Delayed treatment with nicotinamide (Vitamin B(3)) improves neurological outcome and reduces infarct volume after transient focal cerebral ischemia in Wistar rats

BACKGROUND AND PURPOSE: We have previously shown that nicotinamide (NAm) acutely reduces brain infarction induced by permanent middle cerebral artery occlusion (MCAo) in rats. In this study, we investigate whether NAm may protect against ischemia/reperfusion injury by improving sensory and motor behavior as well as brain infarction volumes in a model of transient focal cerebral ischemia. METHODS: Forty-eight male Wistar rats were used, and transient focal cerebral ischemia was induced by MCAo for 2 hours, followed by reperfusion for either 3 or 7 days. Animals were treated with either intraperitoneal saline or NAm (500 mg/kg) 2 hours after the onset of MCAo (ie, on reperfusion). Sensory and motor behavior scores and body weight were obtained daily, and brain infarction volumes were measured on euthanasia. RESULTS: Relative to treatment with saline, treatment with NAm (500 mg/kg IP) 2 hours after the onset of transient focal cerebral ischemia in Wistar rats significantly improved sensory (38%, P<0.005) and motor (42%, P<0.05) neurological behavior and weight gain (7%, P<0.05) up to 7 days after MCAo. The cerebral infarct volumes were also reduced 46% (P<0.05) at 3 days and 35% (P=0.09) at 7 days after MCAo. CONCLUSIONS: NAm is a robust neuroprotective agent against ischemia/reperfusion-induced brain injury in rats, even when administered up to 2 hours after the onset of stroke. Delayed NAm treatment improved both anatomic and functional indices of brain damage. Further studies are needed to clarify whether multiple doses of NAm will improve the extent and duration of this neuroprotective effect and to determine the mechanism(s) of action underlying the neuroprotection observed. Because NAm is already used clinically in large doses and has few side effects, these results are encouraging for the further examination of the possible use of NAm as a therapeutic neuroprotective agent in the clinical treatment of acute ischemic stroke.     

Ischemic preconditioning reduces ischemic brain injury by suppressing nuclear factor kappa B expression and neuronal apoptosis

Ischemic stroke induces a series of complex pathophysiological events including blood-brain barrier disruption, inflammatory response and neuronal apoptosis. Previous studies demonstrate that ischemic preconditioning attenuates ischemic brain damage via inhibiting blood-brain barrier disruption and the inflammatory response. Rats underwent transient (15 minutes) occlusion of the bilateral common carotid artery with 48 hours of reperfusion, and were subjected to permanent middle cerebral artery occlusion. This study explored whether ischemic preconditioning could reduce ischemic brain injury and relevant molecular mechanisms by inhibiting neuronal apoptosis. Results found that at 72 hours following cerebral ischemia, myeloperoxidase activity was enhanced, malondialdehyde levels increased, and neurological function was obviously damaged. Simultaneously, neuronal apoptosis increased, and nuclear factor-κB and cleaved caspase-3 expression was significantly increased in ischemic brain tissues. Ischemic preconditioning reduced the cerebral ischemia-induced inflammatory response, lipid peroxidation, and neurological function injury. In addition, ischemic preconditioning decreased nuclear factor-κB p65 and cleaved caspase-3 expression. These results suggested that ischemic preconditioning plays a protective effect against ischemic brain injury by suppressing the inflammatory response, reducing lipid peroxidation, and neuronal apoptosis via inhibition of nuclear factor-κB and cleaved caspase-3 expression.     

Microglia is a key player in the reduction of stroke damage promoted by the new antithrombotic agent ticagrelor

The ADP-responsive P2Y₁₂ receptor is expressed on both platelets and microglia. Clinical data show that ticagrelor, a direct-acting, reversibly binding P2Y₁₂-receptor antagonist, reduces total cardiovascular events, including stroke. In our present study, we investigated the expression of P2Y₁₂ receptors and the effects of ticagrelor on brain injury in Sprague-Dawley rats subjected to a permanent middle cerebral artery occlusion (MCAo). Rats were treated per os with ticagrelor 3 mg/kg or vehicle at 10 minutes, 22, and 36 hours after MCAo and killed after 48 hours. Immunofluorescence analysis showed an ischemia-related modulation of the P2Y₁₂ receptor, which is constitutively expressed in Iba1⁺ resting microglia. After MCAo, activated microglia was mainly concentrated around the lesion, with fewer cells present inside the ischemic core. Ticagrelor significantly attenuated the evolution of ischemic damage—evaluated by magnetic resonance imaging (MRI) at 2, 24, and 48 hours after MCAo—, the number of infiltrating cells expressing the microglia/monocyte marker ED-1, the cerebral expression of proinflammatory mediators (interleukin 1 (IL-1), monocyte chemoattractant protein 1 (MCP-1), nitric oxide synthase (iNOS)) and the associated neurologic impairment. In transgenic fluorescent reporter CX3CR1-green fluorescent protein (GFP) mice, 72 hours after MCAo, ticagrelor markedly reduced GFP⁺ microglia and both early and late infiltrating blood-borne cells. Finally, in primary cultured microglia, ticagrelor fully inhibited ADP-induced chemotaxis (P<0.01). Our results show that ticagrelor is protective against ischemia-induced cerebral injury and this effect is mediated, at least partly, by inhibition of P2Y₁₂-mediated microglia activation and chemotaxis.     

Persistent neuroprotection with prolonged postischemic hypothermia in adult rats subjected to transient middle cerebral artery occlusion

Postischemic hypothermia provides long-lasting neuroprotection against global cerebral ischemia in adult rats and gerbils. Studies indicate that hypothermia must be prolonged (e.g., 24 h) to indefatigably salvage hippocampal CA1 neurons. Delayed hypothermia also reduces focal ischemic injury. However, no study has examined long-term outcome following postischemic hypothermia in adult animals. Furthermore, most studies examined only brief hypothermia (e.g., 3 h). Since previous studies may have overestimated long-term benefit and have likely used suboptimal durations of hypothermia, we examined whether prolonged cooling would attenuate infarction at a 2-month survival time following middle cerebral artery occlusion (MCAo) in rats. Adult male Wistar rats were implanted with telemetry brain temperature probes and later subjected to 30 min of normothermic MCAo (contralateral to side of probe placement) or sham operation. Ischemia was produced by the insertion of an intraluminal suture combined with systemic hypotension (60 mm Hg). Sham rats and one ischemic group controlled their own postischemic temperature while another ischemic group was cooled to 34 degrees C for 48 h starting at 30 min following the onset of reperfusion. The infarct area was quantified after a 2-month survival time. Normothermic MCAo resulted in almost complete striatal destruction (91% loss +/- 12 SD) with extensive cortical damage (36% +/- 16 SD). Delayed hypothermia treatment significantly reduced cortical injury to 10% +/- 10 SD (P < 0.001) while striatal injury was marginally reduced to 79% loss +/- 17 SD (P < 0.05). Delayed hypothermia of only 34 degrees C provided long-lasting cortical and striatal protection in adult rats subjected to a severe MCAo insult. These results strongly support the clinical assessment of hypothermia in acute stroke.     

Transfection of Noggin in bone marrow stromal cells (BMSCs) enhances BMSC-induced functional outcome after stroke in rats

Early intervention with intravenous administration of bone marrow stromal cells (BMSCs) reduces infarction size and ameliorates functional deficits in rat ischemia models. Noggin, an inhibitor of bone morphogenetic protein (BMP), has been demonstrated to provide protection from ischemic disease. In the present work, we hypothesize that administering Noggin-transfected BMSCs enhances BMSC-induced brain repair after cerebral ischemia. We compared the effects of BMSCs alone and Noggin-transfected BMSCs (Noggin-BMSCs) systematically delivered into the middle cerebral artery occlusion (MCAo) rat model. Noggin expression in BMSCs was achieved using adenoviral infection together with a green fluorescent protein (GFP) vector to monitor transduction efficiency and facilitate posttransplantation tracking. BMSCs and Noggin-BMSCs were intravenously injected into the rats 6 hr after MCAo. At 7 days after MCAo, the GFP-expressing BMSCs and Noggin-BMSCs were found primarily in the ischemic penumbra, which indicated that the intravenously delivered cells survived and reached in the lesion site. Both BMSC and Noggin-BMSC treatment significantly promoted neurogenesis in the ipsilateral subventrical zone (SVZ), reduced infarct volume, and led to functional improvement compared with the control group. Moreover, these beneficial effects were significantly greater in the Noggin-BMSC-treated group compared with BMSCs alone treatment (P < 0.05). Noggin expression in the ischemic hemisphere was significantly increased in the Noggin-BMSC-treated group as revealed by enzyme-linked immunosorbent assay (ELISA) at 7 days after MCAo compared with BMSC-treated and control groups (P < 0.05). These results indicate that transfection of Noggin in BMSCs enhances BMSC-induced neuroprotective effects when administered intravenously during the acute phase after stroke.     

缺氧诱导因子-1α及促红细胞生成素在脑缺血耐受大鼠中的表达

目的 探讨缺氧诱导因子-1α（HIF-lα）及其靶基因促红细胞生成素（EPO）在脑缺血预处理诱导的大鼠脑缺血耐受机制中的作用。方法 将84只Wistar大鼠随机分成假手术对照组（SS+SS,4只）、假手术＋再缺血组（SS+MCAO,40只）、预缺血＋再缺血组（IP+MCAO,40只）,后两组再随机分成5个亚组。线栓法阻塞大脑中动脉建立局灶性缺血预处理模型（预缺血10 min）,分别在预缺血后1 d、3 d、7 d、14 d、21 d进行再次缺血2 h再灌注22 h,然后取脑组织进行脑梗死体积测量和病理观察,免疫组化方法检测HIF-lα与EPO蛋白的表达。结果 ⑴IP+MCAO组中1 d、3 d、7 d亚组的梗死体积与SS+MCAO各对应亚组相比明显减小;⑵IP+MCAO组1 d、3 d、7 d亚组中HIF-lα蛋白表达与SS+MCAO各对应亚组相比明显增高;IP+MCAO组3 d、7 d亚组中EPO蛋白表达与SS+MCAO各对应亚组相比明显增高。结论 缺血预处理诱导了脑缺血耐受,预缺血诱导的内源性HIF-lα及EPO蛋白表达增加参与脑缺血耐受形成的机制。     

脑缺血预处理对沙鼠脑缺血再灌注损伤 p38MAPK活化的作用

目的 探讨脑缺血预处理对脑缺血后p38MAPK信号的影响.方法 蒙古沙鼠分成对照组、脑缺血再灌注组、脑缺血预处理组和抑制剂SB203580组.制备脑缺血及脑缺血预处理动物模型.免疫组织化学法和蛋白质印迹法检测海马区磷酸化p38MAPK的表达,TUNEL 法检测神经细胞凋亡,TTC染色测定脑梗死体积.结果 与对照组比较,脑缺血再灌注组磷酸化p38MAPK表达增高,凋亡神经细胞数量增加(P<0.05),磷酸化p38MAPK阳性细胞与TUNEL阳性细胞为同一神经元.与脑缺血再灌注组比较,脑缺血预处理组凋亡神经细胞下降、磷酸化p38MAPK表达较少、梗死面积缩小(P<0.05);抑制剂SB203580组磷酸化p38MAPK表达水平与脑缺血预处理组相似,但两组神经细胞凋亡数量及脑梗死体积比较,差异有统计学意义(P<0.05).结论 缺血预处理对脑缺血性损伤具有保护作用,其机制并非完全依赖p38MAPK信号活化.

Abstract：

Objective To study the effect of ischemic preconditioning on p38MAPK pathway after ischemia - reperfusion injury in gerbils. Method Gerbils were divided randomly into control group, ischemia - reperfusion group ( I/R ) , ischemia preconditioning group ( IP ) and inhibitor SB203580 group. Transient ischemia - reperfusion model and ischemia preconditioning model were performed. The expression levels of p38MAPK phosphorylation were detected by immunohistochemistry and Western blot, the neurons apoptosis were detected by TUNEL method and the infarction volume assessments were performed by TTC staining. Results Compared with control group, there were higher expression levels of p38MAPK phosphorylation,more apoptotic neurons in I/R group. The p38MAPK phosphorylation \positive cells and TUNEL positive cells were located in the same neurons. Compared with I/R group, there were lower expression levels of p38MAPK phosphorylation,fewer apoptotic neurons and smaller infarction volumes in IP group( P <0.05). The levels of p38MAPK phosphorylation in SB203580 group were similar as those in IP group( P > 0. 05 ) . However, the number of apoptotic neurons and infarction volumes were obviously changed ( P <0.05). Conclusions IP has protective effect from I/R damage in gerbils, which might be not only involved p38MAPK pathway.     

多次缺血预处理对兔脊髓缺血性损伤时金属元素的影响

目的　探讨多次缺血预处理 (IPC)对兔脊髓缺血再灌注损伤的保护作用及其机制。方法　 2 4只日本大白兔随机双盲分为假手术组 (A组 )、缺血再灌注组 (B组 )和IPC保护组 (C组 ) ,每组 8只。A组不阻断主动脉 ,B组阻断主动脉 4 5min ,C组阻断主动脉 5min ,开放 5min ,反复 4次之后再阻断 4 5min。术后第 7天检测脊髓组织金属元素 (Ca、Mg、Cu、Zn)的浓度。术后观察后肢神经功能的评分、后肢针电极肌电图(EMG)和脊髓组织病理学的改变。结果　B组脊髓组织Ca、Cu的浓度较A组显著性升高 (P <0 .0 5或0 .0 1) ,Mg、Zn的浓度则显著性降低 (P <0 .0 5 )。B组脊髓组织Ca、Zn的浓度分别较C组显著性升高或降低(P <0 .0 1)。B组后肢神经功能评分均显著性低于A、C组 (P <0 .0 5或 0 .0 1) ,脊髓病理学和后肢EMG亦较C组有显著性病理改变 (P <0 .0 1)。结论　多次IPC对兔脊髓缺血再灌注损伤具有显著而又快速的保护作用 ,其保护机制与维持缺血区域Ca、Mg、Cu、Zn元素的平衡有关。     

Application of real-time polymerase chain reaction to quantitate induced expression of interleukin-1beta mRNA in ischemic brain tolerance

A short duration of ischemia (i.e., ischemic preconditioning) was shown to result in significant tolerance to subsequent ischemic injury. Since previous reports suggest that interleukin-1beta (IL-1beta) may be involved in both ischemic damage and neuroprotection, the present work examined the expression of IL-1beta mRNA in cortical brain tissue after an established preconditioning (PC) stimulus known to produce significant brain tolerance to focal stroke after 1-7 days. Significant induction of IL-1beta mRNA was observed in the ipsilateral cortex at 6 hr (87+/-9 copies of the mRNA per microgram of brain tissue compared to 16+/-5 copies in sham-operated samples, P < 0.001, n = 4) and 8 hr (46+/-4 copies, P < 0.01, n = 4) after PC by means of real-time Taqman polymerase chain reaction (PCR). The peak expression of IL-1beta mRNA after PC was significantly (P < 0.01) lower than that after permanent occlusion of the middle cerebral artery (MCAO), i.e., 87+/-9 and 546+/-92 copies of RNA per microgram tissue at peak levels for PC and focal stroke, respectively. Immunohistochemistry studies revealed a parallel induction of IL-1beta in the ipsilateral cortex after PC. The maximal expression of IL-1beta was observed during the first week post-PC, showing marked parallelism with the duration of ischemic tolerance. These data suggest that the significant but low levels of IL-1beta induction after PC may contribute to ischemic brain tolerance.     

Neuroprotective effects of erythropoietin posttreatment against kainate-induced excitotoxicity in mixed spinal cultures

Although the neuroprotective effects of erythropoietin (EPO) preconditioning are well known, the potential of postapplied EPO to protect neurons against excitotoxic injury has not been clearly established. Here we show that kainate (KA)-induced excitotoxicity, which plays a key role in secondary spinal cord injury, decreased neuron survival, inhibited neurite extension, and significantly reduced the expression of erythropoietin receptors (EpoR) in cultured spinal neurons. Posttreatment with EPO for 48 hr protected neurons against KA-induced injury, opposing KA-induced apoptosis and promoting regrowth of motoneuron neurites. These neuroprotective effects were paralleled by a restoration of EpoR expression. The importance of the EpoR signaling pathway was demonstrated using an EpoR blocking antibody, which neutralized the neuroprotective action of EPO posttreatment and prevented EPO-induced increases in EpoR expression. We also found that up-regulated EpoR stimulated the Janus kinase 2 (JAK2) pathway, which is known to facilitate neuronal growth and neurite regeneration. Although EPO posttreatment modestly attenuated KA-induced reactive gliosis in mixed neuron-glial cultures, blocking EpoR activity did not alter glial fibrillary acidic protein expression or astrocyte proliferation. In conclusion, 48 hr treatment with EPO following KA exposure induced EpoR-dependent protection against excitotoxic injury, demonstrating that preconditioning is not a prerequisite for neuroprotection by EPO. The neuroprotective effects of EPO posttreatment were mediated by an EpoR-dependent signaling pathway that possibly involves JAK2. The neuroprotective effect of EPO posttreatment against KA excitotoxicity appears to reflect direct effects on neurons and not indirect effects mediated by astrocytes.     

Rapamycin protects against middle cerebral artery occlusion induced focal cerebral ischemia in rats

Stroke is a major cause of mortality and disability. The management with thrombolytic therapy has to be initiated within 3-4 h and is associated with limitations like increased risk of intracranial hemorrhage and progression of cerebral injury. Immunophilin inhibitors such as cyclosporine A and tacrolimus have been shown to afford neuroprotection by improving neurological functions and infarct volume in models of ischemic stroke. In the present study, the effect of rapamycin in middle cerebral artery occlusion (MCAo) model of ischemic stroke was evaluated.Ischemic stroke was induced in rats by occluding the MCA using the intraluminal thread. After 1 h of MCAo, animals were administered rapamycin (50, 150, 250 μg/kg, i.p.). After 2 h of occlusion, reperfusion was done. Thirty minutes after reperfusion, animals were subjected to diffusion-weighted magnetic resonance imaging for assessment of protective effect of rapamycin. Twenty-four hours after MCAo, motor performance was assessed, the animals were euthanized and the brains were removed for estimation of malondialdehyde, glutathione, nitric oxide and myeloperoxidase.Significant improvement was observed with rapamycin 150 and 250 μg/kg in percent infarct area, apparent diffusion coefficient and signal intensity as compared to vehicle treated group. Rapamycin treatment ameliorated motor impairment associated with MCAo and significantly reversed the changes in levels of malondialdehyde, glutathione, nitric oxide and myeloperoxidase.The results of the present study indicate neuroprotective effect of rapamycin in MCAo model of stroke. Therefore, rapamycin might be considered as a therapeutic strategy for stroke management.     

Neuroprotective effect of ischemic preconditioning via modulating the expression of cerebral miRNAs against transient cerebral ischemia in diabetic rats

Objectives: In this study, we aimed to evaluate the effect of the Ischemic preconditioning (IPreC) on the expression profile of cerebral miRNAs against stroke by induced transient middle cerebral artery occlusion (MCAo) in diabetic rats.

Methods: Eighty male Spraque Dawley rats were allocated to eight groups. In order to evaluate the expression profile of miRNAs, we induced transient MCAo seven days after STZ-induced diabetes (DM). Also we performed IPreC 72 h before transient MCAo to assess whether IPreC could have a neuroprotective effect against ischemia-reperfusion injury.

Results: The general characteristics of STZ-treated rats included reduced body weight and elevated blood glucose levels compared to non-diabetic ones. We demonstrated that miRNA expression profiles, which are determined for biological functions such as aquaporin 4 formation (miR-29b-2, miR-124a-3p, miR-130a, miR-223 and miR-320a), glutamate toxicity (miR107, miR-145, miR-223), salvageable ischemic area (miR-9a, miR-19b, miR-29b-2, miR-341, miR-339–5p, miR-15–5p, miR-99b-5p), and neoangiogenesis (let-7f-5p, miR-126a and miR-322–3p), were regulated following IPreC. Ischemic preconditioning before cerebral ischemia significantly reduced infarction size compared with the other groups [IPreC + MCAo (27 ± 11 mm³) vs. MCAo (109 ± 15 mm³) p < 0.001; DM + IPreC + MCAo (38 ± 9 mm³) vs. DM + MCAo (165 ± 41 mm³) p < 0.001, respectively].

Discussion: The study results revealed the neuroprotective effects of ischemic preconditioning, supported with the upregulated pro-survival miRNAs in MCA infarcts.     

Erythropoietin protects CA1 neurons against global cerebral ischemia in rat: potential signaling mechanisms

Erythropoietin (EPO) is a hormone that is neuroprotective in models of neurodegenerative diseases. This study examined whether EPO can protect against neuronal death in the CA1 region of the rat hippocampus following global cerebral ischemia. Recombinant human EPO was infused into the intracerebral ventricle either before or after the induction of ischemia produced by using the four-vessel-occlusion model in rat. Hippocampal CA1 neuron damage was ameliorated by infusion of 50 U EPO. Administration of EPO was neuroprotective if given 20 hr before or 20 min after ischemia, but not 1 hr following ischemia. Coinjection of the phosphoinositide 3 kinase inhibitor LY294002 with EPO inhibited the protective effects of EPO. Treatment with EPO induced phosphorylation of both AKT and its substrate, glycogen synthase kinase-3beta, in the CA1 region. EPO also enhanced the CA1 level of brain-derived neurotrophic factor. Finally, we determined that ERK activation played minor roles in EPO-mediated neuroprotection. These studies demonstrate that a single injection of EPO ICV up to 20 min after global ischemia is an effective neuroprotective agent and suggest that EPO is a viable candidate for treating global ischemic brain injury.     

去铁敏预处理对神经元缺氧性损伤的保护作用

目的 探讨去铁敏预处理对体内外神经元缺氧损伤的保护作用及可能机制.方法 体外培养皮质神经元,建立神经元去铁敏糖氧剥夺模型,采用细胞活力测定、细胞凋亡比率、形态学改变评价去铁敏预处理后的神经元保护效应.去铁敏预处理后不同时间点制作大鼠大脑中动脉阻塞(MCAO)模型,采用神经功能评分和梗死体积评价去铁敏预处理后的脑保护效应.用免疫荧光染色检测去铁敏预处理后神经元的缺氧诱导因子-1α(hypoxia inducible factor 1α,HIF-1α)和促红细胞生成素(erythropoietin,EPO)蛋白表达情况,RT-PCR检测HIF-1α和EPO的mRNA变化情况.结果 去铁敏预处理后再给予缺氧损伤后神经元活力下降至49%(无预处理组25%,t=8.544,P<0.05),凋亡细胞百分比为38%(无预处理组30%,t=4.409,P<0.05),预处理后细胞形态保持良好.去铁敏30 ms/kg预处理后第3天行MCAO手术,大鼠神经功能评分降低,梗死体积缩小8.5%.去铁敏100 mg/kg预处理后第2、3、7天行MCAO手术,与生理盐水组(8.13±0.17)相比,神经功能评分分别下降为7.44±0.39(t=2.903,P<0.05)、5.60±0.47(t=10.143,P<0.01)、6.97±0.73(t=3.142,P<0.05),脑梗死体积分别缩小12.0%(t=5.056,P<0.05)、32.3%(t=10.993,P<0.01)、10.6%(t=4.385,P<0.05).免疫荧光染色显示:体外培养的皮质神经元在预处理后出现HIF-1α和EPO蛋白表达,大鼠预处理后脑内神经元也出现HIF-1α和EPO蛋白表达上调.RT-PCR显示去铁敏化学缺氧能上调体外培养的神经元HIF-1α及EPO mRNA表达.结论 去铁敏预处理有确切有效的抗缺氧保护效应,这种效应与保护神经元有关,其机制可能是去铁敏诱导了神经元HIF-1α和EPO的表达增加.     

Peripheral Administration of Interleukin-1 Receptor Antagonist Inhibits Brain Damage after Focal Cerebral Ischemia in the Rat

We assessed the efficacy of recombinant human interleukin-1 receptor antagonist (rhIL-1ra) on brain injury and edema formation after permanent middle cerebral artery occlusion (MCAo) in the rat. Previous studies showed that low amounts of rhIL-1ra injected directly into the brain significantly decreased infarct size after MCAo or excitotoxic injury in rats. Peripheral administration of rhIL-1ra (100 mg/kg sc at 0, 4, 8, 12, and 18 h after MCAo) significantly inhibited infarct size, by 46% (P < 0.05), measured at 24 h. This was greater than the effect of MK801 administered immediately after MCAo (4 mg/kg ip, 0 h) which did not significantly reduce infarct size. rhIL-1ra (100 mg/kg) also significantly inhibited cerebral edema formation by 49% (P < 0.05) measured 24 h after MCAo, but did not reduce edema formation measured 2 h after MCAo. Inhibition of infarction by rhIL-1ra was dependent on dose and time of administration. Together the results demonstrate that peripherally administered rhIL-1ra at high doses is able to mimic the efficacy of a low dose of rhIL-1ra administered directly into the brain in a rodent model of stroke and that protection observed with rhIL-1ra was better than that offered by MK801 in this model.     

去铁敏预处理通过增加缺氧诱导因子1α和促红细胞生成素的表达减轻大鼠缺血性脑损伤

目的观察去铁敏（Desferoxamine,DFO）预处理后大鼠脑组织和体外培养神经元中缺氧诱导因子1α（hypoxia inducible factor1α,HIF-1α）和促红细胞生成素（erythropoietin,EPO）表达的变化,探讨预处理是否对体内及体外的脑缺血损伤的具有保护效应。方法去铁敏预处理大鼠后不同时间点制作大脑中动脉阻塞（middle cerebral artery occlusion,MCAO）模型,术后24h后处死动物。采用神经功能评分（neurological severity scores,NSS）和计算梗死体积（TTC染色）评价DFO的脑保护效应,细胞活力测定评价DFO对缺氧缺糖条件下（oxygen-glucosede privation,OGD）皮层神经元的保护效应。免疫荧光染色检测HIF-1α和EPO蛋白表达情况。结果与生理盐水对照组比较,去铁敏预处理后2d,MCAO大鼠出现梗塞面积缩小,神经功能损伤减轻,在预处理后3d达到高峰,7d仍然有效,14d去铁敏预处理的保护效应消失。去铁敏对OGD神经元同样具有神经保护作用：与未进行预处理的神经元细胞相比,预处理后8h的细胞活力增加23％,12h增加34％,24h增加40％,36h增加48％,48h增加56％（P〈0．05）。免疫荧光染色发现,大鼠脑组织的HIF-1α和EPO在去铁敏预处理后3d及7d表达上调;皮层神经元细胞的HIF-1α和EPO在去铁敏预处理后36h及48h表达上调。结论去铁敏预处理有确切有效的脑保护效应,不仅可以预防脑缺血损伤,对体外培养的OGD皮层神经元细胞损伤也具有保护作用,其机制可能与脑神经细胞的HIF-1α和EPO蛋白表达增加有关。     

Hypoxia-inducible factor 1alpha and erythropoietin upregulation with deferoxamine salvage after neonatal stroke

Treatment with deferoxamine (DFO) is protective against focal ischemia with global hypoxia when given as a preconditioning stimulus in neonatal rodents. DFO acts as an iron chelator and may stabilize HIF1alpha. Therefore, we hypothesized that DFO would protect against pure ischemia-reperfusion injury when given after the insult and that the protection would be associated with expression of hypoxia-inducible factor 1alpha (HIF1alpha) and downstream target genes such as erythropoietin (Epo). To test these hypotheses, we performed middle cerebral artery (MCA) occlusion in postnatal day 10 (P10) rats for 1.5 h followed by treatment with DFO or vehicle upon reperfusion. Preserved brain volumes were measured with cresyl violet staining 1 week after the insult. HIF1alpha and Epo expression were determined by Western blot and immunocytochemical analyses at different time points after injury. We found that DFO treatment preserved brain volumes when compared to vehicle (P < 0.05). In DFO-treated ischemic cortices, HIF1alpha expression peaked early, while Epo expression was seen in two phases and in different cell populations. Epo immunoreactivity colocalized with neuronal markers at 8 h but with astrocytic markers at 1 week. These results suggest that DFO is protective when administered after neonatal ischemic stroke and that this protection may be like that afforded by preconditioning through the upregulation of similar downstream pathways.     

大鼠局灶性脑缺血预处理的抗细胞凋亡作用机制的研究

目的研究大鼠短暂局灶性脑缺血预处理对再次脑缺血神经细胞凋亡的保护作用,及bcl-2、bax与脑缺血耐受的关系.方法用开颅方法阻断大鼠大脑中动脉(MCA)20分钟,3天后再次阻断6小时.观察大鼠脑梗死体积及组织病理学改变,采用TUNEL法观察神经细胞凋亡状况,采用免疫组织化学方法观察bcl-2、bax蛋白表达的改变.结果与假预处理组和缺血组相比,预处理后缺血组梗死灶体积明显减小(均P＜0.01),半影区凋亡细胞数明显减少(P＜0.01),bax蛋白表达下降(P＜0.05),bcl-2蛋白表达显著上升(P＜0.01).结论 20分钟局灶性脑缺血预处理能够通过bcl-2表达增加及bax表达下降对再次脑缺血神经细胞起保护作用.     

Endotoxin preconditioning protects against the cytotoxic effects of TNFalpha after stroke: a novel role for TNFalpha in LPS-ischemic tolerance.

Lipopolysaccharide (LPS) preconditioning provides neuroprotection against subsequent cerebral ischemic injury. Tumor necrosis factor-alpha (TNFalpha) is protective in LPS-induced preconditioning yet exacerbates neuronal injury in ischemia. Here, we define dual roles of TNFalpha in LPS-induced ischemic tolerance in a murine model of stroke and in primary neuronal cultures in vitro, and show that the cytotoxic effects of TNFalpha are attenuated by LPS preconditioning. We show that LPS preconditioning significantly increases circulating levels of TNFalpha before middle cerebral artery occlusion in mice and show that TNFalpha is required to establish subsequent neuroprotection against ischemia, as mice lacking TNFalpha are not protected from ischemic injury by LPS preconditioning. After stroke, LPS preconditioned mice have a significant reduction in the levels of TNFalpha (approximately threefold) and the proximal TNFalpha signaling molecules, neuronal TNF-receptor 1 (TNFR1), and TNFR-associated death domain (TRADD). Soluble TNFR1 (s-TNFR1) levels were significantly increased after stroke in LPS-preconditioned mice (approximately 2.5-fold), which may neutralize the effect of TNFalpha and reduce TNFalpha-mediated injury in ischemia. Importantly, LPS-preconditioned mice show marked resistance to brain injury caused by intracerebral administration of exogenous TNFalpha after stroke. We establish an in vitro model of LPS preconditioning in primary cortical neuronal cultures and show that LPS preconditioning causes significant protection against injurious TNFalpha in the setting of ischemia. Our studies suggest that TNFalpha is a twin-edged sword in the setting of stroke: TNFalpha upregulation is needed to establish LPS-induced tolerance before ischemia, whereas suppression of TNFalpha signaling during ischemia confers neuroprotection after LPS preconditioning.