Laboratory of Cerebrovascular Research, Department of Surgical Sciences, Anesthesiology and Intensive Care Medicine, University Hospital, Uppsala University, SE-75185 Uppsala, Sweden.
CNS Neurol Disord Drug Targets. 2012 Feb;11(1):7-25. doi: 10.2174/187152712799960790.
In recent years, the incidence of heat stroke and associated brain pathology are increasing Worldwide. More than half of the world's population are living in areas associated with high environmental heat especially during the summer seasons. Thus, new research is needed using novel drug targets to achieve neuroprotection in heat-induced brain pathology. Previous research from our laboratory showed that the pathophysiology of brain injuries following heat stroke are exacerbated by chronic intoxication of engineered nanoparticles of small sizes (50-60 nm) following identical heat exposure in rats. Interestingly, in nanoparticle-intoxicated animals the known neuroprotective agents in standard doses failed to induce effective neuroprotection. This suggests that the dose-response of the drugs either requires modification or new therapeutic agents are needed to provide better neuroprotection in nanoparticle-intoxicated animals after heat stroke. This review is focused on the use of cerebrolysin, a mixture of several neurotrophic factors and active peptide fragments, in relation to other neuroprotective agents normally used to treat ischemic stroke in clinics in nanoparticle-induced exacerbation of brain damage in heat stroke. It appears that cerebrolysin exerts the most superior neuroprotective effects in heat stress as compared to other neuroprotective agents on brain pathology in normal rats. Interestingly, to induce effective neuroprotection in nanoparticle-induced exacerbation of brain pathology a double dose of cerebrolysin is needed. On the other hand, double doses of the other drugs were quite ineffective in reducing brain damage. These observations suggest that the drug type and doses are important factors in attenuating nanoparticle-induced exacerbation of brain pathology in heat stroke. The functional significance and possible mechanisms of drug-induced neuroprotection in nanoparticle-treated, heat-stressed rats are discussed.
近年来,全球范围内中暑及其相关脑病理的发病率不断上升。世界上超过一半的人口生活在与高温环境相关的地区,尤其是在夏季。因此,需要利用新的药物靶点,对热诱导的脑病理进行神经保护的新研究。我们实验室的先前研究表明,在大鼠接受相同的热暴露后,慢性摄入小尺寸(50-60nm)的工程纳米颗粒会加剧中暑后脑损伤的病理生理学,这表明热诱导的脑损伤。有趣的是,在纳米颗粒中毒的动物中,标准剂量的已知神经保护剂未能诱导有效的神经保护作用。这表明,药物的剂量反应要么需要修改,要么需要新的治疗剂,以便在中暑后纳米颗粒中毒的动物中提供更好的神经保护。
本综述重点介绍脑活素(一种多种神经营养因子和活性肽片段的混合物)在与其他神经保护剂的关系,这些神经保护剂通常用于治疗临床上的缺血性中风,以治疗纳米颗粒诱导的中暑中脑损伤的加剧。与其他神经保护剂相比,脑活素在热应激下对脑病理的神经保护作用似乎最为优越。有趣的是,在纳米颗粒诱导的脑病理加剧中,需要双倍剂量的脑活素来诱导有效的神经保护。另一方面,其他药物的双倍剂量在减轻脑损伤方面效果不佳。这些观察结果表明,药物类型和剂量是减轻中暑中纳米颗粒诱导的脑病理加剧的重要因素。讨论了药物诱导的神经保护在纳米颗粒处理、热应激大鼠中的功能意义和可能机制。