Ment L R, Stewart W B, Petroff O A, Duncan C C, Montoya D
Department of Pediatrics, Yale University School of Medicine, New Haven, CT 06510.
Pediatr Neurol. 1989 Sep-Oct;5(5):281-6. doi: 10.1016/0887-8994(89)90018-0.
The N-methyl-D-aspartate receptor antagonist MK801 has been reported to prevent neuronal change in models of ischemia in adult animal systems. We studied the hypothesis that blockade of the N-methyl-D-aspartate receptor would prevent the depression of cerebral high-energy phosphates found in perinatal asphyxia without producing alterations in cerebral blood flow, and thus prevent neuropathologic damage. Newborn beagle puppies were anesthetized, tracheotomized, ventilated, and randomized to asphyxial insult (I = discontinuation of ventilatory support for 5 min) or no insult (NI) and drug treatment with MK801 (10 mg/kg intravenously) or an equal volume of saline (S). Puppies received MK801 or saline 15 min prior to I/NI. In S/I pups during insult, blood flow increased to brainstem structures but decreased elsewhere. MK801 had no effect on cerebral blood flow in either control or insulted puppies. 1H NMR studies demonstrated no effect of the MK801 on NI brains. Phosphocreatine levels were 1.7 +/- 0.1, 0.6 +/- 0.1, and 0.9 +/- 0.1 mmole/kg (mean: +/- S.D.) for the S/NI, S/I, and MK801/I pups, respectively. Cerebral lactate was 1.3 +/- 0.2, 3.0 +/- 0.7, and 2.0 +/- 0.4, respectively. The pH fell 0.8 units in the S/I puppies, compared to 0.4 units in the MK801/I puppies. We conclude that pretreatment with the N-methyl-D-aspartate receptor antagonist MK801 in part protects the developing brain against severe metabolic insult.
据报道,N-甲基-D-天冬氨酸受体拮抗剂MK801可防止成年动物系统缺血模型中的神经元变化。我们研究了这样一种假说,即阻断N-甲基-D-天冬氨酸受体会防止围产期窒息时出现的脑高能磷酸盐降低,而不会引起脑血流改变,从而预防神经病理损伤。新生比格幼犬接受麻醉、气管切开、通气,并随机分为窒息损伤组(I = 停止通气支持5分钟)或无损伤组(NI),以及接受MK801(10 mg/kg静脉注射)或等体积生理盐水(S)的药物治疗。幼犬在I/NI前15分钟接受MK801或生理盐水。在S/I幼犬损伤期间,脑干结构的血流增加,而其他部位的血流减少。MK801对对照组或损伤幼犬的脑血流均无影响。1H NMR研究表明MK801对NI组大脑无影响。S/NI、S/I和MK801/I组幼犬的磷酸肌酸水平分别为1.7±0.1、0.6±0.1和0.9±0.1毫摩尔/千克(平均值±标准差)。脑乳酸水平分别为1.3±0.2、3.0±0.7和2.0±0.4。S/I组幼犬的pH值下降了0.8个单位,而MK801/I组幼犬下降了0.4个单位。我们得出结论,用N-甲基-D-天冬氨酸受体拮抗剂MK801预处理可部分保护发育中的大脑免受严重代谢损伤。