Miyamoto Ryohei, Shimakawa Shuichi, Suzuki Shuhei, Ogihara Tohru, Tamai Hiroshi
Department of Pediatrics, Osaka Medical College, Japan.
Brain Res. 2008 May 13;1209:85-91. doi: 10.1016/j.brainres.2008.02.064. Epub 2008 Mar 3.
There is growing evidence that free radical generation may play a key role in the neuronal damage induced by prolonged convulsions. Free radical scavengers are known to inhibit neuronal death induced by exposure to excitotoxins. However, this neuroprotective effect has not been demonstrated with treatment after seizures had been stopped. We investigated whether 3-methyl-1-phenyl-2-pyrazolin-5-one, edaravone (Ed), a newly developed free radical scavenger that has been used clinically to treat cerebral infarction, could prevent neuronal loss when administered after the occurrence of seizures in a kainic acid (KA)-induced seizure model. Compared with KA alone, cell loss was significantly reduced when animals received Ed (10 mg/kg i.v.) just after seizures, and when Ed was administered both 60 min before (30 mg/kg i.p.) and after KA injection. Combined before-and-after treatment with Ed significantly ameliorated the KA-induced decrease of glutathione and blocked the KA-induced increase of 4-hydroxy-2-nonenal (HNE). Because before-and-after treatment with Ed significantly lessened the KA-induced increase of HNE, Ed may exert its neuroprotective effect by inhibiting lipid peroxidation. However, post-treatment with Ed prevented neuronal cell loss, while HNE and glutathione levels did not differ from those in animals without Ed, so a mechanism other than free radical scavenging must be involved in the prevention of cell loss. Patients who develop status epilepticus are unlikely to receive adequate antioxidant therapy before the onset, so it is an advantage that Ed can prevent neuronal death even when administered after seizures.
越来越多的证据表明,自由基生成可能在长时间惊厥所致的神经元损伤中起关键作用。已知自由基清除剂可抑制暴露于兴奋性毒素所诱导的神经元死亡。然而,在惊厥停止后进行治疗时,这种神经保护作用尚未得到证实。我们研究了3-甲基-1-苯基-2-吡唑啉-5-酮依达拉奉(Ed),一种新开发的自由基清除剂,已用于临床治疗脑梗死,在 kainic 酸(KA)诱导的癫痫模型中惊厥发生后给药时,是否能预防神经元丢失。与单独使用 KA 相比,动物在惊厥刚结束时接受 Ed(10mg/kg 静脉注射),以及在 KA 注射前 60 分钟(30mg/kg 腹腔注射)和注射后均给予 Ed 时,细胞丢失显著减少。Ed 前后联合治疗显著改善了 KA 诱导的谷胱甘肽减少,并阻断了 KA 诱导的 4-羟基-2-壬烯醛(HNE)增加。因为 Ed 前后联合治疗显著减轻了 KA 诱导的 HNE 增加,Ed 可能通过抑制脂质过氧化发挥其神经保护作用。然而,Ed 治疗后可预防神经元细胞丢失,而 HNE 和谷胱甘肽水平与未使用 Ed 的动物无差异,因此预防细胞丢失必定涉及自由基清除以外的机制。发生癫痫持续状态的患者在发作前不太可能接受足够的抗氧化治疗,所以即使在惊厥后给药,Ed 能预防神经元死亡是一个优势。