhibition of SAH-induced loss of this activity are attractive candidates. An MPL-based therapy could represent a useful addition to current therapies for SAH-induced cerebral injury.
Collapse
Affiliation(s)
- T Toyoda
- Department of Neurological Surgery, University of Virginia Health Sciences Center, Charlottesville 22908, USA
| | | | | | | | | | | |
Collapse
|
31
|
Wengenack TM, Curran GL, Poduslo JF. Postischemic, systemic administration of polyamine-modified superoxide dismutase reduces hippocampal CA1 neurodegeneration in rat global cerebral ischemia. Brain Res 1997; 754:46-54. [PMID: 9134958 DOI: 10.1016/s0006-8993(97)00041-3] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Antioxidant enzymes such as superoxide dismutase (SOD) have shown neuroprotective effects in animal models of cerebral ischemia, but only at very high doses. Modifications to increase the plasma half-life or blood-brain barrier (BBB) permeability of SOD have resulted in limited neuroprotective effects. No one has demonstrated neuroprotection with postischemic administration. The specific aim of the present study was to administer systemically a polyamine-modified SOD, having increased BBB permeability and preserved enzymatic activity, following global cerebral ischemia in rats and analyze the effects on the selective vulnerability of CA1 hippocampal neurons. Following 12 min of four-vessel occlusion, global cerebral ischemia, male Wistar rats were dosed (i.v.) with either saline, native SOD (5000 U/kg), polyamine-modified SOD (5000 U/kg), or enzymatically inactive, polyamine-modified SOD (2.1 mg/kg) twice daily for 3 days. Neuroprotective effects on hippocampal CA1 neurons were assessed using standard histological methods. Saline-treated animals had very few remaining CA1 neurons (1.44 +/- 0.60 neurons/reticle; x +/- S.E.M.) compared to sham rats (58.57 +/- 0.69). Native (10.38 +/- 2.96) or inactive, polyamine-modified SOD (7.32 +/- 2.68) did not show significant neuroprotective effects. Polyamine-modified SOD, however, resulted in the survival of significantly more CA1 neurons (24.61 +/- 5.90; P < 0.01). Postischemic, systemic administration of polyamine-modified SOD, having increased BBB permeability and preserved enzymatic activity, significantly reduced hippocampal CA1 neuron loss following global cerebral ischemia. Similar modification of other antioxidant enzymes and neurotrophic factors with polyamines may provide a useful technique for the systemic delivery of therapeutic proteins across the BBB for the treatment of stroke and other neurodegenerative disorders.
Collapse
Affiliation(s)
- T M Wengenack
- Department of Neurology, Mayo Clinic and Foundation, Rochester, MN 55905, USA.
| | | | | |
Collapse
|
32
|
Zhou D, Mayberg MR, London S, Gajdusek C. Reduction of intracellular glutathione levels produces sustained arterial narrowing. Neurosurgery 1996; 39:991-7. [PMID: 8905756 DOI: 10.1097/00006123-199611000-00021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
OBJECTIVE Although lipid peroxidation and alterations in endogenous antioxidants have been hypothesized to contribute to cerebral vasospasm after subarachnoid hemorrhage, there has been no direct evidence demonstrating the relationship between oxidative stress and delayed arterial narrowing. To elaborate the role of the endogenous intracellular antioxidant and electron exchanger glutathione (GSH) in cerebral vasospasm, rat femoral arteries were treated with perivascular application of I-buthionine-(SR)-sulfoximine (BSO), which inhibits the synthesis of GSH. METHODS To determine the dose-response relationship, BSO at doses of 10 to 100 mg/ml, in platelet-rich plasma, was applied for 7 days to rat femoral arteries in vivo. Vessels were then perfusion-fixed for morphometric analysis of luminal cross-sectional area. To determine the time course of arterial narrowing, BSO (75 mg/ml) was applied to femoral arteries for 1, 3, 7, or 21 days before histological analysis, as described above. With rats treated with 50 to 100 mg/ml BSO, exogenous GSH (100 mg/kg) was administered, by intraperitoneal injection, daily for 7 days. To demonstrate the mechanism of BSO effects in smooth muscle cells (SMCs), cultured rat aortic SMCs were treated with 1 mmol/l BSO for 24 hours and assayed for intracellular levels of GSH and two products of lipid peroxidation, malondialdehyde and 4-hydroxyalkenal. RESULTS Compared with control arteries treated with platelet-rich plasma alone, perivascularly administered BSO applied for periods of 1 to 21 days produced sustained and reversible narrowing of rat femoral arteries with a time course, severity, and histological appearance analogous to those observed after perivascular application of whole blood. BSO-induced arterial narrowing was dose-dependent, with 60% reductions in the luminal cross-sectional area being noted at 75 and 100 mg/ml (P < 0.005). Systemic administration of exogenous GSH slightly inhibited the effect of BSO on arterial narrowing, although the inhibition was not statistically significant. Cultured rat aortic SMCs exposed to BSO for 24 hours showed a 70% decrease in intracellular GSH levels (P = 0.03); levels of two products of lipid peroxidation, malondialdehyde and 4-hydroxyalkenal, were increased by 25% (P = 0.24) and 38% (P = 0.09), respectively. CONCLUSION These data support the hypothesis that diminished intracellular levels of GSH may produce delayed chronic arterial narrowing after subarachnoid hemorrhage. The specific mechanism by which GSH levels modulate vasoconstriction remains uncertain but may involve endogenous antioxidant capacity in SMCs.
Collapse
Affiliation(s)
- D Zhou
- Department of Neurological Surgery, University of Washington, Seattle, USA
| | | | | | | |
Collapse
|
33
|
Zhou D, Mayberg MR, London S, Gajdusek C. Reduction of Intracellular Glutathione Levels Produces Sustained Arterial Narrowing. Neurosurgery 1996. [DOI: 10.1227/00006123-199611000-00021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
|
34
|
Hoffman SW, Roof RL, Stein DG. A reliable and sensitive enzyme immunoassay method for measuring 8-isoprostaglandin F2 alpha: a marker for lipid peroxidation after experimental brain injury. J Neurosci Methods 1996; 68:133-6. [PMID: 8912185 DOI: 10.1016/0165-0270(96)00014-3] [Citation(s) in RCA: 65] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The objectives of this study were to determine (1) if levels of 8-isoprostaglandin F2 alpha (8-isoPGF2 alpha), a non-enzymatically produced prostaglandin, were increased after cortical contusion and (2) if enzyme immunoassay (EIA) could be used to quantify 8-isoPGF2 alpha levels. 24 h after the contusion there was a significant rise in 8-isoPGF2 alpha compared to control levels. The levels returned to baseline by 72 h postinjury. The results show that this EIA method is a reliable and sensitive technique for measuring brain lipid peroxidation.
Collapse
Affiliation(s)
- S W Hoffman
- Brain Research Laboratory, Rutgers University, Newark, NJ 07102, USA
| | | | | |
Collapse
|
35
|
Duhaime AC, Gennarelli LM, Yachnis A. Acute subdural hematoma: is the blood itself toxic? J Neurotrauma 1994; 11:669-78. [PMID: 7723066 DOI: 10.1089/neu.1994.11.669] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Recently developed rodent models of acute subdural hematoma have shown an associated large area of infarction underlying the clot. Excitotoxic processes have been postulated to play an important role in the extensive cell death seen with these models. However, whether increased pressure, vasoactive effects, or toxicity of the blood itself is responsible for initiating or sustaining these processes remains unclear. To study the effect of blood itself, an opaque layer of autologous clot was placed on the widely exposed parietal cortex of 15 Long-Evans rats and left in place for 72 h. In control animals the cortical surface was exposed but no blood was placed and contact with blood products was carefully limited. These animals were compared to a group in whom blood was injected into the closed subdural space. Histologic analysis showed that the majority of the cortex in both control and experimental animals in the open cranial model group appeared normal. Scattered small, discrete hemorrhagic lesions on the cortical surface of both control and experimental animals were seen, which had the appearance of focal mechanical trauma or vessel avulsion. There was no significant difference in average volume of lesions between experimental and control animals (9.1 versus 9.7 mm3, p = 0.85). No areas of infarction or selective neuronal loss were seen. In comparison, animals in which blood was injected into the subdural space had significantly larger lesions underlying clot, averaging 133.6 mm3 in volume (p < 0.0003). Blood in prolonged contact with the cortical surface in the absence of increased pressure, ischemia, or other insult is insufficient to cause underlying infarction like that seen when a similar volume of blood is injected into the closed subdural space.
Collapse
Affiliation(s)
- A C Duhaime
- Department of Neurosurgery, Children's Hospital of Philadelphia, University of Pennsylvania School of Medicine, USA
| | | | | |
Collapse
|