Schroeder Daniel C, Popp Erik, Rohleder Cathrin, Vus Stefanie, Bethencourt David de la Puente, Finke Simon R, Zlatopolskiy Boris D, Zischler Johannes, Drzezga Alexander, Herff Holger, Annecke Thorsten, Hucho Tim, Neumaier Bernd, Böttiger Bernd W, Endepols Heike
Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
Department of Anaesthesiology, University Hospital of Heidelberg, Heidelberg, Germany.
Shock. 2021 May 1;55(5):620-629. doi: 10.1097/SHK.0000000000001546.
Knowledge about the neuroinflammatory state during months after sudden cardiac arrest is scarce. Neuroinflammation is mediated by cells that express the 18 kDa translocator protein (TSPO). We determined the time course of TSPO-expressing cells in a rat model of sudden cardiac arrest using longitudinal in vivo positron emission tomography (PET) imaging with the TSPO-specific tracer [18F]DAA1106 over a period of 6 months.
Five male Sprague Dawley rats were resuscitated from 6 min sudden cardiac arrest due to ventricular fibrillation, three animals served as shams. PET measurements were performed on day 5, 8, 14, 90, and 180 after intervention. Magnetic resonance imaging was performed on day 140. Imaging was preceded by Barnes Maze spatial memory testing on day 3, 13, 90, and 180. Specificity of [18F]DAA1106 binding was confirmed by Iba-1 immunohistochemistry.
[18F]DAA1106 accumulated bilaterally in the dorsal hippocampus of all sudden cardiac arrest animals on all measured time points. Immunohistochemistry confirmed Iba-1 expressing cells in the hippocampal CA1 region. The number of Iba-1-immunoreactive objects per mm2 was significantly correlated with [18F]DAA1106 uptake. Additionally, two of the five sudden cardiac arrest rats showed bilateral TSPO-expression in the striatum that persisted until day 180. In Barnes Maze, the relative time spent in the target quadrant negatively correlates with dorsal hippocampal [18F]DAA1106 uptake on day 14 and 180.
After sudden cardiac arrest, TSPO remains expressed over the long-term. Sustainable treatment options for neuroinflammation may be considered to improve cognitive functions after sudden cardiac arrest.
关于心脏骤停后数月内神经炎症状态的了解甚少。神经炎症由表达18 kDa转运蛋白(TSPO)的细胞介导。我们使用TSPO特异性示踪剂[18F]DAA1106,通过纵向体内正电子发射断层扫描(PET)成像,在6个月的时间内确定了心脏骤停大鼠模型中表达TSPO的细胞的时间进程。
五只雄性Sprague Dawley大鼠从因室颤导致的6分钟心脏骤停中复苏,三只动物作为假手术组。在干预后的第5、8、14、90和180天进行PET测量。在第140天进行磁共振成像。在第3、13、90和180天进行巴恩斯迷宫空间记忆测试之前进行成像。通过Iba-1免疫组织化学证实[18F]DAA1106结合的特异性。
在所有测量时间点,[18F]DAA1106在所有心脏骤停动物的双侧背侧海马中积聚。免疫组织化学证实海马CA1区有Iba-1表达细胞。每平方毫米Iba-1免疫反应性物体的数量与[18F]DAA1106摄取显著相关。此外,五只心脏骤停大鼠中的两只在纹状体中表现出双侧TSPO表达,持续到第180天。在巴恩斯迷宫中,在目标象限花费的相对时间与第14天和180天背侧海马[18F]DAA1106摄取呈负相关。
心脏骤停后,TSPO长期持续表达。可考虑采用可持续的神经炎症治疗方案来改善心脏骤停后的认知功能。