Wang Haichen, James Michael L, Venkatraman Talaignair N, Wilson Lawrence J, Lyuboslavsky Polina, Myers Scott J, Lascola Christopher D, Laskowitz Daniel T
Multidisciplinary Neuroprotection Laboratories, Durham, NC, USA.
Neurocrit Care. 2014 Feb;20(1):119-31. doi: 10.1007/s12028-013-9944-9.
Despite intensive research, neurological morbidity from delayed cerebral ischemia remains common after aneurysmal subarachnoid hemorrhage (SAH). In the current study, we evaluate the neuroprotective effects of a pH-dependent GluN2B subunit-selective NMDA receptor antagonist in a murine model of SAH.
Following induction of SAH, 12 ± 2 week old male C57-BL/6 mice received NP10075, a pH-dependent NMDA receptor antagonist, or vehicle. In a separate series of experiments, NP10075 and the non-pH sensitive NMDA antagonist, NP10191, were administered to normoglycemic and hyperglycemic mice. Both histological (right middle cerebral artery diameter, NeuN, and Fluoro-Jade B staining) and functional endpoints (rotarod latency and neuroseverity score) were evaluated to assess the therapeutic benefit of NP10075.
Administration of NP10075 was well tolerated and had minimal hemodynamic effects following SAH. Administration of the pH-sensitive NMDA antagonist NP10075, but not NP10191, was associated with a durable improvement in the functional performance of both normoglycemic and hyperglycemic animals. NP10075 was also associated with a reduction in vasospasm in the middle cerebral artery associated with hemorrhage. There was no significant difference between treatment with nimodipine + NP10075, as compared to NP10075 alone.
These data demonstrate that use of a pH-dependent NMDA antagonist has the potential to work selectively in areas of ischemia known to undergo acidic pH shifts, and thus may be associated with selective regional efficacy and fewer behavioral side effects than non-selective NMDA antagonists.
尽管进行了深入研究,但动脉瘤性蛛网膜下腔出血(SAH)后迟发性脑缺血导致的神经功能障碍仍然很常见。在本研究中,我们评估了一种pH依赖性GluN2B亚基选择性NMDA受体拮抗剂在SAH小鼠模型中的神经保护作用。
在诱导SAH后,12±2周龄的雄性C57-BL/6小鼠接受pH依赖性NMDA受体拮抗剂NP10075或赋形剂。在另一系列实验中,将NP10075和非pH敏感的NMDA拮抗剂NP10191分别给予血糖正常和高血糖的小鼠。评估组织学指标(右侧大脑中动脉直径、NeuN和Fluoro-Jade B染色)和功能指标(转棒试验潜伏期和神经严重程度评分)以评估NP10075的治疗效果。
NP10075给药耐受性良好,SAH后对血流动力学影响极小。给予pH敏感的NMDA拮抗剂NP10075而非NP10191,可使血糖正常和高血糖动物的功能表现持续改善。NP10075还与出血相关的大脑中动脉血管痉挛减轻有关。与单独使用NP10075相比,尼莫地平+NP10075联合治疗无显著差异。
这些数据表明,使用pH依赖性NMDA拮抗剂有可能在已知会发生酸性pH变化的缺血区域选择性发挥作用,因此与非选择性NMDA拮抗剂相比,可能具有选择性区域疗效且行为副作用更少。