Maier Christian, Scheuerle Angelika, Hauser Balázs, Schelzig Hubert, Szabó Csaba, Radermacher Peter, Kick Jochen
Sektion Anästhesiologische Pathophysiologie und Verfahrensentwicklung, Universitätsklinikum, 89073, Ulm, Germany.
Abteilung Thorax- und Gefäßchirurgie, Universitätsklinikum, 89070, Ulm, Germany.
Intensive Care Med. 2007 May;33(5):845-850. doi: 10.1007/s00134-007-0585-3. Epub 2007 Mar 15.
It is well-established that poly(ADP)ribose-polymerase (PARP) assumes major importance during ischemic brain damage, and the selective PARP-1 inhibitor PJ34 reduced spinal cord damage in murine aortic occlusion-induced ischemia/reperfusion injury. We investigated the effect of the PARP-1 inhibitor INO1001 on aortic-occlusion-related porcine spinal cord injury.
Prospective, randomized, controlled experimental study in an animal laboratory.
Ten anesthetized, mechanically ventilated, and instrumented pigs.
Animals underwent 45 min of thoracic aortic cross-clamping after receiving vehicle (n=5) or intravenous INO1001 (n=5, total dose 4 mg/kg administered both before clamping and during reperfusion). During reperfusion continuous intravenous norepinephrine was incrementally adjusted to maintain blood pressure at or above 80% of the preclamping level. Plasma INO1001 levels were analyzed by HPLC. After 4[Symbol: see text]h of reperfusion spinal cord biopsy samples were analyzed for neuronal damage (hematoxyline-eosine and Nissl staining), expression of the cyclin-dependent kinase inhibitor genes p21 and p27 (immunohistochemistry), and apoptosis (terminal deoxynucleotidyl transferase mediated nick end labeling assay).
Plasma INO1001 levels were 0.8-2.3 and 0.30-0.76 mM before and after clamping, respectively. While 3-5% of the spinal cord neurons were irreversibly damaged in the INO1001 animals, the neuronal cell injury was three times higher in the control group. Neither p21 and p27 expression nor apoptosis showed any intergroup difference.
The selective PARP-1 inhibitor INO1001 markedly reduced aortic occlusion-induced spinal cord injury. Given the close correlation reported in the literature between morphological damage and impaired spinal cord function, INO1001 may improve spinal cord recovery after thoracic aortic cross-clamping.
多聚(ADP)核糖聚合酶(PARP)在缺血性脑损伤中起主要作用,这一点已得到充分证实,且选择性PARP - 1抑制剂PJ34可减轻小鼠主动脉闭塞诱导的缺血/再灌注损伤中的脊髓损伤。我们研究了PARP - 1抑制剂INO1001对主动脉闭塞相关的猪脊髓损伤的影响。
在动物实验室进行的前瞻性、随机、对照实验研究。
十只麻醉、机械通气并安装仪器的猪。
动物在接受赋形剂(n = 5)或静脉注射INO1001(n = 5,在夹闭前和再灌注期间均给予总剂量4 mg/kg)后,进行45分钟的胸主动脉交叉夹闭。在再灌注期间,持续静脉注射去甲肾上腺素并逐步调整剂量,以将血压维持在夹闭前水平的80%或以上。通过高效液相色谱法分析血浆INO1001水平。再灌注4小时后,对脊髓活检样本进行分析,检测神经元损伤(苏木精 - 伊红染色和尼氏染色)、细胞周期蛋白依赖性激酶抑制剂基因p21和p27的表达(免疫组织化学)以及细胞凋亡(末端脱氧核苷酸转移酶介导的缺口末端标记法)。
夹闭前和夹闭后血浆INO1001水平分别为0.8 - 2.3 mM和0.30 - 0.76 mM。在接受INO1001治疗的动物中,3% - 5% 的脊髓神经元发生不可逆损伤,而对照组的神经元细胞损伤是其3倍。p21和p27的表达以及细胞凋亡在两组间均无差异。
选择性PARP - 1抑制剂INO1001显著减轻了主动脉闭塞诱导的脊髓损伤。鉴于文献报道的形态学损伤与脊髓功能受损之间的密切相关性,INO1001可能会改善胸主动脉交叉夹闭后的脊髓恢复情况。