Posod Anna, Winkler Ira, Wegleiter Karina, Huber Eva, Urbanek Martina, Kiechl-Kohlendorfer Ursula, Griesmaier Elke
Pediatrics II (Neonatology), Department of Pediatrics, Medical University of Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria.
IBRO Rep. 2020 Sep 24;9:247-257. doi: 10.1016/j.ibror.2020.09.003. eCollection 2020 Dec.
Levomepromazine (LMP) is a phenothiazine neuroleptic drug with strong analgesic and sedative properties that is increasingly used off-label in pediatrics and is being discussed as an adjunct therapy in neonatal intensive care. Basic research points towards neuroprotective potential of phenothiazines, but LMP's effect on the developing brain is currently unknown. The aim of the present study was to assess LMP as a pharmacologic strategy in established neonatal and models of the healthy and injured developing mouse brain. , HT-22 cells kept exposure-naïve or injured by glutamate were pre-treated with vehicle or increasing doses of LMP and cell viability was determined. , LMP's effects were first assessed in 5-day-old healthy, uninjured CD-1 mouse pups receiving a single intraperitoneal injection of vehicle or different dosages of LMP. In a second step, mouse pups were subjected to excitotoxic brain injury and subsequently treated with vehicle or LMP. Endpoints included somatometric data as well as histological and immunohistochemical analyses. , cell viability in exposure-naïve cells was significantly reduced by high doses of LMP, but remained unaffected in glutamate-injured cells. , no specific toxic effects of LMP were observed neither in healthy mouse pups nor in experimental animals subjected to excitotoxic injury, but body weight gain was significantly lower following higher-dose LMP treatment. Also, LMP failed to produce a neuroprotective effect in the injured developing brain. Additional studies are required prior to a routine clinical use of LMP in neonatal intensive care units.
左美丙嗪(LMP)是一种具有强大镇痛和镇静特性的吩噻嗪类抗精神病药物,在儿科越来越多地被用于非标签用途,并且正在作为新生儿重症监护中的辅助治疗进行讨论。基础研究表明吩噻嗪类药物具有神经保护潜力,但LMP对发育中大脑的影响目前尚不清楚。本研究的目的是评估LMP作为一种药理学策略在已建立的新生小鼠以及健康和受伤的发育中小鼠脑模型中的作用。首先,将未接触过药物或被谷氨酸损伤的HT-22细胞用溶剂或递增剂量的LMP进行预处理,然后测定细胞活力。其次,在5日龄健康、未受伤的CD-1小鼠幼崽中评估LMP的作用,这些幼崽接受单次腹腔注射溶剂或不同剂量的LMP。第二步,将小鼠幼崽进行兴奋性毒性脑损伤,随后用溶剂或LMP进行治疗。终点包括身体测量数据以及组织学和免疫组织化学分析。结果显示,高剂量的LMP可显著降低未接触过药物的细胞的活力,但对谷氨酸损伤的细胞没有影响。此外,在健康小鼠幼崽或遭受兴奋性毒性损伤的实验动物中均未观察到LMP的特定毒性作用,但高剂量LMP治疗后体重增加明显较低。而且,LMP在受伤的发育中大脑中未能产生神经保护作用。在新生儿重症监护病房常规临床使用LMP之前,还需要进行更多研究。