Kim K O, Choe G, Chung S H, Kim C S
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul, Korea.
Acta Anaesthesiol Scand. 2008 Feb;52(2):236-42. doi: 10.1111/j.1399-6576.2007.01534.x. Epub 2007 Nov 13.
Diazoxide, pharmacological openers of mitochondrial ATP-sensitive potassium channels have been shown to induce early pre-conditioning in the spinal cord. Here, the authors investigated whether diazoxide also induce delayed pre-conditioning and thereby reduce neurologic complications using a rabbit model of spinal cord ischemia.
Infrarenal blood flow was interrupted for 20 min in 21 rabbits. Non-treated control animals received no pre-treatment. Diazoxide (5 mg/kg) were given 48 h before 20 min ischemia in the 48-h DZ group, whereas 15-min DZ group received diazoxide (5 mg/kg) 15 min before 20-min ischemia. Neurological functions were evaluated using Johnson scores for 3 days after reperfusion, after which, spinal cords were procured for hematoxylin and eosin staining for cell counting.
Johnson scores revealed a marked improvement in both the diazoxide-treated groups vs. the non-treated control group at 3, 24, 48, and 72 h after reperfusion (P<0.01). The histologic changes were proportional to the Johnson scores, with better preservation of motor neuron numbers in the animals of the 48-h DZ and 15-min DZ group relative to the non-treated controls (81+/-12, 90+/-10, 50+/-23 motor neurons, respectively, P<0.01). No difference was found between the 48-h DZ group and 15-min DZ group with respect to the Johnson scores or neuron numbers.
The study demonstrates that pre-treatment with diazoxide 48 h before ischemia, induce delayed pharmacological pre-conditioning, thereby significantly improving clinical neurologic scores and histologic findings in this animal model.
二氮嗪作为线粒体ATP敏感性钾通道的药理学开放剂,已被证明可诱导脊髓早期预处理。在此,作者使用脊髓缺血兔模型研究二氮嗪是否也能诱导延迟预处理,从而减少神经并发症。
21只兔子的肾下血流中断20分钟。未治疗的对照动物未接受预处理。48小时二氮嗪组在缺血20分钟前48小时给予二氮嗪(5毫克/千克),而15分钟二氮嗪组在缺血20分钟前15分钟给予二氮嗪(5毫克/千克)。再灌注后3天使用约翰逊评分评估神经功能,之后获取脊髓进行苏木精和伊红染色以进行细胞计数。
约翰逊评分显示,再灌注后3、24、48和72小时,二氮嗪治疗组与未治疗对照组相比均有显著改善(P<0.01)。组织学变化与约翰逊评分成正比,48小时二氮嗪组和15分钟二氮嗪组动物的运动神经元数量相对于未治疗对照组保存得更好(分别为81±12、90±10、50±23个运动神经元,P<0.01)。48小时二氮嗪组和15分钟二氮嗪组在约翰逊评分或神经元数量方面没有差异。
该研究表明,缺血前48小时用二氮嗪预处理可诱导延迟药理学预处理,从而显著改善该动物模型的临床神经评分和组织学结果。