Lee Jae Hyuk, Kim Kyuseok, Jo You Hwan, Lee Soo Hoon, Kang Changwoo, Kim Joonghee, Park Chan Jong, Kim Min A, Lee Min Ji, Rhee Joong Eui
Department of Emergency Medicine, Seoul National University Bundang Hospital, Gyeonggi-do, Republic of Korea.
Resuscitation. 2013 Oct;84(10):1443-9. doi: 10.1016/j.resuscitation.2013.04.027. Epub 2013 May 4.
Valproic acid (VPA) has been known to reduce neuronal injury, has anti-inflammatory and anti-apoptotic effects as a histone deacetylase (HDAC) inhibitor. Thus, this study was performed to investigate the effects of VPA on survival and neurological outcomes in an asphyxial cardiac arrest model of rats.
Male Sprague-Dawley rats were subjected to asphyxial cardiac arrest. For survival study, rats were subjected to 450s of asphyxial cardiac arrest. Cardiopulmonary resuscitation (CPR) was performed and then rats were blindly allocated to one of two groups (control group, n=10; VPA group, n=10). Valproic acid (300mgkg(-1)) or vehicle (normal saline) was administered via tail vein immediately after return of spontaneous circulation (ROSC) and observed for 72h. For neurological outcome study, rats (n=7 for each group) were subjected to same experimental procedures except duration of cardiac arrest of 360s. Neurological deficit scale (NDS) score was measured every 24h after ROSC for 72h and was ranged from 0 (brain dead) to 80 (normal). Brain tissues were harvested at 72h for evaluation of apoptotic injury and acetylation status of histone H3.
In survival study, 2 rats in VPA group were excluded because cardiac arrest was not achieved in predetermined time. Thus, 10 rats were allocated to control group and 8 rats were allocated to VPA group. The survival rates at 72h after cardiac arrest were significantly higher in VPA group than in control group (6/8 in VPA group, 3/10 rats in control group; log rank test, p<0.05). In neurological outcome study, all rats survived for 72h and NDS at 72h were significantly higher in VPA group than in control group (p<0.05). In brain tissues, expressions of acetylated histone H3 were not significantly different. However, expressions of cleaved caspase-3 were significantly lower in VPA group than in control group (p<0.05).
VPA increased survival rates and improved neurologic outcome in asphyxial cardiac arrest model of rats while decreasing expressions of cleaved caspase-3.
丙戊酸(VPA)作为一种组蛋白去乙酰化酶(HDAC)抑制剂,已知其具有减轻神经元损伤、抗炎和抗凋亡作用。因此,本研究旨在探讨VPA对大鼠窒息性心脏骤停模型中生存率和神经功能转归的影响。
雄性Sprague-Dawley大鼠接受窒息性心脏骤停。在生存研究中,大鼠经历450秒的窒息性心脏骤停。进行心肺复苏(CPR),然后将大鼠随机分为两组(对照组,n = 10;VPA组,n = 10)。自主循环恢复(ROSC)后立即经尾静脉给予丙戊酸(300mgkg(-1))或溶剂(生理盐水),并观察72小时。在神经功能转归研究中,大鼠(每组n = 7)接受相同的实验程序,除了心脏骤停持续时间为360秒。ROSC后每24小时测量一次神经功能缺损量表(NDS)评分,持续72小时,评分范围为0(脑死亡)至80(正常)。在72小时时采集脑组织,评估凋亡损伤和组蛋白H3的乙酰化状态。
在生存研究中,VPA组有2只大鼠被排除,因为未在预定时间内实现心脏骤停。因此,10只大鼠被分配到对照组,8只大鼠被分配到VPA组。心脏骤停后72小时,VPA组的生存率显著高于对照组(VPA组6/8,对照组3/10;对数秩检验,p<0.05)。在神经功能转归研究中,所有大鼠均存活72小时,VPA组72小时时的NDS显著高于对照组(p<0.05)。在脑组织中,乙酰化组蛋白H3的表达无显著差异。然而,VPA组中裂解的半胱天冬酶-3的表达显著低于对照组(p<0.05)。
VPA提高了大鼠窒息性心脏骤停模型的生存率,改善了神经功能转归,同时降低了裂解的半胱天冬酶-3的表达。