1
|
Chen Q, Sun J, Liu X, Qin Z, Li J, Ma J, Xue Z, Li Y, Yang Z, Sun Q, Wu L, Chang E, Zhao H, Zhang Y, Gu J, Ma D. Dexmedetomidine and argon in combination against ferroptosis through tackling TXNIP-mediated oxidative stress in DCD porcine livers. Cell Death Discov 2024; 10:319. [PMID: 38992027 PMCID: PMC11239900 DOI: 10.1038/s41420-024-02071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 07/13/2024] Open
Abstract
Graft availability from donation after circulatory death (DCD) is significantly limited by ischaemia reperfusion (IR) injury. Effective strategies to mitigate IR injury in DCD grafts are essential to improve graft quality and expand the donor pool. In this study, liver grafts from DCD pigs were preserved in the University of Wisconsin (UW) solution saturated with 0.1 nM dexmedetomidine (Dex) and various concentrations of noble gases Argon (Ar) and/or Xenon (Xe) at 4 °C for 24 or 72 h. The combined 50% Ar and Dex provided maximum protection to liver grafts by reducing morphological damage, apoptosis, necroptosis, ferroptosis, hepatocyte glycogen depletion, reticulin framework collapse, iron deposition, and oxidative stress. In vitro, human liver Hep G2 cells were preserved in the UW solution saturated with 0.1 nM Dex and 50% Ar in combination at 4 °C for 24 h, followed by recovery in medium at 37 °C for up to 48 h to mimic clinical IR injury. This treatment significantly increased the expression of anti-oxidative stress proteins by promoting the translocation of thioredoxin-interacting protein (TXNIP) to mitochondria, thereby inhibiting ferroptosis, increasing plasma membrane integrity, and maintaining cell viability.In summary, The combination of 0.1 nM Dex and 50% Ar may be a promising strategy to reduce ferroptosis and other form cell death, and preserve liver grafts.
Collapse
Affiliation(s)
- Qian Chen
- Department of Anesthesiology, Perioperative and Systems Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, Zhejiang, China
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
| | - Jiashi Sun
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
| | - Xiangfeng Liu
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhigang Qin
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jieyu Li
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Jianbo Ma
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Zhengwei Xue
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Yirong Li
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Ziheng Yang
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China
| | - Qizhe Sun
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
| | - Lingzhi Wu
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
| | - Enqiang Chang
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
| | - Hailin Zhao
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
| | - Yiwen Zhang
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK
- Department of Anesthesiology, Shunde Hospital, Southern Medical University, Shunde, Guangdong, China
| | - Jianteng Gu
- Department of Anesthesiology, Southwest Hospital, Army Medical University, Chongqing, China.
| | - Daqing Ma
- Department of Anesthesiology, Perioperative and Systems Medicine, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Centre for Child Health, Hangzhou, Zhejiang, China.
- Division of Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, London, UK.
| |
Collapse
|
2
|
Tang C, Li Y, Lai Y. Intraoperative Dexmedetomidine for Prevention of Postoperative Cognitive Dysfunction and Delirium in Elderly Patients with Lobectomy: A Propensity Score-Matched, Retrospective Study. Int J Gen Med 2024; 17:2673-2680. [PMID: 38863738 PMCID: PMC11166154 DOI: 10.2147/ijgm.s456762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 03/25/2024] [Indexed: 06/13/2024] Open
Abstract
Purpose This study aims to investigate whether dexmedetomidine could prevent postoperative cognitive dysfunction and delirium in patients with lobectomy. Patients and Methods Patients with lung cancer who underwent thoracoscopic lobectomy under general anesthesia were enrolled in this study and divided into dexmedetomidine group or control group. Propensity-score match (PSM) was used to reduce the bias and imbalance of confounding variables. After PSM, 87 patients in each group were included. Primary outcomes were postoperative cognitive function and delirium. Secondary outcomes include plasma TNF-α, IL-6, and S100 β protein concentrations. Adverse events were also collected. Results There were no significant differences in the demographic characteristics and hemodynamic parameters between the two groups. Compared with the control group, the MoCA scores were significantly higher (P<0.01), while the incidence of delirium (P<0.01) and the plasma TNF-α (P<0.01), IL-6 (P<0.01), and S100 β protein (P<0.01) concentrations were significantly lower in the dexmedetomidine group at 7 days post-operatively. The incidences of adverse events were similar between the two groups. Conclusion Dexmedetomidine could prevent postoperative cognitive dysfunction and delirium in patients with lobectomy by decreasing neuroinflammation.
Collapse
Affiliation(s)
- Chaojun Tang
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of China
| | - Yalan Li
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of China
| | - Yong Lai
- Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, 510630, People’s Republic of China
| |
Collapse
|
3
|
Zhu C, Wang D, Chang C, Liu A, Zhou J, Yang T, Jiang Y, Li X, Jiang W. Dexmedetomidine alleviates blood-brain barrier disruption in rats after cerebral ischemia-reperfusion by suppressing JNK and p38 MAPK signaling. THE KOREAN JOURNAL OF PHYSIOLOGY & PHARMACOLOGY : OFFICIAL JOURNAL OF THE KOREAN PHYSIOLOGICAL SOCIETY AND THE KOREAN SOCIETY OF PHARMACOLOGY 2024; 28:239-252. [PMID: 38682172 PMCID: PMC11058545 DOI: 10.4196/kjpp.2024.28.3.239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 05/01/2024]
Abstract
Dexmedetomidine displays multiple mechanisms of neuroprotection in ameliorating ischemic brain injury. In this study, we explored the beneficial effects of dexmedetomidine on blood-brain barrier (BBB) integrity and neuroinflammation in cerebral ischemia/reperfusion injury. Sprague-Dawley rats were subjected to middle cerebral artery occlusion (MCAO) for 1.5 h and reperfusion for 24 h to establish a rat model of cerebral ischemia/reperfusion injury. Dexmedetomidine (9 g/kg) was administered to rats 30 min after MCAO through intravenous injection, and SB203580 (a p38 MAPK inhibitor, 200 g/kg) was injected intraperitoneally 30 min before MCAO. Brain damages were evaluated by 2,3,5-triphenyltetrazolium chloride staining, hematoxylin-eosin staining, Nissl staining, and brain water content assessment. BBB permeability was examined by Evans blue staining. Expression levels of claudin-5, zonula occludens-1, occludin, and matrix metalloproteinase-9 (MMP-9) as well as M1/M2 phenotypes-associated markers were assessed using immunofluorescence, RT-qPCR, Western blotting, and gelatin zymography. Enzyme-linked immunosorbent assay was used to examine inflammatory cytokine levels. We found that dexmedetomidine or SB203580 attenuated infarct volume, brain edema, BBB permeability, and neuroinflammation, and promoted M2 microglial polarization after cerebral ischemia/reperfusion injury. Increased MMP-9 activity by ischemia/reperfusion injury was inhibited by dexmedetomidine or SB203580. Dexmedetomidine inhibited the activation of the ERK, JNK, and p38 MAPK pathways. Moreover, activation of JNK or p38 MAPK reversed the protective effects of dexmedetomidine against ischemic brain injury. Overall, dexmedetomidine ameliorated brain injury by alleviating BBB permeability and promoting M2 polarization in experimental cerebral ischemia/reperfusion injury model by inhibiting the activation of JNK and p38 MAPK pathways.
Collapse
Affiliation(s)
- Canmin Zhu
- Department of Neurology, The First Peopleʼs Hospital of Jiangxia District, Wuhan 430200, Hubei, China
| | - Dili Wang
- Department of Neurology, The First Peopleʼs Hospital of Jiangxia District, Wuhan 430200, Hubei, China
| | - Chang Chang
- Department of Neurology, The First Peopleʼs Hospital of Jiangxia District, Wuhan 430200, Hubei, China
| | - Aofei Liu
- Department of Medicine, Soochow University, Suzhou 215006, Jiangsu, China
- Department of Vascular Neurosurgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Ji Zhou
- Department of Medicine, Soochow University, Suzhou 215006, Jiangsu, China
- Department of Vascular Neurosurgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Ting Yang
- Department of Neurology, The First Peopleʼs Hospital of Jiangxia District, Wuhan 430200, Hubei, China
| | - Yuanfeng Jiang
- Department of Medicine, Soochow University, Suzhou 215006, Jiangsu, China
- Department of Vascular Neurosurgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Xia Li
- Department of Medicine, Soochow University, Suzhou 215006, Jiangsu, China
- Department of Vascular Neurosurgery, PLA Rocket Force Characteristic Medical Center, Beijing 100088, China
| | - Weijian Jiang
- Department of Medicine, Soochow University, Suzhou 215006, Jiangsu, China
| |
Collapse
|
4
|
Sen A, Erdivanlı B, Tümkaya L, Uydu HA, Mercantepe T, Batcik Ş, Ozdemir A. The effects of dexmedetomidine on trauma-induced secondary injury in rat brain. Neurol Res 2024; 46:23-32. [PMID: 37842946 DOI: 10.1080/01616412.2023.2257446] [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: 03/05/2023] [Accepted: 07/29/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND The objective of this study was to investigate the effect of dexmedetomidine (Dex), a sedative drug with little or no depressant effect on respiratory centers, on secondary injury in rat brain tissue by means of the Na+/K+ ATPase enzyme, which maintains the cell membrane ion gradient; malondialdehyde, an indicator of membrane lipid peroxidation; glutathione, an indicator of antioxidant capacity; and histopathological analyses. METHODS Eighteen rats were randomized into three groups: the trauma group received anesthesia, followed by head trauma with a Mild Traumatic Brain Injury Apparatus; the Trauma+Dex group received an additional treatment of 100 µg/kg intraperitoneal dexmedetomidine daily for three days; the Control group received anesthesia only. RESULTS The highest MDA levels compared to the Control group were found in the Trauma group. Mean levels in the Trauma+Dex group were lower, albeit still significantly high compared to the Control group. Glutathione levels were similar in all groups. Na/K-ATPase levels were significantly lower in the Trauma group compared to both the Control group and the Trauma+Dex group. Histopathologic findings of tissue degeneration including edema, vascular congestion and neuronal injury, and cleaved caspase-3 levels were lower in the Trauma+Dex group compared with the Trauma group. CONCLUSIONS Dexmedetomidine administered during the early stage of traumatic brain injury may inhibit caspase-3 cleavageHowever, the mechanism does not seem to be related to the improvement of MDA or GSH levels.
Collapse
Affiliation(s)
- Ahmet Sen
- Department of Anesthesiology and Reanimation, Trabzon Faculty of Medicine, University of Health Sciences, Trabzon, Turkey
| | - Basar Erdivanlı
- Department of Anestjesıology and Reamınatıon, Faculty of Medıcıne, Recep Tayyıp Erdogan Unıversıty
| | - Levent Tümkaya
- Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Hüseyin Avni Uydu
- Histology and Embryology and Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Tolga Mercantepe
- Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Şule Batcik
- Department of Anestjesıology and Reamınatıon, Faculty of Medıcıne, Recep Tayyıp Erdogan Unıversıty
| | - Abdullah Ozdemir
- Department of Anestjesıology and Reamınatıon, Faculty of Medıcıne, Recep Tayyıp Erdogan Unıversıty
| |
Collapse
|
5
|
Peršec J, Šribar A, Ilić M, Mamić I, Kifer D, Domijan AM, Maleš Ž, Turčić P. Effects of epidurally administered dexmedetomidine and dexamethasone on postoperative pain, analgesic requirements, inflammation, and oxidative stress in thoracic surgery. ACTA PHARMACEUTICA (ZAGREB, CROATIA) 2023; 73:691-708. [PMID: 38147472 DOI: 10.2478/acph-2023-0040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/11/2023] [Indexed: 12/28/2023]
Abstract
The aim of this study was to compare the effects of dexmedetomidine and dexamethasone as adjuvants to preoperative epidural administration of local anesthetic (ropivacaine) in thoracic surgery on the postoperative level of pain, use of analgesics, inflammation, and oxidative stress. The study enrolled 42 patients who underwent elective thoracic surgery in a one-year period at the University Hospital Dubrava (Zagreb, Croatia). Based on a computer-generated randomization list the patients were assigned to the dexmedetomidine (n = 18) or dexamethasone (n = 24) group. Postoperatively, patients of dexmedetomidine group reported lower pain (VAS value 1 h post surgery, 3.4 ± 2.7 vs. 5.4 ± 1.8, dexmedetomidine vs. dexamethasone, p < 0.01) and had lower anal-gesic requirements in comparison with dexamethasone group. Thus, dexmedetomidine in comparison with dexamethasone was more efficient in lowering pain and analgesia requirements 24 h after the surgery. On the contrary, dexamethasone had better anti-inflammatory properties (CRP level 24 h post surgery, 131.9 ± 90.7 vs. 26.0 ± 55.2 mg L-1, dexmedetomidine vs. dexamethasone, p < 0.01). Both dexmedetomidine and dexamethasone exhibited antioxidant effects, however, their antioxidant properties should be further explored. The results of this study improve current knowledge of pain control in thoracic surgery.
Collapse
Affiliation(s)
- Jasminka Peršec
- 1Clinical Department for Anesthesiology Reanimatology and Intensive Care Medicine, University Hospital Dubrava Zagreb, Croatia
- 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Andrej Šribar
- 1Clinical Department for Anesthesiology Reanimatology and Intensive Care Medicine, University Hospital Dubrava Zagreb, Croatia
- 2School of Dental Medicine, University of Zagreb, Zagreb, Croatia
| | - Monika Ilić
- 1Clinical Department for Anesthesiology Reanimatology and Intensive Care Medicine, University Hospital Dubrava Zagreb, Croatia
| | - Ivan Mamić
- 3University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmacology, Zagreb, Croatia
| | - Domagoj Kifer
- 4University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Biophysics, Zagreb, Croatia
| | - Ana-Marija Domijan
- 5University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmaceutical Botany, Zagreb, Croatia
| | - Željan Maleš
- 5University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmaceutical Botany, Zagreb, Croatia
| | - Petra Turčić
- 3University of Zagreb Faculty of Pharmacy and Biochemistry, Department of Pharmacology, Zagreb, Croatia
| |
Collapse
|
6
|
Chauhan R, Singh N, Reddy A, Singh A. The role of dexmedetomidine in post cranioplasty refractory status epilepticus. Anaesth Rep 2023; 11:e12246. [PMID: 37736063 PMCID: PMC10511152 DOI: 10.1002/anr3.12246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/23/2023] Open
Abstract
Cranioplasty, specifically a repair of the skull defect resulting from a previous decompressive craniectomy, is a relatively simple procedure associated with a minimal rate of complications. Even though seizures are seen in up to 30% of the patients postoperatively, status epilepticus is not commonly described. Cerebral oedema, ischaemia and neuro-inflammation have been reported as putative causes of seizures in this population. Here, we report a case of refractory status epilepticus unresponsive to standard anti-epileptic and anaesthetic agents. The use of dexmedetomidine helped terminate the episode and led to a favourable outcome. Most of the standard anti-epileptic and anaesthetic agents act through potentiation of GABAergic transmission or sodium channel blockade and postsynaptic adrenoceptor activation by dexmedetomidine may help potentiate their effect. Further studies are needed to investigate its anticonvulsant effect on post-traumatic brain injury and elaborate on optimal dosage.
Collapse
Affiliation(s)
- R. Chauhan
- Department of Anaesthesia and Intensive CarePostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - N. Singh
- Department of AnaesthesiologySanjay Gandhi Postgraduate Institute of Medical Sciences and ResearchLucknowIndia
| | - A. Reddy
- Department of Anaesthesia and Intensive CarePostgraduate Institute of Medical Education and ResearchChandigarhIndia
| | - A. Singh
- Department of NeurosurgeryPostgraduate Institute of Medical Education and ResearchChandigarhIndia
| |
Collapse
|
7
|
Park JH, Lee TK, Kim DW, Ahn JH, Lee CH, Lim SS, Kim YH, Cho JH, Kang IJ, Won MH. Aucubin Exerts Neuroprotection against Forebrain Ischemia and Reperfusion Injury in Gerbils through Antioxidative and Neurotrophic Effects. Antioxidants (Basel) 2023; 12:antiox12051082. [PMID: 37237948 DOI: 10.3390/antiox12051082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 05/07/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
Aucubin is an iridoid glycoside that displays various pharmacological actions including antioxidant activity. However, there are few reports available on the neuroprotective effects of aucubin against ischemic brain injury. Thus, the aim of this study was to investigate whether aucubin protected against damage to hippocampal function induced by forebrain ischemia-reperfusion injury (fIRI) in gerbils, and to examine whether aucubin produced neuroprotection in the hippocampus against fIRI and to explore its mechanisms by histopathology, immunohistochemistry, and Western analysis. Gerbils were given intraperitoneal injections of aucubin at doses of 1, 5, and 10 mg/kg, respectively, once a day for seven days before fIRI. As assessed by the passive avoidance test, short-term memory function following fIRI significantly declined, whereas the decline in short-term memory function due to fIRI was ameliorated by pretreatment with 10 mg/kg, but not 1 or 5 mg/kg, of aucubin. Most of the pyramidal cells (principal cells) of the hippocampus died in the Cornu Ammonis 1 (CA1) area four days after fIRI. Treatment with 10 mg/kg, but not 1 or 5 mg/kg, of aucubin protected the pyramidal cells from IRI. The treatment with 10 mg/kg of aucubin significantly reduced IRI-induced superoxide anion production, oxidative DNA damage, and lipid peroxidation in the CA1 pyramidal cells. In addition, the aucubin treatment significantly increased the expressions of superoxide dismutases (SOD1 and SOD2) in the pyramidal cells before and after fIRI. Furthermore, the aucubin treatment significantly enhanced the protein expression levels of neurotrophic factors, such as brain-derived neurotrophic factor and insulin-like growth factor-I, in the hippocampal CA1 area before and after IRI. Collectively, in this experiment, pretreatment with aucubin protected CA1 pyramidal cells from forebrain IRI by attenuating oxidative stress and increasing neurotrophic factors. Thus, pretreatment with aucubin can be a promising candidate for preventing brain IRI.
Collapse
Affiliation(s)
- Joon Ha Park
- Department of Anatomy, College of Korean Medicine, Dongguk University, Gyeongju 38066, Republic of Korea
| | - Tae-Kyeong Lee
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Republic of Korea
| | - Dae Won Kim
- Department of Biochemistry and Molecular Biology, Research Institute of Oral Sciences, College of Dentistry, Gangnung-Wonju National University, Gangneung 25457, Republic of Korea
| | - Ji Hyeon Ahn
- Department of Physical Therapy, College of Health Science, Youngsan University, Yangsan 50510, Republic of Korea
| | - Choong-Hyun Lee
- Department of Pharmacy, College of Pharmacy, Dankook University, Cheonan 31116, Republic of Korea
| | - Soon Sung Lim
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Republic of Korea
| | - Yang Hee Kim
- Department of Surgery, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon 24289, Republic of Korea
| | - Jun Hwi Cho
- Department of Emergency Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon 24289, Republic of Korea
| | - Il Jun Kang
- Department of Food Science and Nutrition, Hallym University, Chuncheon 24252, Republic of Korea
| | - Moo-Ho Won
- Department of Emergency Medicine, Kangwon National University Hospital, School of Medicine, Kangwon National University, Chuncheon 24289, Republic of Korea
| |
Collapse
|
8
|
Cerebral Protection of Intraoperative Infusion of Dexmedetomidine in Patients with Chronic Cerebrovascular Stenosis Undergoing Endovascular Interventional Therapies: A Prospective Randomized Controlled Trial. Ann Vasc Surg 2023; 89:182-189. [PMID: 36309168 DOI: 10.1016/j.avsg.2022.09.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/06/2022] [Accepted: 09/20/2022] [Indexed: 01/28/2023]
Abstract
BACKGROUND To investigate the cerebral protective effect of intraoperative dexmedetomidine infusion on patients with chronic cerebral vascular stenosis receiving endovascular interventional therapy. METHODS Sixty patients with carotid artery or cerebral artery stenosis or occlusion stenting under elective general anesthesia were divided into dexmedetomidine group (group D) and normal saline group (group N). Group D was given dexmedetomidine loading dose 1.0 μg/kg after peripheral vein opening for 10 min, and then adjusted infusion rate to 0.5 μg/kg/h until stopped 30 min before end. RESULTS At 7 days after operation, the contents of S100β, neuron-specific enolase (NSE) and interleukin-6 (IL-6) in group D were apparently lower than those in group N (P < 0.05), while the contents of IL-1β and tumor necrosis factor-α in 2 groups showed no statistical significance (P > 0.05). Additionally, at 4 days and 7 days after operation, the scores of Mini-Mental State Scale (MMSE) and Wechsler Memory Scale (WMS) in group D were significantly higher than those in group N (P < 0.05). Thirty days after surgery, the cerebral hemodynamic indexes (relative mean transit time, relative time to peak) in group D were significantly improved, and obviously better than those in group N (P < 0.05). CONCLUSIONS The S-100β, NSE, and inflammatory mediator IL-6 in group D were significantly decreased compared with group N, the MMSE and WMS cognitive function scores, and the cerebral blood perfusion were apparently improved in group D, clarifying dexmedetomidine has protective effect on nerve tissue injury by inhibiting inflammation.
Collapse
|
9
|
Wallace SR, Pagano PJ, Kračun D. MicroRNAs in the Regulation of NADPH Oxidases in Vascular Diabetic and Ischemic Pathologies: A Case for Alternate Inhibitory Strategies? Antioxidants (Basel) 2022; 12:70. [PMID: 36670932 PMCID: PMC9854786 DOI: 10.3390/antiox12010070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 12/24/2022] [Accepted: 12/27/2022] [Indexed: 12/30/2022] Open
Abstract
Since their discovery in the vasculature, different NADPH oxidase (NOX) isoforms have been associated with numerous complex vascular processes such as endothelial dysfunction, vascular inflammation, arterial remodeling, and dyslipidemia. In turn, these often underlie cardiovascular and metabolic pathologies including diabetes mellitus type II, cardiomyopathy, systemic and pulmonary hypertension and atherosclerosis. Increasing attention has been directed toward miRNA involvement in type II diabetes mellitus and its cardiovascular and metabolic co-morbidities in the search for predictive and stratifying biomarkers and therapeutic targets. Owing to the challenges of generating isoform-selective NOX inhibitors (NOXi), the development of specific NOXis suitable for therapeutic purposes has been hindered. In that vein, differential regulation of specific NOX isoforms by a particular miRNA or combina-tion thereof could at some point become a reasonable approach for therapeutic targeting under some circumstances. Whereas administration of miRNAs chronically, or even acutely, to patients poses its own set of difficulties, miRNA-mediated regulation of NOXs in the vasculature is worth surveying. In this review, a distinct focus on the role of miRNAs in the regulation of NOXs was made in the context of type II diabetes mellitus and ischemic injury models.
Collapse
Affiliation(s)
- Sean R. Wallace
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Patrick J. Pagano
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Damir Kračun
- Pittsburgh Heart, Lung, Blood and Vascular Medicine Institute, University of Pittsburgh, Pittsburgh, PA 15261, USA
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA 15261, USA
| |
Collapse
|
10
|
Pang Y, Li Y, Zhang Y, Wang H, Lang J, Han L, Liu H, Xiong X, Gu L, Wu X. Effects of inflammation and oxidative stress on postoperative delirium in cardiac surgery. Front Cardiovasc Med 2022; 9:1049600. [PMID: 36505383 PMCID: PMC9731159 DOI: 10.3389/fcvm.2022.1049600] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
The past decade has witnessed unprecedented medical progress, which has translated into cardiac surgery being increasingly common and safe. However, complications such as postoperative delirium remain a major concern. Although the pathophysiological changes of delirium after cardiac surgery remain poorly understood, it is widely thought that inflammation and oxidative stress may be potential triggers of delirium. The development of delirium following cardiac surgery is associated with perioperative risk factors. Multiple interventions are being explored to prevent and treat delirium. Therefore, research on the potential role of biomarkers in delirium as well as identification of perioperative risk factors and pharmacological interventions are necessary to mitigate the development of delirium.
Collapse
Affiliation(s)
- Yi Pang
- Bengbu Medical College, Bengbu, Anhui, China
| | - Yuntao Li
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yonggang Zhang
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Hongfa Wang
- Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Junhui Lang
- Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Liang Han
- Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - He Liu
- Department of Anesthesiology, The Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou Central Hospital, Huzhou, China
| | - Xiaoxing Xiong
- Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijuan Gu
- Central Laboratory, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xiaomin Wu
- Center for Rehabilitation Medicine, Department of Anesthesiology, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China,*Correspondence: Xiaomin Wu,
| |
Collapse
|
11
|
Liu T, Liu FC, Xia Y, Luo TJ, Wang F, Chen B, Wang C, Gao GK, Zhai WT, Liu W. Effect of dexmedetomidine on the Montreal Cognitive Assessment in older patients undergoing pulmonary surgery. J Int Med Res 2022; 50:3000605221123680. [PMID: 36151758 PMCID: PMC9513575 DOI: 10.1177/03000605221123680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective We investigated the effect of dexmedetomidine anesthesia on postoperative
cognitive function after pulmonary surgery. Methods A blinded, prospective, randomized, placebo-controlled study was performed on
60 patients (age range 65–74 years) undergoing lobectomy by video-assisted
thoracoscopic surgery (29 in the dexmedetomidine group; 31 in the placebo
group). Dexmedetomidine group patients received dexmedetomidine, and placebo
group patients received an equal volume of physiological saline 20 minutes
before anesthesia induction. Cognitive function was evaluated using the
Montreal Cognitive Assessment 1 day before surgery and on postoperative day
(POD)1, POD3, and POD7. The regional cerebral oxygen saturation
(rSO2) was monitored continuously by near-infrared
spectroscopy before anesthesia. Results The Montreal Cognitive Assessment score was significantly different between
the two groups on POD1 (dexmedetomidine 26.4 ± 0.73 vs.
placebo 25.5 ± 0.96) and POD3 (dexmedetomidine 27.1 ± 0.79
vs. placebo 26.6 ± 0.80). Specifically, attention and
orientation scores were increased in the dexmedetomidine group on POD1 and
POD3. The rSO2 was not significantly different between the
dexmedetomidine and placebo groups. Conclusion Dexmedetomidine given before induction of anesthesia could reduce the risk of
postoperative cognitive dysfunction and might not decrease rSO2.
Hence, dexmedetomidine could be employed in pulmonary surgical procedures,
especially for older patients with a high risk of cognitive dysfunction.
Collapse
Affiliation(s)
- Tao Liu
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Fang-Chao Liu
- Scientific Research Office, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Yu Xia
- National Clinical Laboratory on Tuberculosis, Beijing Key Laboratory for Drug-resistant Tuberculosis Research, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Institute, Beijing, China
| | - Tai-Jun Luo
- Department of Anesthesiology, Beijing Jishuitan Hospital, Beijing, China
| | - Fei Wang
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Bin Chen
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Chun Wang
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Guang-Kuo Gao
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Wen-Ting Zhai
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| | - Wei Liu
- Department of Anesthesiology, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing, China
| |
Collapse
|
12
|
Role of Keap1-Nrf2/ARE signal transduction pathway in protection of dexmedetomidine preconditioning against myocardial ischemia/reperfusion injury. Biosci Rep 2022; 42:231655. [PMID: 35959640 PMCID: PMC9446386 DOI: 10.1042/bsr20221306] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/17/2022] Open
Abstract
Objective: To explore the role and mechanism of the Kelch sample related protein-1-nuclear factor erythroid-2 related factor 2/antioxidant response element (Keap1-Nrf2/ARE) signaling pathway in protection of dexmedetomidine (DEX) preconditioning against myocardial ischemia/reperfusion injury (MIRI). Methods: A total of 70 male SD rats were randomly divided into seven equal groups (n=10): blank control (S group), ischemia/reperfusion injury (C group), DEX preconditioning (DEX group), tertiary butylhydroquinone (tBHQ) control (tBHQ group), combined tBHQ and DEX preconditioning (tBHQ+DEX group), all-trans retinoic acid (ATRA) control (ATRA group), and combined ATRA and DEX preconditioning (ATRA+DEX group). Serum creatine kinase-MB (CK-MB) and cardiac troponin I (cTnI) concentrations were measured by ELISA kits, and the infarct size (IS) was assessed by Evan’s blue and 2,3,5-triphenyltetrazolium chloride (TTC) staining. Oxidative stress was assessed through Western blotting for expression of Keap1-Nrf2/ARE pathway members and oxidative stress markers. Results: Cardioprotection of DEX, tBHQ, and tBHQ+DEX preconditioning treatments were shown as lower concentrations of serum CK-MB and cTnI and a smaller IS following MIRI in rats compared with those of MIRI rats without pre-treatment. In addition, tBHQ+DEX preconditioning exhibited stronger myocardial protection compared with DEX preconditioning. Mechanistically, the cardioprotection offered by DEX, tBHQ, and tBHQ+DEX preconditioning treatments was mediated via exerting antioxidant stress through activation of the Keap1-Nrf2/ARE signal transduction pathway. Conversely, the protective effects of DEX were diminished by blocking the Keap1-Nrf2/ARE pathway with inhibitor ATRA. Conclusion: DEX preconditioning protects against MIRI by exerting antioxidant stress through activation of the Keap1-Nrf2/ARE signal transduction pathway, while inhibition of the Keap1-Nrf2/ARE signal transduction pathway reverses the protective effect of DEX preconditioning on MIRI.
Collapse
|
13
|
Gene Networks of Hyperglycemia, Diabetic Complications, and Human Proteins Targeted by SARS-CoV-2: What Is the Molecular Basis for Comorbidity? Int J Mol Sci 2022; 23:ijms23137247. [PMID: 35806251 PMCID: PMC9266766 DOI: 10.3390/ijms23137247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/10/2022] Open
Abstract
People with diabetes are more likely to have severe COVID-19 compared to the general population. Moreover, diabetes and COVID-19 demonstrate a certain parallelism in the mechanisms and organ damage. In this work, we applied bioinformatics analysis of associative molecular networks to identify key molecules and pathophysiological processes that determine SARS-CoV-2-induced disorders in patients with diabetes. Using text-mining-based approaches and ANDSystem as a bioinformatics tool, we reconstructed and matched networks related to hyperglycemia, diabetic complications, insulin resistance, and beta cell dysfunction with networks of SARS-CoV-2-targeted proteins. The latter included SARS-CoV-2 entry receptors (ACE2 and DPP4), SARS-CoV-2 entry associated proteases (TMPRSS2, CTSB, and CTSL), and 332 human intracellular proteins interacting with SARS-CoV-2. A number of genes/proteins targeted by SARS-CoV-2 (ACE2, BRD2, COMT, CTSB, CTSL, DNMT1, DPP4, ERP44, F2RL1, GDF15, GPX1, HDAC2, HMOX1, HYOU1, IDE, LOX, NUTF2, PCNT, PLAT, RAB10, RHOA, SCARB1, and SELENOS) were found in the networks of vascular diabetic complications and insulin resistance. According to the Gene Ontology enrichment analysis, the defined molecules are involved in the response to hypoxia, reactive oxygen species metabolism, immune and inflammatory response, regulation of angiogenesis, platelet degranulation, and other processes. The results expand the understanding of the molecular basis of diabetes and COVID-19 comorbidity.
Collapse
|
14
|
Liu H, Busl KM, Doré S. Role of Dexmedetomidine in Aneurysmal Subarachnoid Hemorrhage: A Comprehensive Scoping Review. J Neurosurg Anesthesiol 2022; 34:176-182. [PMID: 33060552 DOI: 10.1097/ana.0000000000000728] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 08/05/2020] [Indexed: 11/26/2022]
Abstract
Dexmedetomidine (DEX), an α2-adrenergic agonist, has been widely used for anesthesia, pain control, and intensive care unit sedation. Besides sleep-like sedation, DEX has many other beneficial effects, such as anti-inflammation, antioxidation, and anticell death. Subarachnoid hemorrhage (SAH), a severe and potentially fatal form of stroke, is a complex disease that is divided into 2 phases: early brain injury and delayed cerebral ischemia. In each phase, several pathologic changes are involved, including disturbed intracranial homeostasis, metabolic failure, blood-brain barrier damage, vasospasm, microthrombosis, and cortical spreading depolarization. DEX has been shown to have an effect on these SAH-related pathologic processes. Research shows that DEX could serve as a protective therapy for patients with SAH due to its ability to maintain stable intracerebral homeostasis, balance coagulation-fibrinolysis, repair a damaged blood-brain barrier as well as prevent vasospasm and suppress cortical spreading depolarization by anti-inflammatory, antioxidative, antiapoptotic, and vasoconstriction-dilation effects. In this scoping review, we critically assess the existing data on the potential protective effect of DEX after SAH. So far, only 1 retrospective clinical trial assessing the effect of DEX on clinical outcomes after SAH has been performed. Hence, more trials are still needed as well as translational research bringing results from bench to bedside.
Collapse
Affiliation(s)
- Hongtao Liu
- Department of Anesthesiology, the Second Affiliated Hospital of Xi'an JiaoTong University, Xi'an, ShaanXi Province, China
- Departments of Anesthesiology, Neurology, Psychiatry, Pharmaceutics, and Neuroscience, McKnight Brain Institute, Center for Translational Research in Neurodegenerative Disease
| | - Katharina M Busl
- Neurology and Neurosurgery, University of Florida College of Medicine, Gainesville, FL
| | - Sylvain Doré
- Departments of Anesthesiology, Neurology, Psychiatry, Pharmaceutics, and Neuroscience, McKnight Brain Institute, Center for Translational Research in Neurodegenerative Disease
| |
Collapse
|
15
|
Li Q, Qu M, Wang N, Wang L, Fan G, Yang C. Betaine Ameliorates Brain Damage in a Rat Model of Ischemia/Reperfusion Injury. J Neurophysiol 2022; 127:444-451. [PMID: 35020521 DOI: 10.1152/jn.00400.2021] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
Brain ischemia and reperfusion (I/R) injury may lead to a poor prognosis for ischemic stroke, which could be alleviated by anti-oxidants with diminished oxidative stress. Betaine is a natural nutrient found in beetroot and seafood to improve cognitive performance in the elderly. The present study investigated whether betaine could protect the brain from I/R injury. Results showed that betaine treatment could reduce H2O2-induced cell death in the PC12 cell line. Pretreatment with betaine reduced the brain infarct volume and neuronal apoptosis in a rat I/R injury model induced by two-hour middle cerebral artery occlusion (MCAO). Biochemical analyses indicated that betaine treatment decreased pro-inflammatory cytokine production and reduced oxidative stress after I/R injury. Betaine increased the expression of anti-oxidative enzymes, such as glutathione peroxidase 4 (Gpx4) and superoxide dismutase 1 (Sod1), and anti-oxidative non-enzymatic genes, such as 3-mercaptopyruvate sulfurtransferase (Mpst), methionine sulfoxide reductases b1 (Msrb1), and Msrb2. These data suggest that betaine exerts a neuroprotective effect in I/R injury through enzymatic and non-enzymatic anti-oxidative systems and anti-inflammatory mechanisms.
Collapse
Affiliation(s)
- Qian Li
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Mingwei Qu
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Ningning Wang
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Limin Wang
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Guimei Fan
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Chaoping Yang
- Department of Neurology, Cangzhou Central Hospital, Cangzhou, Hebei, China
| |
Collapse
|
16
|
Gheitasi I, Savari F, Akbari G, Mohammadi J, Fallahzadeh AR, Sadeghi H. Molecular Mechanisms of Hawthorn Extracts in Multiple Organs Disorders in Underlying of Diabetes: A Review. Int J Endocrinol 2022; 2022:2002768. [PMID: 35711333 PMCID: PMC9197671 DOI: 10.1155/2022/2002768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 05/08/2022] [Indexed: 12/15/2022] Open
Abstract
Diabetes mellitus (DM) is one of the most important metabolic disorders associated with chronic hyperglycemia and occurs when the body cannot manage insulin secretion, insulin action, or both. Autoimmune destruction of pancreatic beta cells and insulin resistance are the major pathophysiological factors of types 1 and 2 of DM, respectively. Prolonged hyperglycemia leads to multiple organs dysfunctions, including nephropathy, neuropathy, cardiomyopathy, gastropathy, and micro- and macrovascular disorders. The basis of the metabolic abnormalities in carbohydrate, fat, and protein in diabetes is insufficient action of insulin on various target tissues. Medicinal plants are rich sources of bioactive chemical compounds with therapeutic effects. The beneficial effects of leaves, fruits, and flowers extracts of Crataegus oxyacantha, commonly called hawthorn, belonging to the Rosaceae family, are widely used as hawthorn-derived medicines. Data in this review have been collected from the scientific articles published in databases such as Science Direct, Scopus, PubMed, Web of Science, and Scientific Information Database from 2000 to 2021. Based on this review, hawthorn extracts appear both therapeutic and protective effects against diabetic-related complications in various organs through molecular mechanisms, such as decreasing triglyceride, cholesterol, very low density lipoprotein and increasing the antioxidant activity of superoxide dismutase, catalase, glutathione peroxidase, total antioxidant capacity, decreasing malondialdehyde level, and attenuating tumor necrosis factor alpha, interleukin 6 and sirtuin 1/AMP-activated protein kinase (AMPK)/nuclear factor kappa B (NF-κB) pathway and increasing the phosphorylation of glucose transporter 4, insulin receptor substrate 1, AKT and phosphoinositide 3-kinases, and attenuating blood sugar and regulation of insulin secretion, insulin resistance, and improvement of histopathological changes in pancreatic beta cells. Collectively, hawthorn can be considered as one new target for the research and development of innovative drugs for the prevention or treatment of DM and related problems.
Collapse
Affiliation(s)
- Izadpanah Gheitasi
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Feryal Savari
- Department of Basic Sciences, Shoushtar Faculty of Medical Sciences, Shoushtar, Iran
| | - Ghaidafeh Akbari
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Jamshid Mohammadi
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Ali Reza Fallahzadeh
- Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Hossein Sadeghi
- Medicinal Plants Research Center, Yasuj University of Medical Sciences, Yasuj, Iran
| |
Collapse
|
17
|
Wang YY, Lin SY, Chang CY, Wu CC, Chen WY, Liao SL, Chen YF, Wang WY, Chen CJ. Jak2 Inhibitor AG490 Improved Poststroke Central and Peripheral Inflammation and Metabolic Abnormalities in a Rat Model of Ischemic Stroke. Antioxidants (Basel) 2021; 10:antiox10121958. [PMID: 34943061 PMCID: PMC8750281 DOI: 10.3390/antiox10121958] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 12/15/2022] Open
Abstract
Poststroke hyperglycemia and inflammation have been implicated in the pathogenesis of stroke. Janus Kinase 2 (Jak2), a catalytic signaling component for cytokine receptors such as Interleukin-6 (IL-6), has inflammatory and metabolic properties. This study aimed to investigate the roles of Jak2 in poststroke inflammation and metabolic abnormality in a rat model of permanent cerebral ischemia. Pretreatment with Jak2 inhibitor AG490 ameliorated neurological deficit, brain infarction, edema, oxidative stress, inflammation, caspase-3 activation, and Zonula Occludens-1 (ZO-1) reduction. Moreover, in injured cortical tissues, Tumor Necrosis Factor-α, IL-1β, and IL-6 levels were reduced with concurrent decreased NF-κB p65 phosphorylation, Signal Transducers and Activators of Transcription 3 phosphorylation, Ubiquitin Protein Ligase E3 Component N-Recognin 1 expression, and Matrix Metalloproteinase activity. In the in vitro study on bEnd.3 endothelial cells, AG490 diminished IL-6-induced endothelial barrier disruption by decreasing ZO-1 decline. Metabolically, administration of AG490 lowered fasting glucose, with improvements in glucose intolerance, plasma-free fatty acids, and plasma C Reactive Proteins. In conclusion, AG490 improved the inflammation and oxidative stress of neuronal, hepatic, and muscle tissues of stroke rats as well as impairing insulin signaling in the liver and skeletal muscles. Therefore, Jak2 blockades may have benefits for combating poststroke central and peripheral inflammation, and metabolic abnormalities.
Collapse
Affiliation(s)
- Ya-Yu Wang
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung City 407, Taiwan;
| | - Shih-Yi Lin
- Institute of Clinical Medicine, National Yang-Ming Chiao Tung University, Taipei City 112, Taiwan;
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung City 407, Taiwan
| | - Cheng-Yi Chang
- Department of Surgery, Feng Yuan Hospital, Taichung City 420, Taiwan;
| | - Chih-Cheng Wu
- Department of Anesthesiology, Taichung Veterans General Hospital, Taichung City 407, Taiwan;
- Department of Financial Engineering, Providence University, Taichung City 433, Taiwan
- Department of Data Science and Big Data Analytics, Providence University, Taichung City 433, Taiwan
| | - Wen-Ying Chen
- Department of Veterinary Medicine, National Chung Hsing University, Taichung City 402, Taiwan;
| | - Su-Lan Liao
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City 407, Taiwan;
| | - Yu-Fan Chen
- Department of Medical Laboratory Science, I-Shou University, Kaohsiung City 840, Taiwan;
| | - Wen-Yi Wang
- Department of Nursing, Hung Kuang University, Taichung City 433, Taiwan;
| | - Chun-Jung Chen
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City 407, Taiwan;
- Department of Medical Laboratory Science and Biotechnology, China Medical University, Taichung City 404, Taiwan
- Correspondence: ; Tel.: +886-4-2359-2525 (ext. 4022)
| |
Collapse
|
18
|
Abstract
PURPOSE OF REVIEW Postoperative neurocognitive disorders (NCD) are significant causes of morbidity and mortality. In this paper, we will review our understanding and potential management of postoperative NCD. RECENT FINDINGS Postoperative delirium, delayed neurocognitive recovery and postoperative cognitive dysfunction (POCD) are recognized as a part of the continuous spectrum of postoperative NCD. Although the pathophysiology is still poorly understood, there is renewed focus on improving neurocognitive outcomes of aging surgical population. Novel methods of neurocognitive screening are developed and research in the prevention and management of NCD has gained traction. SUMMARY A spectrum of NCD exists in surgical patients ranging from postoperative delirium, delayed neurocognitive recovery, and POCD. Identification of patients at-risk for developing NCD can help target appropriate perioperative intervention. Also, specialized care teams and the implementation of standardized protocols are crucial for the successful management perioperative NCD. Finally, large, randomized, multicenter studies are needed to confirm benefits of preventive and treatment strategies.
Collapse
|
19
|
Chu Y, Teng J, Feng P, Liu H, Wang F, Wang H. Dexmedetomidine Attenuates Hypoxia/Reoxygenation Injury of H9C2 Myocardial Cells by Upregulating miR-146a Expression via the MAPK Signal Pathway. Pharmacology 2021; 107:14-27. [PMID: 34718238 DOI: 10.1159/000506814] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 02/26/2020] [Indexed: 11/19/2022]
Abstract
INTRODUCTION AND OBJECTIVE Dexmedetomidine (Dex) and a number of miRNAs contribute to ischemia/reperfusion injury. We aimed to explore the role of Dex and miR-146a on myocardial cells injured by hypoxia/reoxygenation (H/R). METHOD H9C2 cells were injured by H/R. Cell viability was tested using the cell counting kit-8. Lactate dehydrogenase (LDH) activity, superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were determined using commercial kits. Flow cytometry was performed to determine apoptosis rate and reactive oxygen species (ROS) level. Protein and mRNA levels were assessed using Western blot and qPCR. RESULTS miR-146a expression and cell viability of H9C2 cells were downregulated under the circumstance of H/R injury. The tendency could be reversed by Dex, which could also upregulate SOD activity and decrease apoptosis, LDH activity, MDA, 78-kDa glucose-regulated protein (GRP78), and C/EBP homologous protein (CHOP) levels of H9C2 cells. GRP78, CHOP levels, and cell viability were negatively modulated by miR-146a. Dex elevated cell viability, catalase, MnSOD, and NAD(P)H dehydrogenase (NQO1) levels but suppressed apoptosis rate, GRP78, and CHOP levels by increasing miR-146a expression and downregulating ROS, phosphorylation of p38, and extracellular signal-regulated kinases 1/2 levels. By using SB203580 (SB), the p38 mitogen-activated protein kinase (MAPK) inhibitor, Dex or the inhibition of miR-146 upregulated cell viability but downregulated GRP78 and CHOP levels. CONCLUSION Dex might regulate miR-146a expression, which could further modulate the endoplasmic reticulum stress and oxidative stress and eventually affect the cell viability and apoptosis of myocardial cells injured by H/R via the MAPK signal pathway.
Collapse
Affiliation(s)
- Yi Chu
- Department of Cardiology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | - Jiwei Teng
- Department of Cardiology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | - Pin Feng
- Department of Cardiology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | - Hui Liu
- Department of Cardiology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | - Fangfang Wang
- Department of Cardiology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| | - Haiyan Wang
- Department of Cardiology, The Second Affiliated Hospital of Air Force Military Medical University, Xi'an, China
| |
Collapse
|
20
|
Rizk S, Taha H, Abdel Moneim AE, Amin HK. Neuroprotective effect of green and roasted coffee bean extracts on cerebral ischemia-induced injury in rats. Metab Brain Dis 2021; 36:1943-1956. [PMID: 34228267 DOI: 10.1007/s11011-021-00769-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 06/06/2021] [Indexed: 12/18/2022]
Abstract
Stroke is a lethal event with a high incidence in Egypt. Quick early intervention can be lifesaving. Transient global ischemia (TGI), a type of ischemic stroke, is mainly instigated by cardiac arrest. Ischemia followed by reperfusion causes further neuronal cell damage. In this study, we aimed to evaluate the potential apoptotic, anti-inflammatory, and neuroprotective effects of green (GCBE) and roasted (RCBE) coffee bean water extract against transient global ischemia-induced via a bilateral common carotid artery occlusion (CAO) in rats. Before CAO, 1.5 ml/kg body weight/day of GCBE or RCBE was administered for 14 days by oral gavage. Ischemia/reperfusion (I/R) and sham groups were treated with a vehicle. Oxidative stress biomarkers and antioxidant enzyme activities, such as MDA, NO, GSH, SOD, CAT, GR, GPx, inflammatory markers TNF-α, IL-1β, and NF-κB, and BDNF were investigated. Quantitative real-time PCR analysis of mitogen-activated protein kinase pathways, in addition to heme oxygenase 1, and nuclear factor erythroid 2-related factor 2 were determined. Apoptotic markers, including Bcl-2, Bax, and caspase 3, in addition to the vascular endothelial growth factor-a, were investigated, followed by an examination of hippocampal histopathology. Pre-administration of GCBE and RCBE improved neurological function and neuronal survival, suppressed the spread of oxidative stress, inflammation, and apoptosis, and reversed most of the pathological changes. However, green coffee bean extract was more effective than roasted coffee bean extract, perhaps due to the roasting process, which may affect active compounds. In conclusion, GCBE and RCBE represent a potential clinical strategy for pre-ischemic conditioning.
Collapse
Affiliation(s)
- Sara Rizk
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Heba Taha
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Ahmed E Abdel Moneim
- Department of Zoology and Entomology, Faculty of Science, Helwan University, Cairo, Egypt.
| | - Hatem K Amin
- Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| |
Collapse
|
21
|
Unchiti K, Leurcharusmee P, Samerchua A, Pipanmekaporn T, Chattipakorn N, Chattipakorn SC. The potential role of dexmedetomidine on neuroprotection and its possible mechanisms: Evidence from in vitro and in vivo studies. Eur J Neurosci 2021; 54:7006-7047. [PMID: 34561931 DOI: 10.1111/ejn.15474] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 12/24/2022]
Abstract
Neurological disorders following brain injuries and neurodegeneration are on the rise worldwide and cause disability and suffering in patients. It is crucial to explore novel neuroprotectants. Dexmedetomidine, a selective α2-adrenoceptor agonist, is commonly used for anxiolysis, sedation and analgesia in clinical anaesthesia and critical care. Recent studies have shown that dexmedetomidine exerts protective effects on multiple organs. This review summarized and discussed the current neuroprotective effects of dexmedetomidine, as well as the underlying mechanisms. In preclinical studies, dexmedetomidine reduced neuronal injury and improved functional outcomes in several models, including hypoxia-induced neuronal injury, ischaemic-reperfusion injury, intracerebral haemorrhage, post-traumatic brain injury, anaesthetic-induced neuronal injury, substance-induced neuronal injury, neuroinflammation, epilepsy and neurodegeneration. Several mechanisms are associated with the neuroprotective function of dexmedetomidine, including neurotransmitter regulation, inflammatory response, oxidative stress, apoptotic pathway, autophagy, mitochondrial function and other cell signalling pathways. In summary, dexmedetomidine has the potential to be a novel neuroprotective agent for a wide range of neurological disorders.
Collapse
Affiliation(s)
- Kantarakorn Unchiti
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Prangmalee Leurcharusmee
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Artid Samerchua
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Tanyong Pipanmekaporn
- Department of Anesthesiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Nipon Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand
| | - Siriporn C Chattipakorn
- Neurophysiology Unit, Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai, Thailand.,Department of Oral Biology and Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai, Thailand
| |
Collapse
|
22
|
Li G, LeiQian, Gu P, Fan D. Dexmedetomidine post-conditioning attenuates cerebral ischemia following asphyxia cardiac arrest through down-regulation of apoptosis and neuroinflammation in rats. BMC Anesthesiol 2021; 21:180. [PMID: 34182937 PMCID: PMC8236741 DOI: 10.1186/s12871-021-01394-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 06/10/2021] [Indexed: 12/17/2022] Open
Abstract
Background Neuroprotection strategies after cardiac arrest (CA)/cardiopulmonary resuscitation (CPR) remain key areas of basic and clinical research. This study was designed to investigate the neuroprotective effects of dexmedetomidine following resuscitation and potential mechanisms. Methods Anesthetized rats underwent 6-min asphyxia-based cardiac arrest and resuscitation, after which the experimental group received a single intravenous dose of dexmedetomidine (25 μg/kg). Neurological outcomes and ataxia were assessed after the return of spontaneous circulation. The serum levels and brain expression of inflammation markers was examined, and apoptotic cells were quantified by TUNEL staining. Results Neuroprotection was enhanced by dexmedetomidine post-conditioning after the return of spontaneous circulation. This enhancement was characterized by the promotion of neurological function scores and coordination. In addition, dexmedetomidine post-conditioning attenuated the serum levels of the pro-inflammatory cytokine tumor necrosis factor (TNF)-α at 2 h, as well as interleukin IL-1β at 2, 24, and 48 h. TUNEL staining showed that the number of apoptotic cells in the dexmedetomidine post-conditioning group was significantly reduced compared with the control group. Further western blot analysis indicated that dexmedetomidine markedly reduced the levels of caspase-3 and nuclear factor-kappa B (NF-κB) in the brain. Conclusions Dexmedetomidine post-conditioning had a neuroprotective effect against cerebral injury following asphyxia-induced cardiac arrest. The mechanism was associated with the downregulation of apoptosis and neuroinflammation.
Collapse
Affiliation(s)
- Guangqian Li
- School of Medicine, Universityof Electronic Science and Technology of China, Chengdu, China
| | - LeiQian
- School of Medicine, Universityof Electronic Science and Technology of China, Chengdu, China
| | - Pan Gu
- School of Medicine, Universityof Electronic Science and Technology of China, Chengdu, China
| | - Dan Fan
- School of Medicine, Universityof Electronic Science and Technology of China, Chengdu, China. .,Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, No. 32 West Second Section, First RingRoad, Chengdu, 610072, Sichuan, China.
| |
Collapse
|
23
|
Pan C, Chen Z, Li C, Han T, Liu H, Wang X. Sestrin2 as a gatekeeper of cellular homeostasis: Physiological effects for the regulation of hypoxia-related diseases. J Cell Mol Med 2021; 25:5341-5350. [PMID: 33942488 PMCID: PMC8184687 DOI: 10.1111/jcmm.16540] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/16/2021] [Accepted: 03/25/2021] [Indexed: 12/11/2022] Open
Abstract
Sestrin2 (SESN2) is a conserved stress‐inducible protein (also known as hypoxia‐inducible gene 95 (HI95)) that is induced under hypoxic conditions. SESN2 represses the production of reactive oxygen species (ROS) and provides cytoprotection against various noxious stimuli, including hypoxia, oxidative stress, endoplasmic reticulum (ER) stress and DNA damage. In recent years, the determination of the regulation and signalling mechanisms of SESN2 has increased our understanding of its role in the hypoxic response. SESN2 has well‐documented roles in hypoxia‐related diseases, making it a potential target for diagnosis and treatment. This review discusses the regulatory mechanisms of SESN2 and highlights the significance of SESN2 as a biomarker and therapeutic target in hypoxia‐related diseases, such as cancer, respiratory‐related diseases, cardiovascular diseases and cerebrovascular diseases.
Collapse
Affiliation(s)
- Cunyao Pan
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China.,Department of Public Health, Lanzhou University, Lanzhou, China
| | - Zhaoli Chen
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Chao Li
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Tie Han
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| | - Hui Liu
- Department of Public Health, Lanzhou University, Lanzhou, China
| | - Xinxing Wang
- Tianjin Institute of Environmental and Operational Medicine, Tianjin, China
| |
Collapse
|
24
|
Sheikholeslami MA, Ghafghazi S, Pouriran R, Mortazavi SE, Parvardeh S. Attenuating effect of paroxetine on memory impairment following cerebral ischemia-reperfusion injury in rat: The involvement of BDNF and antioxidant capacity. Eur J Pharmacol 2021; 893:173821. [PMID: 33347827 DOI: 10.1016/j.ejphar.2020.173821] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 12/11/2020] [Accepted: 12/16/2020] [Indexed: 10/22/2022]
Abstract
Memory impairments are frequently reported in patients suffering from brain ischemic diseases. Oxidative/nitrosative stress, synaptic plasticity, and brain-derived neurotrophic factor (BDNF) are involved in the physiopathology of brain ischemia-induced memory disorders. In the present study, the effect of paroxetine as an efficacious antidepressant medication with antioxidant properties was evaluated on passive avoidance memory deficit following cerebral ischemia in rats. Transient occlusion of common carotid arteries was applied to induce ischemia-reperfusion injury in male Wistar rats. Paroxetine (5, 10, 20 mg/kg) was administered intraperitoneally once daily before (for 3 days) or after (for 7 days) the induction of ischemia. A week after ischemia-reperfusion injury, passive avoidance memory, long-term potentiation (LTP), BDNF levels, total antioxidant capacity, the activity of antioxidant enzymes (including catalase, glutathione peroxidase, and superoxide dismutase), the concentration of malondialdehyde (MDA), and nitric oxide (NO) were investigated in the hippocampus. In the passive avoidance test, paroxetine significantly increased the step-through latency and decreased the time spent in the dark compartment. This affirmative function of paroxetine on the passive avoidance memory was accompanied by the improvement of hippocampal LTP and an obvious augmentation in the BDNF contents. Besides, paroxetine caused a significant rise in the total antioxidant capacity and antioxidant enzyme activity; while decreased the hippocampal levels of NO and MDA. It was ultimately attained that paroxetine attenuates cerebral ischemia-induced passive avoidance memory dysfunction in rats by the enhancement of hippocampal synaptic plasticity and BDNF content together with the suppression of oxidative/nitrosative stress.
Collapse
Affiliation(s)
| | - Shiva Ghafghazi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramin Pouriran
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Erfan Mortazavi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Siavash Parvardeh
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
25
|
Zhang SY, Zhao H, Xu C, Zhang Q, Chen Y, Li HY, Zhang XL, Zhao C, Chen M, Yang DH. Combination of Dexmedetomidine and Tramadol in Patient-Controlled Intravenous Analgesia Strengthens Sedative Effect in Pregnancy-Induced Hypertension. Front Pharmacol 2021; 12:739749. [PMID: 34744722 PMCID: PMC8569426 DOI: 10.3389/fphar.2021.739749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 10/07/2021] [Indexed: 02/05/2023] Open
Abstract
Objective: The aim of the present study is to explore the combination of dexmedetomidine (DXM) and tramadol (TMD) on sedative effect in patients with pregnancy-induced hypertension (PIH). Methods: A total of 356 patients with pregnancy-induced hypertension (PIH) were randomly divided into three groups: DXM, TMD and DXM + TMD groups. These patients were treated with different doses of DXM, TMD or combination of DXM and TMD by a patient-controlled intravenous injection device. The scores of static pain and dynamic pain, sedation degree, and adverse reaction were recorded. The plasma levels of inflammatory mediators IL-10 and C-reactive protein (CRP), and the serum level of p-p38-MAPK were evaluated. Results: It was found that administration with DXM 1.0 µg/kg/h + TMD 700 mg and DXM 2.0 µg/kg/h + TMD 600 mg result in stronger sedative effect than single administration with DXM or TMD. The mean arterial pressure (MAP) and heart rate (HR) of patients with PIH were decreased with the combinational treatment of DXM and TMD. Interestingly, the PIH patients injected with DXM 1.0 µg/kg/h + TMD 700 mg and DXM 2.0 µg/kg/h + TMD 600 mg showed stronger sedative effect. In addition, the plasma level of level of IL-10 was increased and CRP decreased. The serum level of p-p38/MAPK was decreased. Conclusion: Taken together, our study indicates that combination of DXM and TMD effectively lowers blood pressure and reduces inflammation through increasing the level of IL-10, reducing CRP and inhibiting p-p38/MAPK in patients with PIH. This study suggests that the combination of DXM and TMD could be an anesthetic choice in the management of PIH.
Collapse
Affiliation(s)
- Shu-Yao Zhang
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
| | - Hui Zhao
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chengcheng Xu
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Qiuzhen Zhang
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Yun Chen
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
| | - Hai-Yan Li
- Department of Nursing, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
| | - Xia-Lan Zhang
- Department of Gynecology and Obstetrics, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Chengkuan Zhao
- Department of Pharmacy, Guangzhou Red Cross Hospital Jinan University, Guangzhou, China
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Meini Chen
- Department of Pharmacology, Shantou University Medical College, Shantou, China
| | - Dong-Hua Yang
- Department of Pharmaceutical Sciences, St. John’s University College of Pharmacy and Health Sciences, Queens, NY, United States
- *Correspondence: Dong-Hua Yang,
| |
Collapse
|
26
|
Yuan S, Zhang T. Boeravinone B Protects Brain against Cerebral Ichemia Reperfusion Injury in Rats: Possible Role of Anti-inflammatory and Antioxidant. J Oleo Sci 2021; 70:927-936. [PMID: 34193669 DOI: 10.5650/jos.ess21037] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
It is well known that inflammatory reactions and oxidative stress play a key role in the pathogenesis of cerebral ischemia and secondary injury. Boeravinone B (BB) proofed their anti-inflammatory and antioxidant effect, but their neuroprotective effects still unknown. In this experimental study, we explore the neuro-protective effect of Boeravinone B on the ischemia/reperfusion and explore the possible mechanism. Male Wistar rats were used for the current experimental study. First induces natural I/R injury in rats and treated with BB and nifedipine, respectively. Rats were subjected to ischemia after 6 consecutive days by occlusion of the bilateral common carotid arteries (BCCAO). Neurological score, biochemical, antioxidant, pro-inflammatory cytokines and inflammatory parameters were estimated in the serum and brain tissue. BB treatment significantly (p < 0.001) suppressed neuronal injury, dose-dependently decreased the cerebral water content. BB treatment altered the pro-inflammatory cytokines, antioxidant and inflammatory mediators in the serum and brain tissue. BB regulated the expression of glycine (Gly), glutamic acid (Glu), taurine (Tau), aspartic acid (Asp) and γ-aminobutyric acid (GABA) and enhanced the activity of Na+, K+ ATPase and Ca2+ ATPase. BB significantly (p < 0.001) reduced antioxidant enzymes such as glutathione (GSH), glutathione peroxidase (GPx), catalase (CAT), malondialdehyde (MDA), glutathione reductase (GR); inflammatory cytokines include interleukin-4 (IL-4), interleukin-1 (IL-1), tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), interleukin-6 (IL-6) and interleukin-1β (IL-1β); inflammatory mediators include prostaglandin (PGE2), nuclear kappa factor B (NF-κB) and cyclooxygenase-2 (COX-2), respectively. In this study, we have found that Boeravinone B exhibited protection against cerebral I/R by reducing oxidative stress and inflammatory reaction.
Collapse
Affiliation(s)
- Shaojie Yuan
- Department of Neurology, Xingtai People's Hospital
| | - Tong Zhang
- Department of Neurology, Xingtai People's Hospital
| |
Collapse
|
27
|
Saleh DO, Jaleel GAA, Al-Awdan SW, Hassan A, Asaad GF. Melatonin suppresses the brain injury after cerebral ischemia/reperfusion in hyperglycaemic rats. Res Pharm Sci 2020; 15:418-428. [PMID: 33628283 PMCID: PMC7879790 DOI: 10.4103/1735-5362.297844] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Revised: 06/10/2020] [Accepted: 10/02/2020] [Indexed: 11/04/2022] Open
Abstract
Background and purpose Diabetes mellitus is a disorder accompanied by oxidative and inflammatory responses, that might exacerbate vascular complications. The purpose of this study was to investigate the potential antioxidant and anti-inflammatory effects of melatonin (MLN) on streptozotocin (STZ)-induced diabetic rats subjected to middle cerebral artery occlusion followed by reperfusion (MCAO/Re). Experimental approach Diabetes was induced in rats by a single injection of STZ (55 mg/kg; i.p.). The cerebral injury was then induced by MCAO/Re after six weeks. After 24 h of MCAO/Re the MLN (10 mg/kg) was administered orally for 14 days. Serum and tissue samples were extracted to determine malondialdehyde (MDA), reduced glutathione (GSH), nitric oxide (NO), interleukin-1β (IL-1β), and the tumor necrosis factor- α (TNF-α). Part of the brain tissue was kept in formalin for pathological and immunohistochemical studies to determine nuclear factor kappa B (NF-kB) and cyclooxygenase-2 (COX-2) immune reactivity. Findings/Results MCAO/Re in STZ-induced hyperglycaemic rats caused a decrease in brain GSH, an increase in brain MDA, and NO was increased in both serum and brain tissue. Rats showed a prominent increase in the serum and brain inflammatory markers viz. IL-1β and TNF-α. Oral treatment with MLN (10 mg/kg) for two weeks reduced the brain levels of MDA, NO, IL-1β, and TNF-α. Impressive amelioration in pathological findings, as well as a significant decrease in NF-kB and COX2 immune stained cells of the cerebral cortex, hippocampus, and cerebellum, occurred after treatment with MLN. It also succeeded to suppress the exacerbation of damage in the brain of hyperglycaemic rats. Conclusion and implications Daily intake of MLN attenuates the exacerbation of cerebral ischemic injury in a diabetic state.
Collapse
Affiliation(s)
- Dalia O Saleh
- Pharmacology Department, National Research Centre, Dokki, Giza, Egypt
| | | | - Sally W Al-Awdan
- Pharmacology Department, National Research Centre, Dokki, Giza, Egypt
| | - Azza Hassan
- Department of Pathology, Faculty of Veterinary Medicine, Cairo University, Giza, Egypt
| | - Gihan F Asaad
- Pharmacology Department, National Research Centre, Dokki, Giza, Egypt
| |
Collapse
|
28
|
Kim H, Kwon H, Jeon S, Choi EK. The effect of dexmedetomidine and remifentanil on the postoperative sore throat after thyroidectomy. Medicine (Baltimore) 2020; 99:e21060. [PMID: 32702848 PMCID: PMC7373553 DOI: 10.1097/md.0000000000021060] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Postoperative sore throat (POST) is an important concern in surgical patients undergoing endotracheal intubation. Its prevalence after thyroidectomy is up to 80%. The current study aimed to assess the effect of dexmedetomidine and remifentanil on postoperative sore throat. METHODS Seventy-four patients who underwent thyroidectomy were randomized to receive either dexmedetomidine (group D) or remifentanil (group R). At anesthesia induction, group D received dexmedetomidine 1 μg/kg over 10 minutes, followed by continuous dexmedetomidine infusion at 0.3 to 0.6 μg/kg/hour during surgery. Group R received remifentanil of 3 to 4 ng/ml during induction, followed by 1.5 to 2.5 ng/ml remifentanil infusion during surgery. POST at rest and swallowing was assessed during the first 24 hours in serial time periods (0-1, 1-6, and 6-24 hours). Hoarseness and postoperative pain score were also assessed. RESULTS POST incidence at rest (0-1, 1-6, and 6-24 hours) and swallowing (1-6 and 6-24 hours) was lower in group D than in group R. POST severity was significantly lower in group D than in group R during each time period. The incidence of postoperative hoarseness was also lower in group D than in group R at 1 to 6 and 6 to 24 hours. The postoperative pain score was lower in group D than in group R during each time period. CONCLUSION Intraoperative dexmedetomidine infusion reduced the incidence and severity of POST for 24 hours after thyroidectomy.
Collapse
|
29
|
Liang S, Chen Z, Li H, Cang Z, Yin K, Wu M, Luo S. Neuroprotective effect of Umbelliferone against Cerebral ischemia/Reperfusion induced neurological deficits: in-vivo and in-silico studies. J Biomol Struct Dyn 2020; 39:4715-4725. [PMID: 32552356 DOI: 10.1080/07391102.2020.1780153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Inflammatory pathway is the significant marker of neuro-inflammation and plays a significant role in the expansion of cerebral ischemia/reperfusion injury. Umbelliferone (UF), 7-hydroxy coumarin, has been already proved for its anti-inflammatory and anti-oxidative effects against ischemic brain injury in the rodent model, but its underlying pharmacological mechanism for neuro-protection remain unclear. In this study, we try to explore the neuro-protective effect of umbelliferone against ischemia/Reperfusion induced neurological deficits in rats and explore the underlying mechanism. Inserting thread into the middle cerebral artery was used to induce the ischemic stroke model. The rats were treated with the umbelliferone (5, 10 and 20 mg/kg) for 14 days prior to the ischemic stroke. At the end of the experimental study, brain infarction volume, neurological score, brain edema, pro-inflammatory cytokines, inflammatory mediator were estimated in the region of brain and serum. The mRNA expression of Toll-like receptor-4 (TLR4), myeloid differentiation factor 88 (MyD88), Fas and FasL were also estimated at the end of the study. Dose dependently treatment of umbelliferone down-regulated the neurological score, brain infarction, inflammatory mediator (TNF-α, IL-1β, IL-6, COX-2, NF-kB and PGE2) in the serum and brain tissue as compared to I/R induced control group rats. Umbelliferone also reduced the expression of TRL4, MyD88, Fas and FasL as compared to I/R control group rats. Umbelliferone also decreased the level of nuclear factor kappa B (NF-kB) compared to MACO control group rats. Collectively, the obtained result showed that the umbelliferone protected the brain against the ischemic injury in the rats through the inhibition of inflammatory pathway.Communicated by Ramaswamy H. Sarma.
Collapse
Affiliation(s)
- Sen Liang
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| | - Zhaoyao Chen
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| | - Hui Li
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| | - Zhilan Cang
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| | - Kailin Yin
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| | - Minghua Wu
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| | - Shouzhen Luo
- Department of Neurology, Jiangsu Province Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Nanjing University of Traditional Chinese Medicine, Nanjing city, Jiangsu, China
| |
Collapse
|
30
|
Ahmari M, Sharafi A, Mahmoudi J, Jafari-Anarkoli I, Gharbavi M, Hosseini MJ. Selegiline (L-Deprenyl) Mitigated Oxidative Stress, Cognitive Abnormalities, and Histopathological Change in Rats: Alternative Therapy in Transient Global Ischemia. J Mol Neurosci 2020; 70:1639-1648. [PMID: 32488846 DOI: 10.1007/s12031-020-01544-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Accepted: 04/13/2020] [Indexed: 12/16/2022]
Abstract
Selegiline (L-deprenyl) is the major drug which is used in the treatment of Parkinson's disease because of its neurotrophic and antiapoptotic properties. Previous studies suggested that low dose of L-methamphetamine (L-METH) caused lower mortality rate in patients with severe traumatic brain injury. As L-methamphetamine is one of the metabolites of selegiline, the present study aims to examine whether L-deprenyl can improve cognitive, biochemical, and histopathological injury in animal model of transient global ischemia. The animals were randomized in ten groups orally gavaged three times a week for 28 days. Then, novel object recognition (NOR) was conducted to assess their behavioral abnormality. After scarification of the rats, their brains were divided into two sections to measure oxidative stress parameters and perform pathological evaluations in rats. Our data revealed the involvement of oxidative stress, behavioral despair, and pathological data in transient global ischemia rats. Significant recovery in cognitive behavior, oxidative stress biomarker, and number of dead cell in histopathological assay was observed in rats treated with 1,2 and 4 mg/kg of selegiline. So, selegiline appears to be useful in alternative therapy of transient global ischemia.
Collapse
Affiliation(s)
- Mahroo Ahmari
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical sciences, Zanjan, Iran.,Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, P.O. Box: 45139-56184, Zanjan, Iran
| | - Ali Sharafi
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical sciences, Zanjan, Iran.,Zanjan Pharmaceutical Biotechnology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Javad Mahmoudi
- Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Iraj Jafari-Anarkoli
- Department of Anatomical Sciences, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mahmoud Gharbavi
- Zanjan Pharmaceutical Biotechnology Research Center, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Mir-Jamal Hosseini
- Zanjan Applied Pharmacology Research Center, Zanjan University of Medical sciences, Zanjan, Iran. .,Department of Pharmacology and Toxicology, School of Pharmacy, Zanjan University of Medical Sciences, P.O. Box: 45139-56184, Zanjan, Iran.
| |
Collapse
|
31
|
Lei D, Sha Y, Wen S, Xie S, Liu L, Han C. Dexmedetomidine May Reduce IL-6 Level and the Risk of Postoperative Cognitive Dysfunction in Patients After Surgery: A Meta-Analysis. Dose Response 2020; 18:1559325820902345. [PMID: 32076394 PMCID: PMC7003176 DOI: 10.1177/1559325820902345] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2019] [Revised: 12/11/2019] [Accepted: 12/19/2019] [Indexed: 01/27/2023] Open
Abstract
Dexmedetomidine (DEX) was widely used in clinical work. However, the effectiveness of DEX on postoperative cognitive dysfunction (POCD) was still need to be confirmed. The aim of this meta-analysis was to explore whether DEX can reduce the incidence of POCD on the first day and seventh postoperative day. The results showed that lower incidence of POCD associated with DEX treatment on the first (odds ratio [OR]: 0.41; 95% confidence interval [CI]: 0.31-0.54) or seventh postoperative day (OR: 0.53; 95% CI: 0.36-0.77). Mini-Mental State Examination scores on the first (mean difference [MD]: 4.67; 95% CI: 1.72-7.63) and seventh postoperative days (MD: 3.71; 95% CI: 2.51-4.90) were higher in DEX use group than that in physiological saline group. Meanwhile, neuron-specific enolase (NSE; MD: −3.99; 95% CI: −6.20 to −1.78) and interleukin 6 (IL-6) levels (MD: −17.53; 95% CI: −21.51 to −13.54) on the first postoperative day in DEX group were lower than that in the physiological saline group. This meta-analysis suggested that DEX use could reduce the risk of POCD and the reduction in levels of NSE and IL-6 can improve long-term cognitive dysfunction and anti-inflammation.
Collapse
Affiliation(s)
- Daoyun Lei
- Department of Anesthesiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, China
| | - Yeqin Sha
- Nanjing Medical University, Jiangsu, China
| | - Shuang Wen
- Nanjing Medical University, Jiangsu, China
| | - Songhui Xie
- Department of Anesthesiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, China
| | - Li Liu
- Department of Anesthesiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, China
| | - Chao Han
- Department of Anesthesiology, The Affiliated Yixing Hospital of Jiangsu University, Yixing, China.,Yixing Clinical College, Medical College of Yangzhou University, Yixing, Jiangsu, China
| |
Collapse
|
32
|
Zhai Y, Zhu Y, Liu J, Xie K, Yu J, Yu L, Deng H. Dexmedetomidine Post-Conditioning Alleviates Cerebral Ischemia-Reperfusion Injury in Rats by Inhibiting High Mobility Group Protein B1 Group (HMGB1)/Toll-Like Receptor 4 (TLR4)/Nuclear Factor kappa B (NF-κB) Signaling Pathway. Med Sci Monit 2020; 26:e918617. [PMID: 31912804 PMCID: PMC6977611 DOI: 10.12659/msm.918617] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Cerebral ischemia-reperfusion injury is a pivotal cause of deaths due to cerebrovascular accident. Increased research efforts are needed to reveal the mechanism underlying its aggravation or alleviation. In this study, the effects of dexmedetomidine post-conditioning on the HMGB1/TLR4/NF-kappaB signaling pathway in cerebral ischemia-reperfusion rats was explored. MATERIAL AND METHODS Ninety rats were randomly divided into 5 groups - a sham group (Sham), a model group (I/R), a dexmedetomidine post-conditioning group (Dex), a recombinant high mobility group protein B1 group (rHMGB1), and a recombinant HMGB1+dexmedetomidine post-conditioning group (rHMGB1+Dex) - with 18 rats in each group. Longa grading, wet-dry weighing, TTC staining, HE staining, and immunohistochemical staining were used to assess brain damage. ELISA, RT-PCR, and Western blot analyses were performed to assess expression of IL-1ß, TNF-alpha, IL-6, IL-8, HMGB1, TLR4, and NF-kappaB. RESULTS Compared with the I/R group, the neurological function score, brain water content, infarction area, and the number of COX-2- and IBA-1-positive cells in the Dex group were significantly lower, accompanied by downregulated expression of the HMGB1/TLR4/NF-kappaB pathway, alleviated inflammation, and oxidative stress injury in brain tissue. These trends were mostly reversed in the rHMGB1 group and rHMGB1+Dex group, but not in the Dex group. Furthermore, when compared to the Dex group, there were significant increases of H₂O₂, MDA, NO, IL-1ß, TNF-alpha, IL-6, IL-8, HMGB1, TLR4, and p-P65 in the rHMGB1 group and rHMGB1+Dex group, in which a significant decrease of T-AOC, SOD, and p-IkappaBalpha was also detected. CONCLUSIONS Dexmedetomidine post-conditioning can alleviate cerebral ischemia-reperfusion injury in rats by inhibiting the HMGB1/TLR4/NF-kappaB signaling pathway.
Collapse
Affiliation(s)
- Yongyi Zhai
- Department of Rehabilitation, Linzi District People's Hospital, Zibo, Shandong, China (mainland)
| | - Yulin Zhu
- Department of Anesthesiology, Yantaishan Hospital, Yantai, Shandong, China (mainland)
| | - Jingying Liu
- Department of Obstetrics, Yantaishan Hospital, Yantai, Shandong, China (mainland)
| | - Kun Xie
- Department of Anesthesiology, The Second Hospital of Shandong University, Jinan, Shandong, China (mainland)
| | - Jingui Yu
- Department of Anesthesiology, Qilu Hospital of Shandong University, Jinan, Shandong, China (mainland)
| | - Lingzhi Yu
- Department of Pain, Jinan Central Hospital affiliated to Shandong University, Jinan, Shandong, China (mainland)
| | - Hongyan Deng
- Department of Anesthesiology, Haiyang People's Hospital, Haiyang, Shandong, China (mainland)
| |
Collapse
|
33
|
Sun Y, Li L, Wu J, Gong B, Liu H. Germacrone cooperates with dexmedetomidine to alleviate high-fat diet-induced type 2 diabetes mellitus via upregulating AMPKα1 expression. Exp Ther Med 2019; 18:3514-3524. [PMID: 31602228 PMCID: PMC6777304 DOI: 10.3892/etm.2019.7990] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 06/27/2019] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to investigate the effects of germacrone (GM) and dexmedetomidine (DEX) in treating type 2 diabetes mellitus (T2DM). A high-fat diet (HFD)-induced T2DM rat model was established. The experimental rats were divided into the control group, HFD group, GM treatment group, DEX treatment group and GM + DEX treatment group. In addition, adenosine monophosphate-activated protein kinase (AMPK) inhibitor compound C (CC) was used to inhibit AMPKα1 expression. All rats received their respective treatment daily for 21 days. Blood glucose and lipid levels, apoptosis of hepatic cells, and levels of inflammatory factors and oxidative stress indicators in serum samples were evaluated. Protein expression of AMPKα1 and its downstream targets were also investigated. Results demonstrated that blood glucose concentration, blood lipid indicators (endothelin, total cholesterol, triglyceride and low density lipoprotein cholesterol), cell apoptosis in liver tissues, total oxidant status, malondialdehyde, interleukin (IL)-6, tumor necrosis factor-α (TNF-α) and IL-1β levels in serum were increased in the high-fat group compared to the control but decreased following GM and/or DEX treatment. By contrast, high-density lipoprotein cholesterol and antioxidative stress indicator superoxide dismutase (SOD) were decreased in the high-fat group but increased following GM and/or DEX treatment. Protein expression of AMPKα1 and the catabolic genes carnitine palmitoyltransferase-1, peroxisome proliferator-activated receptor-α and acyl coenzyme A were decreased whilst anabolic genes, including sterol regulatory element binding protein-1c, fatty acid synthase and diacylglycerol acyltransferase-2, were increased in the HFD group. These effects were attenuated by GM and/or DEX treatment. AMPKα1 inhibition resulted in decreased SOD and increased cell apoptosis in liver tissues as well as increased IL-6, TNF-α and IL-1β levels compared with the HFD group. However, these effects were abolished following treatment with CC, GM and DEX together. Taken together these results indicated that GM worked synergistically with DEX to attenuate symptoms of high-fat-induced T2DM, with the effect potentially involving an increase in AMPKα1 expression.
Collapse
Affiliation(s)
- Yang Sun
- Department of Anesthesia, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150000, P.R. China
| | - Lanlan Li
- Department of Anesthesia, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150000, P.R. China
| | - Jun Wu
- Department of Anesthesia, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150000, P.R. China
| | - Bing Gong
- Department of Anesthesia, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150000, P.R. China
| | - Haiyan Liu
- Department of Anesthesia, Heilongjiang Provincial Hospital, Harbin, Heilongjiang 150000, P.R. China
| |
Collapse
|
34
|
|
35
|
Dexmedetomidine Impairs Diaphragm Function and Increases Oxidative Stress but Does Not Aggravate Diaphragmatic Atrophy in Mechanically Ventilated Rats. Anesthesiology 2019; 128:784-795. [PMID: 29346133 DOI: 10.1097/aln.0000000000002081] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Anesthetics in ventilated patients are critical as any cofactor hampering diaphragmatic function may have a negative impact on the weaning progress and therefore on patients' mortality. Dexmedetomidine may display antioxidant and antiproteolytic properties, but it also reduced glucose uptake by the muscle, which may impair diaphragm force production. This study tested the hypothesis that dexmedetomidine could inhibit ventilator-induced diaphragmatic dysfunction. METHODS Twenty-four rats were separated into three groups (n = 8/group). Two groups were mechanically ventilated during either dexmedetomidine or pentobarbital exposure for 24 h, referred to as interventional groups. A third group of directly euthanized rats served as control. Force generation, fiber dimensions, proteolysis markers, protein oxidation and lipid peroxidation, calcium homeostasis markers, and glucose transporter-4 (Glut-4) translocation were measured in the diaphragm. RESULTS Diaphragm force, corrected for cross-sectional area, was significantly decreased in both interventional groups compared to controls and was significantly lower with dexmedetomidine compared to pentobarbital (e.g., 100 Hz: -18%, P < 0.0001). In contrast to pentobarbital, dexmedetomidine did not lead to diaphragmatic atrophy, but it induced more protein oxidation (200% vs. 73% in pentobarbital, P = 0.0015), induced less upregulation of muscle atrophy F-box (149% vs. 374% in pentobarbital, P < 0.001) and impaired Glut-4 translocation (-73%, P < 0.0005). It activated autophagy, the calcium-dependent proteases, and caused lipid peroxidation similarly to pentobarbital. CONCLUSIONS Twenty-four hours of mechanical ventilation during dexmedetomidine sedation led to a worsening of ventilation-induced diaphragm dysfunction, possibly through impaired Glut-4 translocation. Although dexmedetomidine prevented diaphragmatic fiber atrophy, it did not inhibit oxidative stress and activation of the proteolytic pathways.
Collapse
|
36
|
Effect of Dexmedetomidine on Cerebral Vasospasm and Associated Biomarkers in a Rat Subarachnoid Hemorrhage Model. J Neurosurg Anesthesiol 2019; 31:342-349. [DOI: 10.1097/ana.0000000000000504] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
37
|
Yao Y, Hu X, Feng X, Zhao Y, Song M, Wang C, Fan H. Dexmedetomidine alleviates lipopolysaccharide-induced acute kidney injury by inhibiting the NLRP3 inflammasome activation via regulating the TLR4/NOX4/NF-κB pathway. J Cell Biochem 2019; 120:18509-18523. [PMID: 31243816 DOI: 10.1002/jcb.29173] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/22/2019] [Accepted: 05/23/2019] [Indexed: 02/06/2023]
Abstract
Dexmedetomidine (DEX) prevents kidney damage caused by sepsis, but the mechanism of this effect remains unclear. In this study, the protective molecular mechanism of DEX in lipopolysaccharide (LPS)-induced acute kidney injury was investigated and its potential pharmacological targets from the perspective of inhibiting oxidative stress damage and the nucleotide-binding domain-like receptor protein 3 (NLRP3) inflammasome activation. Intraperitoneal injection of DEX (30 μg/kg) significantly improved LPS (10 mg/kg) induced renal pathological damage and renal dysfunction. DEX also ameliorated oxidative stress damage by reducing the contents of reactive oxygen species, malondialdehyde and hydrogen peroxide, and increasing the level of glutathione, as well as the activity of superoxide dismutase and catalase. In addition, DEX prevented nuclear factor-kappa B (NF-κB) activation and I-kappa B (IκB) phosphorylation, as well as the expressions of NLRP3 inflammasome-associated protein and downstream IL-18 and IL-1β. The messengerRNA (mRNA) and protein expressions of toll-like receptor 4 (TLR4), NADPH oxidase-4 (NOX4), NF-κB, and NLRP3 were also significantly reduced by DEX. Their expressions were further evaluated by immunohistochemistry, yielding results were consistent with the results of mRNA and protein detection. Interestingly, the protective effects of DEX were reversed by atipamezole-an alpha 2 adrenal receptor (α2 AR) inhibitor, whereas idazoxan-an imidazoline receptor (IR) inhibitor failed to reverse this change. In conclusion, DEX attenuated LPS-induced AKI by inhibiting oxidative stress damage and NLRP3 inflammasome activation via regulating the TLR4/NOX4/NF-κB pathway, mainly acting on the α2 AR rather than IR.
Collapse
Affiliation(s)
- Yujie Yao
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Xueyuan Hu
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Xiujing Feng
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Yuan Zhao
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Manyu Song
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Chaoran Wang
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China
| | - Honggang Fan
- College of Veterinary Medicine, Northeast Agricultural University, Harbin, China.,College of Veterinary Medicine, Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, Harbin, China
| |
Collapse
|
38
|
Feng X, Guan W, Zhao Y, Wang C, Song M, Yao Y, Yang T, Fan H. Dexmedetomidine ameliorates lipopolysaccharide-induced acute kidney injury in rats by inhibiting inflammation and oxidative stress via the GSK-3β/Nrf2 signaling pathway. J Cell Physiol 2019; 234:18994-19009. [PMID: 30919976 DOI: 10.1002/jcp.28539] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Revised: 02/22/2019] [Accepted: 03/05/2019] [Indexed: 12/19/2022]
Abstract
Acute kidney injury (AKI) is a frequent and serious complication of sepsis; however, there are currently no effective therapies. Inflammation and oxidative stress are the major mechanisms implicated in lipopolysaccharide (LPS)-induced AKI. Dexmedetomidine (DEX) has been reported to have remarkable anti-inflammatory and antioxidant effects. Here, we examined the renoprotective effects of DEX and potential underlying mechanisms in rats with LPS-induced AKI. We analyzed renal function and structure; serum inflammatory cytokine; renal oxidant and antioxidant levels; and renal expression of glycogen synthase kinase-3β (GSK-3β)/nuclear factor erythroid 2-related factor 2 (Nrf2) pathway-related proteins in rats 4 hr after administration of LPS. Pretreatment with DEX improved renal function and significantly reduced the levels of inflammatory cytokines and oxidative stress markers. Treatment with DEX and the GSK-3β inhibitor SB216367 promoted phosphorylation of GSK-3β, induced Nrf2 nuclear translocation, and increased transcription of the Nrf2 target genes heme oxygenase-1 and NAD(P)H quinone oxidoreductase-1, primarily in renal tubules. Alpha-2-adrenergic receptor (α2-AR) antagonist atipamezole and imidazoline I 2 receptor (I 2 R) antagonist idazoxan reversed the effects of DEX. These results suggest that the renoprotective effects of DEX are mediated via α2-AR and I 2 R-dependent pathways that reduce inflammation and oxidative stress through GSK-3β/Nrf2 signaling.
Collapse
Affiliation(s)
- Xiujing Feng
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Wei Guan
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Yuan Zhao
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Chaoran Wang
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Manyu Song
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Yujie Yao
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Tianyuan Yang
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| | - Honggang Fan
- Heilongjiang Key Laboratory for Laboratory Animals and Comparative Medicine, College of Veterinary Medicine, Northeast Agricultural University, Harbin, People's Republic of China
| |
Collapse
|
39
|
Kim SH, Kim DH, Shin S, Kim SJ, Kim TL, Choi YS. Effects of dexmedetomidine on inflammatory mediators after tourniquet-induced ischemia-reperfusion injury: a randomized, double-blinded, controlled study. Minerva Anestesiol 2019; 85:279-287. [DOI: 10.23736/s0375-9393.18.13015-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
40
|
Comparison of dexmedetomidine vs. remifentanil combined with sevoflurane during radiofrequency ablation of hepatocellular carcinoma: a randomized controlled trial. Trials 2019; 20:28. [PMID: 30621749 PMCID: PMC6326039 DOI: 10.1186/s13063-018-3010-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 10/20/2018] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Remifentanil is widely used for ultrasound-guided percutaneous radiofrequency ablation (RFA) of small hepatocellular carcinoma (HCC). We determined whether dexmedetomidine could be an alternative to remifentanil for RFA of HCC under general anesthesia with sevoflurane. METHODS We prospectively randomized patients scheduled to undergo RFA for HCC to a dexmedetomidine (DEX) group or remifentanil (REMI) group (47 patients each). In the DEX group, a bolus infusion (0.4 μg kg- 1) was started 15 min before anesthesia induction and continued at 0.2 μg kg- 1 h- 1 until 10 min before the end of surgery. In the REMI group, 3 μg kg- 1 h- 1 of remifentanil was administered from 15 min before anesthesia induction to the end of the surgery. The primary endpoint was postoperative pain intensity. Secondary endpoints included analgesic requirement, postoperative liver function, patient comfort, and hemodynamic changes. Group allocation was concealed from patients and data analysts but not from anesthesiologists. RESULTS Postoperative pain intensity, analgesic consumption, comfort, liver function, and time to emergence and extubation did not differ between the two groups. Heart rate, but not mean arterial pressure, was significantly lower in the DEX group than in the REMI group, at 1 min after intubation and from 30 min after the start of the surgery until anesthesia recovery. Sevoflurane concentration and dosage were significantly lower in the DEX group than in the REMI group. CONCLUSION During RFA for HCC, low-dose dexmedetomidine reduced the heart rate and need for inhalational anesthetics, without exacerbating postoperative discomfort or liver dysfunction. Although it did not exhibit outstanding advantages over remifentanil in terms of pain management, dexmedetomidine could be a safe alternative adjuvant for RFA under sevoflurane anesthesia. TRIAL REGISTRATION Chinese Clinical Trial Registry, ChiCTR-OPC-15006613 . Registered on 16 June 2015.
Collapse
|
41
|
Oh JE, Jun JH, Hwang HJ, Shin EJ, Oh YJ, Choi YS. Dexmedetomidine restores autophagy and cardiac dysfunction in rats with streptozotocin-induced diabetes mellitus. Acta Diabetol 2019; 56:105-114. [PMID: 30206697 DOI: 10.1007/s00592-018-1225-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 09/03/2018] [Indexed: 12/17/2022]
Abstract
AIMS Dexmedetomidine (DEX), a highly selective and potent α2-adrenergic receptor agonist, has anti-apoptotic, anti-inflammatory, and anti-oxidative stress effects in diabetes mellitus (DM) rats. The underlying molecular mechanisms and signaling pathways of diabetic cardiomyopathy remain poorly understood. This study aimed to elucidate the effect of DEX on cardiac function in DM rats. METHODS Eight-week-old male Sprague Dawley rats were divided into three groups: control (n = 5), diabetes (DM, n = 7), and diabetes + DEX (DM + DEX, n = 10). DM was induced via intraperitoneal injection of streptozotocin (70 mg/kg); at 3 days later, DEX (1 µg/kg/h) was administered for 4 weeks. Cardiac function was evaluated using pressure-volume loop analysis and echocardiography. Left ventricular (LV) histological sections were used to analyze the interstitial collagen fraction. Using the LV samples, we performed a western blot analysis to evaluate signaling pathways and autophagic markers. RESULTS The DM group had lower body weight and higher blood glucose level and heart weight/body weight ratio than the control group. However, metabolic changes did not differ between the DM and DM + DEX groups. Pressure-volume loop analysis and echocardiography showed impaired cardiac function, evidenced by a decrease in systolic and diastolic function, in both DM groups. DEX treatment in DM rats was associated with increased LV end-systolic pressure, LV contractility, cardiac output, and relaxed LV function compared with that in non-treated DM rats. LC3B and autophagy-related gene (ATG) proteins increased in the hearts of DM rats compared with the hearts of control rats. However, DEX reduced the expression of LC3B and ATG proteins in the hearts of DM rats. Increased p-ERK and decreased p-AKT were reduced in the hearts of DEX-treated DM rats. CONCLUSIONS DEX reduces cardiac dysfunction and impaired autophagy in DM rats. This study reinforces our understanding of the potential anti-autophagic effect of DEX in patients with diabetic cardiomyopathy.
Collapse
Affiliation(s)
- Ju Eun Oh
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Ji Hae Jun
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hye Jeong Hwang
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Eun Jung Shin
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Young Jun Oh
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Yong Seon Choi
- Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
- Department of Anesthesiology and Pain Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea.
| |
Collapse
|
42
|
Li J, Zhao Y, Zhou N, Li L, Li K. Dexmedetomidine Attenuates Myocardial Ischemia-Reperfusion Injury in Diabetes Mellitus by Inhibiting Endoplasmic Reticulum Stress. J Diabetes Res 2019; 2019:7869318. [PMID: 31886285 PMCID: PMC6914963 DOI: 10.1155/2019/7869318] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 09/24/2019] [Accepted: 10/25/2019] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE With the increasing incidence of diabetes mellitus (DM) combined with myocardial ischemia, how to reduce myocardial ischemia-reperfusion injury in DM patients has become a major problem faced by clinicians. We investigated the therapeutic effects of dexmedetomidine (DEX) on myocardial ischemia-reperfusion injury in DM rats and its effect on endoplasmic reticulum stress. METHODS SD rats with SPF grade were randomly divided into 6 groups: non-DM rats were divided into the sham operation group (NDM-S group), ischemia-reperfusion group (NDM-IR group), and dexmedetomidine group (NDM-DEX group); DM rats were divided into the diabetic sham operation group (DM-S group), diabetes-reperfusion group (DM-IR group), and diabetes-dexmedetomidine (DM-DEX) group, with 10 rats in each group. Then the effects of DEX on the changes of CK-MB and cTnT levels were examined. The effects of myocardial pathological damage and myocardial infarct size were detected. The apoptosis of cardiomyocytes was detected. The apoptosis of heart tissue cells was also tested through the expressions of cleaved caspase-3, Bcl-2, and Bax proteins. The expression of endoplasmic reticulum stress-related proteins GRP78, CHOP, ERO1α, ERO1β, and PDI was examined. The hypoxia/reoxygenation (H/R) injury cell model was established, the effects of DEX, DEX+ ERS agonist on cell apoptosis was also detected. RESULTS The myocardial damage of DM-IR was more severe than that of NDM-IR rats. DEX could reduce the expression of CK-MB and cTnT, reduce pathological damage, and reduce scar formation and improve fibrosis. DEX can reduce the expression of GRP78, CHOP, ERO1α, ERO1β, and PDI proteins in vivo and in vitro. And the effect of DEX on cell apoptosis could be blocked by ERS agonist. CONCLUSION DEX attenuates myocardial ischemia-reperfusion injury in DM rats and H/R injury cell, which is associated with the reduction of ERS-induced cardiomyocyte apoptosis.
Collapse
MESH Headings
- Animals
- Apoptosis/drug effects
- Cell Line
- Creatine Kinase, MB Form/blood
- Dexmedetomidine/pharmacology
- Diabetes Mellitus, Experimental/complications
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Endoplasmic Reticulum Stress/drug effects
- Fibrosis
- Heat-Shock Proteins/metabolism
- Male
- Membrane Glycoproteins/metabolism
- Myocardial Infarction/metabolism
- Myocardial Infarction/pathology
- Myocardial Infarction/prevention & control
- Myocardial Reperfusion Injury/complications
- Myocardial Reperfusion Injury/metabolism
- Myocardial Reperfusion Injury/pathology
- Myocardial Reperfusion Injury/prevention & control
- Myocytes, Cardiac/drug effects
- Myocytes, Cardiac/metabolism
- Myocytes, Cardiac/pathology
- Protein Disulfide-Isomerases/metabolism
- Rats, Sprague-Dawley
- Signal Transduction
- Transcription Factor CHOP/metabolism
- Troponin T/blood
Collapse
Affiliation(s)
- Jinjie Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin 130033, China
| | - Ying Zhao
- Department of Nephrology, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun Jilin 130021, China
| | - Nan Zhou
- Department of Anesthesia, The General Hospital of Northern Theater Command, Shenyang 110016, China
| | - Longyun Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin 130033, China
| | - Kai Li
- Department of Anesthesiology, China-Japan Union Hospital of Jilin University, No. 126, Xiantai Street, Changchun, Jilin 130033, China
| |
Collapse
|
43
|
Pan L, Qian S. Apocynin promotes neural function recovery and suppresses neuronal apoptosis by inhibiting Tlr4/NF-κB signaling pathway in a rat model of cerebral infarction. Int J Immunopathol Pharmacol 2018. [PMCID: PMC6291862 DOI: 10.1177/2058738418817700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Occlusion of arteries in the brain is a common cause of cerebral infarction which
induces inflammatory response and oxidative stress resulting in neuronal
apoptosis and disruption of neurological function. The present study
investigated the protective roles of an nicotinamide adenine dinucleotide
phosphate oxidase inhibitor, apocynin, against cerebral infarction. Rat went
through a surgery of middle cerebral artery occlusion and a subset of rats was
treated with apocynin by intraperitoneal injection. The volume of cerebral
infarction and water content were measured. Neuronal apoptosis, inflammatory
response, and oxidative stress were assessed following middle cerebral artery
occlusion and apocynin treatment. We found that apocynin significantly improved
neurological function, increased forelimb placement test scores, and suppressed
balance beam walk latency in rats with cerebral infarction. Histological and
biochemistry analysis revealed that apocynin lead to a significant reduction in
the volume of cerebral infarction as well as cerebral water content, suppressed
neuronal apoptosis, oxidative stress, and inflammatory response induced by
middle cerebral artery occlusion. Finally, we found that apocynin suppressed
Tlr4/nuclear factor-k-gene binding signaling pathway that was upregulated in
rats with cerebral infarction. Our results indicate that apocynin may represent
a potent therapeutic strategy in alleviating neurological dysfunctions in
patients with cerebral infarction.
Collapse
Affiliation(s)
- Lemen Pan
- Department of Vascular Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Shuxia Qian
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| |
Collapse
|
44
|
Kuzgun Ö, Özkardeşler S, Özbilgin Ş, Akan M, Ergür BU, Kamacı G, Güneli ME, Ateş N, Şişman AR, Dalak RM. Effects of Dexmedetomidine on Renal Ischaemia Reperfusion Injury in Streptozotocin-Induced Diabetic Rats. Turk J Anaesthesiol Reanim 2018; 46:462-469. [PMID: 30505609 DOI: 10.5152/tjar.2018.62592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Accepted: 06/10/2018] [Indexed: 11/22/2022] Open
Abstract
Objective The aim of this study was to investigate the effects of dexmedetomidine before and after ischaemia in diabetic rat kidney ischaemia reperfusion (IR) injury in the experimental diabetic rat model. Methods Data belonging to 35 rats weighing between 250 and 300 g were analysed. Diabetes mellitus (DM) was induced using streptozotocin. Groups had bilateral renal vasculature clamped for 45 min ischaemia before clamps were removed, and 4 hours reperfusion was applied. Rats were divided into five groups: Group I or nondiabetic sham group (n=7), Group II or diabetic sham group (n=7), Group III or diabetic IR group (n=7), Group IV or diabetic IR+prophylactic Dex P (before ischaemia) (n=7) and Group V or diabetic IR+therapeutic Dex T (following reperfusion) (n=7). Dexmedetomidine was administered at a dose of 100 μg kg-1 intraperitoneally. Histomorphological and biochemical methods were used to assess the blood and tissue samples. Results The proximal tubule injury score in the control sham group was significantly lower than in other groups. The proximal tubule and total cell damage scores of the diabetic IR group were significantly higher than the diabetic IR+Dex T group, and no significant difference was detected in the diabetic IR+Dex P group. The biochemical parameters of the IR group were significantly increased compared to Groups I and II; however, there was no significant reduction in these parameters in the groups administered dexmedetomidine. Conclusion Although administration of dexmedetomidine after ischaemia in the diabetic rat renal IR model was found to be more effective on the histopathological injury scores compared to preischaemic administration, this study has not shown that dexmedetomidine provides effective and complete protection in DM.
Collapse
Affiliation(s)
- Özge Kuzgun
- Department of Anaesthesiology and Intensive Care, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Sevda Özkardeşler
- Department of Anaesthesiology and Intensive Care, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Şule Özbilgin
- Department of Anaesthesiology and Intensive Care, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Mert Akan
- Department of Anaesthesiology and Intensive Care, Kent Private Hospital, İzmir, Turkey
| | - Bekir Uğur Ergür
- Department of Histology, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Gonca Kamacı
- Department of Experienced Laboratory Animal Science, Dokuz Eylül University, Vocational School of Health Services, İzmir, Turkey
| | - Mehmet Ensari Güneli
- Department of Experienced Laboratory Animal Science, Dokuz Eylül University, Vocational School of Health Services, İzmir, Turkey
| | - Nazire Ateş
- Department of Anaesthesiology and Intensive Care, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Ali Rıza Şişman
- Departments of Biochemistry, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Reci Meseri Dalak
- Department of Nutrition and Dietetics, Ege University İzmir Atatürk School of Health, İzmir, Turkey
| |
Collapse
|
45
|
Abad-Gurumeta A, Gómez-Ríos MÁ, Calvo-Vecino JM. Intravenous dexmedetomidine: can it modulate the effects of inflammation, or is it only an antinociceptive agent? Minerva Anestesiol 2018; 85:226-228. [PMID: 30484298 DOI: 10.23736/s0375-9393.18.13217-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Alfredo Abad-Gurumeta
- Department of Anesthesiology and Perioperative Medicine, Infanta Leonor University Hospital, Madrid, Spain -
| | - Manuel Á Gómez-Ríos
- Department of Anesthesiology and Perioperative Medicine, University Hospital of A Coruña, A Coruña, Spain.,Anesthesiology and Pain Management Research Group, Institute for Biomedical Research of A Coruña (INIBIC), A Coruña, Spain.,Spanish Difficult Airway Group (GEVAD), A Coruña, Spain
| | - José M Calvo-Vecino
- Department of Anesthesia and Perioperative Medicine, University Care Complex of Salamanca, Salamanca, Spain
| |
Collapse
|
46
|
Xie W, Xie W, Kang Z, Jiang C, Liu N. Hydromorphone protects CA1 neurons by activating mTOR pathway. Neurosci Lett 2018; 687:49-54. [DOI: 10.1016/j.neulet.2018.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/14/2018] [Accepted: 09/15/2018] [Indexed: 12/20/2022]
|
47
|
Guo D, Li Y, Wang H, Wang X, Hua W, Tang Q, Miao L, Wang G. Propofol post-conditioning after temporary clipping reverses oxidative stress in aneurysm surgery. Int J Neurosci 2018; 129:155-164. [PMID: 29882696 DOI: 10.1080/00207454.2018.1483920] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
PURPOSE Animal studies have demonstrated that propofol post-conditioning produces long-term neuroprotection in focal cerebral ischemia-reperfusion injury. However, whether propofol post-conditioning provides neuroprotection in human beings has never been explored. The aim of this study was to evaluate the role of propofol post-conditioning on oxidative stress and post-operative cognitive function following aneurysm clipping. MATERIALS AND METHODS Sixty patients undergoing intracranial aneurysm clipping were randomized into a propofol post-conditioning group or a sevoflurane group. Sevoflurane (0.5-2%) was used for maintenance anesthesia in both groups. In the propofol post-conditioning group, the inhaled concentration of sevoflurane was reduced after temporary clip removal to keep the bispectral index (BIS) value between 40 and 60, and propofol (Cp 1.2 µg/mL) was subsequently started. Blood samples were drawn at six time points: before induction, immediately after clip removal, at the end of the operation, 24-h post-surgery, 3 days post-surgery, and 7 days post-surgery. Oxidative stress and cognitive function were measured. RESULTS Between the conclusion of the operation to 7 days after surgery, propofol post-conditioning decreased the serum concentration of •OH and 8-isoprostane and increased γ-tocopherol and SOD. Reduced micronuclei and nucleoplasmic bridges were observed in the propofol post-conditioning group. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were improved by propofol post-conditioning compared to the group that received no propofol. CONCLUSIONS Together, our data suggest that propofol post-conditioning (Cp 1.2 µg/mL) may protect the brain from oxidative stress injury up to 7 days post-surgery after temporary parent artery clipping. Furthermore, the neuroprotection induced by propofol post-conditioning may contribute to improvement in cognitive function.
Collapse
Affiliation(s)
- Di Guo
- a Department of Anesthesiology, Key Laboratory of Artificial Cell , Institute of Hepatobiliary Disease, The Third Central Clinical College of Tianjin Medical University, Tianjin the Third Central Hospital , Tianjin , China
| | - Yanli Li
- a Department of Anesthesiology, Key Laboratory of Artificial Cell , Institute of Hepatobiliary Disease, The Third Central Clinical College of Tianjin Medical University, Tianjin the Third Central Hospital , Tianjin , China
| | - Haiyun Wang
- a Department of Anesthesiology, Key Laboratory of Artificial Cell , Institute of Hepatobiliary Disease, The Third Central Clinical College of Tianjin Medical University, Tianjin the Third Central Hospital , Tianjin , China.,b Department of Anesthesiology , Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology , Tianjin , China
| | - Xinyue Wang
- a Department of Anesthesiology, Key Laboratory of Artificial Cell , Institute of Hepatobiliary Disease, The Third Central Clinical College of Tianjin Medical University, Tianjin the Third Central Hospital , Tianjin , China
| | - Wei Hua
- a Department of Anesthesiology, Key Laboratory of Artificial Cell , Institute of Hepatobiliary Disease, The Third Central Clinical College of Tianjin Medical University, Tianjin the Third Central Hospital , Tianjin , China
| | - Qingkai Tang
- a Department of Anesthesiology, Key Laboratory of Artificial Cell , Institute of Hepatobiliary Disease, The Third Central Clinical College of Tianjin Medical University, Tianjin the Third Central Hospital , Tianjin , China
| | - Lumin Miao
- b Department of Anesthesiology , Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology , Tianjin , China
| | - Guolin Wang
- b Department of Anesthesiology , Tianjin Medical University General Hospital, Tianjin Research Institute of Anesthesiology , Tianjin , China
| |
Collapse
|
48
|
Renoprotective effects of dexmedetomidine against ischemia-reperfusion injury in streptozotocin-induced diabetic rats. PLoS One 2018; 13:e0198307. [PMID: 30114208 PMCID: PMC6095484 DOI: 10.1371/journal.pone.0198307] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 08/02/2018] [Indexed: 12/21/2022] Open
Abstract
Background Diabetic patients are susceptible to renal ischemia-reperfusion injury, which leads to perioperative complications. Activation of NOD-like receptor protein 3 (NLRP3) inflammasome participates in the development of diabetes, and contributes to renal ischemia-reperfusion injury. Dexmedetomidine (DEX), a highly selective α2-adrenoreceptor agonist, shows renoprotective effects against ischemia-reperfusion injury. We aimed to elucidate the effects, underlying mechanisms, and optimal timing of DEX treatment in diabetic rats. Methods Male Sprague-Dawley rats (n = 12 per group) were randomly divided into normal-sham, diabetes-sham, diabetes-ischemia-reperfusion-control, diabetes-ischemia-reperfusion-DEX-pre-treatment, and diabetes-ischemia-reperfusion-DEX-post-treatment groups. Renal ischemia-reperfusion injury was induced in diabetic rats by occlusion of both renal arteries for 45 min, followed by reperfusion for 24 h. DEX (10 μg/kg) was administered intraperitoneally 1 h before ischemia (pre-treatment) or upon reperfusion (post-treatment). After reperfusion, renal tissue was biochemically and histopathologically evaluated. Results DEX treatment attenuated ischemia reperfusion-induced increase in NLRP3, caspase-1, IL-1β, phospho-AKT, and phospho-ERK signaling. Moreover, oxidative stress injury, inflammatory reactions, apoptosis, and renal tubular damage were favorably modulated by DEX treatment. Furthermore, post-reperfusion treatment with DEX was significantly more effective than pre-treatment in modulating NLRP3 inflammasome, AKT and ERK signaling, and oxidative stress. Conclusions This study shows that the protective effects of DEX in renal ischemia-reperfusion injury are preserved in diabetic conditions and may potentially provide a basis for the use of DEX in clinical treatment of renal ischemia-reperfusion injury.
Collapse
|
49
|
Wang Z, Zhou W, Dong H, Ma X, He Z. Dexmedetomidine pretreatment inhibits cerebral ischemia/reperfusion‑induced neuroinflammation via activation of AMPK. Mol Med Rep 2018; 18:3957-3964. [PMID: 30106098 DOI: 10.3892/mmr.2018.9349] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 04/11/2018] [Indexed: 11/06/2022] Open
Abstract
Focal ischemia/reperfusion (I/R) injury induced cerebral inflammation, aggravates brain damage. The aim of the present study was to investigate the protective mechanisms of dexmedetomidine (DEX) on I/R brain injury in rats. Sprague‑Dawley rats were divided to seven experimental groups (18 rats/group): Sham surgery; middle cerebral artery occlusion (MCAO) surgery (90 min); DEX10 [10 µg/kg intraperitoneal (i.p.) injection 30 min prior to MCAO]; DEX50 (50 µg/kg i.p. 30 min prior to MCAO); DEX100 (100 µg/kg i.p. 30 min prior to MCAO); DEX50+Yohimbine [YOH; 5 mg/kg 10 min prior to DEX (50 µg/kg i.p.) administration and MCAO] and YOH (5 mg/kg 40 min prior to MCAO). At 24 h post‑MCAO surgery, neurological deficit was examined by staining damaged brain tissues with 2,3,5‑triphenyltetrazolium chloride. Neuronal apoptosis in the cerebral cortex was histologically assessed by terminal deoxynucleotidyl‑transferase‑mediated dUTP nick end labeling staining, and the expression levels of phosphorylated (p)‑AMP‑activated protein kinase (AMPK; Thr172) was detected by western blotting. In addition, the expression levels of tumor necrosis factor (TNF)‑α and interleukin (IL)‑1β were assessed by ELISA. At days 1, 2 and 5 following I/R, motor functions were assessed by an observer blinded to the study. The brain infarct size, neurological deficit scores, number of apoptotic neurons, expression levels of pro‑inflammatory cytokines TNF‑α and IL‑1β were increased following MCAO, whereas the motor function scores were reduced. Pretreatment with DEX prior to MCAO can reverse the effects induced by I/R. Compared with rats in the Sham group, the expression levels of p‑AMPK were mildly increased in the MCAO group and highly increased in the three DEX‑treatment groups. Pretreatment with YOH reversed the above effects of DEX and produced a similar level of cerebral I/R injury. The results demonstrated that precondition with DEX exhibited anti‑inflammatory effects on brain ischemic injury mediated by AMPK signal pathway.
Collapse
Affiliation(s)
- Zhenhong Wang
- Department of Anesthesiology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, P.R. China
| | - Wei Zhou
- Department of Anesthesiology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, P.R. China
| | - Haiping Dong
- Department of Anesthesiology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, P.R. China
| | - Xiaoxiao Ma
- Department of Anesthesiology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, P.R. China
| | - Zhenzhou He
- Department of Anesthesiology, South Campus, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 201112, P.R. China
| |
Collapse
|
50
|
Zhang Z, Zhang L, Ding Y, Han Z, Ji X. Effects of Therapeutic Hypothermia Combined with Other Neuroprotective Strategies on Ischemic Stroke: Review of Evidence. Aging Dis 2018; 9:507-522. [PMID: 29896438 PMCID: PMC5988605 DOI: 10.14336/ad.2017.0628] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2017] [Accepted: 06/28/2017] [Indexed: 12/19/2022] Open
Abstract
Ischemic stroke is a major cause of death and disability globally, and its incidence is increasing. The only treatment approved by the US Food and Drug Administration for acute ischemic stroke is thrombolytic treatment with recombinant tissue plasminogen activator. As an alternative, therapeutic hypothermia has shown excellent potential in preclinical and small clinical studies, but it has largely failed in large clinical studies. This has led clinicians to explore the combination of therapeutic hypothermia with other neuroprotective strategies. This review examines preclinical and clinical progress towards developing highly effective combination therapy involving hypothermia for stroke patients.
Collapse
Affiliation(s)
- Zheng Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- Department of Neurology, the First Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Linlei Zhang
- Department of Neurology, the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Yuchuan Ding
- Department of Neurological Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Zhao Han
- Department of Neurology, the Second Affiliated Hospital, Wenzhou Medical University, Wenzhou, China
| | - Xunming Ji
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
- China-America Institute of Neuroscience, Xuanwu Hospital, Capital Medical University, Beijing, China
| |
Collapse
|