1
|
AlRuwaili R, Al-Kuraishy HM, Alruwaili M, Khalifa AK, Alexiou A, Papadakis M, Saad HM, Batiha GES. The potential therapeutic effect of phosphodiesterase 5 inhibitors in the acute ischemic stroke (AIS). Mol Cell Biochem 2024; 479:1267-1278. [PMID: 37395897 PMCID: PMC11116240 DOI: 10.1007/s11010-023-04793-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 06/16/2023] [Indexed: 07/04/2023]
Abstract
Acute ischemic stroke (AIS) is a focal neurological disorder that accounts for 85% of all stroke types, due to occlusion of cerebral arteries by thrombosis and emboli. AIS is also developed due to cerebral hemodynamic abnormality. AIS is associated with the development of neuroinflammation which increases the severity of AIS. Phosphodiesterase enzyme (PDEs) inhibitors have neuro-restorative and neuroprotective effects against the development of AIS through modulation of the cerebral cyclic adenosine monophosphate (cAMP)/cyclic guanosine monophosphate (cGMP)/nitric oxide (NO) pathway. PDE5 inhibitors through mitigation of neuroinflammation may decrease the risk of long-term AIS-induced complications. PDE5 inhibitors may affect the hemodynamic properties and coagulation pathway which are associated with thrombotic complications in AIS. PDE5 inhibitors reduce activation of the pro-coagulant pathway and improve the microcirculatory level in patients with hemodynamic disturbances in AIS. PDE5 inhibitors mainly tadalafil and sildenafil improve clinical outcomes in AIS patients through the regulation of cerebral perfusion and cerebral blood flow (CBF). PDE5 inhibitors reduced thrombomodulin, P-selectin, and tissue plasminogen activator. Herein, PDE5 inhibitors may reduce activation of the pro-coagulant pathway and improve the microcirculatory level in patients with hemodynamic disturbances in AIS. In conclusion, PDE5 inhibitors may have potential roles in the management of AIS through modulation of CBF, cAMP/cGMP/NO pathway, neuroinflammation, and inflammatory signaling pathways. Preclinical and clinical studies are recommended in this regard.
Collapse
Affiliation(s)
- Raed AlRuwaili
- Department of Internal Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Hayder M Al-Kuraishy
- Department of Clinical Pharmacology and Medicine, College of Medicine, ALmustansiriyia University, Baghdad, Iraq
| | - Mubarak Alruwaili
- Department of Internal Medicine, College of Medicine, Jouf University, Sakaka, Saudi Arabia
| | - Amira Karam Khalifa
- Department of Medical Pharmacology, Kasr El-Ainy School of Medicine, Cairo University, El Manial, Cairo, 11562, Egypt
- Lecturer of Medical Pharmacology, Nahda Faculty of Medicine, Beni Suef, Egypt
| | - Athanasios Alexiou
- Department of Science and Engineering, Novel Global Community Educational Foundation, Hebersham, NSW, 2770, Australia
- AFNP Med, 1030, Vienna, Austria
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Heusnerstrasse 40, 42283, Wuppertal, Germany.
| | - Hebatallah M Saad
- Department of Pathology, Faculty of Veterinary Medicine, Matrouh University, Marsa Matrouh, 51744, Egypt
| | - Gaber El-Saber Batiha
- Department of Pharmacology and Therapeutics, Faculty of Veterinary Medicine, Damanhour University, Damanhour, 22511, AlBeheira, Egypt
| |
Collapse
|
2
|
Modak A, Zappi KE, Catoya AJ, Lemdani MS, Koller GM, Seltzer L, Radwanski RE, Pannullo SC. Sex Differences in Adult Incarceration After Pediatric Traumatic Brain Injury. Neurotrauma Rep 2024; 5:417-423. [PMID: 38655115 PMCID: PMC11035846 DOI: 10.1089/neur.2023.0066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
Pediatric traumatic brain injury (pTBI) is a major risk factor associated with adulthood incarceration. Most research into the link between pTBI and adulthood incarceration has focused on incarcerated males, who comprise the vast majority of incarcerated adults, particularly in industrialized nations. In this review, we sought to identify sex-related differences in the incidence and pathophysiology of pTBI and subsequent risk of adulthood incarceration. A scoping review was undertaken using PubMed, Scopus, Ovid, and the Cochrane Library. Articles analyzing sex-related differences in pTBI and adult incarceration rates, studies conducted on an incarcerated population, and cohort studies, cross-sectional studies, clinical trials, systematic reviews, or meta-analyses were included in this review. Of the 85 unique results, 25 articles met our inclusion criteria. Male children are 1.5 times more likely to suffer a TBI than females; however, the prevalence of incarcerated adults with a history of pTBI is ∼35-45% for both sexes. Neurophysiologically, female sex hormones are implicated in neuroprotective roles, mitigating central nervous system (CNS) damage post-TBI, although this role may be more complex, given that injury severity and sequelae have been correlated with male sex whereas increased mortality has been correlated with female sex. Further investigation into the relationship between estrogen and subsequent clinical measurements of CNS function is needed to develop interventions that may alleviate the pathophysiological consequences of pTBI.
Collapse
Affiliation(s)
- Anurag Modak
- Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
- Center for Advanced Biotechnology and Medicine, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
- Brain and Spine Group, Bridgewater, New Jersey, USA
| | - Kyle E. Zappi
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Department of Neurological Surgery, Joan & Sanford I. Weill Medical College, College of Engineering, Cornell University, New York, New York, USA
| | - Alexander J. Catoya
- Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
| | - Mehdi S. Lemdani
- Department of Neurosurgery, New Jersey Medical School, Robert Wood Johnson Medical School, Rutgers University, Newark, New Jersey, USA
| | - Gretchen M. Koller
- Brain and Spine Group, Bridgewater, New Jersey, USA
- College of Medicine, Kansas City University, Kansas City, Missouri, USA
| | - Laurel Seltzer
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Tulane University School of Medicine, New Orleans, Louisiana, USA
| | - Ryan E. Radwanski
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Department of Neurological Surgery, Joan & Sanford I. Weill Medical College, College of Engineering, Cornell University, New York, New York, USA
| | - Susan C. Pannullo
- Brain and Spine Group, Bridgewater, New Jersey, USA
- Department of Neurological Surgery, Joan & Sanford I. Weill Medical College, College of Engineering, Cornell University, New York, New York, USA
- Department of Biomedical Engineering, College of Engineering, Cornell University, New York, New York, USA
| |
Collapse
|
3
|
Julien P, Zinni M, Bonnel N, El Kamouh M, Odorcyk F, Peters L, Gautier EF, Leduc M, Broussard C, Baud O. Synergistic effect of sildenafil combined with controlled hypothermia to alleviate microglial activation after neonatal hypoxia-ischemia in rats. J Neuroinflammation 2024; 21:31. [PMID: 38263116 PMCID: PMC10804557 DOI: 10.1186/s12974-024-03022-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND AND PURPOSE The only validated treatment to prevent brain damage associated with hypoxia-ischemia (HI) encephalopathy of the newborn is controlled hypothermia with limited benefits. Additional putative neuroprotective drug candidates include sildenafil citrate, a phosphodiesterase-type 5 inhibitor. The main objective of this preclinical study is to assess its ability to reduce HI-induced neuroinflammation, in particular through its potential effect on microglial activation. METHODS HI was induced in P10 Sprague-Dawley rats by unilateral carotid permanent artery occlusion and hypoxia (HI) and treated by either hypothermia (HT) alone, Sildenafil (Sild) alone or combined treatment (SildHT). Lesion size and glial activation were analyzed by immunohistochemistry, qRT-PCR, and proteomic analyses performed at P13. RESULTS None of the treatments was associated with a significant early reduction in lesion size 72h after HI, despite significant changes in tissue loss distribution. Significant reductions in both Iba1 + (within the ipsilateral hemisphere) and GFAP + cells (within the ipsilateral hippocampus) were observed in SildHT group, but not in the other treatment groups. In microglia-sorted cells, pro-inflammatory markers, i.e. Il1b, Il6, Nos2, and CD86 were significantly downregulated in SildHT treatment group only. These changes were restricted to the ipsilateral hemisphere, were not evidenced in sorted astrocytes, and were not sex dependent. Proteomic analyses in sorted microglia refined the pro-inflammatory effect of HI and confirmed a biologically relevant impact of SildHT on specific molecular pathways including genes related to neutrophilic functions. CONCLUSIONS Our findings suggest that Sildenafil combined with controlled hypothermia produces maximum effect in mitigating microglial activation induced by HI through complex proteomic regulation. The reduction of neuroinflammation induced by Sildenafil may represent an interesting therapeutic strategy for neonatal neuroprotection.
Collapse
Affiliation(s)
- Pansiot Julien
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France
| | - Manuela Zinni
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France
| | - Natacha Bonnel
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France
| | - Marina El Kamouh
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France
| | - Felipe Odorcyk
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France
| | - Lea Peters
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France
| | - Emilie-Fleur Gautier
- Institut Cochin, Proteom'IC Facility, INSERM, CNRS, Université Paris Cité, Paris, France
| | - Marjorie Leduc
- Institut Cochin, Proteom'IC Facility, INSERM, CNRS, Université Paris Cité, Paris, France
| | - Cédric Broussard
- Institut Cochin, Proteom'IC Facility, INSERM, CNRS, Université Paris Cité, Paris, France
| | - Olivier Baud
- Inserm UMR1141 NeuroDiderot, Université Paris Cité, Paris, France.
- Laboratory of Child Growth and Development, University of Geneva, Geneva, Switzerland.
- Division of Neonatology and Pediatric Intensive Care, Département de Pédiatrie, Hôpitaux Universitaires de Genève, Laboratoire de Développement et Croissance, Children's University Hospital of Geneva, Geneva, Switzerland.
| |
Collapse
|
4
|
Loron G, Pansiot J, Olivier P, Charriaut-Marlangue C, Baud O. Inhaled Nitric Oxide Promotes Angiogenesis in the Rodent Developing Brain. Int J Mol Sci 2023; 24:ijms24065871. [PMID: 36982947 PMCID: PMC10054632 DOI: 10.3390/ijms24065871] [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: 01/26/2023] [Revised: 03/12/2023] [Accepted: 03/14/2023] [Indexed: 03/30/2023] Open
Abstract
Inhaled nitric oxide (iNO) is a therapy used in neonates with pulmonary hypertension. Some evidence of its neuroprotective properties has been reported in both mature and immature brains subjected to injury. NO is a key mediator of the VEGF pathway, and angiogenesis may be involved in the reduced vulnerability to injury of white matter and the cortex conferred by iNO. Here, we report the effect of iNO on angiogenesis in the developing brain and its potential effectors. We found that iNO promotes angiogenesis in the developing white matter and cortex during a critical window in P14 rat pups. This shift in the developmental program of brain angiogenesis was not related to a regulation of NO synthases by exogenous NO exposure, nor the VEGF pathway or other angiogenic factors. The effects of iNO on brain angiogenesis were found to be mimicked by circulating nitrate/nitrite, suggesting that these carriers may play a role in transporting NO to the brain. Finally, our data show that the soluble guanylate cyclase/cGMP signaling pathway is likely to be involved in the pro-angiogenetic effect of iNO through thrombospondin-1, a glycoprotein of the extracellular matrix, inhibiting soluble guanylate cyclase through CD42 and CD36. In conclusion, this study provides new insights into the biological basis of the effect of iNO in the developing brain.
Collapse
Affiliation(s)
- Gauthier Loron
- Service de Médecine Néonatale et de Réanimation Pédiatrique, Université de Reims Champagne-Ardenne, CReSTIC, CHU Reims, 51100 Reims, France
| | - Julien Pansiot
- Inserm, NeuroDiderot, Faculty of Medicine, Université Paris Cité, 75019 Paris, France
| | - Paul Olivier
- Inserm, NeuroDiderot, Faculty of Medicine, Université Paris Cité, 75019 Paris, France
| | | | - Olivier Baud
- Inserm, NeuroDiderot, Faculty of Medicine, Université Paris Cité, 75019 Paris, France
- Division of Neonatology and Pediatric Intensive Care, Children's University Hospital of Geneva, 1205 Geneva, Switzerland
| |
Collapse
|
5
|
Inocencio IM, Kaur N, Tran NT, Wong FY. Cerebral haemodynamic response to somatosensory stimulation in preterm lambs is enhanced following sildenafil and inhaled nitric oxide administration. Front Physiol 2023; 14:1101647. [PMID: 36760535 PMCID: PMC9905131 DOI: 10.3389/fphys.2023.1101647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 01/11/2023] [Indexed: 01/26/2023] Open
Abstract
Background: Neurovascular coupling (NVC) leads to an increase in local cerebral blood flow and oxygenation in response to increased neural activity and metabolic demand. Impaired or immature NVC reported in the preterm brain, potentially reduces cerebral oxygenation following increased neural activity, predisposing to cerebral tissue hypoxia. Endogenous nitric oxide (NO) is a potent vasodilator and a major mediator of NVC and the cerebral haemodynamic response. NO modulators, such as inhaled nitric oxide (iNO) and sildenafil, induce vasodilation and are used clinically to treat pulmonary hypertension in preterm neonates. However, their impact on NVC in the preterm brain are unknown. We aimed to characterise the cerebral functional haemodynamic response in the preterm brain exposed to NO modulators. We hypothesized that iNO and sildenafil in clinical dosages would increase the baseline cerebral perfusion and the cerebral haemodynamic response to neural activation. Methods: Preterm lambs (126-7 days' gestation) were delivered and mechanically ventilated. The cerebral functional haemodynamic response was measured using near infrared spectroscopy as changes in cerebral oxy- and deoxyhaemoglobin (ΔoxyHb, ΔdeoxyHb), following left median nerve stimulations of 1.8, 4.8, and 7.8 s durations in control preterm lambs (n = 11), and following 4.8 and 7.8 s stimulations in preterm lambs receiving either sildenafil citrate (n = 6, 1.33 mcg/kg/hr) or iNO (n = 8, 20 ppm). Results: Following 1.8, 4.8, and 7.8 s stimulations, ∆oxyHb in the contralateral cortex increased (positive functional response) in 7/11 (64%), 7/11 (64%), and 4/11 (36%) control lambs respectively (p < 0.05). Remaining lambs showed decreased ΔoxyHb (negative functional response). Following 4.8 s stimulations, more lambs receiving sildenafil or iNO (83% and 100% respectively) showed positive functional response compared to the controls (p < 0.05). No significant difference between the three groups was observed at 7.8 s stimulations. Conclusion: In the preterm brain, prolonged somatosensory stimulations increased the incidence of negative functional responses with decreased cerebral oxygenation, suggesting that cerebral oxygen delivery may not match the oxygen demand. Sildenafil and iNO increased the incidence of positive functional responses, potentially enhancing NVC, and cerebral oxygenation.
Collapse
Affiliation(s)
- Ishmael Miguel Inocencio
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Navneet Kaur
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia,Department of Paediatrics, Monash University, Melbourne, VIC, Australia
| | - Nhi T. Tran
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia
| | - Flora Y. Wong
- The Ritchie Centre, The Hudson Institute of Medical Research, Melbourne, VIC, Australia,Department of Paediatrics, Monash University, Melbourne, VIC, Australia,Monash Newborn, Monash Children’s Hospital, Melbourne, VIC, Australia,*Correspondence: Flora Y. Wong,
| |
Collapse
|
6
|
Holden JM, Wareham LK. cGMP signaling: a potential therapeutic target for neurodegeneration in glaucoma? Neural Regen Res 2022; 18:1267-1268. [PMID: 36453407 PMCID: PMC9838148 DOI: 10.4103/1673-5374.360169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Affiliation(s)
- Joseph M. Holden
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Lauren K. Wareham
- Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA,Correspondence to: Lauren K. Wareham, .
| |
Collapse
|
7
|
Xiong Y, Wintermark P. The Role of Sildenafil in Treating Brain Injuries in Adults and Neonates. Front Cell Neurosci 2022; 16:879649. [PMID: 35620219 PMCID: PMC9127063 DOI: 10.3389/fncel.2022.879649] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 04/04/2022] [Indexed: 12/02/2022] Open
Abstract
Sildenafil is a recognized treatment for patients suffering from erectile dysfunction and pulmonary hypertension. However, new evidence suggests that it may have a neuroprotective and a neurorestorative role in the central nervous system of both adults and neonates. Phosphodiesterase type 5-the target of sildenafil-is distributed in many cells throughout the body, including neurons and glial cells. This study is a comprehensive review of the demonstrated effects of sildenafil on the brain with respect to its function, extent of injury, neurons, neuroinflammation, myelination, and cerebral vessels.
Collapse
Affiliation(s)
- Ying Xiong
- Department of Anesthesiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
| | - Pia Wintermark
- Research Institute of the McGill University Health Centre, Montreal, QC, Canada
- Division of Newborn Medicine, Department of Pediatrics, Montreal Children’s Hospital, Montreal, QC, Canada
| |
Collapse
|
8
|
Drug Therapy for Unexplained Dyspnea in Post-COVID-19 Fatigue Syndrome: Empagliflozin and Sildenafil. Am J Ther 2022; 29:e447-e448. [PMID: 35412483 DOI: 10.1097/mjt.0000000000001483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|