亚低温对大鼠短暂全脑缺血后神经元凋亡的影响

目的 探讨亚低温对大鼠脑缺血后神经元凋亡的影响，揭示亚低温的部分神经保护机制。方法 采用“双侧颈总动脉阻断＋全身低血压”方法来建立大鼠短暂性全脑缺血模型。用神经元尼氏体亚甲兰特殊染色法观察大鼠脑缺血后海马CA1区神经元损害情况；原位细胞凋亡检测法（TUNEL染色）及电镜观察脑缺血后CA1区神经元凋亡情况。结果 与假手术组、低温缺血组相比，常温缺血组海马CA1区神经元缺失明显（P＜0．01）。常温及低温缺血组海马CA1区均存在神经元凋亡，但低温缺血组海马CA1区凋亡神经元数明显少于缺血组（P＜0．01）。结论 经“双侧颈总动脉阻断＋全身低血压”方法建立的大鼠短暂全脑缺血模型证实了亚低温的脑保护作用。全脑缺血后的迟发性神经元死亡很可能经由凋亡途径，而亚低温可通过抑制缺血性神经元凋亡而发挥一定的神经保护作用。     

亚低温对缺血性神经元凋亡、细胞色素C释放的影响

通过大鼠短暂全脑缺血模型来探讨亚低温对大鼠脑缺血后细胞色素c(Cytoehrome c,CytC)释放及缺血性神经元凋亡的影响,揭示亚低温的部分神经保护机制.用原位细胞凋亡检测法(TUNEL染色)检测及电镜观察脑缺血后大鼠脑海马CAi区神经元凋亡发生情况;免疫组织化学法测定脑缺血后大鼠脑海马区神经元中细胞色素C释放情况.结果显示:①低温缺血组海马CAi区凋亡神经元数明显少于常温缺血组(P<0.01);②低温缺血3 h组海马CA1区神经元CytC阳性表达低于常温缺血3 h组(P<0.01).据此认为,全脑缺血后的迟发性神经元死亡很可能经由凋亡途径,而CytC激活、释放是缺血性神经元凋亡的一个关键事件.亚低温可抑制CytC的释放.推测经此途径减少缺血性神经元凋亡而发挥一定的神经保护作用.     

亚低温对缺血性神经元凋亡、细胞色素C释放的影响

通过大鼠短暂全脑缺血模型来探讨亚低温对大鼠脑缺血后细胞色素C(CytochromeC ,CytC)释放及缺血性神经元凋亡的影响 ,揭示亚低温的部分神经保护机制。用原位细胞凋亡检测法 (TUNEL染色 )检测及电镜观察脑缺血后大鼠脑海马CA1区神经元凋亡发生情况 ;免疫组织化学法测定脑缺血后大鼠脑海马区神经元中细胞色素C释放情况。结果显示 :①低温缺血组海马CA1区凋亡神经元数明显少于常温缺血组 (P <0 .0 1) ;②低温缺血3h组海马CA1区神经元CytC阳性表达低于常温缺血 3h组 (P <0 .0 1)。据此认为 ,全脑缺血后的迟发性神经元死亡很可能经由凋亡途径 ,而CytC激活、释放是缺血性神经元凋亡的一个关键事件。亚低温可抑制CytC的释放 ,推测经此途径减少缺血性神经元凋亡而发挥一定的神经保护作用。     

亚低温在急性脑缺血中对氨基酸和自由基含量的影响

目的研究亚低温状态下,急性脑缺血时皮质内四种氨基酸和自由基含量的改变,探讨亚低温对缺血脑组织的保护机制。方法将63只Wistar大鼠随机分为9组,假手术组7只,缺血组(手术后将其颞厂讥温度控制在36．5+-0．5℃)-缺血3h组,缺血3h分别再灌注1h、2h、3h组各7只;亚低温组(手术后将其颞肌温度控制在32．5±0．5℃)-缺血3h,缺血3h分别再灌注1h、2h、3h组各7只。动物模型参照Zealonga的大脑中动脉线栓模型并加以改进。结果比较缺血组和低温组,可见低温组缺血皮质内的谷氨酸(Glu)、天门冬安酸(Asp)、丙醛(MDA)的产生明显减少,而超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-PX)的生成和释放明显增加,γ-氨基丁酸(GABA)的含量亦增加。结论亚低温状态下4种氨基酸含量及自由基系统的改变是其保护缺血神经元的重要机制。     

Magnesium treatment and spontaneous mild hypothermia after transient focal cerebral ischemia in the rat

There is evidence from global cerebral ischemia experiments in the rat that the neuroprotection attributable to magnesium treatment depends on the concurrent presence of at least mild hypothermia. We set out to determine to what extent spontaneous hypothermia occurred after transient middle cerebral artery occlusion in the rat, and whether this hypothermia influenced the outcome of magnesium treatment. We found that rectal temperatures from 30 min to 3h after recovery from anaesthesia/surgery were 1 °C lower than in the period from 4 to 6h. Striatal infarcts were significantly reduced by 32% in animals treated with 360 μmol/kg MgSO(4) intravenously immediately prior to ischemia. A higher magnesium dose of 720 μmol/kg had not effect on infarct volume. Having previously established that these two doses of magnesium are ineffective in normothermic animals using this model, we conclude that the mild spontaneous hypothermia contributed to the observed neuroprotective effect of magnesium in this study, and that previous studies of magnesium in cerebral ischemia have likely been confounded in this way.     

病变侧亚低温对大鼠局灶性脑缺血再灌注后神经元存活的影响

目的 通过检测Survivin及NF-κB蛋白的表达,探讨亚低温对局灶性脑缺血再灌注后神经元存活的影响.方法 用线拴法制作大鼠大脑中动脉闭塞（MCAO）局灶性脑缺血再灌注模型,将164只SD大鼠随机分成假手术组、常温缺血组和亚低温缺血组,缺血组分别缺血2h、3h、6h、8h再灌注4h、24h、72h、1周、2周后处死,亚低温组于缺血后13～14 min实施病灶侧亚低温持续4h.免疫组织化学法检测Survivin、NF-κB蛋白的表达.结果 相同缺血再灌注时间点,亚低温组比常温组缺血侧Survivin表达水平显著增高（P＜0.05）,NF-κB P65核内移明显降低（P＜0.01）.结论 病灶侧亚低温通过促进缺血半暗带脑组织Survivin表达,抑制NF-κB的核内移,从而抑制神经元凋亡,促进脑缺血后神经功能恢复.     

Effect of induced tolerance on biochemical disturbances in hippocampal slices from the gerbil during and after oxygen/glucose deprivation.

To evaluate whether the state of tolerance is stable enough to be studied under in vitro conditions after induction by ischemic preconditioning in vivo, metabolic disturbances of hippocampal slices prepared from control and preconditioned gerbils were evaluated during and after oxygen/glucose deprivation (OGD). Slices were subjected to 5, 10 or 15 min OGD with or without 2h recovery. During the state of metabolic stress, changes in energy metabolism were identical in slices taken from control and preconditioned gerbils. Following OGD, however, recovery of protein synthesis was significantly improved in hippocampal slices of preconditioned animals, indicating that the effect of preconditioning on metabolic disturbances induced by transient OGD in vitro or transient ischemia in vivo is similar. It is suggested that the hippocampal slice preparation is an in vitro model suitable for the study of basic mechanisms underlying the induction of tolerance in vivo.     

Effect of preceding in vivo sublethal ischemia on the evoked potentials during secondary in vitro hypoxia evaluated with gerbil hippocampal slices

We investigated the mechanism of ‘ischemic tolerance phenomenon' by characterizing the physiological events, modified by preceding sublethal ischemia, during secondary hypoxia. Slices from brains after pretreatment of sublethal forebrain ischemia were subjected to a 70% reduction of PO₂ (threshold hypoxia). Although evoked potentials disappeared completely in five of eight slices from sham-operated brain, they were sustained in 28/32 slices from pretreated brains. This study indicates that the maintenance of membrane function might be the mechanism of ischemic tolerance.     

亚低温对大鼠缺血脑组织血管新生的影响

目的研究亚低温对脑缺血后血管新生的影响,探讨亚低温的脑保护作用机制。方法20只SD大鼠随机分成常温组和亚低温组,每组10只,用线栓法制成持续性大脑中动脉闭塞(MCAO)模型,常温组在室温下喂养,亚低温组在术后2h开始亚低温诱导,温度控制在34~35℃,持续72h,2两组均在术后第7d处死取脑,测脑梗死体积和免疫组化后测血管密度。结果大脑中动脉阻塞后,亚低温组脑梗死体积(153.25±23.14)mm3明显小于常温组(253.45±36.21)mm3(P<0.01);亚低温组VEGF细胞数(24.02个/400倍视野)明显低于常温组(36.07个/400倍视野)(P<0.01);亚低温组脑梗死区周围血管数量为39.19条/400倍视野,和常温组的39.96条/400倍视野没有明显差别(P>0.05)。结论亚低温能使梗死体积减小,但是不影响血管新生。     

病变侧亚低温对大鼠局脑缺血再灌注后Akt、Survivin表达的影响

目的 通过检测Akt及Survivin蛋白的表达,探讨亚低温对局脑缺血再灌注后神经元存活的影响.方法 用线拴法制作大鼠大脑中动脉闭塞（MCAO）局脑缺血再灌注模型,将44只SD大鼠随机分成假手术组、常温缺血组和亚低温缺血组,缺血组分别缺血2,6 h再灌注4,24,72 h,1周,2周后处死,亚低温组于缺血后13～14 min实施病灶侧亚低温持续4 h.免疫组织化学法检测Akt、Survivin 蛋白的表达.结果 相同缺血再灌注时间点,亚低温组比常温组缺血侧Akt、Survivin、表达水平显著增高（P＜0.05）.结论 病灶侧亚低温通过促进缺血半暗带脑组织Akt、Survivin表达的核内移,从而抑制神经元凋亡,促进脑缺血后神经功能恢复.     

Actin redistribution underlies the sparing effect of mild hypothermia on dendritic spine morphology after in vitro ischemia.

Brain hypothermia is at present the most effective neuroprotective treatment against brain ischemia in man. Ischemia induces a redistribution of proteins involved in synaptic functions, which is markedly diminished by therapeutic hypothermia (33 degrees C). Dendritic spines at excitatory synapses are motile and show both shape changes and rearrangement of synaptic proteins as a consequence of neuronal activity. We investigated the effect of reduced temperature (33 degrees C and 27 degrees C compared with 37 degrees C), on spine motility, length and morphology by studying the distribution of GFP-actin before, during and after induction of in vitro ischemia. Because high-concentration actin filaments are located inside spines, dissociated hippocampal neurons (7-11 DIV) from transgenic mice expressing GFP-actin were used in this study. The movement of the spines and the distribution of GFP-actin were recorded using time-lapse fluorescence microscopy. Under normal conditions rapid rearrangement of GFP-actin was seen in dendritic spines, indicating highly motile spines at 37 degrees C. Decreasing the incubation temperature to 33 degrees C or 27 degrees C, dramatically reduces actin dynamics (spine motility) by approximately 50% and 70%, respectively. In addition, the length of the spine shaft was reduced by 20%. We propose that decreasing the temperature from 37 degrees C to 33 degrees C during ischemia decreases the neuronal actin polymerization rate, which reduces spine calcium kinetics, disrupts detrimental cell signaling and protects neurons against damage.     

Effect of mild hyperthermia on recovery of metabolic function after global cerebral ischemia in cats

We investigated the effect of mild whole-body hyperthermia before and after 16 minutes of global cerebral ischemia on metabolic recovery during recirculation in cats using in vivo phosphorus-31 nuclear magnetic resonance spectroscopy. Hyperthermia (temperature 40.6 +/- 0.2 degrees C) was induced greater than or equal to 1 hour before ischemia and was maintained during 1.5-2 hours of recirculation in nine cats; four cats were subjected to hyperthermia without cerebral ischemia, six to hyperthermia during recirculation (after return of intracellular pH to preischemic values), and 14 to normothermic ischemia and recirculation. Our data indicate that preischemic hyperthermia results in an intracellular cerebral pH during recirculation significantly lower than that in normothermic cats. In hyperthermic cats beta-ATP and phosphocreatine (PCr) concentrations and the ratio of PCr to inorganic phosphate failed to return to preischemic levels during recirculation in contrast to normothermic cats. Hyperthermia without ischemia and hyperthermia during recirculation had no significant effect on intracellular pH. Thus, preischemic hyperthermia has a detrimental effect on metabolic recovery after transient global cerebral ischemia.     

亚低温对大鼠短暂性全脑缺血后皮质NOS亚型表达及神经元凋亡的影响

目的观察亚低温对大鼠全脑缺血再灌注后皮质3种一氧化氮合酶亚型表达、一氧化氮产生以及神经元凋亡的影响,探讨亚低温的神经保护机制。方法成年雄性SD大鼠,采用双侧颈总动脉阻断闭塞+低血压法制备短暂性全脑缺血动物模型,随机分为常温缺血组、亚低温缺血组和常温假手术对照组;常温时的脑温为36.5℃～37.5℃,肛温为35.9℃～36.9℃;亚低温时控制在32.5℃～33.5℃,相对应肛温为32.2℃～33.1℃;分别于缺血后及亚低温治疗后30min、2h、24h和72h观察短暂缺血对脑组织一氧化氮合酶亚型表达及神经元凋亡的影响,以及亚低温对缺血性脑损伤的保护作用。行神经元尼氏体亚甲蓝染色观察神经元数目及形态学的变化;免疫组化染色检测神经元型、诱导型和内皮型一氧化氮合酶的表达水平;应用硝酸还原酶法检测硝酸盐/亚硝酸盐水平的变化;采用TUNEL染色法并结合电子显微镜观察神经元凋亡的变化。结果常温缺血组大鼠额叶皮质3种一氧化氮合酶亚型表达水平及硝酸盐/亚硝酸盐含量均明显高于常温假手术对照组(P<0.05或P<0.01),出现凋亡神经元;低温缺血组大鼠3种一氧化氮合酶亚型表达水平和硝酸盐/亚硝酸盐含量明显低于常温缺血组(P<0.05或P<0.01),未检测到凋亡神经元。结论脑缺血后一氧化氮参与了神经元的凋亡过程,而亚低温治疗可以     

亚低温对脑缺血再灌注后缺血核心区皮质内MCP-1作用的实验研究

目的观察缺血过程中亚低温对大鼠脑缺血再灌注后缺血核心区皮质内单核细胞趋化蛋白(MCP)-1mRNA和蛋白质含量的影响。方法将60只雄性Wistar大鼠随机分为常温组(37℃)和亚低温组(32～33℃),以半定量逆转录PCR(RT-PCR)法测定MCP-1mRNA的表达,ELISA法测定缺血2 h再灌注不同时间缺血核心区脑皮质内MCP-1含量的变化,2,3,5三苯基四氮唑(TTC)染色法观察脑皮质梗死灶的变化并对大鼠进行神经病学评分。结果缺血2hMCP-1mRNA表达明显升高,再灌注后16h达高峰,此后仍维持较高水平的表达,直至再灌注后48 h;MCP-1含量于再灌注后6h开始升高,至48h逐渐达到高峰。亚低温能显著抑制再灌注后6h和16 hMCP-1mRNA的表达(P <0.05),但对再灌注后24h和48hMCP-1mRNA的表达无影响(P >0.05);亚低温能显著抑制再灌注后6h及48h脑皮质内MCP-1含量的升高(P <0.05)。亚低温组的脑梗死灶面积和神经病学评分较相应时间点的常温组明显减小。结论抑制缺血再灌注后脑皮质内MCP-1mRNA的表达和蛋白质分泌可能是亚低温发挥脑保护作用的重要途径之一。     

Effects of hypothermia and rewarming on evoked potentials during transient focal cerebral ischemia in cats

Abstract

We examined the effects of mild to moderate hypothermia and the influence of rewarming on electrophysiological function using somatosensory evoked potentials (SEPs) in transient focal ischemia in the brain. Nineteen cats underwent 60 min of left middle cerebral artery occlusion under normothermic (36 ° -37 ° C, n = 6) or hypothermic (30 ° -31 ° C, n = 13) conditions followed by 300 min of reperfusion with slow (120 min, n = 6) or rapid (30 min, n = 7) rewarming. Whole-body hypothermia was induced during ischemia and the first 180 min of reperfusion. SEPs and regional cerebral blood flow were measured before and during ischemia and during reperfusion. The specific gravity of gray and white matter was examined as the indicator of edema. During rewarming, SEP amplitudes recovered gradually. After rewarming, SEPs in the normothermic and rapid rewarming groups remained depressed (20%-40% of pre-occlusion values); however, recovery of SEPs was significantly enhanced in the slow rewarming group (p < 0.05). Hypothermia followed by slow rewarming reduced edema in gray and white matter. Rapid rewarming did not reduce edema in the white matter. The recovery of SEPs correlated with the extent of brain edema in transient focal ischemia. Rapid rewarming reduced the protective effect of hypothermia. [Neurol Res 2002; 24: 621-626]     

Effects of hypothermia and rewarming on evoked potentials during transient focal cerebral ischemia in cats

We examined the effects of mild to moderate hypothermia and the influence of rewarming on electrophysiological function using somatosensory evoked potentials (SEPs) in transient focal ischemia in the brain. Nineteen cats underwent 60 min of left middle cerebral artery occlusion under normothermic (36 degrees-37 degrees C, n = 6) or hypothermic (30 degrees -31 degrees C, n = 13) conditions followed by 300 min of reperfusion with slow (120 min, n = 6) or rapid (30 min, n = 7) rewarming. Whole-body hypothermia was induced during ischemia and the first 180 min of reperfusion. SEPs and regional cerebral blood flow were measured before and during ischemia and during reperfusion. The specific gravity of gray and white matter was examined as the indicator of edema. During rewarming, SEP amplitudes recovered gradually. After rewarming, SEPs in the normothermic and rapid rewarming groups remained depressed (20%-40% of pre-occlusion values); however, recovery of SEPs was significantly enhanced in the slow rewarming group (p < 0.05). Hypothermia followed by slow rewarming reduced edema in gray and white matter. Rapid rewarming did not reduce edema in the white matter. The recovery of SEPs correlated with the extent of brain edema in transient focal ischemia. Rapid rewarming reduced the protective effect of hypothermia.     

Effect of mild hypothermia on focal cerebral ischemia. Review of experimental studies

The purposes of this review are to clarify the effect of hypothermia therapy on focal cerebral ischemia in rats, and to consider the relevancy of its application to human focal cerebral ischemia. Since 1990, 26 reports confirming the brain-protecting effect of hypothermia in rat focal cerebral ischemia models have been published. Seventy-four experimental groups in these 26 reports were classified as having transient middle cerebral arterial occlusion (MCAO) with mild hypothermia (group A; 43 groups), permanent MCAO with mild hypothermia (group B; 14 groups), permanent MCAO with deep hypothermia (group C; 8 groups) and transient or permanent MCAO with mild hyperthermia (group D; 9 groups). The results were evaluated as the % infarct volume change caused by hypothermia or hyperthermia compared with the infarct volume in normothermic animals. The effectiveness was confirmed in 36 (83%) of the 43 groups in group A, 10 (71%) of the 14 in group B, and six (75%) of the eight in group C. The infarct volume of eight of the nine groups in group D was markedly aggravated. The percent infarct volume change was 55.3% +/- 27.1% in group A, 57.6% +/- 24.7% in group B, 60.8% +/- 45.5% in group C, and 189.7% +/- 89.4% in group D. For effective reduction of the infarct volume, hypothermia should be started during ischemia or within 1 h, at latest, after the beginning of reperfusion in the rat transient MCAO model. However, it is not clear whether this neuroprotective effect of hypothermia can also be observed in the chronic stage, such as several months later. Keeping the body temperature normothermic in order to avoid mild hyperthermia seems to be rather important for not aggravating cerebral infarction. Clinical randomized studies on the efficacy of mild hypothermia for focal cerebral ischemia and sophisticated mild hypothermia therapy techniques are mandatory.     

Electrical responses in hippocampal slices after prolonged global ischemia: effects of neuroprotectors

A simple and reproducible animal model of global ischemia, induced by decapitation in 30-day-old Wistar rats, has been developed. It allows to perform electrophysiological analysis of the postischemic reperfusion period in the brain slices. Periods of ischemia up to 40 min increase population spikes measured in the CA1 area of the hippocampus during 2–5 h of reperfusion. Thus after 30-min decapitation-induced ischemia (at t_ischem=25°C), the mean amplitude of the recorded maximum orthodromic population spikes was 159% of the control obtained in the non-ischemic animals. Longer ischemic episodes result in the depression of the population spikes. After 2 h of ischemia, the amplitude of population spikes was about 89% of control. After 3 h of decapitation ischemia, the neurons could not be reactivated. The duration of ischemic episode needed for the irreversible depression of the electrical activity of the brain neurons drastically depends on the temperature at which the ischemic brain is maintained. Thus, only 2 h were needed at 30°C as compared to nearly 3 h at 25°C. We have found that intraperitoneal injection of neuroprotectors which precedes decapitation enables reactivation of the post-ischemic neurons even after very long periods of global ischemia. Thus, MK-801, a non-competitive NMDA receptors antagonist, or NBQX, a blocker of AMPA receptors, administrated 15 min before the long-term (90 min) decapitation ischemia (30°C), induced dose-dependent recovery of population spike with ED₅₀ values 0.2 mg/kg and 3 mg/kg respectively. Our results demonstrate that, in spite of the high vulnerability of hippocampal neurons to hypoxia and ischemia, their electrical activity can be restored after prolonged (more then 1 h) decapitation ischemia. Administration of NMDA or AMPA antagonists enhances recovery.     

Relation of apparent diffusion coefficient changes and metabolic disturbances after 1 hour of focal cerebral ischemia and at different reperfusion phases in rats.

Changes in apparent diffusion coefficients (ADC) were compared with alterations of adenosine triphosphate (ATP) concentration and pH in different phases of transient focal cerebral ischemia to study the ADC threshold for breakdown of energy metabolism and tissue acidosis during ischemia and reperfusion. Male Wistar rats underwent 1 hour of middle cerebral artery occlusion without recirculation (n = 3) or with 1 hour (n = 4) or 10 hours of reperfusion (n=5) inside the magnet, using a remotely controlled thread occlusion model. ADC maps were calculated from diffusion-weighted images and normalized to the preischemic value to obtain relative ADC maps. Hemispheric lesion volume (HLV) was determined on the last relative ADC maps at different relative ADC thresholds and was compared to the HLV measured by ATP depletion and by tissue acidosis. The HLVs, defined by ATP depletion and tissue acidosis, were 26.0% +/- 10.6% and 38.1% +/- 6.5% at the end of ischemia, 3.3% +/- 2.4% and 4.8% +/- 3.5% after 1 hour of reperfusion, and 11.2% +/- 4.7% and 10.9% +/- 5.2% after 10 hours of recirculation, respectively. The relative ADC thresholds for energy failure were consistently approximately 77% of the control value in the three different groups. The threshold for tissue acidosis was higher at the end of ischemia (86% of control) but was similar to the results obtained for ATP depletion after 1 hour (78% of control) and 10 hours (76% of control) of recirculation. These results indicate that the described relative ADC threshold of approximately 77% of control provides a good estimate for the breakdown of energy metabolism not only during middle cerebral artery occlusion but also at the early phase of reperfusion, when recovery of energy metabolism is expected to occur, or some hours later, when development of secondary energy failure was described.