亚低温对大鼠脑创伤后海马区凋亡相关蛋白表达的影响

目的观察亚低温对大鼠创伤性脑损伤(TBI)后海马CA3区细胞凋亡及相关蛋白Bcl-2、Bax及Caspase-3表达的影响,探讨亚低温脑保护的分子生物学机制.方法将大鼠随机分成假手术、单纯脑损伤和脑损伤后亚低温治疗3组,应用改良Marmarou方法制作大鼠TBI模型,分别用流式细胞仪(FCM)和免疫组化法检测各组动物脑海马CA3区细胞凋亡率和Bcl-2、Bax及Caspase-3蛋白的表达.结果与假手术组相比,大鼠TBI后海马CA3区细胞凋亡率及Caspase-3表达增高(P<0.05),Bcl-2/Bax表达比下降(P<0.05).亚低温治疗后,大鼠脑海马CA3区细胞凋亡率及Caspase-3表达较单纯脑损伤组降低(P<0.05),而Bcl-2/Bax表达比升高(P<0.05).结论亚低温对TBI的脑保护作用机制可能与干预伤后凋亡相关基因表达并减少神经细胞凋亡有关.     

亚低温抑制大鼠弥漫性脑损伤后细胞凋亡的研究

目的探讨大鼠不同程度弥漫性脑损伤后脑组织的凋亡变化过程及亚低温治疗对脑细胞凋亡的抑制作用.方法采用大鼠Marmarou颅脑创伤装置制作弥漫性脑损伤模型,然后将128只Wistar大鼠分为未损伤组(对照组)、重度损伤组、轻度损伤组和亚低温治疗组.通过电子显微镜、组织切片原位末端标记DNA片段(TUNEL染色)、琼脂糖凝胶电泳(DNA Ladder法)等方法,观察和比较不同程度脑损伤后,大鼠脑皮层及海马区凋亡细胞的形态、特点和数量.结果(1)损伤后24～48 h,皮层及海马区可见大量细胞皱缩、核碎裂、核不规则等细胞凋亡现象,48 h较24 h更为严重;亚低温治疗后24～48 h,电子显微镜观察皮层及海马区未见细胞皱缩、核碎裂等细胞凋亡现象.(2)TUNEL染色结果显示,随着损伤程度的加重凋亡明显加重,损伤后48 h达高峰,然后逐渐下降.轻度损伤组细胞凋亡主要限于海马CA2和CA3区;重度脑损伤组细胞凋亡涉及整个海马结构,同时还广泛累及额顶区皮质.损伤后第24、48、72 h,皮层及海马区的凋亡细胞数量较同期未治疗组明显减少.(3)重度损伤后48 h,海马和皮层区细胞琼脂糖电泳可见典型的DNA梯状带,其他时间未见梯状带.亚低温治疗组、轻度脑损伤组及未损伤组亦未见梯状带.结论轻度弥漫性脑损伤后,脑细胞凋亡多发生于海马CA2和CA3区;重度脑损伤后皮层及海马区细胞可发生广泛凋亡.细胞凋亡随着损伤程度的加重而加重,高峰位于伤后第2 d.亚低温治疗可有效地抑制大鼠弥漫性脑损伤后的细胞凋亡.     

亚低温抑制大鼠弥漫性脑损伤后细胞凋亡的研究

目的：探讨大鼠不同程度弥漫性脑损伤后脑组织的凋亡变化过程及亚低温治疗对脑细胞凋亡的抑制作用。方法：采用大鼠Marmarou颅脑创伤装置制作弥漫性脑损伤模型,然后将128只Wistar大鼠分为未损伤组（对照组）、重度损伤组、轻度损伤组和亚低温治疗组。通过电子显微镜、组织切片原位末端标记DNA片段（TUNEL染色）、琼脂糖凝胶电泳（DNA Ladder法）等方法,观察和比较不同程度脑损伤后,大鼠脑皮层及海马区凋亡细胞的形态、特点和数量。结果：（1）损伤后24-48h,皮层及海马区可见大量细胞皱缩、核碎裂、核不规则等细胞凋亡现象,48h较24h更为严重;亚低温治疗后24-48h,电子显微镜观察皮层及海马区未见细胞皱缩、核碎裂等细胞凋亡现象。（2）TUNEL染色结果显示,随着损伤程度的加重凋亡明显加重,损伤后48h达高峰,然后逐渐下降。轻度损伤组细胞凋亡主要限于海马CA2和CA3区;重度脑损伤组细胞凋亡涉及整个海马结构,同时还广泛累及额顶区皮质。损伤后第24、48、72h,皮层及海马区的凋亡细胞数量较同期未治疗组明显减少。（3）重度损伤后48h,海马和皮层区细胞琼脂糖电泳可见典型的DNA梯状带,其他时间未见梯状带。亚低温治疗组、轻度脑损伤组及未损伤组亦未见梯状带。结论：轻度弥漫性脑损伤后,脑细胞凋亡多发生于海马CA2和CA3区;重度脑损伤后皮层及海马区细胞可发生广泛凋亡。细胞调亡随着损伤程度的加重而加重,高峰位于伤后第2d。亚低温治疗可有效地抑制大鼠弥漫性脑损伤的细胞凋亡。     

脑室周围白质软化大鼠脑组织NF-κBp65蛋白表达与细胞凋亡的关系

目的通过检测NF-κBp65蛋白在脑室周围白质软化(PVL)大鼠中的表达变化,并与凋亡状况进行对比分析,探讨其在PVL发病机制中的作用,为早产儿脑损伤防治提供新的理论依据。方法选取100只3日龄新生健康大鼠,随机分为实验组和对照组各50只。实验组缺氧处理,显微镜下观察标本变化情况,TUNEL法检测脑组织细胞凋亡状况和免疫组化SABC法检测NF-κBp65基因的蛋白表达变化。结果实验组动物缺氧后有异常表现;体质量增长缓慢,显微镜下可见神经细胞凋亡。细胞凋亡缺氧处理6h后阳性率上升,至3d达到高峰。NF-κBp65实验组于缺氧6h即出现阳性表达,12h、24h、72h三组间比较结果统计学处理均无显著差异(P>0.05),总体随时间延长呈上升趋势。实验组与对照组在各时间点比较差异均有统计学意义(P<0.05)。NF-κBp65与急性期细胞凋亡状况呈正相关(r=0.432)。结论细胞凋亡是脑室周围白质软化大鼠的重要发病机制之一。PVL大鼠缺氧缺血性脑损伤模型中,NF-κBp65蛋白参与了缺氧缺血脑损伤的发病机制;与凋亡的关系有待进一步研究。     

缺氧/复氧后星形胶质细胞AQP5表达的变化及亚低温的干预效应

目的观察缺氧/复氧条件下大脑星形胶质细胞水通道蛋白5(AQP5)的表达变化以及亚低温对其表达的影响。方法利用新生24 h内的SD大鼠,进行原代、传代培养,将星形胶质细胞分为对照组、常温组及亚低温组。用台盼蓝染色法测定37℃及32℃时,缺氧/复氧不同时间点星形胶质细胞的存活率,作为细胞受损指标,用倒置相差显微镜对细胞进行形态学观察,应用细胞免疫化学技术检测星形胶质细胞缺氧/复氧各个时间点AQP5的表达变化及亚低温的干预效果。结果 (1)缺氧4、8 h细胞形态变化不明显,随着复氧时间的延长,可见活化逐渐明显,而亚低温干预的细胞形态及细胞存活力变化均较相应的常温组明显减轻;(2)缺氧及复氧早期AQP5的表达水平降低,复氧后6 h随着时间延长AQP5表达明显增多,在复氧≤8 h常温组及亚低温组的表达水平均低于对照组(P<0.05或0.01),而复氧后10、12 h AQP5蛋白表达水平均明显高于对照组(P<0.05或0.01);(3)在复氧后各时间点亚低温组AQP5的表达水平均明显低于常温组(P<0.05或0.01)。结论亚低温可以减轻缺氧/复氧后星形胶质细胞的损伤,通过降低AQP5的表达水平,可能是亚低温减轻缺血性脑水肿的作用机制之一。     

异丙酚联合亚低温对脑缺血-再灌注损伤后P75基因的影响

目的探讨脑缺血-再灌注(I/R)损伤后P75基因的表达变化及异丙酚联合亚低温对脑损伤的保护作用。方法 96只雌性SD大鼠随机分为对照组(A组)、异丙酚组(B组)、亚低温组(C组)、异丙酚联合亚低温组(D组),各组又分为再灌注后4h、8h、12h亚组,每组8只动物。采用RT-PCR技术检测各组大鼠不同时间点大脑皮质中P75基因表达变化,TUNEL技术观察再灌注12h大鼠脑皮质细胞凋亡情况。结果各组大鼠脑皮质于I/R损伤后各时间均可检测到P75 mRNA表达,且随再灌注时间延长表达水平逐渐升高(P<0.01);B、C、D组P75 mR-NA水平于再灌注4h、8h、12h均显著减低于A组(P<0.01),以D组降低最为明显(P<0.01)。D组大鼠再灌注12h脑皮质凋亡细胞数明显少于其他各组(P<0.05)。结论异丙酚和亚低温处理可通过抑制P75表达减轻缺血-再灌注损伤大脑细胞凋亡的发生,实现对脑组织的保护,异丙酚联合亚低温处理对脑组织的保护效果更佳。     

全身亚低温治疗在新生儿缺氧缺血性脑损伤的应用与监护

目的探讨全身亚低温对新生儿缺氧缺血性脑损伤治疗过程中的监护措施。方法我院儿科收治的符合新生儿缺氧缺血性脑病诊断标准并采用亚低温治疗患儿24例,在生后2～10h内给予全身亚低温治疗,维持肛温在33～34℃,持续72h,在亚低温治疗中给与全程监护。通过全程监护保证亚低温治疗的顺利。结果24例患儿全部治愈和好转出院。结论全身亚低温治疗对新生儿缺氧缺血性脑损伤有明显的神经保护作用,全程监护是保障治疗顺利进行的关键。     

亚低温对缺氧/复氧后星形胶质细胞AQP4表达的影响

目的 观察缺氧/复氧条件下大脑星形胶质细胞水通道蛋白4(AQP4)的表达变化以及亚低温对其表达的影响,探讨脑缺血再灌注脑水肿与AQP4的关系以及亚低温对脑缺血再灌注损伤的保护机制.方法 利用新生24 h内的SD大鼠,进行原代、传代培养,将星形胶质细胞分为对照组、常温组及亚低温组.用台盼蓝染色法测定37℃及32℃时,缺氧/复氧不同时间点星形胶质细胞的存活率,作为细胞受损指标,用倒置相差显微镜对细胞进行形态学观察,应用细胞免疫化学技术检测星形胶质细胞缺氧/复氧各个时间点AQP4的表达变化及亚低温的干预效果.结果 (1)缺氧4,8h时细胞形态变化不明显,随着复氧时间的延长,可见细化逐渐明显,而亚低温干预的细胞形态及细胞存活力变化均较相应的常温组明显减轻;(2)缺氧及复氧早期AQP4的表达降低,复氧后6h随着时间延长AQP4表达明显增多,在复氧≤8h,常温组及亚低温组的表达均低于对照组(均P＜0.05或0.01),而复氧后10,12h,AQP4蛋白表达均明显高于对照组(均P＜0.05或0.01);(3)在复氧后各时间点亚低温组AQP4的表达均明显低于常温组(均P＜0.05或0.01).结论 星形胶质细胞对缺氧的耐受能力较强,亚低温可以减轻缺氧/复氧后星形胶质细胞的损伤,通过降低AQP4的表达,可能是亚低温减轻缺血性脑水肿的作用机制之一.     

全身亚低温治疗在新生儿缺氧缺血性脑损伤的应用与监护

目的探讨全身亚低温对新生儿缺氧缺血性脑损伤治疗过程中的监护措施。方法我院儿科收治的符合新生儿缺氧缺血性脑病诊断标准并采用亚低温治疗患儿24例，在生后2～10h内给予全身亚低温治疗，维持肛温在33-34℃，持续72h，在亚低温治疗中给与全程监护。通过全程监护保证亚低温治疗的顺利。结果24例患儿全部治愈和好转出院。结论全身亚低温治疗对新生儿缺氧缺血性脑损伤有明显的神经保护作用，全程监护是保障治疗顺利进行的关键。     

亚低温对星形胶质细胞缺氧后缝隙连接功能的影响

目的观察亚低温对缺氧条件下星形胶质细胞缝隙连接变化的影响,探讨亚低温对脑缺血的保护机制。方法原代培养星形胶质细胞,传至第3代以神经胶质纤维酸性蛋白(GFAP)免疫细胞化学染色鉴定星形胶质细胞,采用三气培养箱分别调节温度,缺氧12 h。分为正常对照组(对照组)、常温(37.0 oC)缺氧组、亚低温(32.0 oC)缺氧组。用锥虫蓝染色法测定各组缺氧后星形胶质细胞存活率;应用划痕标记染料示踪技术在激光扫描共聚焦显微镜下测定缺氧12 h荧光黄染料在缝隙连接间的扩散距离;细胞免疫荧光技术检验缺氧星形胶质细胞缝隙连接的主要缝隙连接蛋白成分Cx43表达水平。结果常温缺氧组部分细胞边缘皱缩;亚低温缺氧组经亚低温干预后大部分细胞轮廓较清晰,胞周光晕明显,细胞存活力较常温缺氧组增加;对照组、常温缺氧组及亚低温缺氧组死亡细胞数分别为(6.19±0.29)个、(8.54±0.99)个和(6.89±2.41)个,对照组死亡细胞数最少,组间两两比较均差异有统计学意义(P0.05);常温缺氧组荧光黄染料仍可在细胞间进行扩散,扩散距离和Cx43荧光强度较对照组无明显变化(P0.05);亚低温缺氧组与对照组和常温缺氧组比较,荧光染料扩散距离减少、Cx43荧光强度降低,差异有统计学意义(P0.05)。结论亚低温可以减轻体外培养星形胶质细胞的缺氧损伤;降低Cx43表达而抑制缝隙连接功能,可能是亚低温干预的脑保护机制之一。     

Rewarming from therapeutic hypothermia induces cortical neuron apoptosis in a swine model of neonatal hypoxic–ischemic encephalopathy

The consequences of therapeutic hypothermia for neonatal hypoxic–ischemic encephalopathy are poorly understood. Adverse effects from suboptimal rewarming could diminish neuroprotection from hypothermia. Therefore, we tested whether rewarming is associated with apoptosis. Piglets underwent hypoxia–asphyxia followed by normothermic or hypothermic recovery at 2 hours. Hypothermic groups were divided into those with no rewarming, rewarming at 0.5 °C/hour, or rewarming at 4 °C/hour. Neurodegeneration at 29 hours was assessed by hematoxylin and eosin staining, TUNEL assay, and immunoblotting for cleaved caspase-3. Rewarmed piglets had more apoptosis in motor cortex than did those that remained hypothermic after hypoxia–asphyxia. Apoptosis in piriform cortex was greater in hypoxic–asphyxic, rewarmed piglets than in naive/sham piglets. Caspase-3 inhibitor suppressed apoptosis with rewarming. Rapidly rewarmed piglets had more caspase-3 cleavage in cerebral cortex than did piglets that remained hypothermic or piglets that were rewarmed slowly. We conclude that rewarming from therapeutic hypothermia can adversely affect the newborn brain by inducing apoptosis through caspase mechanisms.     

Prolonged hypothermia protects neonatal rat brain against hypoxic-ischemia by reducing both apoptosis and necrosis

Although hypothermia is an effective treatment for perinatal cerebral hypoxic-ischemic (HI) injury, it remains unclear how long and how deep we need to maintain hypothermia to obtain maximum neuroprotection. We examined effects of prolonged hypothermia on HI immature rat brain and its protective mechanisms using the Rice-Vannucci model. Immediately after the end of hypoxic exposure, the pups divided into a hypothermia group (30 degrees C) and a normothermia one (37 degrees C). Rectal temperature was maintained until they were sacrificed at each time point before 72h post HI. Prolonged hypothermia significantly reduced macroscopic brain injury compared with normothermia group. Quantitative analysis of cell death using H&E-stained sections revealed the number of both apoptotic and necrotic cells was significantly reduced by hypothermia after 24h post HI. Hypothermia seemed to decrease the number of TUNEL-positive cells. Immunohistochemistry and Western blot showed that prolonged hypothermia suppressed cytochrome c release from mitochondria to cytosol and activation of both caspase-3 and calpain in cortex, hippocampus, thalamus and striatum throughout the experiment. These results showed that prolonged hypothermia significantly reduced neonatal brain injury even when it was started after HI insult. Our results suggest that prolonged hypothermia protects neonatal brain after HI by reducing both apoptosis and necrosis.     

Mild hypothermia enhances the neuroprotective effects of FK506 and expands its therapeutic window following transient focal ischemia in rats

FK506 (tacrolimus), an immunosuppressant, reportedly reduces ischemic brain injury following transient middle cerebral artery occlusion (MCAO) in rats. The authors previously reported that the therapeutic window of FK506 in this model is more than 1 h, but less than 2 h. The aim of the present study is to determine whether mild hypothermia (35 degrees C) enhances the neuroprotective effects of FK506 and expands its therapeutic window. Sprague-Dawley rats were subjected to 2 h MCAO followed by 24 h reperfusion. Animals were randomly divided into four groups: (I) vehicle-treated normothermic group; (II) FK506-treated normothermic group; (III) vehicle-treated hypothermic group; (IV) FK506-treated hypothermic group. Animals received a single injection of FK506 (0.3 mg/kg) or vehicle intravenously at 2 h after ischemic induction. During ischemia, temporal muscle and rectal temperatures were maintained at 37 degrees C in the normothermic animals and at 35 degrees C in the hypothermic animals. Infarct volumes and neurological performance were evaluated at 24 h after reperfusion. The combination of FK506 and mild hypothermia significantly reduced infarct volume (cortex, -61%; striatum, -31%) and edema volume (cortex, -57%; striatum, -41%), while mild hypothermia or FK506 alone failed to improve ischemic brain damage. Furthermore, this combination also provided for the best functional outcome. These results demonstrate that the combination of FK506 and mild hypothermia significantly reduces ischemic brain damage following transient MCAO in rats, and expands the therapeutic window for FK506. This therapy may be a new approach for treatment of acute stroke.     

Neuroprotective efficacy of selective brain hypothermia induced by a novel external cooling device on permanent cerebral ischemia in rats

OBJECTIVES: This study was aimed at examining whether hypothermia is neuroprotective against permanent cerebral ischemia in rats.METHODS: A total of 32 male Sprague--Dawley rats were subjected to a middle cerebral artery occlusion. In the hypothermic group, rats (n=10) underwent selective brain hypothermia for 5 hours with the use of a novel surface coil with coolant circulating inside. In the control (n=13) and sham groups (n=9), the rats were maintained at normothermia. After a period of 168 hours ischemia, animals were killed to measure the infarction volume of the brain stained with hematoxylin-eosin.RESULTS: There were no significant differences in physiological parameters except for the temperature. The present style of hypothermia significantly reduced infarction volume in the cortex and caudoputamen.DISCUSSION: The present results endorse the neuroprotective effect of our method of hypothermia in permanent focal cerebral ischemia at an endpoint of 1 week under the following two conditions: (1) reduction of muscle and caudoputamen temperature to 29 and 31 degrees C, respectively; (2) maintenance of the mean arterial blood pressure above 90 mmHg during hypothermia.     

Brain-derived neurotrophic factor and its related enzymes and receptors play important roles after hypoxic-ischemic brain damage

Brain-derived neurotrophic factor(BDNF) regulates many neurological functions and plays a vital role during the recovery from central nervous system injuries. However, the changes in BDNF expression and associated factors following hypoxia-ischemia induced neonatal brain damage, and the significance of these changes are not fully understood. In the present study, a rat model of hypoxic-ischemic brain damage was established through the occlusion of the right common carotid artery, followed by 2 hours in a hypoxic-ischemic environment. Rats with hypoxic-ischemic brain damage presented deficits in both sensory and motor functions, and obvious pathological changes could be detected in brain tissues. The m RNA expression levels of BDNF and its processing enzymes and receptors(Furin, matrix metallopeptidase 9, tissuetype plasminogen activator, tyrosine Kinase receptor B, plasminogen activator inhibitor-1, and Sortilin) were upregulated in the ipsilateral hippocampus and cerebral cortex 6 hours after injury; however, the expression levels of these m RNAs were found to be downregulated in the contralateral hippocampus and cerebral cortex. These findings suggest that BDNF and its processing enzymes and receptors may play important roles in the pathogenesis and recovery from neonatal hypoxic-ischemic brain damage. This study was approved by the Animal Ethics Committee of the University of South Australia(approval No. U12-18) on July 30, 2018.     

Moderate hypothermia in neonatal encephalopathy: efficacy outcomes

Therapeutic hypothermia holds promise as a rescue neuroprotective strategy for hypoxic-ischemic injury, but the incidence of severe neurologic sequelae with hypothermia is unknown in encephalopathic neonates who present shortly after birth. This study reports a multicenter, randomized, controlled, pilot trial of moderate systemic hypothermia (33 degrees C) vs normothermia (37 degrees C) for 48 hours in neonates initiated within 6 hours of birth or hypoxic-ischemic event. The trial tested the ability to initiate systemic hypothermia in outlying hospitals and participating tertiary care centers, and determined the incidence of adverse neurologic outcomes of death and developmental scores at 12 months by Bayley II or Vineland tests between normothermic and hypothermic groups. Thirty-two hypothermic and 33 normothermic neonates were enrolled. The entry criteria selected a severely affected group of neonates, with 77% Sarnat stage III. Ten hypothermia (10/32, 31%) and 14 normothermia (14/33, 42%) patients expired. Controlling for treatment group, outborn infants were significantly more likely to die than hypoxic-ischemic infants born in participating tertiary care centers (odds ratio 10.7, 95% confidence interval 1.3-90). Severely abnormal motor scores (Psychomotor Development Index < 70) were recorded in 64% of normothermia patients and in 24% of hypothermia patients. The combined outcome of death or severe motor scores yielded fewer bad outcomes in the hypothermia group (52%) than the normothermia group (84%) (P = 0.019). Although these results need to be validated in a large clinical trial, this pilot trial provides important data for clinical trial design of hypothermia treatment in neonatal hypoxic-ischemic injury.     

Mild hypothermia on anoxic depolarization and subsequent cortical injury following transient ischemia

Abstract

Anoxic depolarization (AD) is one of the major physiological characteristics in the ischemic core. The effect of mild hypothermia on the appearance of AD and subsequent brain injury following profound ischemia is studied to evaluate the protective mechanism of hypothermia against severe ischemia. Sprague-Dawley rats were subjected to transient ischemia by hypotension (50-20 mmHg) and bilateral carotid artery occlusion (BCA-O) for 20 min in normothermia and 30 min in hypothermia. The temperature of body and temporal muscles was maintained at 37.5°C and 36.5°C in normothermia and 33.0°C and 31.0°C in hypothermia, respectively. Recording of the DC potential shift and electrocorticogram and monitoring of the cortical blood flow (CoBF) with a laser Doppler flowmeter were done epidurally on the right parietal cortex. The right parietal cortex pathology was examined 24 h after ischemia in normothermia and after 30 days in hypothermia. AD appeared in all seven normothermic rats with a fall in the CoBF to 9%-10% of the control flow. However, in spite of CoBF reduction to 8%-9% of the control flow, it did not appear in five hypothermic rats. Intra-ischemic CoBF was not statistically different between these two groups. AD appeared with the CoBF decreasing to 4%-5% of the control flow in seven hypothermic rats. Intra-ischemic CoBF in hypothermic rats exhibiting AD was significantly lower than the other two groups. The interval between BCA-O and the appearance of AD in hypothermic rats was 5.1 ± 0.3 min (mean ± SE), which was significantly longer than the 2.2 ± 0.5 min observed in normothermia (p < 0.0005). Of seven normothermic rats exhibiting AD, two died within 24 h and four revealed massive neuronal injury. Of seven hypothermic rats with AD, four died between day 2 and day 13, and one revealed diffuse cerebral infarction. However, no severe ischemic injury or ischemic death was observed in all five hypothermic rats without AD. The incidence of severe neuronal injury or ischemic death was significantly lower in hypothermic rats without AD compared with normothermic rats with AD (p < 0.02) or hypothermic rats with AD (p < 0.05). Although mild hypothermia delays AD, it is suggested that raising the cerebral blood flow threshold for AD appearance has a key role in the hypothermic protection of a severely ischemic area such as the ischemic core. [Neurol Res 1999; 21: 670-676]     

Mild hypothermia combined with neural stem cell transplantation for hypoxic-ischemic encephalopathy： neuroprotective effects of combined therapy

Neural stem cell transplantation is a useful treatment for ischemic stroke, but apoptosis often occurs in the hypoxic-ischemic environment of the brain after cell transplantation. In this study, we determined if mild hypothermia(27–28°C) can increase the survival rate of neural stem cells(1.0 × 105 /μL) transplanted into neonatal mice with hypoxic-ischemic encephalopathy. Long-term effects on neurological functioning of the mice were also examined. After mild hypothermia combined with neural stem cell transplantation, we observed decreased expression levels of inflammatory factor nuclear factor-kappa B and apoptotic factor caspase-3, reduced cerebral infarct volumes, increased survival rate of transplanted cells, and marked improvements in neurological function. Thus, the neuroprotective effects of mild hypothermia combined with neural stem cell transplantation are superior to those of monotherapy. Moreover, our findings suggest that the neuroprotective effects of mild hypothermia combined with neural stem cell transplantation on hypoxic-ischemic encephalopathy are achieved by anti-inflammatory and anti-apoptotic mechanisms.     

The effect of graded hypothermia on hypoxic-ischemic brain damage: a neuropathologic study in the neonatal rat

To investigate the relationship between neuropathologic damage and cerebral metabolic alterations during hypothermia in the neonatal animal, 7 day old Sprague-Dawley rats were subjected to unilateral common carotid artery ligation and hypoxia at 37 degrees C, 29 degrees C, and 21 degrees C. At 37 degrees C, animals had extensive infarction of tectum and ipsilateral cerebral hemisphere, and marked depletion of brain ATP. At 29 degrees C, there was no significant change in brain ATP; neuropathologic damage was limited to a few areas of necrosis in the deeper layers of cerebral cortex. No histologic injury was seen in the 21 degrees C group of rats. Profound hypothermia may prevent cerebral edema and visible neuropathologic damage associated with hypoxic-ischemic injury by decreasing cerebral metabolic demands. Moderate hypothermia confers a partial, but incomplete degree of protection; whereas during normothermia, the full extent of hypoxicischemic injury is manifest.