Cao L B, Gui Q F, Chen Y Y, Li J, Zhou J J, Wang Q, Duan M L, Xu J G
Department of Anesthesiology, Jinling Hospital, School of Medicine, Nanjing University, Nanjing 210002, China.
Zhonghua Yi Xue Za Zhi. 2018 Nov 27;98(44):3592-3597. doi: 10.3760/cma.j.issn.0376-2491.2018.44.009.
To investigate the effect of mild hypothermia combined with hydrogen sulfide on hippocampal endoplasmic reticulum stress (ERS) after global cerebral ischemia-reperfusion (I/R) injury. Sixty healthy male Sprague-Dawley rats, 8-10 week old, weighing 280-320 g, were randomly divided into 5 groups (=12) using a random number table: sham operation group (group Sham), global cerebral I/R group (group I/R), hydrogen sulfide group (group H(2)S), mild hypothermia group (group MH) and hydrogen sulfide + mild hypothermia group (group H(2)S+ MH). Cardiac arrest was induced with transoesophageal cardiac pacing followed by cardiopulmonary resuscitation to establish the global cerebral I/R model. The administration regimen for sodium hydrosulfide (NaHS) was as follows: Sodium hydrosulfide was intraperitoneal injection as a bolus of 2.5 mg/kg immediately restoration of spontaneous circulation. The implementation of mild hypothermia: wipe the body surface of rats with ethanol immediately after restoration of spontaneous circulation, and reduce the rectal temperature to 32-34 ℃ within 15 min, and maintain 6 h with the ice bag. At 72 h of reperfusion, neurological deficit was scored, and the rats were sacrificed (Neurological Deficit Scores, NDS), the expression of glucose-regulated protein 78 (GRP78), CHOP and Caspase-12 were detected by Western blot. After reperfusion 72 h, the hippocampal tissue were removed and stained with haematoxylin and eosin to examine the pathological findings in hippocampal CA1 area (under microscope). The apoptosis rate of hippocampal CA1 area cells was detected by TUNEL staining and the apoptosis index was calculated. The expression levels of endoplasmic reticulum stress marker, GRP78, CHOP and Caspase-12, were upregulates during the global cerebral ischemia reperfusion injury, indicating activation of severe endoplasmic reticulum stress. The GRP78 contents of Sham group, I/R group, H(2)S group, MH group and H(2)S+ MH group were as follows: GRP78: 0.11±0.03, 1.11±0.10, 0.67±0.09, 0.66±0.08, 0.48±0.04, CHOP contents: 0.16±0.03, 1.60±0.11, 1.39±0.09, 1.34±0.08, 1.13±0.09, Caspase-12 contents: 0.09±0.02, 0.87±0.08, 0.65±0.08, 0.59±0.06, 0.45±0.06, the differences were statistically significant (=147.569, 264.983, 119.356, all <0.01). The apoptosis index of Sham group, I/R group, H(2)S group, MH group and H(2)S+ MH group were as follows: (1.83±0.75)%, (53.17±4.62)%, (35.17±2.14)%, (32.67±2.25)%, (17.83±2.79)%, the differences were statistically significant (=284.962, <0.01). The neurological deficit scores of Sham group, I/R group, H(2)S group, MH group and H(2)S+ MH group were as follows: 0%, (76±9)%, (54±5)%, (47±6)%, (35±6)%, the differences were statistically significant(=135.218, <0.01). Mild hypothermia combined with hydrogen sulfide alleviates hippocampal endoplasmic reticulum stress after global cerebral ischemia-reperfusion, and the combined effect is better than that of a single application.
探讨亚低温联合硫化氢对全脑缺血再灌注(I/R)损伤后海马内质网应激(ERS)的影响。选取60只8-10周龄、体重280-320 g的健康雄性Sprague-Dawley大鼠,采用随机数字表法将其随机分为5组(每组12只):假手术组(Sham组)、全脑I/R组(I/R组)、硫化氢组(H₂S组)、亚低温组(MH组)和硫化氢+亚低温组(H₂S+MH组)。通过经食管心脏起搏诱导心脏骤停,随后进行心肺复苏以建立全脑I/R模型。氢硫化钠(NaHS)的给药方案如下:在自主循环恢复后立即腹腔注射2.5 mg/kg氢硫化钠。亚低温的实施:在自主循环恢复后立即用乙醇擦拭大鼠体表,并在15分钟内将直肠温度降至32-34℃,并用冰袋维持6小时。在再灌注72小时时,对神经功能缺损进行评分,然后处死大鼠(神经功能缺损评分,NDS),通过蛋白质免疫印迹法检测葡萄糖调节蛋白78(GRP78)、CHOP和半胱天冬酶-12的表达。再灌注72小时后,取出海马组织,用苏木精和伊红染色,在显微镜下观察海马CA1区的病理变化。通过TUNEL染色检测海马CA1区细胞的凋亡率并计算凋亡指数。在全脑缺血再灌注损伤期间,内质网应激标志物GRP78、CHOP和半胱天冬酶-12的表达水平上调,表明严重内质网应激被激活。Sham组、I/R组、H₂S组、MH组和H₂S+MH组的GRP78含量分别为:GRP78:0.11±0.03、1.11±0.10、0.67±0.09、0.66±0.08、0.48±0.04,CHOP含量分别为:0.16±0.03、1.60±0.11、1.39±0.09、1.34±0.08、1.13±0.09,半胱天冬酶-12含量分别为:0.09±0.02、0.87±0.08、0.65±0.08、0.59±0.06、0.45±0.06,差异均有统计学意义(F=147.569、264.983、119.356,均P<0.01)。Sham组、I/R组、H₂S组、MH组和H₂S+MH组的凋亡指数分别为:(1.83±0.75)%、(53.17±4.62)%、(35.17±2.14)%、(32.67±2.25)%、(17.83±2.79)%,差异有统计学意义(F=2,84.962,P<0.01)。Sham组、I/R组、H₂S组、MH组和H₂S+MH组的神经功能缺损评分分别为:0%、(76±9)%、(54±5)%、(47±6)%、(35±6)%,差异有统计学意义(F=135.218,P<0.01)。亚低温联合硫化氢可减轻全脑缺血再灌注后海马内质网应激,且联合作用优于单一应用。