I-Shou University School of Medicine, No. 8, Yi-Da road, Kaohsiung, 824, Taiwan.
Department of Neurosurgery, E-Da Cancer Hospital, No. 1, Yi-Da road, Kaohsiung, 824, Taiwan.
Fundam Clin Pharmacol. 2021 Aug;35(4):634-644. doi: 10.1111/fcp.12635. Epub 2021 Jan 19.
Intracerebral hemorrhage (ICH) is a common and severe neurological disorder associated with high morbidity and mortality rates. Despite extensive research into its pathology, there are no clinically approved neuroprotective treatments for ICH. Increasing evidence has revealed that inflammatory responses mediate the pathophysiological processes of brain injury following ICH. Experimental ICH was induced by direct infusion of 100 μL fresh (non-heparinized) autologous whole blood into the right basal ganglia of Sprague-Dawley rats at a constant rate (10 μL/min). The simvastatin group was administered simvastatin (15 mg/kg) and the combination therapy group was administered simvastatin (10 mg/kg) and ezetimibe (10 mg/kg). Magnetic resonance imaging (MRI), the forelimb use asymmetry test, the Morris water maze test, and two biomarkers were used to evaluate the effect of simvastatin and combination therapy. MRI imaging revealed that combination therapy resulted in significantly reduced perihematomal edema. Biomarker analyses revealed that both treatments led to significantly reduced endothelial inflammatory responses. The forelimb use asymmetry test revealed that both treatment groups had significantly improved neurological outcomes. The Morris water maze test revealed improved neurological function after combined therapy, which also led to less neuronal loss in the hippocampal CA1 region. In conclusion, simvastatin-ezetimibe combination therapy can improve neurological function, attenuate the endothelial inflammatory response and lead to less neuronal loss in the hippocampal CA1 region in a rat model of ICH.
脑出血(ICH)是一种常见且严重的神经系统疾病,其发病率和死亡率均较高。尽管对其病理学进行了广泛的研究,但目前尚无经临床批准的 ICH 神经保护治疗方法。越来越多的证据表明,炎症反应介导了 ICH 后脑损伤的病理生理过程。实验性 ICH 通过以 10μL/min 的恒定速度将 100μL 新鲜(未肝素化)自体全血直接输注到 Sprague-Dawley 大鼠右侧基底节而诱发。辛伐他汀组给予辛伐他汀(15mg/kg),联合治疗组给予辛伐他汀(10mg/kg)和依折麦布(10mg/kg)。磁共振成像(MRI)、前肢使用不对称测试、Morris 水迷宫测试和两种生物标志物用于评估辛伐他汀和联合治疗的效果。MRI 成像显示联合治疗可显著减少血肿周围水肿。生物标志物分析表明,两种治疗方法均导致内皮炎症反应显著减轻。前肢使用不对称测试显示,两组治疗均显著改善了神经功能。Morris 水迷宫测试显示联合治疗后神经功能得到改善,同时海马 CA1 区神经元丢失也减少。总之,辛伐他汀-依折麦布联合治疗可改善神经功能,减轻内皮炎症反应,并减少 ICH 大鼠海马 CA1 区神经元丢失。