Kim Tae-Youn, Yi Jung-Sun, Chung Sun-Ju, Kim Dong-Kyu, Byun Hyae-Ran, Lee Joo-Yong, Koh Jae-Young
Neural Injury Research Lab, University of Ulsan College of Medicine, Seoul 138-736, Korea.
Exp Neurol. 2007 Nov;208(1):159-67. doi: 10.1016/j.expneurol.2007.08.013. Epub 2007 Sep 4.
Although the majority of epileptic seizures can be effectively controlled with antiepileptic drugs and/or surgery, a significant number progress to status epilepticus of sufficient duration to cause permanent brain damage. Combined treatment with antiepileptic drugs and neuroprotective agents, however, may help protect these individuals from permanent brain damage. Since toxicity induced by endogenous zinc contributes to epileptic brain injury, and since pyruvate is effective in reducing zinc-triggered neuronal death in cortical culture as well as ischemic neuronal death in vivo, we examined whether systemic pyruvate administration reduces seizure-induced brain damage. Na pyruvate (500 mg/kg) or osmolarity-matched saline (265 mg/kg NaCl, i.p.) were given to adult SD rats 30 or 150 min after 10 mg/kg kainite injection (i.p.), and there was no significant difference in the time course or severity of seizures between these groups. Zinc accumulation in neuronal cell bodies in the hippocampus, however, was much lower in the pyruvate than in the saline group. There was a close correlation between zinc accumulation and cell death, as assessed by acid-fuchsin and TUNEL staining. Pyruvate treatment markedly reduced neuronal death in the hippocampus, neocortex and thalamus. Pyruvate increased HSP-70 expression in hippocampal neurons. These results suggest that pyruvate, a natural glucose metabolite, may be useful as adjunct treatment in status epilepticus to reduce permanent brain damage.
尽管大多数癫痫发作可用抗癫痫药物和/或手术有效控制,但仍有相当一部分会进展为持续时间足够长的癫痫持续状态,从而导致永久性脑损伤。然而,抗癫痫药物与神经保护剂联合治疗可能有助于保护这些个体免受永久性脑损伤。由于内源性锌诱导的毒性会导致癫痫性脑损伤,且丙酮酸在减少皮质培养中锌引发的神经元死亡以及体内缺血性神经元死亡方面有效,我们研究了全身性给予丙酮酸是否能减轻癫痫发作引起的脑损伤。在成年SD大鼠腹腔注射10 mg/kg红藻氨酸30或150分钟后,分别给予丙酮酸(500 mg/kg)或等渗盐水(265 mg/kg NaCl,腹腔注射),两组之间癫痫发作的时间进程或严重程度无显著差异。然而,丙酮酸组海马神经元细胞体内的锌积累量远低于盐水组。通过酸性品红和TUNEL染色评估,锌积累与细胞死亡之间存在密切相关性。丙酮酸治疗显著减少了海马、新皮质和丘脑的神经元死亡。丙酮酸增加了海马神经元中HSP-70的表达。这些结果表明,丙酮酸作为一种天然的葡萄糖代谢产物,可能作为癫痫持续状态的辅助治疗手段,以减少永久性脑损伤。