Yuan Hui-Bih, Huang Yueming, Zheng Shuqiu, Zuo Zhiyi
Department of Anesthesiology, University of Virginia Health System, Charlottesville, Virginia, USA.
Anesthesiology. 2004 Feb;100(2):331-7. doi: 10.1097/00000542-200402000-00023.
A period of hypothermia before ischemia (hypothermic preconditioning) induces a delayed phase of ischemic tolerance in rat brain. However, whether hypothermic preconditioning induces an acute phase (within a few hours after the hypothermia) of ischemic tolerance remains unknown. This study was designed to determine the time window of the hypothermic preconditioning-induced acute phase of neuroprotection, which is useful information for situations during surgery with anticipated ischemic episodes, and its involved mechanisms.
Survival of Purkinje cells in rat cerebellar slices was evaluated after a 20-min oxygen-glucose deprivation (OGD, in vitro simulated ischemia) followed by a 4-h recovery. Mild hypothermia (33 degrees C) for 20 min was applied at various times before the OGD.
The hypothermia applied immediately to 3 h before the OGD equally effectively reduced OGD-induced Purkinje cell death/injury. Glibenclamide, a selective KATP channel blocker; 8-cyclopentyl-1,3-dipropylxanthine, a selective adenosine A1 receptor antagonist; and farnesyl protein transferase inhibitor III, a selective inhibitor to reduce Ras farnesylation, abolished hypothermic preconditioning-induced neuroprotection when applied during the hypothermia. OGD increased the expression of high-mobility group I(Y) proteins, which are nuclear transcription factors to enhance the expression of putatively damaging proteins such as cyclooxygenase-2, in cerebellar slices. This increase was attenuated by hypothermic preconditioning.
Hypothermic preconditioning induces an acute phase of neuroprotection. This neuroprotection depends on activation of the signaling molecules, adenosine A1 receptors, KATP channels, and Ras. Inhibition of putatively damaging proteins via the effects of hypothermic preconditioning on high-mobility group I(Y) expression may also be involved in hypothermic preconditioning-induced neuroprotection.
缺血前的低温期(低温预处理)可诱导大鼠脑内延迟性缺血耐受期。然而,低温预处理是否能诱导急性期(低温后数小时内)的缺血耐受尚不清楚。本研究旨在确定低温预处理诱导神经保护急性期的时间窗,这对于预期有缺血发作的手术情况是有用的信息,同时也研究其相关机制。
在大鼠小脑切片进行20分钟氧糖剥夺(OGD,体外模拟缺血)后再恢复4小时,评估浦肯野细胞的存活情况。在OGD前的不同时间施加20分钟的轻度低温(33℃)。
在OGD前立即至3小时施加低温,均能同样有效地减少OGD诱导的浦肯野细胞死亡/损伤。格列本脲,一种选择性钾离子通道阻滞剂;8-环戊基-1,3-二丙基黄嘌呤,一种选择性腺苷A1受体拮抗剂;法尼基蛋白转移酶抑制剂III,一种减少Ras法尼基化的选择性抑制剂,在低温期间应用时可消除低温预处理诱导的神经保护作用。OGD增加了小脑切片中高迁移率族蛋白I(Y)的表达,高迁移率族蛋白I(Y)是核转录因子,可增强环氧化酶-2等潜在损伤蛋白的表达。低温预处理可减弱这种增加。
低温预处理可诱导神经保护急性期。这种神经保护依赖于信号分子腺苷A1受体、钾离子通道和Ras的激活。低温预处理对高迁移率族蛋白I(Y)表达的影响抑制潜在损伤蛋白,这也可能参与低温预处理诱导的神经保护作用。