Rodríguez José A, Sobrino Tomás, López-Arias Esteban, Ugarte Ana, Sánchez-Arias Juan A, Vieites-Prado Alba, de Miguel Irene, Oyarzabal Julen, Páramo José A, Campos Francisco, Orbe Josune, Castillo José
Atherosclerosis Research Laboratory, Health Research Institute of Navarra-IdiSNA, University of Navarra, Pamplona, Spain.
CIBER Cardiovascular, Instituto de Salud Carlos III, Madrid, Spain.
J Am Heart Assoc. 2017 Jun 1;6(6):e006042. doi: 10.1161/JAHA.117.006042.
Intracerebral hemorrhage (ICH) is an acute neurological disorder with high mortality and no effective treatment. In addition to the initial bleeding event, rebleeding and hematoma expansion are associated with poor outcome in these patients. We studied the effectiveness of the new antifibrinolytic agent CM352, a short-half-life matrix metalloproteinase inhibitor, for achieving early hemostasis and improving functional recovery in a rat model of collagenase-induced ICH.
ICH was induced by striatal injection of collagenase, and 1 hour later, rats received an intravenous injection of saline (n=6) or CM352 (1 mg/kg, n=6). Hematoma (basal and after 3 and 24 hours) and lesion (14 days) volumes were quantified on T2-weighted (T2) magnetic resonance images. Neurological and functional recovery was evaluated by using Bederson score and a cylinder test (basal, 24 hours, and 14 days). Early treatment (1 hour) with CM352 was efficient reducing hematoma expansion at 3 hours (<0.01) and, more markedly, at 24 hours (<0.01). Decreased bleeding after antifibrinolytic treatment was accompanied by reduced interleukin-6 levels at 3 hours (<0.05) and smaller lesion volume at 14 days (<0.01). CM352 drastically reduced sensorimotor impairment (cylinder test) after ICH in rats at 24 hours (<0.01) and 14 days (<0.01). Similarly, it also attenuated neurological deficit (Bederson scale) at 24 hours (<0.01) and 14 days (<0.01). Interestingly, late (3 hours) CM352 administration also resulted in reduced lesion size and better functional outcome.
CM352, a new antifibrinolytic agent and matrix metalloproteinase inhibitor, effectively prevented hematoma growth and reduced lesion size in ICH in association with improved functional and neurological recovery.
脑出血(ICH)是一种急性神经疾病,死亡率高且尚无有效治疗方法。除了初始出血事件外,再出血和血肿扩大与这些患者的不良预后相关。我们研究了新型抗纤溶药物CM352(一种半衰期短的基质金属蛋白酶抑制剂)在胶原酶诱导的脑出血大鼠模型中实现早期止血和改善功能恢复的有效性。
通过纹状体内注射胶原酶诱导脑出血,1小时后,大鼠接受静脉注射生理盐水(n = 6)或CM352(1mg/kg,n = 6)。在T2加权(T2)磁共振图像上定量血肿(基础值、3小时和24小时后)和病变(14天)体积。使用贝德森评分和圆筒试验(基础值、24小时和14天)评估神经和功能恢复情况。CM352早期治疗(1小时)能有效减少3小时(<0.01)时的血肿扩大,更显著的是在24小时(<0.01)时。抗纤溶治疗后出血减少,同时3小时时白细胞介素-6水平降低(<0.05),14天时病变体积减小(<0.01)。CM352在24小时(<0.01)和14天(<0.01)时显著减轻大鼠脑出血后的感觉运动障碍(圆筒试验)。同样,它在24小时(<0.01)和14天(<0.01)时也减轻了神经功能缺损(贝德森量表)。有趣的是,CM352延迟(3小时)给药也导致病变大小减小和功能预后改善。
新型抗纤溶药物CM352作为基质金属蛋白酶抑制剂,能有效预防脑出血中的血肿生长并减小病变大小,同时改善功能和神经恢复。