Department of Neurosurgery, West Virginia University School of Medicine, Morgantown, West Virginia, USA.
J Neurosurg. 2011 Jan;114(1):77-84. doi: 10.3171/2010.5.JNS08914. Epub 2010 Jul 16.
Traumatic brain injury remains the most common cause of death in persons under 45 years of age in the Western world. Recent evidence from animal studies suggests that supplementation with omega-3 fatty acid (O3FA) (particularly eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]) improves functional outcomes following focal neural injury. The purpose of this study is to determine the benefits of O3FA supplementation following diffuse axonal injury in rats.
Forty adult male Sprague-Dawley rats were used. Three groups of 10 rats were subjected to an impact acceleration injury and the remaining group underwent a sham-injury procedure (surgery, but no impact injury). Two of the groups subjected to the injury were supplemented with 10 or 40 mg/kg/day of O3FA; the third injured group served as an unsupplemented control group. The sham-injured rats likewise received no O3FA supplementation. Serum fatty acid levels were determined from the isolated plasma phospholipids prior to the injury and at the end of the 30 days of supplementation. After the animals had been killed, immunohistochemical analysis of brainstem white matter tracts was performed to assess the presence of β-amyloid precursor protein (APP), a marker of axonal injury. Immunohistochemical analyses of axonal injury mechanisms-including analysis for caspase-3, a marker of apoptosis; RMO-14, a marker of neurofilament compaction; and cytochrome c, a marker of mitochondrial injury-were performed.
Dietary supplementation with a fish oil concentrate rich in EPA and DHA for 30 days resulted in significant increases in O3FA serum levels: 11.6% ± 4.9% over initial levels in the 10 mg/kg/day group and 30.7% ± 3.6% in the 40 mg/kg/day group. Immunohistochemical analysis revealed significantly (p < 0.05) decreased numbers of APP-positive axons in animals receiving O3FA supplementation: 7.7 ± 14.4 axons per mm(2) in the 10 mg/kg/day group and 6.2 ± 11.4 axons per mm(2) in the 40 mg/kg/day group, versus 182.2 ± 44.6 axons per mm(2) in unsupplemented animals. Sham-injured animals had 4.1 ± 1.3 APP-positive axons per mm(2). Similarly, immunohistochemical analysis of caspase-3 expression demonstrated significant (p < 0.05) reduction in animals receiving O3FA supplementation, 18.5 ± 28.3 axons per mm(2) in the 10 mg/kg/day group and 13.8 ± 18.9 axons per mm(2) in the 40 mg/kg/day group, versus 129.3 ± 49.1 axons per mm(2) in unsupplemented animals.
Dietary supplementation with a fish oil concentrate rich in the O3FAs EPA and DHA increases serum levels of these same fatty acids in a dose-response effect. Omega-3 fatty acid supplementation significantly reduces the number of APP-positive axons at 30 days postinjury to levels similar to those in uninjured animals. Omega-3 fatty acids are safe, affordable, and readily available worldwide to potentially reduce the burden of traumatic brain injury.
在西方世界,创伤性脑损伤仍然是 45 岁以下人群死亡的最常见原因。最近来自动物研究的证据表明,补充ω-3 脂肪酸(O3FA)(特别是二十碳五烯酸[EPA]和二十二碳六烯酸[DHA])可改善局灶性神经损伤后的功能结果。本研究的目的是确定在大鼠弥漫性轴索损伤后补充 O3FA 的益处。
使用 40 只成年雄性 Sprague-Dawley 大鼠。三组 10 只大鼠接受撞击加速损伤,其余一组接受假损伤手术(手术,但无撞击损伤)。两组受伤的大鼠分别补充 10 或 40mg/kg/天的 O3FA;第三组受伤大鼠作为未补充的对照组。假损伤大鼠同样没有补充 O3FA。在损伤前和补充 30 天后从分离的血浆磷脂中测定血清脂肪酸水平。动物死亡后,进行脑干白质束的免疫组织化学分析,以评估β-淀粉样前体蛋白(APP)的存在,APP 是轴索损伤的标志物。进行了针对轴索损伤机制的免疫组织化学分析,包括分析半胱氨酸天冬氨酸蛋白酶-3(caspase-3),这是细胞凋亡的标志物;RMO-14,神经丝紧缩的标志物;细胞色素 c,线粒体损伤的标志物。
富含 EPA 和 DHA 的鱼油浓缩物连续 30 天补充饮食可显著增加 O3FA 的血清水平:10mg/kg/天组初始水平增加 11.6%±4.9%,40mg/kg/天组增加 30.7%±3.6%。免疫组织化学分析显示,接受 O3FA 补充的动物中 APP 阳性轴突的数量明显减少:10mg/kg/天组为 7.7±14.4 个轴突/mm2,40mg/kg/天组为 6.2±11.4 个轴突/mm2,而未补充的动物为 182.2±44.6 个轴突/mm2。假损伤动物有 4.1±1.3 个 APP 阳性轴突/mm2。同样,caspase-3 表达的免疫组织化学分析表明,接受 O3FA 补充的动物的表达显著减少(p<0.05),10mg/kg/天组为 18.5±28.3 个轴突/mm2,40mg/kg/天组为 13.8±18.9 个轴突/mm2,未补充的动物为 129.3±49.1 个轴突/mm2。
富含 EPA 和 DHA 的鱼油浓缩物的饮食补充以剂量反应的方式增加了这些相同脂肪酸的血清水平。ω-3 脂肪酸补充可显著减少 APP 阳性轴突的数量,在损伤后 30 天达到与未受伤动物相似的水平。ω-3 脂肪酸安全、经济实惠且在全球范围内易于获得,有可能减轻创伤性脑损伤的负担。