Department of Emergency and Intensive Care Medicine, Nanjing Integrated Traditional Chinese and Western Medicine Hospital, Affiliated with Nanjing University of Chinese Medicine, Nanjing 210014, China.
Inflammation. 2015 Oct;38(5):1949-58. doi: 10.1007/s10753-015-0175-4.
Sepsis-associated encephalopathy (SAE) is a frequent complication in critically ill patients and is associated with long-term cognitive impairments. However, the pathophysiology underlying SAE is poorly understood and the pharmacologic treatment is lacking. The purpose of the present study was to investigate the effects of erythropoietin (EPO) on cognitive impairments in an animal model of SAE induced by peripheral administration of lipopolysaccharide (LPS). Mice were randomly divided into the sham + vehicle, sham + EPO, LPS + vehicle, and LPS + EPO groups. EPO was administrated 30 min after the LPS administration and daily afterward for 2 days. Behavioral tests were performed on days 6 and 7 with open field and fear conditioning tests, respectively. The survival rate was estimated by the Kaplan-Meier method. The levels of proinflammatory responses, oxidative stress, and apoptosis-related markers were measured in the hippocampus at the indicated time points. The synaptic morphometry changes in the CA1 region were observed with transmission electron microscopy. Our results showed that LPS administration resulted in high mortality rate and cognitive impairments, which were accompanied by increased expressions of interleukin-1β, malondialdehyde, cleaved caspase-3, and abnormal synaptic morphometry changes in the hippocampus. Notably, EPO treatment reversed the cognitive impairments and rescued the brain pathology induced by LPS administration. In conclusion, our data suggested that treatment with EPO reduced the mortality rate and ameliorated cognitive impairments in an animal model of SAE.
脓毒症相关性脑病(SAE)是危重病患者的常见并发症,并与长期认知障碍有关。然而,SAE 的病理生理学机制尚不清楚,且缺乏药物治疗。本研究旨在探讨促红细胞生成素(EPO)对脂多糖(LPS)外周给药诱导的 SAE 动物模型中认知障碍的影响。小鼠随机分为假手术+载体组、假手术+EPO 组、LPS+载体组和 LPS+EPO 组。LPS 给药后 30 分钟给予 EPO,并在之后的 2 天每天给予。第 6 天和第 7 天分别进行开放场和恐惧条件反射测试,进行行为测试。采用 Kaplan-Meier 法估计生存率。在指定时间点测量海马中的促炎反应、氧化应激和细胞凋亡相关标志物的水平。用透射电子显微镜观察 CA1 区的突触形态变化。结果显示,LPS 给药导致高死亡率和认知障碍,同时伴有白细胞介素-1β、丙二醛、caspase-3 切割和海马突触形态异常的表达增加。值得注意的是,EPO 治疗逆转了 LPS 给药引起的认知障碍和脑病理改变。总之,我们的数据表明,EPO 治疗可降低 SAE 动物模型的死亡率并改善认知障碍。