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Ciarrocchi N, Pose F, Videla CG, Del Carmen García M, Goldenberg FD, Lazaridis C, Issa NP, Redelico FO, Mansour A. Novel EEG Metric Correlates with Intracranial Pressure in an Animal Model. Neurocrit Care 2024; 40:918-930. [PMID: 37940837 DOI: 10.1007/s12028-023-01848-5] [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: 05/03/2023] [Accepted: 08/23/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Intracranial pressure (ICP) can be continuously and reliably measured using invasive monitoring through an external ventricular catheter or an intraparenchymal probe. We explore electroencephalography (EEG) to identify a reliable real-time noninvasive ICP correlate. METHODS Using a previously described porcine model of intracranial hypertension, we examined the cross correlation between ICP time series and the slope of the EEG power spectral density as described by ϕ. We calculated ϕ as tan-1 (slope of power spectral density) and normalized it by π, where slope is that of the power-law fit (log frequency vs. log power) to the power spectral density of the EEG signal. Additionally, we explored the relationship between the ϕ time series and cerebral perfusion pressure. A total of 11 intracranial hypertension episodes across three different animals were studied. RESULTS The mean correlation between ϕ angle and ICP was - 0.85 (0.15); the mean correlation with cerebral perfusion pressure was 0.92 (0.02). Significant correlation occurred at zero lag. In the absence of intracranial hypertension, the absolute value of the ϕ angle was greater than 0.9 (mean 0.936 radians). However, during extreme intracranial hypertension causing cerebral circulatory arrest, the ϕ angle is on average below 0.9 radians (mean 0.855 radians). CONCLUSIONS EEG ϕ angle is a promising real-time noninvasive measure of ICP/cerebral perfusion using surface electroencephalography.
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Affiliation(s)
- Nicolás Ciarrocchi
- Servicio de Terapia Intensiva de Adultos, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190 - (C1199ABB), Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando Pose
- Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires and, Consejo Nacional de Investigaciones Científicas y Técnicas, Perón 4190, Ciudad Autónoma de Buenos Aires, Argentina
| | - Carlos Gustavo Videla
- Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires and, Consejo Nacional de Investigaciones Científicas y Técnicas, Perón 4190, Ciudad Autónoma de Buenos Aires, Argentina
| | - María Del Carmen García
- Servicio de Neurología Adultos, Hospital Italiano de Buenos Aires, Tte. Gral. Juan Domingo Perón 4190, Ciudad Autónoma de Buenos Aires, Argentina
| | - Fernando D Goldenberg
- Neurocritical Care Section, Department of Neurology, University of Chicago, Chicago, IL, USA
| | - Christos Lazaridis
- Neurocritical Care Section, Department of Neurology, University of Chicago, Chicago, IL, USA
| | - Naoum P Issa
- Epilepsy Section, Department of Neurology, University of Chicago, Chicago, IL, USA
| | - Francisco O Redelico
- Instituto de Medicina Traslacional e Ingeniería Biomédica, Hospital Italiano de Buenos Aires, Instituto Universitario del Hospital Italiano de Buenos Aires and, Consejo Nacional de Investigaciones Científicas y Técnicas, Perón 4190, Ciudad Autónoma de Buenos Aires, Argentina.
- Departamento de Ciencia y Tecnología, Universidad Nacional de Quilmes, Roque Sáenz Peña 352 - (B1876BXD), Bernal, Buenos Aires, Argentina.
| | - Ali Mansour
- Neurocritical Care Section, Department of Neurology, University of Chicago, Chicago, IL, USA.
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Bera KD, Tabak J, Ploeg RJ. No Evidence of Progressive Proinflammatory Cytokine Storm in Brain-dead Organ Donors-A Time-course Analysis Using Clinical Samples. Transplantation 2024; 108:923-929. [PMID: 38192028 PMCID: PMC10962432 DOI: 10.1097/tp.0000000000004900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 10/04/2023] [Accepted: 10/25/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Solid organ transplantation is a cost-effective treatment for end-stage organ failure. Organ donation after brain death is an important source of transplanted organs. Data are limited on the effects of brain injury or donor management on grafts. The consensus view has been that brain death creates a progressively proinflammatory environment. We aimed to investigate time-course changes across a range of cytokines in a donation after brain death cohort of donors who died of intracranial hemorrhage without any other systemic source of inflammation. METHODS A donor cohort was defined using the UK Quality in Organ Donation biobank. Serum levels of proteins involved in proinflammatory and brain injury pathways (tumor necrosis factor-alpha, interleukin-6, complement C5a, neuron-specific enolase, and glial fibrillary acidic protein) were measured from admission to organ recovery. Moving median analysis was used to combine donor trajectories and delineate a time-course. RESULTS A cohort of 27 donors with brain death duration between 10 and 30 h was created, with 24 donors contributing to the time-course analysis. We observed no increase in tumor necrosis factor-alpha or interleukin-6 throughout the donor management period. Neuronal injury marker and complement C5a remain high from admission to organ recovery, whereas glial fibrillary acidic protein rises around the confirmation of brain death. CONCLUSIONS We found no evidence of a progressive rise of proinflammatory mediators with prolonged duration of brain death, questioning the hypothesis of a progressively proinflammatory environment. Furthermore, the proposed approach allows us to study chronological changes and identify biomarkers or target pathways when logistical or ethical considerations limit sample availability.
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Affiliation(s)
- Katarzyna D. Bera
- Nuffield Department of Surgical Sciences, Oxford Transplant Centre, Oxford, United Kingdom
- Oxford University NHS Foundation Trust, Oxford, United Kingdom
| | - Joel Tabak
- Department of Clinical and Biomedical Sciences, University of Exeter, Exeter, United Kingdom
| | - Rutger J. Ploeg
- Nuffield Department of Surgical Sciences, Oxford Transplant Centre, Oxford, United Kingdom
- Oxford University NHS Foundation Trust, Oxford, United Kingdom
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Dyhrfort P, Wettervik TS, Clausen F, Enblad P, Hillered L, Lewén A. A Dedicated 21-Plex Proximity Extension Assay Panel for High-Sensitivity Protein Biomarker Detection Using Microdialysis in Severe Traumatic Brain Injury: The Next Step in Precision Medicine? Neurotrauma Rep 2023; 4:25-40. [PMID: 36726870 PMCID: PMC9886191 DOI: 10.1089/neur.2022.0067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Cerebral protein profiling in traumatic brain injury (TBI) is needed to better comprehend secondary injury pathways. Cerebral microdialysis (CMD), in combination with the proximity extension assay (PEA) technique, has great potential in this field. By using PEA, we have previously screened >500 proteins from CMD samples collected from TBI patients. In this study, we customized a PEA panel prototype of 21 selected candidate protein biomarkers, involved in inflammation (13), neuroplasticity/-repair (six), and axonal injury (two). The aim was to study their temporal dynamics and relation to age, structural injury, and clinical outcome. Ten patients with severe TBI and CMD monitoring, who were treated in the Neurointensive Care Unit, Uppsala University Hospital, Sweden, were included. Hourly CMD samples were collected for up to 7 days after trauma and analyzed with the 21-plex PEA panel. Seventeen of the 21 proteins from the CMD sample analyses showed significantly different mean levels between days. Early peaks (within 48 h) were noted with interleukin (IL)-1β, IL-6, IL-8, granulocyte colony-stimulating factor, transforming growth factor alpha, brevican, junctional adhesion molecule B, and neurocan. C-X-C motif chemokine ligand 10 peaked after 3 days. Late peaks (>5 days) were noted with interleukin-1 receptor antagonist (IL-1ra), monocyte chemoattractant protein (MCP)-2, MCP-3, urokinase-type plasminogen activator, Dickkopf-related protein 1, and DRAXIN. IL-8, neurofilament heavy chain, and TAU were biphasic. Age (above/below 22 years) interacted with the temporal dynamics of IL-6, IL-1ra, vascular endothelial growth factor, MCP-3, and TAU. There was no association between radiological injury (Marshall grade) or clinical outcome (Extended Glasgow Outcome Scale) with the protein expression pattern. The PEA method is a highly sensitive molecular tool for protein profiling from cerebral tissue in TBI. The novel TBI dedicated 21-plex panel showed marked regulation of proteins belonging to the inflammation, plasticity/repair, and axonal injury families. The method may enable important insights into complex injury processes on a molecular level that may be of value in future efforts to tailor pharmacological TBI trials to better address specific disease processes and optimize timing of treatments.
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Affiliation(s)
- Philip Dyhrfort
- Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Teodor Svedung Wettervik
- Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden.,Address correspondence to: Teodor Svedung Wettervik, MD, PhD, Department of Medical Sciences, Section of Neurosurgery, Uppsala University, SE-751 85 Uppsala, Sweden.
| | - Fredrik Clausen
- Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Per Enblad
- Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Lars Hillered
- Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden
| | - Anders Lewén
- Department of Medical Sciences, Section of Neurosurgery, Uppsala University, Uppsala, Sweden
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Sun J, Li N, Xu M, Li L, Chen JL, Chen Y, Xu JG, Wang TH. Mechanism of gene network in the treatment of intracerebral hemorrhage by natural plant drugs in Lutong granules. PLoS One 2022; 17:e0274639. [PMID: 36441671 PMCID: PMC9704616 DOI: 10.1371/journal.pone.0274639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022] Open
Abstract
PURPOSE To study the effects of Lu-tong Granules (LTG) in ICH etermine the underlying mechanism of molecular network. METHODS Modern bioinformatics and network pharmacology methods were used to predict molecular network mechanisms between ICH and LTG. Animal experiments were carried out to verify the effect of LTG for the treatment of ICH, combined with behavior test and morphologic detection. RESULTS Forty-three active components in LTG and involved 192 gene targets were identified successfully. Moreoner, they were intersected with 1132 genes of ICH,88 intersection targets were obtained. subsequently, Cytoscape was used to screen Hub genes, in which,6 core molecules, including AKT1, IL6, VEGFA, CASP3, JUN and MMP9 were recognized. Furthermore, we constructed Six core compounds by " disease-drug-active ingredient-target-KEGG " (D-D-A-T-K) network, showed including quercetin, luteolin, β sitosterol, stigmasterol, kaempferol and formononetin, and PPI protein network interaction showed that AKT1:OS3 and CNA2:DKN1A had the highest correlation. Whereas the enrichment of GO and KEGG indicated that LTG was most likely to play a therapeutic role in ICH through AGE-RAGE signaling pathway in diabetic complications. Integrated analysis also showed that the first 10 pathways of KEGG are integrated into 59 genes, among which 6 core genes are closely involved. Lastly, molecular docking showed that there was a good binding activity between the core components and the core genes, and animal experiments confirmed effect of LTG in the treatment of ICH, by using TTC staining and behavior test. CONCLUSION LTG are effective for the treatment of ICH, the underlying mechanism could be involved in gene network including anti-inflammatory response, nerve repair, analgesia, anti-epilepsy and other aspects.
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Affiliation(s)
- Jie Sun
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- Department of Neurosurgery, The first Hospital of Kunming, Kunming, Yunnan Province, China
| | - Na Li
- The Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Min Xu
- School of Basic Medicine, Jinzhou Medical University, Jinzhou, Liaoning Province, China
| | - Li Li
- Department of acupuncture, Kunming Municipal Hospital of Traditional Chinese Medicine, Kunming, Yunnan Province, China
| | - Ji Lin Chen
- The Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Yong Chen
- The Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
| | - Jian Guo Xu
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- * E-mail: (THW); (JGX)
| | - Ting Hua Wang
- Department of Neurosurgery, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
- The Institute of Neuroscience, Kunming Medical University, Kunming, Yunnan Province, China
- School of Basic Medicine, Jinzhou Medical University, Jinzhou, Liaoning Province, China
- * E-mail: (THW); (JGX)
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Synthesis of novel benzothiophene derivatives as protectors against cranial irradiation-induced neuroinflammation. Future Med Chem 2022; 14:1527-1539. [DOI: 10.4155/fmc-2022-0203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aim: Cranial irradiation results in many deleterious effects to normal tissues, including neuroinflammation. There is a need to explore radioprotective agents that could be safely used to ameliorate these effects. Method: Nine novel benzothiophene derivatives bearing pyrimidinone, pyrazolidinone, triazole and other active moieties were synthesized and evaluated as antioxidants in an in vitro screening experiment. The most potent compounds were then tested as protectors against radiation-induced neuroinflammation and oxidative stress in rat brains following cranial irradiation. Results: The most potent antioxidant compounds were compounds 3–5 and 10 . P-fluro,p- bromo and pyrido benzothiophene derivatives offered good antioxidant and anti-inflammatory effects. Conclusion: Compounds 3–5 may be introduced as nontoxic candidates for adjuvant therapeutic protocols used in head and neck tumor radiotherapeutic management.
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