Inosine inhibits apoptosis and cytochrome C mRNA expression in rat neurons after cerebral ischemia/reperfusion

BACKGROUND: It has been demonstrated that adenosine can induce glial cell to release cytochrome C, enhance expression of apoptotic gene bax, inhibit anti-apoptotic gene bcl-2, and activate caspase-3 to apoptosis; Whereas inosine can inhibit neuronal apoptosis which is similar to bcl-2. OBJECTIVE: To observe the effects of inosine on neuronal apoptosis and expression of cytochrome C mRNA in rats after focal cerebral ischemia/reperfusion, and analyze the pathway of its neuroprotective effect. DESIGN: A randomised controlled animal trial. SETTINGS: Department of Neurology, Rongcheng Second People's Hospital; Department of Neurology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. MATERIALS: Sixty-eight rats, weighing 230-280 g and clean grade, were used. TdT-mediated dUTP-biotin nick end labeling (TUNEL) and cytochrome C mRNA in situ hybridization kits and DAB staining kit were purchased from Wuhan Boster Biological Co., Ltd.; Inosine injection [200 mg (2 mL) each] from Qingdao First Pharmaceutical Factory. METHODS: The experiment was accomplished in the animal experimental center in Tongji Medical College of Huazhong University of Science and Technology from December 2003 to June 2005. ① Sixty-four rats were made into focal ischemia by middle cerebral artery occlusion (MCAO) with a nylon monofilament suture. The successfully induced rats were assigned to inosine group (n =32) and model group (n =32) at random. Rats in the inosine group were intraperitoneally administrated with inosine in dose of 100 mg/kg preoperatively, twice a day, 7 days in all. The rats in the control group were injected with the same dose of saline solution by the similar way preoperatively. Each group was randomized into ischemia /reperfusion 2, 6, 12, 24 hours, 2, 3, 7 and 14 days subgroups consisted of 4 rats. The other 4 rats were taken as the sham-operated group, the rats were given the same treatment except for not introduced the filament into the external carotid artery stump, and brain tissue was removed at 2 hours of reperfusion. ② In situ hybridization was performed to examine the expression of cytochrome C mRNA while TUNEL staining was made to characterize apoptosis. ③ The t test was used to compare the difference of measurement data. MAIN OUTCOME MEASURES: ① Neuronal apoptosis in the different regions of the ischemic brain tissue; ② Expression of cytochrome C mRNA in the different regions at different time points after MCAO. RESULTS: All the 68 rats were involved in the analysis of results. ① Neuronal apoptosis: A small number of TUNEL-positive cells were detected in the sham-operated brain and non-ischemic brain. The number of apoptotic cells in the ischemic cortex peaked at 24 hours of reperfusion [(72.00±1.98) cells] and that in the striatum peaked at 2 days [(94.75±3.57) cells], then decreased to the level of sham-operated group at 14 days. Inosine could reduce apoptotic cells from 12 hours to 7 days of reperfusion as compared with the model group (t =6.19-26.67, P < 0.01). ② Cytochrome C mRNA expression: There was weak expression of cytochrome C mRNA in both sham-operated brain and contralateral brain. Cytochrome C was detected at 2 hours of reperfusion in ischemic brain [(25.75±3.50), (39.75±2.49) cells], and strongly increased to a peak at 12 hours and 24 hours of reperfusion in cortex and striatum [(122.50±6.69), (119.25±5.12) cells], respectively. Furthermore, inosine could significantly decrease cytochrome C expression in cortex at 12 hours to 14 days of reperfusion after ischemic reperfusion and that in striatum at 12 hours to 3 days (t =8.67-43.26, P < 0.01). CONCLUSION: Inosine can exert a neuroprotective effect by inhibiting apoptosis and cytochrome C mRNA expression.     

Effect of nicorandil on infarct volume and marker enzyme activity in mitochondria of rats with cerebral ischemia/ reperfusion injury★

BACKGROUND： Recent studies have suggested that mitochondrial ATP-sensitive K＋ channel openers could reduce myocardium infarct size, and protect the function of the mitochondria. OBJECTIVE： To investigate the changes of cerebral infarction volume and the activity of marker enzymes in brain mitochondria of rats given the ATP-sensitive K＋ channel opener, nicorandil, before focal cerebral ischemia/reperfusion （I/R）. DESIGN, TIME AND SETTING： Randomized, controlled animal experiment, completed at the Brain Scientific Research Center of the Affiliated Hospital of Qingdao University from July to November 2007. MATERIALS： Sixty healthy male Wistar rats weighing 280-300 g. Nicorandil, 5-hydroxydecanoate （5-HD） and cytochrome C were purchased from Sigma in the USA. Standard malondialdehyde （MDA） and protein were purchased from Nanjing Jiancheng Biotechnology Institute. METHODS： Sixty rats were randomly divided into a sham operation group, a middle cerebral artery occlusion （MCAO） group, a nicorandil group and a nicorandil＋5-HD group. MCAO for 2 hours was performed in the MCAO group, nicorandil group and nicorandil＋5-HD group. A total of 5 mL saline were given to the MCAO group before MCAO. The nicorandil group was injected with the ATP-sensitive K＋ channel opener nicorandil 10 mg/kg intraperitoneally 30 minutes before MCAO. The nicorandil＋5-HD group was injected with 5-HD 10 mg/kg intravenously 15 minutes before the same treatment as the nicorandil group. MAIN OUTCOME MEASURES： Infarct volume by total brain slice calculation, activities of succinate dehydrogenase （SDH） and cytochrome oxidase （CO）, and content of MDA were observed at 22 hours of reperfusion after 2 hours MCAO. RESULTS： Sixty rats were included in the final analysis, without any loss. （1） Infarct volume： compared with the MCAO group and nicorandil＋5-HD group, the percentage of infarct volume was significantly decreased in the nicorandil group （P 〈 0.01）. （2） The content of MDA, expression of     

Effects of transection of cervical sympathetic trunk on cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury*★

BACKGROUND： Stellate ganglion block （SGB） plays a protective role on the brain, but the precise mechanism of action is not clear. OBJECTIVE： To simulate SGB by transection of the cervical sympathetic trunk （TCST） and to investigate the TCST effects on changes in cerebral infarct volume and oxygen free radical levels in rats with focal cerebral ischemia/reperfusion injury. DESIGN, TIME AND SETTING： A complete randomized control animal experiment was performed at the Institute of Neurological Diseases of Taihe Hospital, Yunyang Medical College from February to December 2005. MATERIALS： A total of 101 healthy Wistar rats, weighing 280-320 g, of both genders, aged 17-18 weeks, were used in this study. 2, 3, 5-triphenyltetrazolium chloride （TTC） was purchased from Changsha Hongyuan Biological Company. Superoxide dismutase （SOD）, malondialdehyde （MDA） and nitric oxide （NO） assay kits were provided by Nanjing Jiancheng Bioengineering Institute. METHODS： Rats were randomly divided into a TCST group, a model group and a sham operation group. Successful models were included in the final analysis, with at least 20 rats in each group. After TCST, rat models of focal cerebral ischemia/reperfusion injury were established in the TCST group by receiving middle cerebral artery occlusion （MCAO） by the intraluminal suture method for 2 hours, followed by 24 hours of reperfusion. Rat models of focal cerebral ischemia/reperfusion injury were made in the model group. Rats in the sham operation group underwent experimental procedures as for the model group, threading depth of 10 mm, and middle cerebral artery was not ligated. MAIN OUTCOME MEASURES： Brain tissue sections of ten rats from each group were used to measure cerebral infarct volume by TTC staining. Brain tissue homogenate of another ten rats from each group was used to detect SOD activities, MDA contents and NO levels. Rat neurological function was assessed by neurobehavioral measures. RESULTS： Cerebral infarct volume was bigger in the     

Cervical sympathetic trunk transection affects inducible nitric oxide synthase expression in rat hippocampus following focal cerebral ischemia/reperfusion injury

BACKGROUND： The stellate ganglion block （SGB） plays a protective role in focal cerebral ischemia/reperfusion injury. The human SGB can be simulated by transection of the cervical sympathetic trunk （TCST） in rats. OBJECTIVE： To observe the effects of TCST on inducible nitric oxide synthase （iNOS） levels and cerebral infarct volume in the hippocampus of rats with cerebral ischemia/reperfusion injury, and to analyze the mechanism of action. DESIGN, TIME AND SETTING： A completely randomized, controlled, neuropathological experiment was performed at the Institute of Neurological Disease, Taihe Hospital, Yunyang Medical College between March and September 2006. MATERIALS： A total of 93 Wistar rats, aged 1718 weeks, of either gender, were used for this study. 2, 3, 5-triphenyl tetrazolium chloride was purchased from Changsha Hongyuan Biological Reagent Company China. Rabbit iNOS antibody and goat anti-rabbit IgG antibody were the products of Wuhan Boster Biological Reagent Co., Ltd., China. METHODS： Ten rats were randomly selected for the sham-operated group. Cerebral ischemia/reperfusion injury was induced by middle cerebral artery occlusion （MCAO） using the suture method in the remaining rats. Forty successful rat models were randomly and equally divided into the following two groups： （1） TCST group： subsequent to TCST, MCAO was performed for 2 hours, followed by 24 hours reperfusion; （2） model group： rats underwent experimental procedures similar to the TCST group, with the exception of TCST. Rats in the sham-operated group were subjected to experimental procedures similar to the model group; however, the thread was only introduced to a depth of 10 mm. MAIN OUTCOME MEASURES： Following 24 hours of reperfusion, functional neurological deficits were scored. Brain tissue sections from ten rats of each group were used to measure cerebral infarct volume by TTC staining. Hippocampal tissue sections of an additional ten rats from each group were used to detect iNOS levels using the s     

bcl-xl over-expression in transgenic mice reduces cerebral ischemia/reperfusion injury

BACKGROUND:Basal cell lymphoma-extra large (bcl-xl) can inhibit neuronal apoptosis by stabilizing the mitochondrial membrane and suppressing cytochrome C release into the cytoplasm. OBJECTIVE: This study aimed to further investigate the cascade reaction pathway of cellular apoptosis. We established an ischemia/reperfusion model by middle cerebral artery occlusion (MCAO) in transgenic and wild-type mice,and observed changes in the number and distribution of apoptotic neural cells,differences in cerebral infa...     

Therapeutic window of Qingkailing injection for focal cerebral ischemia/reperfusion injury

The time window in which a drug is effective varies between drugs. The present study investigated the therapeutic window of Qingkailing injection for focal cerebral ischemia/reperfusion in mice. Animals underwent middle cerebral artery occlusion and were injected with Qingkailing (1.5, 3, 6 mL/kg). Infarct volume and neurological function were assessed after 24 hours of ischemia. In addition, to establish the therapeutic time window, mice were injected with 3 mL/kg Qingkailing at 0, 1, 3, 4, 6, 9 and 12 hours after occlusion. Results revealed that Qingkailing injection significantly reduced infarct volume and improved neurological function in model mice after cerebral infarction for up to 9 hours, demonstrating that the therapeutic window of Qingkailing injection can extend to 9 hours for cerebral ischemia/reperfusion in mice.     

Matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 expression in early focal cerebral infarction following urokinase thrombolysis in rats

Activity of matrix metalloproteinase-9 increases following cerebral ischemia/reperfusion,and is associated with cerebral microvascular permeability,blood-brain barrier destruction,inflammatory cell infiltration and brain edema.Matrix metalloproteinase-9 also likely participates in thrombolysis.A rat model of middle cerebral artery infarction was established by injecting autologous blood clots into the internal carotid artery.At 3 hours following model induction,urokinase was injected into the caudal vein.Decreased neurological severity score,reduced infarct volume,and increased expression of matrix metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 were observed in the cerebral cortex 24 hours after urokinase thrombolysis.These results suggest that urokinase can suppress damage in the acute-early stage of cerebral infarction.     

Therapeutic time window of picroside on cerebral ischemia reperfusion injury in rats

BACKGROUNG: Cerebral schemia may result in cerebral edema and neuronal injury by activating some endogenous mechanisms. It has been confirmed that picrosideⅡ could protect neuronal damage in vitro an ex vitro. OBJECTIVE: The aim of the present study is to explore the neuroprotective effects and the perfect treatment window of picrosideⅡ on brain insult in rats following middle cerebral artery occlusion and reperfusion (MCAO/R). DESIGN, TIME AND SETTING: A randomized, controlled animal experiment was performed at Institute of Cerebrovascular Diseases, Qingdao University Medical College from September 2008 to May 2009. MATERIALS AND METHODS: One hundred and sixty-five adult healthy male Wistar rats were randomly divided into a sham-operation group (n=15), a control group (n=75) and a treatment group (n=75). Rats in the control group and the treatment group were experimented surgery operation of MCAO/R with an intraluminal monofilament suture from left external-internal carotid artery. Those in the treatment group were injected 1.0％ picrosideⅡat a single dosage of 10mg/kg from the tail vein. We evaluated neurological function score by Longa’s method, cerebral infarction volume with tetrazolium chloride (TTC) stain. Then we compared cell apoptosis by terminal deoxynucleotidyl transference-mediated biotinylated deoxyuridine triphosphate nick end labeling technique (TUNEL), and determined the expression alternation of aquaporin-4 (AQP-4) via fluorescence labeling analysis and RT-PCR technique. RESULTS: After MCAO/R, neurological function scores were decreased, and a small infarction focus could be detected in ischemic cortex in the control group at ischemic 0.5h, along with the increased number of positive-apotosis cells and the elevated expression of AQP-4 mRNA and its protein. With the duration of ischemia, neurological scores and infarction sizes obviously increased in the control group during ischemic 1.0h-2.0h. A great deal of positive-apoptotic cells were widespread in the cortex and the striatum in the ischemic ipsilateral. Simultaneously, the expression of AQP-4 mRNA and its protein increased to some extent. PicrosideⅡ treatment significantly improved the loss of neurological function, decreased the infarction volume, and elevated the expression levels of AQP-4 mRNA and its protein compared with those in the control group. The therapeutic effect of picrosideⅡ was notable, especially in the ischemic 1.0h subsection. CONCLUSION: These results demonstrate that picrosideⅡ played a neuroprotective effect on cerebral ischemic reperfusion by inhibiting apoptosis and regulating the expression of AQP-4 mRNA and its protein. The best therapeutic window is at ischemic 1h after MCAO.     

转基因小鼠中bcl-xl基因的过表达在小鼠大脑中动脉栓塞中的保护作用

目的观察bcl-xl基因的过表达对小鼠大脑中动脉栓塞的保护作用,探讨其作用机制。方法通过建立bclxl转基因小鼠,经传代及检测后证实,该转基因小鼠中存在着bclxl基因的过表达,然后将该模型小鼠与同种系野生型小鼠同时行线栓永久性阻塞大脑中动脉,在缺血24h时测其神经功能评分,观察转基因小鼠与野生型小鼠的差别。在缺血后不同时间点测其梗死体积,观察梗死体积的动态变化。用TUNEL法观察小鼠的脑组织缺血后不同时间点再灌注时凋亡细胞的数量和分布情况。用免疫组化方法观察梗死前后两种小鼠脑组织中bcl-xl的表达量的差异。结果缺血24h后转基因小鼠的神经功能评分低于野生型小鼠(P<0.05)。缺血后3、24、72h,转基因小鼠的梗死体积均明显低于野生型小鼠,差异有显著性意义。TUNEL显示在缺血再灌注后的不同时间点,转基因小鼠皮质缺血区内的凋亡细胞数明显少于野生型小鼠,差异有显著性意义。免疫组化结果显示,梗死前后转基因小鼠的皮质细胞bclxl的表达量均明显高于野生型小鼠(P<0.05),且梗死后两种小鼠体内的bclxl的表达量均较梗死前增加(P<0.05)。结论在规范化的标准条件下,转基因小鼠中bclxl基因的过表达能够降低脑梗死的体积并改善小鼠的神经功能;过表达bclxl基因的这种效应可能是通过抑制细胞凋亡而实现的。     

ERK1/2信号通路对缺血后适应大鼠皮层的作用

目的研究脑缺血大鼠缺血后适应模型中大脑皮质的ERK1/2通路表达特点及应用ERK1/2特异性抑制剂PD98059后对缺血后适应神经保护作用的影响,研究缺血后适应是否通过ERK1/2信号通路介导对急性缺血性脑梗死再灌注后的神经保护作用。方法将20只SD大鼠随机分为假手术组、缺血2h再灌注组、缺血2h后适应组以及PD98059+缺血2h后适应组(PD+2h后适应组),每组5只,用线栓法建立急性大脑中动脉闭塞的缺血性脑梗死模型,4组分别进行不同形式的实验。对比4组大鼠再灌注1h、24h的神经功能评分及再灌注24h后的梗死体积。每组另增加15只大鼠,分别于再灌注后2h、6h、24h留取缺血大脑皮质;Western blot检测再灌注2h、6h、24h后总T-ERK1/2、P-ERK1/2表达。结果 PD+2h后适应组与缺血2h再灌注组神经功能缺损评分高于缺血2h后适应组,脑梗死体积大于缺血2h后适应组。缺血后适应组再灌注2h、6h、24h后P-ERK1/2表达明显高于缺血2h再灌注组及PD+2h后适应组;以上表明,缺血后适应通过ERK1/2信号通路减轻大鼠缺血性脑损伤,应用P-ERK1/2的阻滞剂PD98059后,阻断了缺血后适应的脑保护作用。结论通过对本实验研究数据的分析后发现,缺血后适应对大鼠急性缺血性脑梗死具有神经保护作用,应用ERK1/2特异性抑制剂PD98059后,缺血后适应神经保护效应减弱,说明缺血后适应对急性缺血性脑梗死再灌注损伤的保护作用与MAPK/ERK信号通路具有深层次紧密关系。     

依托咪酯预处理对大鼠局灶性脑缺血-再灌注损伤的保护作用

目的 探讨依托咪酯预处理对脑缺血-再灌注损伤的保护作用。方法 18只雄性SD大鼠,随机均分为3组,即脑缺血-再灌注组、依托咪酯预处理组、脂微球对照组。采用颈内动脉线栓栓塞致大脑中动脉阻塞模型,监测肛温及血糖,并于再灌注24h后断头处死动物,取大脑切片行2,3,5-氯化三苯基四氮唑染色,测量并计算脑梗死容积百分比。结果 依托咪酯预处理组脑梗死百分比明显低于脂微球对照组（P＜0.01）,低于缺血-再灌注组（P＜0.05）。但缺血-再灌注组与脂微球对照组相比差异无统计学意义。结论 依托咪酯预处理后可明显减小大鼠局灶性脑缺血-再灌注损伤后的脑梗死面积。     

电针预处理对脑缺血再灌注后SOD_2的表达影响

目的观察电针预处理对脑缺血再灌注后锰超氧化物歧化酶表达的影响。方法成年雄性C57小鼠随机分为假手术组(sham)、电针预处理组(EA)、大脑中动脉栓塞组(MCAO)、电针加大脑中动脉栓塞组(EA+MCAO),采用MCAO法诱导小鼠局灶性脑缺血再灌注模型。再灌2 h应用Western blot以及免疫荧光组织化学染色技术检测SOD2表达,再灌24 h评估神经行为学、测量脑梗死容积和神经细胞凋亡。结果脑缺血再灌注2 h,SOD2表达显著降低,而电针预处理可上调SOD2的表达,增加SOD2在神经元的免疫荧光强度。同时电针预处理可改善缺血再灌注后的神经功能障碍,减轻脑梗死容积率,减少末端脱氧核苷酸转移酶介导的生物素脱氧尿嘧啶核苷酸缺口末端标记法(TUNEL)阳性细胞数目。结论电针预处理可上调脑缺血再灌注后SOD2表达,可能参与其诱导的脑保护作用。     

Hypertonic saline worsens infarct volume after transient focal ischemia in rats

BACKGROUND AND PURPOSE: Hypertonic saline (HS) has been advocated as a hyperosmolar agent for the treatment of cerebral edema, especially after traumatic brain injury. We tested the hypothesis that continuous intravenous HS administered during reperfusion from transient focal cerebral ischemia attenuates infarct volume. METHODS: Halothane-anesthetized male Wistar rats were subjected to 2 hours of middle cerebral artery occlusion (MCAO) by the intraluminal occlusion technique. At the onset of reperfusion, rats received a 10-mL/kg intravenous bolus of 0.9% saline (SAL, n=8) or 7.5% SAL (chloride:acetate 50:50, n=8) followed by a continuous infusion for 22 hours. In a second series of experiments, ischemic damage was determined in cohorts treated with equivolumetric 3% saline (n=8) or 20% mannitol (n=8). In a third series, regional cerebral blood flow was measured ([(14)C]iodoantipyrine autoradiography) at 6 hours of reperfusion in 7.5%-SAL-treated (n=5) or SAL-treated (n=5) animals. RESULTS: In SAL rats, serum Na(+) was 137+/-3 and 138+/-2 mEq/L (mean+/-SEM) at baseline and 22 hours of reperfusion, respectively. In 7.5% SAL, serum Na(+) was 136+/-2 and 154+/-2 mEq/L at baseline and reperfusion, respectively. Physiological variables and reduction in laser-Doppler signal during MCAO and early reperfusion were not different between the 2 treatment groups. Cortical infarct volume was larger in 7.5%-SAL-treated rats (121+/-14 mm(3); 30+/-3% of contralateral cortex; P<0.05) than in SAL (64+/-15 mm(3); 16+/-4% of contralateral cortex). Striatal infarct volume was unchanged by HS therapy. Ipsilateral cortical tissue volume was increased relative to the contralateral side (by 26+/-5% with SAL; by 41+/-5% with 7.5% SAL). In contrast, ischemic damage was unaffected by 3%-SAL or 20%-mannitol treatment compared with SAL. Regional cerebral blood flow during reperfusion was heterogeneous in all animals, but there was no evidence of postischemic hypoperfusion or blood flow maldistribution in 7.5%-SAL-treated animals. CONCLUSIONS: These data demonstrate that hypernatremia resulting from postischemic HS infusion worsens cortical infarct volume in transient focal cerebral ischemia. The deleterious effect is not linked to exacerbation of delayed hypoperfusion during early reperfusion (6 hours); however, blood flow defects at later recovery time points remain to be excluded. These results may have implications for HS therapy in clinical ischemic stroke.     

Exendin-4对MCAO再灌注导致的脑缺血/再灌注损伤具有神经保护作用

目的 探讨GLP-1受体激动剂Exendin-4腹腔给药对大脑中动脉闭塞(MCAO)再灌注所致大鼠脑缺血/再灌注损伤的神经保护作用。方法 SD大鼠术前1 h腹腔注射Exendin-4,MCAO再灌注24 h后进行神经功能缺损评分,TTC染色计算脑梗死体积,免疫荧光观察神经元和小胶质细胞生存数量及检测凋亡通路相关蛋白的相对表达水平。结果 Exendin-4能够保护由于MCAO再灌注后所致的脑缺血再灌注损伤,减少了脑梗死体积,降低皮层凋亡蛋白的相对表达水平,抑制神经元凋亡。结论 Exendin-4可以对MCAO再灌注所致脑缺血/再灌注损伤具有神经保护作用,该作用是通过抑制凋亡蛋白的产生,从而抑制细胞凋亡。     

Delayed and multiple hyperbaric oxygen treatments expand therapeutic window in rat focal cerebral ischemic model

Although the brain-protective effect of single, early applications of hyperbaric oxygen (HBO) has been reported in acute ischemic stroke models, few studies have reported the long-term effect—especially after multiple HBO applications. This study employed delayed, multiple HBO treatments and evaluated cerebral infarction and neurological functional recovery for 4 weeks after transient focal ischemia. Adult male Sprague-Dawley rats were subjected to middle cerebral artery occlusion/reperfusion (MCAO/R) and were subsequently exposed to HBO (2.5 atmospheres absolute [ATA]) for 2 hours per day. HBO was administered at either 6 or 24 hours after MCAO/R and was repeated daily for 6 days. Rat behavior was scored to evaluate neurological deficits. The brains were removed for histological analysis of the infarct ratio at 1 and 4 weeks. Rats with HBO delayed for 6 or 24 hours following MCAO/R displayed a significant decrease of infarct ratio and amelioration of neurological deficits compared to the untreated group. This study suggests that delayed, but multiple, HBO treatments can improve neurological evaluation and reduce cerebral infarction.     

胰岛素对局灶性脑缺血再灌注损伤的作用

目的　观察胰岛素对脑缺血再灌注损伤的治疗作用。方法　制备易卒中型肾血管性高血压大鼠（ Ｒ Ｈ Ｒ Ｓ Ｐ） ,用线栓法复制大脑中动脉阻塞（ Ｍ Ｃ Ａ Ｏ） ,造成缺血６ ｈ 再灌注１８ ｈ ,术后立即及６ 小时后即时使用胰岛素,测定神经功能障碍评分及脑梗死体积的变化。结果　胰岛素可使神经功能障碍评分显著减低,梗死灶体积及其占全大脑体积比值,两半球体积差值显著减小。结论　胰岛素能减轻脑缺血再灌注损伤,早期用药效果更好。     

The novel Nrf2 activator CDDO-EA attenuates cerebral ischemic injury by promoting microglia/macrophage polarization toward M2 phenotype in mice

The aim of present study was to explore whether 2-cyano-3, 12-dioxooleana-1, 9-dien-28-oic acid (CDDO)-ethylamide (CDDO-EA) attenuates cerebral ischemic injury and its possible mechanisms using a middle cerebral artery occlusion (MCAO) model in C57BL/6 mice. Our results showed that intraperitoneal injection (i.p.) of CDDO-EA (2 and 4 mg/kg) augmented NFE2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) expression in ischemic cortex after MCAO. Moreover, CDDO-EA (2 mg/kg, i.p.) significantly enhanced Nrf2 nuclear accumulation, associated with increased cytosolic HO-1 expression, reduced neurological deficit and infarct volume as well as neural apoptosis, and shifted polarization of microglia/macrophages toward an antiinflammatory M2 phenotype in ischemic cortex after MCAO. Using an in vitro model, we confirmed that CDDO-EA (100 μg/mL) increased HO-1 expression and primed microglial polarization toward M2 phenotype under inflammatory stimulation in BV2 microglial cells. These findings suggest that a novel Nrf2 activator CDDO-EA confers neuroprotection against ischemic injury.