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Ma Y, He Z, Wang J, Zheng P, Ma Z, Liang Q, Zhang Q, Zhao X, Huang J, Weng W, Jiang J, Feng J. Mild hypothermia promotes neuronal differentiation of human neural stem cells via RBM3-SOX11 signaling pathway. iScience 2024; 27:109435. [PMID: 38523796 PMCID: PMC10960102 DOI: 10.1016/j.isci.2024.109435] [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: 09/20/2023] [Revised: 01/06/2024] [Accepted: 03/04/2024] [Indexed: 03/26/2024] Open
Abstract
Both therapeutic hypothermia and neural stem cells (NSCs) transplantation have shown promise in neuroprotection and neural repair after brain injury. However, the effects of therapeutic hypothermia on neuronal differentiation of NSCs are not elucidated. In this study, we aimed to investigate whether mild hypothermia promoted neuronal differentiation in cultured and transplanted human NSCs (hNSCs). A significant increase in neuronal differentiation rate of hNSCs was found when exposed to 35°C, from 33% to 45% in vitro and from 7% to 15% in vivo. Additionally, single-cell RNA sequencing identified upregulation of RNA-binding motif protein 3 (RBM3) in neuroblast at 35°C, which stabilized the SRY-box transcription factor 11 (SOX11) mRNA and increased its protein expression, leading to an increase in neuronal differentiation of hNSCs. In conclusion, our study highlights that mild hypothermia at 35°C enhances hNSCs-induced neurogenesis through the novel RBM3-SOX11 signaling pathway, and provides a potential treatment strategy in brain disorders.
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Affiliation(s)
- Yuxiao Ma
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Zhenghui He
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Jiangchang Wang
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Ping Zheng
- Department of Neurosurgery, Shanghai Pudong New Area People’s Hospital, Shanghai 201299, China
| | - Zixuan Ma
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Qian Liang
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Qiao Zhang
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Xiongfei Zhao
- Shanghai Angecon Biotechnology Co., Ltd., Shanghai 201318, China
| | - Jialin Huang
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Weiji Weng
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Jiyao Jiang
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
| | - Junfeng Feng
- Brain Injury Center, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China
- Shanghai Institute of Head Trauma, Shanghai 200127, China
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Cadena AJ, Rincon F. Hypothermia and temperature modulation for intracerebral hemorrhage (ICH): pathophysiology and translational applications. Front Neurosci 2024; 18:1289705. [PMID: 38440392 PMCID: PMC10910040 DOI: 10.3389/fnins.2024.1289705] [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: 09/06/2023] [Accepted: 02/07/2024] [Indexed: 03/06/2024] Open
Abstract
Background Intracerebral hemorrhage (ICH) still poses a substantial challenge in clinical medicine because of the high morbidity and mortality rate that characterizes it. This review article expands into the complex pathophysiological processes underlying primary and secondary neuronal death following ICH. It explores the potential of therapeutic hypothermia as an intervention to mitigate these devastating effects. Methods A comprehensive literature review to gather relevant studies published between 2000 and 2023. Discussion Primary brain injury results from mechanical damage caused by the hematoma, leading to increased intracranial pressure and subsequent structural disruption. Secondary brain injury encompasses a cascade of events, including inflammation, oxidative stress, blood-brain barrier breakdown, cytotoxicity, and neuronal death. Initial surgical trials failed to demonstrate significant benefits, prompting a shift toward molecular mechanisms driving secondary brain injury as potential therapeutic targets. With promising preclinical outcomes, hypothermia has garnered attention, but clinical trials have yet to establish its definitive effectiveness. Localized hypothermia strategies are gaining interest due to their potential to minimize systemic complications and improve outcomes. Ongoing and forthcoming clinical trials seek to clarify the role of hypothermia in ICH management. Conclusion Therapeutic hypothermia offers a potential avenue for intervention by targeting the secondary injury mechanisms. The ongoing pursuit of optimized cooling protocols, localized cooling strategies, and rigorous clinical trials is crucial to unlocking the potential of hypothermia as a therapeutic tool for managing ICH and improving patient outcomes.
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Affiliation(s)
- Angel J. Cadena
- Department of Neurology, Columbia University, New York, NY, United States
| | - Fred Rincon
- Department of Neurology, Division of Neurocritical Care, Cooper University, Camden, NJ, United States
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Wu R, Bao J, Zhang J, Wang Z, Zhang X, Yun Q. Clinical effects of neuroendoscopic hematoma evacuation for hypertensive intracerebral hemorrhage. Am J Transl Res 2022; 14:1084-1091. [PMID: 35273711 PMCID: PMC8902535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 12/29/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To analyze the clinical effects of neuroendoscopic hematoma evacuation for the treatment of hypertensive intracerebral hemorrhage (ICH). METHODS A total of 80 patients with hypertensive ICH who were admitted to our hospital were included as the subjects of this retrospective study. The patients were assigned into a neuroendoscopic hematoma evacuation group (n=35) and a small bone window craniotomy group (n=45). The post-operative hematoma residues and the clearance rate of the hematoma were compared between the two groups. The intraoperative blood loss, duration of the surgery, and Glasgow Coma Scale (GSC) scores before and after surgery were compared between the two groups. The operation time, intraoperative blood loss, the time consumed to stop bleeding, clearance rate of hematoma, manifestation of complications, and the prognosis 6 months after surgery were analyzed statistically. Self-made questionnaires were used to evaluate the satisfaction degree of patients with their lives and to assess the quality of life after surgery. RESULTS The operation time, blood loss, and the time consumed to stop bleeding were less in the neuroendoscopic hematoma evacuation group than those in the small bone window craniotomy group (all P<0.05). The GCS scores in the neuroendoscopic hematoma evacuation group were significantly higher than those in the small bone window craniotomy group (P<0.05). The clearance rate of hematoma was higher in the neuroendoscopic hematoma evacuation group than that in the small bone window craniotomy group (P<0.05). CONCLUSION As compared with small bone window craniotomy for removing hematoma, neuroendoscopic hematoma evacuation showed a better outcome in treating patients with hypertensive ICH. It could improve patients' clinical indications, which is worthy of being widely applied in clinical settings.
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Affiliation(s)
- Rile Wu
- Department of Neurosurgery, Inner Mongolia People's Hospital Hohhot 010017, Inner Mongolia Autonomous Region, China
| | - Jin'gang Bao
- Department of Neurosurgery, Inner Mongolia People's Hospital Hohhot 010017, Inner Mongolia Autonomous Region, China
| | - Jianping Zhang
- Department of Neurosurgery, Inner Mongolia People's Hospital Hohhot 010017, Inner Mongolia Autonomous Region, China
| | - Zhong Wang
- Department of Neurosurgery, Inner Mongolia People's Hospital Hohhot 010017, Inner Mongolia Autonomous Region, China
| | - Xiaojun Zhang
- Department of Neurosurgery, Inner Mongolia People's Hospital Hohhot 010017, Inner Mongolia Autonomous Region, China
| | - Qiang Yun
- Department of Neurosurgery, Inner Mongolia People's Hospital Hohhot 010017, Inner Mongolia Autonomous Region, China
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Neuroprotective Therapies for Spontaneous Intracerebral Hemorrhage. Neurocrit Care 2021; 35:862-886. [PMID: 34341912 DOI: 10.1007/s12028-021-01311-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 06/25/2021] [Indexed: 12/15/2022]
Abstract
Patients who survive the initial ictus of spontaneous intracerebral hemorrhage (ICH) remain vulnerable to subsequent injury of the perilesional parenchyma by molecular and cellular responses to the hematoma. Secondary brain injury after ICH, which contributes to long-term functional impairment and mortality, has emerged as an attractive therapeutic target. This review summarizes preclinical and clinical evidence for neuroprotective therapies targeting secondary injury pathways following ICH. A focus on therapies with pleiotropic antiinflammatory effects that target thrombin-mediated chemotaxis and inflammatory cell migration has led to studies investigating statins, anticholinergics, sphingosine-1-phosphate receptor modulators, peroxisome proliferator activated receptor gamma agonists, and magnesium. Attempts to modulate ICH-induced blood-brain barrier breakdown and perihematomal edema formation has prompted studies of nonsteroidal antiinflammatory agents, matrix metalloproteinase inhibitors, and complement inhibitors. Iron chelators, such as deferoxamine and albumin, have been used to reduce the free radical injury that ensues from erythrocyte lysis. Stem cell transplantation has been assessed for its potential to enhance subacute neurogenesis and functional recovery. Despite promising preclinical results of numerous agents, their outcomes have not yet translated into positive clinical trials in patients with ICH. Further studies are necessary to improve our understanding of the molecular events that promote damage and inflammation of the perihematomal parenchyma after ICH. Elucidating the temporal and pathophysiologic features of this secondary brain injury could enhance the clinical efficacy of neuroprotective therapies for ICH.
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Qian X, Lan S, Zhang X. Effects of mild hypothermia therapy combined with minimally invasive debridement in patients with hypertensive intracranial hemorrhage: a randomized controlled study. Am J Transl Res 2021; 13:7997-8003. [PMID: 34377281 PMCID: PMC8340259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/23/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To investigate the clinical effect of mild hypothermia therapy (MHT) combined with minimally invasive debridement (MID) in patients with severe hypertensive intracranial hemorrhage (HICH). METHODS A total of 120 patients with severe HICH who received clinical intervention in our hospital were enrolled as study subjects. In this randomized, controlled, double-blind trial, they were divided into a study group (SG, n=70) and a control group (CNG, n=50). The CNG was treated with MID, and the SG was treated with MID combined with MHT. The general surgical indices, short-term postoperative outcomes, postoperative neurological and recovery in activities of daily living, and complications were compared between the two groups. Patients' Glasgow prognosis (Glasgow Outcome Scale, GOS) scores at 1 year after surgery were analyzed. RESULTS The operative time, intraoperative blood loss and intensive care unit (ICU) admission were shorter/lower in the SG than in the CNG (P<0.05). The SG had higher hematoma clearance rate at 1 d and 3 d postoperatively, and lower residual hematoma volume at 3 d and 7 d postoperatively than the CNG (P<0.05). Patients in the SG had higher Barthel scores and lower National Institutes of Health Stroke Scale (NIHSS) scores than the CNG at 1-12 months after intervention (P<0.05). The incidence of complications in the SG was lower than that in the CNG (P<0.05). The percentage of GOS grade IV and V was significantly higher in the SG than in the CNG 1 year after surgery (P<0.05). CONCLUSION The combination of MID and MHT in patients with severe HICH has better clinical results in the short and long term, and improves the postoperative outcomes and quality of life. It can also reduce the incidence of perioperative complications.
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Affiliation(s)
- Xuping Qian
- Department of Neurosurgery, Huzhou Central Hospital, Affiliated Hospital of Huzhou Normal UniversityHuzhou 313000, Zhejiang Province, China
| | - Shali Lan
- Department of Neurosurgery, Huzhou Central Hospital, Affiliated Hospital of Huzhou Normal UniversityHuzhou 313000, Zhejiang Province, China
| | - Xiaohua Zhang
- Department of Orthopedics, Huzhou Central Hospital, Affiliated Hospital of Huzhou Normal UniversityHuzhou 313000, Zhejiang Province, China
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彭 羽, 林 赟, 侯 晓, 廖 晓, 刘 进. [Effect of mild hypothermia on behaviors of rats with intracerebral hemorrhage and the possible mechanism]. NAN FANG YI KE DA XUE XUE BAO = JOURNAL OF SOUTHERN MEDICAL UNIVERSITY 2020; 40:1359-1364. [PMID: 32990235 PMCID: PMC7544574 DOI: 10.12122/j.issn.1673-4254.2020.09.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To explore the effect of mild hypothermia on inflammatory response and angiogenesis in brain tissues of rats with intracerebral hemorrhage (ICH) and its possible mechanism for improving behavioral deficits of the rats After ICH. METHODS A total of 120 healthy male SD rats were randomly divided into sham operation group, ICH group and mild hypothermia group. Rat models of ICH were established in the latter two groups by stereotactic injection of autogenous blood in the brain, and the rats in the sham operation group received injection of normal saline in the same manner. At 15 min after modeling, the rats in hypothermia group were subjected to mild hypothermia (30-32 ℃) for 8 h followed by rewarming (37-38 ℃); the body temperature was maintained at 37-38 ℃ in the other two groups. At 2, 4, 7, 14 and 21 days after the treatment, Longa scoring, balance beam scoring and Berderson scoring were used to evaluate the behavioral deficits of the rats. Immunohistochemical staining was used to detect the protein expressions of tumor necrosis factor-α (TNF-α) and nuclear factor-κB (NF-κB) in the brain tissue of the rats, and the mRNA expressions of α subunit of hypoxia-inducible factor 1 (HIF1-α) and vascular endothelial growth factor (VEGF) were detected using RT- PCR. RESULTS At 2, 4, 7, 14 and 21 days after the treatment, the behavioral scores of the rats were significantly higher in ICH group and mild induced hypothermia group than in the sham operation group (P < 0.05 or 0.01). The protein expressions of TNF-α and NF-κB and mRNA expressions of HIF1-α and VEGF were significantly higher in ICH group and mild hypothermia group than in the sham operation group (P < 0.01). The behavioral scores were significantly lower in mild hypothermia group than in ICH group (P < 0.05), and the protein expressions of TNF-α and NF-κB were lower and the mRNA expressions of HIF1- α and VEGF were higher in mild hypothermia group than in ICH group (P < 0.05 or 0.01). CONCLUSIONS Mild hypothermia can improve behavioral deficits in rats with ICH possibly by antagonizing brain inflammation and promoting angiogenesis.
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Affiliation(s)
- 羽 彭
- 四川省医学科学院//四川省人民医院学术期刊部,四川 成都 610072Department of Academic Journals, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - 赟 林
- 四川省医学科学院//四川省人民医院学术期刊部,四川 成都 610072Department of Academic Journals, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - 晓林 侯
- 四川省医学科学院//四川省人民医院心内科,四川 成都 610072Department of Cardiology, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - 晓灵 廖
- 四川省医学科学院//四川省人民医院神经外科,四川 成都 610072Department of Neurosurgery, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Chengdu 610072, China
| | - 进平 刘
- 四川省医学科学院//四川省人民医院神经外科,四川 成都 610072Department of Neurosurgery, Sichuan Academy of Medical Sciences/Sichuan Provincial People's Hospital, Chengdu 610072, China
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Chin SM, Wion D. Early Prophylactic Hypothermia for Patients With Severe Traumatic Injury: Premature to Close the Case. Front Neurol 2019; 10:344. [PMID: 31024437 PMCID: PMC6465559 DOI: 10.3389/fneur.2019.00344] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 03/20/2019] [Indexed: 12/16/2022] Open
Affiliation(s)
- Shan Min Chin
- INSERM UMR1205, Faculté Médecine Pharmacie, Université Grenoble Alpes, La Tronche, France
| | - Didier Wion
- INSERM UMR1205, Faculté Médecine Pharmacie, Université Grenoble Alpes, La Tronche, France
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