Chen Sheng-Hsien, Chang Fong-Ming, Tsai Yung-Chieh, Huang Kuo-Feng, Lin Mao-Tsun
Institute of Clinical Medicine, School of Medicine, National Cheng Kung University, Chi-Mei Medical Center, Tainan, Taiwan.
Crit Care Med. 2005 Jun;33(6):1377-83. doi: 10.1097/01.ccm.0000165966.28936.89.
Human umbilical cord blood cells (HUCBCs) are effective in the treatment of conventional stroke in experimental models. In the study described herein, we administered HUCBCs into the femoral vein or directly into the cerebral ventricular system and assessed their effects on circulatory shock, cerebral ischemia, and damage during heatstroke.
Controlled, prospective study.
Hospital medical research laboratory.
Sprague-Dawley rats (287 +/- 16 g body weight, males).
Anesthetized rats, immediately after the onset of heatstroke, were divided into four major groups and given the following: a) normal saline or AIM-V medium intravenously (0.3 mL) or intracerebroventricularly (10 microL); b) peripheral blood mononuclear cells (5 x 10 in 0.3 mL AIM-V medium, intravenously, or 5 x 10 in 10 microL AIM-V medium, intracerebroventricularly); or c) HUCBCs (5 x 10 in 0.3 mL AIM-V medium, intravenously, or 5 x 10 in 10 microL AIM-V medium, intracerebroventricularly). Another group of rats, under urethane anesthesia, were exposed to room temperature (26 degrees C) and used as normothermic controls. Urethane-anesthetized animals were exposed to an ambient temperature of 43 degrees C to induce heatstroke. Their physiologic and biochemical parameters were continuously monitored.
When the vehicle-treated rats underwent heat exposure, their survival time values were found to be 21-23 mins. Resuscitation with intravenous or intracerebroventricular doses of HUCBCs, but not peripheral blood mononuclear cells, immediately at the onset of heatstroke significantly improved survival during heatstroke (61-148 mins). As compared with values for normothermic controls, the vehicle-treated heatstroke rats had lower mean arterial pressure, cerebral blood flow, and brain PO2 values but higher intracranial pressure and cerebral ischemia values and more injury markers. The circulatory shock, intracranial hypertension, cerebral hypoperfusion and hypoxia, increment of cerebral ischemia, and damage markers during heatstroke were all significantly attenuated by intravenous or intracerebroventricular delivery of HUCBCs but not peripheral blood mononuclear cells.
We successfully demonstrate that HUCBC therapy may resuscitate heatstroke victims by reducing circulatory shock and cerebral ischemic injury; central delivery of HUCBCs seems superior to systemic delivery of HUCBCs in resuscitating patients with heatstroke.
在实验模型中,人脐带血细胞(HUCBCs)对传统中风的治疗有效。在本研究中,我们将HUCBCs注入股静脉或直接注入脑室系统,并评估它们对循环性休克、脑缺血及中暑期间损伤的影响。
对照性前瞻性研究。
医院医学研究实验室。
雄性Sprague-Dawley大鼠(体重287±16 g)。
中暑发作后立即将麻醉的大鼠分为四大组并给予以下处理:a)静脉注射(0.3 mL)或脑室内注射(10 μL)生理盐水或AIM-V培养基;b)静脉注射(0.3 mL AIM-V培养基中含5×10个)或脑室内注射(10 μL AIM-V培养基中含5×10个)外周血单个核细胞;或c)静脉注射(0.3 mL AIM-V培养基中含5×10个)或脑室内注射(10 μL AIM-V培养基中含5×10个)HUCBCs。另一组在氨基甲酸乙酯麻醉下的大鼠置于室温(26℃)环境中作为正常体温对照。用氨基甲酸乙酯麻醉的动物暴露于43℃环境温度下以诱导中暑。持续监测它们的生理和生化参数。
接受载体处理的大鼠受热时,其存活时间为21 - 23分钟。在中暑发作时立即静脉或脑室内注射HUCBCs(而非外周血单个核细胞)进行复苏,可显著提高中暑期间的存活率(61 - 148分钟)。与正常体温对照的值相比,接受载体处理的中暑大鼠平均动脉压、脑血流量和脑PO2值较低,但颅内压和脑缺血值较高,且损伤标志物更多。中暑期间的循环性休克、颅内高压、脑灌注不足和缺氧、脑缺血增加及损伤标志物,通过静脉或脑室内注射HUCBCs(而非外周血单个核细胞)均得到显著减轻。
我们成功证明HUCBC疗法可通过减轻循环性休克和脑缺血损伤来挽救中暑患者;在挽救中暑患者方面,脑室内注射HUCBCs似乎优于全身注射HUCBCs。