College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada.
Department of Veterinary Biomedical Sciences, University of Saskatchewan, Saskatoon, SK S7N 5B4, Canada.
Appl Physiol Nutr Metab. 2020 Sep;45(9):1015-1021. doi: 10.1139/apnm-2019-0865. Epub 2020 Apr 9.
Protein-energy malnutrition (PEM) commonly arises after stroke. We investigated the effects of preventing PEM on spontaneous recovery of forelimb use, infarct size, and the acute phase response in the chronic post-stroke period. Male, adult, Sprague-Dawley rats were acclimatized to control diet (12.5% protein), tested for pre-stroke forelimb use symmetry in the cylinder test, and exposed to photothrombotic cortical stroke or sham surgery. Food intake was monitored daily, and body weight weekly. Forelimb use was tested on day 4 after surgery, before assignment to control diet or PEM (0.5% protein), with subsequent testing on days 16 and 29. Blood, brain, and liver were collected on day 30. The low protein diet resulted in PEM, measured by decreased body weight ( < 0.001) and food intake ( = 0.016) and increased liver lipid ( < 0.001). Stroke ( = 0.016) and PEM ( = 0.001) independently elicited increases in serum α-2-macroglobulin concentration, whereas PEM alone decreased albumin ( < 0.001). PEM reduced recovery of forelimb use symmetry during exploration on days 16 ( = 0.024) and 29 ( = 0.013) but did not influence infarct size ( = 0.775). Stroke reduced reliance on the stroke-affected forelimb to initiate exploration up until day 29 ( < 0.001); PEM had no influence ( ≥ 0.463). Preventing post-stroke PEM appears to yield direct benefits for certain types of motor recovery. Preventing post-stroke malnutrition benefits certain types of motor recovery. An acute phase response may contribute to the poorer recovery with malnutrition.
蛋白质能量营养不良（PEM）通常在中风后发生。我们研究了预防 PEM 对中风后慢性期前肢使用自发性恢复、梗死面积和急性期反应的影响。雄性成年 Sprague-Dawley 大鼠适应对照饮食（12.5%蛋白质），在圆筒测试中测试中风前前肢使用对称性，并暴露于光血栓性皮质中风或假手术。每天监测食物摄入量，每周监测体重。手术后第 4 天测试前肢使用情况，然后分配到对照饮食或 PEM（0.5%蛋白质），随后在第 16 天和第 29 天进行测试。第 30 天收集血液、大脑和肝脏。低蛋白饮食导致 PEM，表现为体重下降（<0.001）和食物摄入减少（=0.016）以及肝脂质增加（<0.001）。中风（=0.016）和 PEM（=0.001）独立引起血清α-2-巨球蛋白浓度增加，而 PEM 单独降低白蛋白（<0.001）。PEM 减少了第 16 天（=0.024）和第 29 天（=0.013）探索时前肢使用对称性的恢复，但不影响梗死面积（=0.775）。中风直到第 29 天（<0.001）减少了对受影响前肢的依赖以开始探索；PEM 没有影响（≥0.463）。预防中风后 PEM 似乎对某些类型的运动恢复有直接益处。预防中风后营养不良有益于某些类型的运动恢复。急性期反应可能导致营养不良时恢复较差。
