Akuzawa Satoshi, Kazui Teruhisa, Shi Enyi, Yamashita Katsushi, Bashar Abul Hasan Muhammad, Terada Hitoshi
First Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
J Vasc Surg. 2008 Sep;48(3):694-700. doi: 10.1016/j.jvs.2008.04.011. Epub 2008 Jun 24.
Thoracic and thoracoabdominal aortic surgery is sometimes complicated by subacute or delayed paraplegia. Pro-inflammatory cytokine interleukin-1 (IL-1) beta has been implicated in extensive inflammation and progressive neurodegeneration after ischemia. Using a rabbit model, we investigated the neuroprotective effects of IL-1 receptor antagonist (IL-1ra) in a temporal fashion.
Spinal cord ischemia was induced by aortic cross-clamping in New Zealand White rabbits. The animals were assigned to three groups. Group C (n = 20) received saline (0.2-mL) and Group I (n = 20) received IL-1ra (200-microg/0.2-mL) intrathecally just after reperfusion. Group S (n = 3) underwent sham operation without aortic occlusion. We assessed the neuroprotective effects of IL-1ra by evaluating neurological function, histopathological changes, and in-situ terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL staining). We also measured the levels of Nitric Oxide (NO) and S100beta in cerebrospinal fluid (CSF). Each evaluation was performed sequentially within 120 hours after reperfusion.
Group C showed progressive deterioration of motor function which became statistically significant from 48 hours after the onset of reperfusion (P < .05, P < .01, P < .001, P < .001 at 48, 72, 96, and 120 hours, respectively). Compared to Group C, a higher number of viable neurons was observed with less severe spinal cord injury in Group I (P < .01, .05 and .05 at 24, 72, and 120 hours, respectively). TUNEL-positive neurons were also significantly reduced by the administration of IL-1ra (P <.01 and .05 at 24, and 120 hours, respectively). The difference between Group C and Group I with regard to NO was significant at 72 and 120 hours (P < .05), while that in terms of S100beta was significant only at 24 hours (P < .05).
Administration of IL-1ra attenuates spinal cord ischemic-reperfusion injury as evidenced by reducing both neuronal necrosis and apoptosis.
胸主动脉和胸腹主动脉手术有时会并发亚急性或迟发性截瘫。促炎细胞因子白细胞介素-1(IL-1)β与缺血后的广泛炎症和进行性神经退行性变有关。我们使用兔模型,以时间顺序研究了IL-1受体拮抗剂(IL-1ra)的神经保护作用。
通过夹闭新西兰白兔的主动脉诱导脊髓缺血。将动物分为三组。C组(n = 20)在再灌注后立即鞘内注射生理盐水(0.2 mL),I组(n = 20)在再灌注后立即鞘内注射IL-1ra(200 μg/0.2 mL)。S组(n = 3)接受假手术,不进行主动脉阻断。我们通过评估神经功能、组织病理学变化和原位末端脱氧核苷酸转移酶介导的dUTP-生物素缺口末端标记(TUNEL染色)来评估IL-1ra的神经保护作用。我们还测量了脑脊液(CSF)中一氧化氮(NO)和S100β的水平。每次评估在再灌注后120小时内依次进行。
C组运动功能逐渐恶化,从再灌注开始后48小时起具有统计学意义(分别在48、72、96和120小时时P <.05、P <.01、P <.001、P <.001)。与C组相比,I组观察到更多存活神经元,脊髓损伤较轻(分别在24、72和120小时时P <.01、.05和.05)。给予IL-1ra后,TUNEL阳性神经元也显著减少(分别在24和120小时时P <.01和.05)。C组和I组在72和120小时时NO差异显著(P <.05),而S100β仅在24小时时有显著差异(P <.05)。
给予IL-1ra可减轻脊髓缺血再灌注损伤,这通过减少神经元坏死和凋亡得到证明。