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新生儿地塞米松治疗对海马和胼胝体增殖和星形胶质细胞免疫反应的急性影响:一种救援策略。

Acute effects of neonatal dexamethasone treatment on proliferation and astrocyte immunoreactivity in hippocampus and corpus callosum: towards a rescue strategy.

机构信息

Department of Medical Pharmacology, LACDR/LUMC, Leiden University, Einsteinweg 55, 2333 CC, Leiden, The Netherlands.

出版信息

Brain Res. 2012 Oct 30;1482:1-12. doi: 10.1016/j.brainres.2012.08.017. Epub 2012 Aug 16.

Abstract

Dexamethasone (DEX), a synthetic glucocorticoid, has been used to treat respiratory distress syndrome in prematurely born infants. Despite the important short-term benefit on lung function, there is growing concern about the long-term outcome of this treatment, since follow-up studies of prematurely born infants have shown lasting adverse neurodevelopmental effects. Since the mechanism underlying these neurodevelopmental impairments is largely unknown, the aim of the present study was (i) to investigate the acute effects of neonatal DEX treatment on the developing brain; and (ii) to block specifically the effects of DEX on the brain by central administration of the glucocorticoid receptor (GR) antagonist mifepristone. Long Evans rat pups were injected subcutaneously with tapering doses of DEX or saline (SAL) on postnatal days (pnd) 1, 2 and 3. Separate groups received intracerebroventricular injections with mifepristone prior to DEX treatment. On pnd 4 and 10, pups were sacrificed and brains collected for analysis of cell proliferation (Ki-67) and astrogliosis (GFAP). We report that neonatal DEX treatment reduced hippocampal cell proliferation on pnd 4, an effect that was normalized by pnd 10. Although on pnd 4, GFAP expression was not affected, DEX treatment caused a significant reduction in the number and density of astrocytes in hippocampus and corpus callosum on pnd 10, which was normalized by mifepristone pre-treatment. These acute alterations in the neonate brain might underlie later functional impairments reported in DEX-treated animals and humans and further illustrate the impact of early GR activation on brain development.

摘要

地塞米松(DEX)是一种合成的糖皮质激素,已被用于治疗早产儿呼吸窘迫综合征。尽管这种治疗方法对肺功能有重要的短期益处,但人们越来越关注这种治疗的长期后果,因为早产儿的随访研究表明,这种治疗会产生持久的神经发育不良影响。由于这种神经发育损伤的机制在很大程度上尚不清楚,本研究的目的是:(i)研究新生儿 DEX 治疗对发育中大脑的急性影响;(ii)通过中枢给予糖皮质激素受体(GR)拮抗剂米非司酮特异性阻断 DEX 对大脑的作用。长爪沙鼠幼仔在出生后第 1、2 和 3 天接受递减剂量的 DEX 或生理盐水(SAL)皮下注射。单独的一组在 DEX 治疗前接受脑室注射米非司酮。在出生后第 4 和 10 天,处死幼仔并收集大脑进行细胞增殖(Ki-67)和星形胶质细胞增生(GFAP)分析。我们报告说,新生儿 DEX 治疗可减少出生后第 4 天海马区的细胞增殖,这种作用在出生后第 10 天恢复正常。尽管出生后第 4 天,GFAP 表达不受影响,但 DEX 治疗导致海马体和胼胝体中星形胶质细胞的数量和密度在出生后第 10 天显著减少,米非司酮预处理可使这种减少恢复正常。新生儿大脑的这些急性改变可能是 DEX 治疗动物和人类后期功能损伤的基础,进一步说明了早期 GR 激活对大脑发育的影响。

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