Department of †Neurosurgery; ‡Oncology Center-Chemical Therapeutics, The Johns Hopkins University School of Medicine, Baltimore, Maryland; §Technion Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Neurosurgery. 2013 Oct;73(4):719-28; discussion 729. doi: 10.1227/NEU.0000000000000080.
Vasospasm contributes to delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage (SAH). Glutamate concentrations increase after SAH and correlate with vasospasm in experimental SAH. The haptoglobin (Hp) 2-2 genotype is associated with higher risk of vasospasm after SAH. We tested the efficacy of (S)-4-carboxyphenylglycine (S-4-CPG), a metabotropic glutamate receptor inhibitor, for the treatment of vasospasm after SAH in Hp 2-2 and Hp 1-1 mice.
To evaluate the effect on vasospasm and neurobehavioral scores after SAH of systemic S-4-CPG, as well as its toxicity, and phosphorylation of vasodilator-stimulated phosphoprotein (VASP) in Hp 2-2 mice.
Western blot was used to assess changes in VASP phosphorylation in response to glutamate with and without S-4-CPG. A pharmacokinetics study was done to evaluate S-4-CPG penetration through the blood-brain barrier in vivo. Toxicity was assessed by administering increasing S-4-CPG doses. Efficacy of S-4-CPG assessed the effect of S-4-CPG on lumen patency of the basilar artery and animal behavior after SAH in Hp 1-1 and Hp 2-2 mice. Immunohistochemistry was used to evaluate the presence of neutrophils surrounding the basilar artery after SAH.
Exposure of human brain microvascular endothelial cells to glutamate decreased phosphorylation of VASP, but glutamate treatment in the presence of S-4-CPG maintains phosphorylation of VASP. S-4-CPG crosses the blood-brain barrier and was not toxic to mice. S-4-CPG treatment significantly prevents vasospasm after SAH. S-4-CPG administered after SAH resulted in a trend toward improvement of animal behavior.
S-4-CPG prevents vasospasm after experimental SAH in Hp2-2 mice. S-4-CPG was not toxic and is a potential therapeutic agent for vasospasm after SAH.
蛛网膜下腔出血(SAH)后血管痉挛导致迟发性脑缺血。SAH 后谷氨酸浓度增加,与实验性 SAH 中的血管痉挛相关。结合珠蛋白(Hp)2-2 基因型与 SAH 后血管痉挛风险增加相关。我们测试了代谢型谷氨酸受体抑制剂(S)-4-羧基苯甘氨酸(S-4-CPG)治疗 Hp 2-2 和 Hp 1-1 小鼠 SAH 后血管痉挛的疗效。
评估系统给予 S-4-CPG 对 SAH 后血管痉挛和神经行为评分的影响,以及其在 Hp 2-2 小鼠中的毒性和血管扩张刺激磷蛋白(VASP)的磷酸化。
采用 Western blot 评估谷氨酸存在和不存在 S-4-CPG 时 VASP 磷酸化的变化。进行药代动力学研究以评估 S-4-CPG 在体内穿透血脑屏障的情况。通过给予递增 S-4-CPG 剂量来评估毒性。通过评估 S-4-CPG 对 Hp 1-1 和 Hp 2-2 小鼠基底动脉管腔通畅性和 SAH 后动物行为的影响来评估 S-4-CPG 的疗效。免疫组织化学用于评估 SAH 后基底动脉周围中性粒细胞的存在。
谷氨酸暴露于人脑微血管内皮细胞会降低 VASP 的磷酸化,但 S-4-CPG 存在时谷氨酸处理可维持 VASP 的磷酸化。S-4-CPG 可穿透血脑屏障,对小鼠无毒。SAH 后给予 S-4-CPG 可显著预防血管痉挛。SAH 后给予 S-4-CPG 可使动物行为呈改善趋势。
S-4-CPG 可预防 Hp2-2 小鼠实验性 SAH 后的血管痉挛。S-4-CPG 无毒,是 SAH 后血管痉挛的潜在治疗药物。