Department of Pediatrics, Division of Neonatology, Faculty of Medicine, Uludag University, Bursa, Turkey.
Neonatology. 2011;99(4):302-10. doi: 10.1159/000320643. Epub 2010 Dec 4.
Perinatal hypoxia-ischemia is a major cause of mortality and long-term neurological deficits.
The objective of this study was to compare the effects of two neuroprotective agents; magnesium sulfate and melatonin, administered alone or in combination, on brain infarct volume and TUNEL positivity in a neonatal hypoxic-ischemic (HI) rat model.
After being anesthetized, 7-day-old pups (n = 80) underwent ischemia followed by exposure to hypoxia for 2 h. The pups were then divided equally and randomly into 4 groups in order to receive the vehicle (saline, control group), magnesium sulfate, melatonin or a combination of magnesium sulfate and melatonin. Treatments were administered intraperitoneally three times; the first being just before ischemia, the second after hypoxia and the third 24 h after the second dose. The pups were sacrificed on postnatal day 10, their brains harvested and evaluated for infarct volume and neuronal apoptosis.
Percent infarcted brain volume was significantly reduced in pups receiving the drugs (either magnesium sulfate, melatonin or their combination) compared with those receiving the vehicle. In addition, TUNEL staining showed markedly reduced numbers of TUNEL-positive cells per unit area in the CA1, CA3 and dentate gyrus regions of the hippocampus and in the cortex. However, no statistically significant differences were found regarding percent infarcted brain volume and number of TUNEL-positive cells among the drug-treated groups.
Magnesium sulfate and melatonin, two agents acting at different stages of HI brain damage, administered either alone or in combination, significantly reduced the percent infarcted brain volume and TUNEL positivity, suggesting that these agents may confer a possible benefit in the treatment of infants with HI encephalopathy.
围产期缺氧缺血是导致死亡和长期神经功能缺陷的主要原因。
本研究的目的是比较两种神经保护剂(硫酸镁和褪黑素)单独或联合应用对新生缺氧缺血(HI)大鼠模型脑梗死体积和 TUNEL 阳性的影响。
在麻醉后,7 日龄幼鼠(n = 80)接受缺血,随后缺氧 2 小时。然后将幼鼠等分为 4 组,分别接受载体(生理盐水,对照组)、硫酸镁、褪黑素或硫酸镁和褪黑素联合治疗。治疗方案为腹腔内给药 3 次;第一次是在缺血前,第二次是在缺氧后,第三次是在第二次给药后 24 小时。在出生后第 10 天处死幼鼠,取出大脑评估梗死体积和神经元凋亡。
与接受载体的幼鼠相比,接受药物(硫酸镁、褪黑素或两者联合)的幼鼠脑梗死体积百分比明显降低。此外,TUNEL 染色显示 CA1、CA3 和齿状回海马区以及皮质区单位面积 TUNEL 阳性细胞数量明显减少。然而,在药物治疗组之间,脑梗死体积百分比和 TUNEL 阳性细胞数量无统计学差异。
硫酸镁和褪黑素是两种作用于 HI 脑损伤不同阶段的药物,单独或联合应用可显著降低脑梗死体积和 TUNEL 阳性率,表明这些药物可能对 HI 脑病患儿的治疗有益。