Subcellular distribution of calcium and ultrastructural changes after cerebral hypoxia-ischemia in immature rats

Recent data imply that mitochondrial regulation of calcium is critical in the process leading to hypoxic-ischemic brain injury. The aim was to study the subcellular distribution of calcium in correlation with ultrastructural changes after hypoxia-ischemia in neonatal rats. Seven-day-old rats were subjected to permanent unilateral carotid artery ligation and exposure to hypoxia (7.7% oxygen in nitrogen) for 90 min. Animals were perfusion-fixed after 30 min, 3 h or 24 h of reperfusion. Sections were sampled for light microscopy and electron microscopy combined with the oxalate-pyroantimonate technique. At 30 min and 3 h of reflow, a progressive accumulation of calcium was detected in the endoplasmic reticulum, cytoplasm, nucleus and, most markedly, in the mitochondrial matrix of neurons in the gray matter in the core area of injury. Some mitochondria developed a considerable degree of swelling reaching a diameter of several microm at 3 h of reflow whereas the majority of mitochondria appeared moderately affected. Chromatin condensation was observed in nuclei of many cells with severely swollen mitochondria with calcium deposits. A whole spectrum of morphological features ranging from necrosis to apoptosis was seen in degenerating cells. After 24 h, there was extensive injury in the cerebral cortex as judged by breaks of mitochondrial and plasma membranes, and a general decrease of cellular electron density. In the white matter of the core area of injury, the axonal elements exhibited varicosity-like swellings filled with calcium-pyroantimonate deposits. Furthermore, the thin myelin sheaths were loaded with calcium. Numerous oligodendroglia-like cells displayed apoptotic morphology with shrunken cytoplasm and chromatin condensation, whereas astroglial necrosis was not seen. In conclusion, markedly swollen 'giant' mitochondria with large amounts of calcium were found at 3 h of reperfusion often in neuronal cells with condensation of the nuclear chromatin. The results are discussed in relation to mitochondrial permeability transition and activation of apoptotic processes.     

BDNF blocks caspase-3 activation in neonatal hypoxia-ischemia

Hypoxic-ischemic (H-I) injury to the brain in the perinatal period often leads to significant long-term neurological deficits. In a model of neonatal H-I injury in postnatal day 7 rats, our previous data have shown that cell death with features of apoptosis is prominent between 6 and 24 h after H-I and that neurotrophins, particularly BDNF, can markedly protect against tissue loss. During brain development, caspase-3 is required for normal levels of programmed cell death. Utilizing an antibody specific for the activated form of caspase-3, CM1, we now show that caspase-3 is specifically activated in neuronal cell bodies and their processes beginning at 6 h and peaking 24 h following unilateral carotid ligation and exposure to hypoxia in postnatal day 7 rats. Caspase-3 activation began to occur in cortex at 6 h and in striatum and hippocampus at 12-18 h. Caspase-3 activation was also observed in developing oligodendrocytes. Intracerebroventricular injection of BDNF prior to H-I injury almost completely abolished evidence of H-I-induced caspase-3 activation in vivo. Utilizing a specific molecular marker of an apoptotic pathway, these findings demonstrate that H-I injury to the developing brain is a strong apoptotic stimulus leading to caspase-3 activation, that BDNF can block this process in vivo, and that the ability of BDNF to inhibit caspase activation and subsequent apoptosis likely accounts in large part for its protection against neuronal injury in this model.     

NMDA blockade attenuates caspase-3 activation and DNA fragmentation after neonatal hypoxia-ischemia

The aim was to study the effects of an NMDA receptor antagonist on caspase-3 activation and DNA fragmentation after hypoxia-ischemia (HI) in 7-day-old rats. Animals were treated with vehicle or MK-801 (0.5 mg/kg) directly after HI and sacrificed 8, 24 or 72h later. MK-801 reduced injury (by 53%), cells positive for active caspase-3 (by 39%) and DNA fragmentation (by 79%) in the cerebral cortex. Furthermore, MK-801 significantly decreased caspase-3 activity, and Western blots revealed a tendency towards decreased proteolytic cleavage of the caspase-3 proform. The data imply that NMDA receptors are involved in the activation of apoptotic processes in the immature brain after HI.     

Regional cerebral blood flow during hypoxia-ischemia in immature rats

Immature rats subjected to a combination of unilateral common carotid artery ligation and hypoxia sustain brain damage confined largely to the ipsilateral cerebral hemisphere. To ascertain the extent and distribution of ischemic alterations in the brains of these small animals, we modified the Sakurada technique to measure regional cerebral blood flow using carbon-14 autoradiography. Seven-day-old rats underwent right common carotid artery ligation following which they were rendered hypoxic with 8% O2 at 37 degrees C. Before and during hypoxia, the rat pups received an injection of iodo[14C]antipyrine for determination of regional cerebral blood flow. Blood flows to individual structures of the ipsilateral cerebral hemisphere were not influenced by arterial occlusion alone; flows to the contralateral hemisphere and to the brainstem and cerebellum actually increased by 25-50%. Hypoxia-ischemia was associated with decreases in regional cerebral blood flow of the ipsilateral hemisphere such that by 2 hours, flows to subcortical white matter, neocortex, striatum, and thalamus were 15, 17, 34, and 41% of control, respectively. The hierarchy of the blood flow reductions correlated closely with the distribution and extent of ischemic neuronal necrosis. However, unlike the pathologic pattern of this model, the degree of ischemia appeared homogeneous within each brain region. Blood flows to contralateral cerebral hemispheric structures were relatively unchanged from prehypoxic values, whereas flows to the brainstem and cerebellum nearly doubled and tripled, respectively. Thus, ischemia is the predominant factor that determines the topography of tissue injury to major regions of immature rat brain, whereas metabolic factors (intrinsic vulnerability) may influence the heterogeneous pattern of damage seen within individual structures.     

Post-ischemic hypothermia blocks caspase-3 activation in the newborn rat brain after hypoxia-ischemia

The effects of hypothermia on caspase-3 activation were investigated in the newborn rat brain after hypoxia–ischemia (HI). Intense caspase-3 activation was observed in the control brains after HI, but this activation was significantly reduced by postischemic hypothermia. These findings suggest that the inhibition of caspase-3 activation may be an interventional point underlying the neuroprotective effect of hypothermia in neonates.     

Brain injury after hypoxia-ischemia in newborn rats: relationship to extracellular levels of excitatory amino acids and cysteine

The aim of this study was to follow extracellular concentrations of excitatory amino acids (EAAs) and cysteine during neonatal hypoxia-ischemia (HI) and reflow and to relate these events to the extent of brain damage evaluated 6 h after the insult. Rat pups (PND 7–10) were subjected to unilateral ligation of the common carotid artery and exposed to hypoxia (7.7% O₂). Extracellular amino acids were sampled during HI and for 6 h of reperfusion with microdialysis and the levels were correlated with the extent of brain damage at the site of probe placement. The concentrations of glutamate, aspartate and cysteine increased transiently during HI (15×, 6× and 3×, respectively) in the extracellular space and returned to normal or remained slightly elevated during reperfusion. Changes of EAAs and cysteine were similar during HI in the infarcted, undamaged and border-zone regions. During reperfusion the concentrations of glutamate, aspartate and cysteine were higher in infarcted and border-zone areas compared to undamaged tissue. In neonatal rats, the extracellular levels of EAAs during HI do not correspond to the extent of brain injury whereas the EAA concentrations during reflow are related to the extent of infarction.     

Secondary energy failure after cerebral hypoxia-ischemia in the immature rat.

A delayed or secondary energy failure occurs during recovery from perinatal cerebral hypoxia-ischemia. The question remains as to whether the energy failure causes or accentuates the ultimate brain damage or is a consequence of cell death. To resolve the issue, 7-day postnatal rats underwent unilateral common carotid artery occlusion followed thereafter by systemic hypoxia with 8% oxygen for 2.5 hours. During recovery, the brains were quick frozen and individually processed for histology and the measurements of 1) high-energy phosphate reserves and 2) neuronal (MAP-2, SNAP-25) and glial (GFAP) proteins. Phosphocreatine (PCr) and ATP, initially depleted during hypoxia-ischemia, were partially restored during the first 18 hours of recovery, with secondary depletions at 24 and 48 hours. During the initial recovery phase (6 to 18 hours), there was a significant correlation between PCr and the histology score (0 to 3), but not for ATP. During the late recovery phase, there was a highly significant correlation between all measured metabolites and the damage score. Significant correlation also exhibited between the neuronal protein markers, MAP-2 and SNAP-25, and PCr as well as the sum of PCr and Cr at both phases of recovery. No correlation existed between the high-energy reserves and the glial protein marker, GFAP. The close correspondence of PCr to histologic brain damage and the loss of MAP-2 and SNAP-25 during both the early and late recovery intervals suggest evolving cellular destruction as the primary event, which precedes and leads to the secondary energy failure.     

Cerebral hypoxia-ischemia in immature rats: methodological considerations

We used a model of perinatal hypoxic/ischemic brain damage which combines unilateral common carotid artery ligation and hypoxia (8% O2). Protein synthesis inhibition and cell loss were found in the ipsilateral forebrain of 11-day-old rats when hypoxia was initiated 4 h but not 24 h after carotid ligation. [14C]Iodoantipyrine uptake studies suggest that compensating vascular changes which protect the ipsilateral forebrain occur within 24 h of carotid ligation.     

局灶性脑缺血再灌注后半胱氨酸蛋白酶-3和其激活的DNA酶与神经元损伤的关系及半胱氨酸蛋白酶-3抑制剂的保护作用

目的 探讨大鼠局灶性脑缺血再灌注后半胱氨酸蛋白酶-3(caspase-3)及由半胱氨酸蛋白酶激活的DNA酶(caspase-activated deoxyribonuclease,CAD)的表达变化与神经元损伤的关系,研究caspase-3特异性抑制剂Ac-DEVD-CHO对缺血神经元的保护作用.方法 实验设干预组和模型组,线栓法建立大鼠大脑中动脉闭塞1 h后再通模型,干预组于侧脑室给予Ac-DEVD-CHO,模型组给予二甲基亚砜(DMSO).应用HE、免疫组织化学、TUNEL染色及电镜观察大鼠大脑中动脉栓塞1 h后再灌注6、12、24、48、72 h时caspase-3和CAD蛋白的表达及神经元损伤程度的变化.结果 HE染色和电镜观察下,模型组和干预组差异不明显;TUNEL染色阳性细胞数除6 h外,两组间其余时间点相比差异具有统计学意义;模型组和干预组caspase-3蛋白表达24 h达高峰,分别为2.360±0.318与0.804±0.206(t'=10.039,P<0.01),12～48 h与模型组同期相比差异均有统计学意义;模型组和干预组CAD蛋白表达于48 h达高峰,分别为3.061±0.567与0.812±0.240(t'=8.960,P<0.01),12～72 h与模型组同期相比差异均有统计学意义.结论 caspase-3-CAD-DNA降解途径是鼠脑缺血再灌注神经元损伤的重要途径,caspase-3抑制剂具有一定程度的神经保护作用.     

人脑出血后海马神经元损伤与Caspase-3的关系

目的　研究人脑出血后海马神经元损伤与凋亡促进因子Caspase- 3之间的关系。方法　选取10例因脑出血而死亡的尸检脑标本,应用HE染色,Caspase- 3免疫组织化学染色和Caspase- 3m RNA原位杂交,观察脑出血时海马CA1 区神经元损伤变化与Caspase- 3表达之间的关系。结果　海马CA1 区,出血5 h可检测Caspase- 3免疫组化染色的阳性细胞(10 .4个/高倍视野) ,2 2～4 8h时达高峰(2 1.7～2 4 .3个/高倍视野)。Caspase- 3m RNA原位杂交阳性表达始于5 h(6 .75个/高倍视野) ,2 4 h达高峰(14 .6 0～18.30个/高倍视野) ;二者均在72 h后呈明显下降趋势。出血2 4 h,可检测到TUNEL阳性细胞,持续至72 h。Caspase- 3m RNA与Caspase- 3呈正相关,相关系数为0 .717(P<0 .0 5 )。4～16 h受损神经元形态基本正常,2 4～4 8h细胞凋亡特征明显,72 h后,几乎所有神经元形态呈现严重病理变化。结论　人脑出血后海马神经元发生一系列形态学变化,其演变规律与凋亡促进因子Caspase- 3有密切相关性。     

人脑局灶性缺血后海马神经元损伤与半胱氨酸蛋白酶-3的关系

目的研究人脑局灶性缺血后海马神经元损伤与凋亡促进因子半胱氨酸蛋白酶-3(caspase-3)之间的关系.方法选取因脑梗死而死亡的尸检脑标本48例,并按缺血时间(发病至死亡的时间)分为8组,选取因其他疾病死亡(无脑缺血)的尸检脑标本6例为对照组;应用HE染色来观察海马CA1区神经元形态变化;应用caspase-3免疫组化染色及caspase-3 mRNA原位杂交来测定人脑缺血后caspase-3的表达情况;用末端脱氧核糖核酸转移酶介导的缺口末端标记(TUNEL)法标记凋亡神经元;用微管相关蛋白-2(MAP-2)的脱失程度反映神经元的受损程度.结果海马CA1区,缺血8 h可检测到caspase-3免疫组化染色的阳性细胞(8.05个/高倍视野),24 h达高峰(24.85个/高倍视野);caspase-3 mRNA原位杂交阳性表达始于4 h(6.75个/高倍视野),16 h达高峰(17.60个/高倍视野);二者均在72 h后呈明显下降趋势.缺血24 h可检测到TUNEL阳性细胞,持续至72 h.MAP-2免疫活性下降早在4 h 即可检测到,之后持续下降,至72 h几乎无阳性表达细胞.72 h前,caspase-3 mRNA在TUNEL染色下与时间成正相关,相关系数为0.721(P<0.05);使用MAP-2时与时间成负相关,相关系数为0.857(P<0.05).4～16 h,受损神经元形态基本正常;24～48 h细胞凋亡特征明显;72 h后,几乎所有神经元形态均呈现严重病理变化.结论人脑局灶性缺血后病灶同侧的海马神经元发生一系列形态学变化,其演变规律与凋亡促进因子caspase-3有密切相关性.     

胰岛素对大鼠脑缺血再灌注后Caspase-3表达及细胞凋亡的影响

目的探讨胰岛素对大鼠脑缺血再灌注后Caspase-3表达及细胞凋亡的影响。方法将动物随机分为假手术组、缺血组及干预组,参照zea longa线栓法建立大鼠左侧大脑中动脉闭塞（mid-dle cerebral artery occlusion,MCAO）再灌注模型,干预组大鼠在脑缺血即刻给予胰岛素及葡萄糖腹腔注射,分别在左侧MCAO2h再灌注不同时间点断头取脑,脑皮质神经元Caspase-3的表达通过免疫组化法来测定,并采用TUNEL法原位标记DNA片段,检测TUNEL阳性细胞的变化。结果缺血组大鼠脑皮质Caspase-3的表达较假手术组显著增强（P〈0.01）,TUNEL阳性细胞数较假手术组显著增多（P〈0.01）;给予胰岛素处理后,Caspase-3的表达较缺血组明显减弱（P〈0.01）,TUNEL阳性细胞数较缺血组明显减少（P〈0.01）,但两者均显著高于假手术组（P〈0.01）。结论短暂的脑缺血再灌注可导致脑皮质神经元Caspase-3的表达增加,促进细胞凋亡,胰岛素可下调脑皮质神经元Caspase-3的表达,发挥神经保护作用。     

Differential activation of c-fos and caspase-3 in hippocampal neuron subpopulations following neonatal hypoxia-ischemia

Neonatal hypoxia-ischemia (HI) induces immediate early gene (IEG) c-fos expression as well as neuron death. The precise role of IEGs in neonatal HI is unclear. We investigated the temporal and spatial patterns of c-Fos expression in postnatal day 7 mice after unilateral carotid ligation and exposure to 8% oxygen. mRNA levels of c-fos quantitated by real-time polymerase chain reaction (PCR) increased nearly 40-fold (log 1.2 +/- 0.4) in the ipsilateral hippocampus 3 hr following neonatal HI, then returned to basal levels within 12 hr, although no change was observed in c-jun mRNA. Frozen coronal brain sections were stained with cresyl violet or used for immunohistochemical detection of c-Fos, cleaved caspase-3, glial fibrillary acidic protein (GFAP), and the mature neuron marker NeuN. c-Fos immunoreactivity increased throughout the injured hippocampus 3 hr after HI but became restricted to the CA2-3 subregion and the dentate gyrus (DG) at 6-12 hr and declined by 24 hr. In contrast, cleaved (activated) caspase-3 immunoreactivity was most abundant in the ipsilateral CA1 region at 3-6 hr after neonatal HI, then became more prominent in CA2-3 and DG. Double-labeling experiments showed c-Fos and cleaved caspase-3 immunoreactivity localized in spatially distinct neuron subpopulations. Prominent c-Fos immunoreactivity was observed in surviving CA2-3 and external granular DG neurons, and robust cleaved caspase-3 immunoreactivity was observed in pyknotic CA1, CA2-3, and subgranular DG neurons. The differential expression of c-Fos in HI-resistant hippocampal subpopulations vs. cleaved caspase-3 in dying neurons suggests a neuroprotective role for c-Fos expression in neonatal HI.     

Hypoxia induces caspase-9 and caspase-3 activation without neuronal death in gerbil brains

To investigate the in vivo apoptotic machinery in oxygen deprived brain, we examined the expression of caspase-9 and caspase-3 in the hippocampus of Mongolian gerbils subjected to either transient hypoxia (4% O2 for 6 min) or forebrain ischemia (10 min bilateral carotid artery occlusion) followed by 8 h to 7 days of reoxygenation or blood recirculation. Apoptotic death was characterized by isolating hippocampal genomic DNA and analysing DNA fragmentation as well as histological studies including TUNEL assay and toluidine blue staining of brain sections. The results showed that both hypoxic and ischemic gerbil brains exhibited an increase in caspase-9 and caspase-3 gene expression. However, no cell damage was detectable following hypoxia, while marked DNA fragmentation and extensive cell death was observed following ischemia. Moreover, although hypoxia did not lead to cell death, both hypoxia and ischemia were associated with cleavage of procaspase-9 and procaspase-3 and increases in their activities as well as cleavage of poly(ADP-ribose) polymerase-1 (PARP-1), a major caspase-3 substrate. These results indicate that, in vivo, even late apoptotic events such as caspase activation and PARP-1 cleavage in hypoxic brains do not necessarily induce an irreversible commitment to apoptotic neuronal death.     

Inhibition of neuroinflammation prevents injury to the serotonergic network after hypoxia-ischemia in the immature rat brain

The phenotypic identities and characterization of neural networks disrupted after neonatal hypoxia-ischemia (HI) in the preterm brain remain to be elucidated. Interruption of the central serotonergic (5-hydroxytryptamine [5-HT]) system can lead to numerous functional deficits, many of which match those in human preterm neonates exposed to HI. How the central serotonergic network is damaged after HI and mechanisms underlying such injury are not known. We used a Postnatal Day 3 rat model of preterm HI and found parallel reductions in the 5-HT transporter expression, 5-HT levels and numbers of 5-HT-positive dorsal raphe neurons 1 week after insult. Post-HI administration of minocycline, an inhibitor of activated microglia, attenuated HI-induced damage to the serotonergic network. Minocycline effects seemed to be region specific, that is, where there was micro-glial activation and increases in tumor necrosis factor-α and inter-leukin 1β. The concurrent improvement in serotonergic outcomes suggests that inhibition of neuroinflammation prevented damage to the serotonergic neurons rather than affected the regulation of 5-HT or serotonin transporter. These data elucidate the mechanisms of serotonergic network injury in HI, and despite the known adverse effects associated with the use of minocycline in neonates, postinsult administration of minocycline may represent a novel approach to counter neuroinflammation and preserve the integrity of the central serotonergic network in the preterm neonate.     

Simvastatin reduces caspase-3 activation and inflammatory markers induced by hypoxia-ischemia in the newborn rat

The present study was undertaken to evaluate whether in a neonatal model of stroke a prophylactic neuroprotective treatment with simvastatin modulates hypoxia-ischemia-induced inflammatory and apoptotic signaling. Procaspase-3 and cleaved caspase-3 expression showed a peak at 24 h and returned to control values after 5 days. Caspase-3 activity followed the same pattern of caspase-3 proteolytic cleavage. In simvastatin-treated ischemic animals, the expression of these proteins and caspase-3 activity were significantly lower when compared to that of ischemic animals. alpha-Spectrin and protein kinase C-alpha (PKCalpha) cleavages were not affected by the treatment. Poly (ADP-ribose) polymerase fragmentation, caspase-1 activation, and IL-1beta and ICAM-1 mRNA expression were increased by hypoxia-ischemia and significantly reduced in simvastatin-treated animals. The results indicate that simvastatin-induced attenuation of hypoxia-ischemia brain injury in the newborn rat occurs through reduction of the inflammatory response, caspase-3 activation, and apoptotic cell death.     

Bcl-2 phosphorylation in the BH4 domain precedes caspase-3 activation and cell death after neonatal cerebral hypoxic-ischemic injury

To date, there are very few in vivo studies addressing the role of Bcl-2 phosphorylation. In a model of neonatal hypoxic-ischemic (HI) brain injury, we characterized the spatial and temporal phosphorylation of Bcl-2 at serine-24 (PS24-Bcl-2), using a site-specific antibody. Very few cells positive for PS24-Bcl-2 were found in control animals, but the number increased during reperfusion in all investigated brain areas in the ipsilateral hemisphere after HI, particularly in the border region between intact and damaged tissue. The highest numbers were encountered 24 h post-HI. Phosphorylation of Bcl-2 at serine-24 coincided with cytochrome c release after hypoxia-ischemia and preceded caspase-3 activation. Injured neurons displayed a predominantly nuclear, but also mitochondrial, localization of PS24-Bcl-2 immunoreactivity. In conclusion, phosphorylation of Bcl-2 at serine 24 was induced by hypoxia-ischemia, presumably resulting in loss of its anti-apoptotic function.