Divisions of Cardiothoracic Surgery, The Children's Hospital of Philadelphia (CHOP), Philadelphia, PA, 19104, USA.
Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA.
J Med Toxicol. 2024 Jan;20(1):39-48. doi: 10.1007/s13181-023-00971-1. Epub 2023 Oct 17.
Carbon monoxide (CO) is a colorless and odorless gas that is a leading cause of environmental poisoning in the USA with substantial mortality and morbidity. The mechanism of CO poisoning is complex and includes hypoxia, inflammation, and leukocyte sequestration in brain microvessel segments leading to increased reactive oxygen species. Another important pathway is the effects of CO on the mitochondria, specifically at cytochrome c oxidase, also known as Complex IV (CIV). One of the glaring gaps is the lack of rigorous experimental models that may recapitulate survivors of acute CO poisoning in the early phase. The primary objective of this preliminary study is to use our advanced swine platform of acute CO poisoning to develop a clinically relevant survivor model to perform behavioral assessment and MRI imaging that will allow future development of biomarkers and therapeutics.
Four swine (10 kg) were divided into two groups: control (n = 2) and CO (n = 2). The CO group received CO at 2000 ppm for over 120 min followed by 30 min of re-oxygenation at room air for one swine and 150 min followed by 30 min of re-oxygenation for another swine. The two swine in the sham group received room air for 150 min. Cerebral microdialysis was performed to obtain semi real-time measurements of cerebral metabolic status. Following exposures, all surviving animals were observed for a 24-h period with neurobehavioral assessment and imaging. At the end of the 24-h period, fresh brain tissue (cortical and hippocampal) was immediately harvested to measure mitochondrial respiration.
While a preliminary ongoing study, animals in the CO group showed alterations in cerebral metabolism and cellular function in the acute exposure phase with possible sustained mitochondrial changes 24 h after the CO exposure ended.
This preliminary research further establishes a large animal swine model investigating survivors of CO poisoning to measure translational metrics relevant to clinical medicine that includes a basic neurobehavioral assessment and post exposure cellular measures.
一氧化碳(CO)是一种无色无味的气体,是美国环境中毒的主要原因,可导致大量死亡和发病。CO 中毒的机制很复杂,包括缺氧、炎症和白细胞在脑微血管段的隔离,导致活性氧增加。另一个重要途径是 CO 对线粒体的影响,特别是细胞色素 c 氧化酶,也称为复合物 IV(CIV)。一个明显的差距是缺乏严格的实验模型,可能无法重现急性 CO 中毒早期的幸存者。本初步研究的主要目的是使用我们先进的急性 CO 中毒猪平台,开发一种具有临床相关性的幸存者模型,进行行为评估和 MRI 成像,以便为未来的生物标志物和治疗方法的发展奠定基础。
将 4 头猪(10kg)分为两组:对照组(n=2)和 CO 组(n=2)。CO 组接受 2000ppm 的 CO 超过 120min,随后在室内空气中再给氧 30min,其中一头猪的再给氧时间为 150min,另一头猪的再给氧时间为 30min。假手术组的两只猪接受 150min 的室内空气。进行脑微透析以获得脑代谢状态的半实时测量。暴露后,所有存活的动物都接受 24 小时的神经行为评估和成像观察。在 24 小时结束时,立即收获新鲜脑组织(皮质和海马)以测量线粒体呼吸。
虽然这是一项正在进行的初步研究,但 CO 组的动物在急性暴露阶段表现出脑代谢和细胞功能的改变,在 CO 暴露结束后 24 小时可能存在持续的线粒体变化。
这项初步研究进一步建立了一个大型动物猪模型,用于研究 CO 中毒幸存者,以测量与临床医学相关的转化指标,包括基本的神经行为评估和暴露后的细胞测量。