Wasterlain C G, Adams L M, Wichmann J K, Sofia R D
Department of Neurology, VA Medical Center at Sepulveda, California 91343-2099, USA.
Stroke. 1996 Jul;27(7):1236-40. doi: 10.1161/01.str.27.7.1236.
Felbamate, a novel anticonvulsant that binds to the glycine site of the N-methyl-D-aspartate receptor, has been shown to have neuroprotective properties in vitro and in vivo. In a rat pup model of hypoxia-ischemia, felbamate selectively reduced delayed death in hippocampal granule cells. The present study explores its neuroprotective potential in a gerbil model of global ischemia, in which good evidence exists that ischemia triggers apoptosis of CA1.
Gerbils were subjected to bilateral carotid occlusion for 5 minutes and then treated with felbamate (100 or 200 mg/kg IV) or vehicle. They were killed 3 days later, and the numbers of live and dead neurons in the CA1 sector of the hippocampus were counted at sterotaxically defined levels.
Felbamate (200 mg/kg IV) administered after the release of carotid clamping did not change brain temperature but reduced neuronal death in CA1 from 332 +/- 60 cells per section of dorsal hippocampus in unmedicated gerbils to 62 +/- 12 cells in felbamate-treated animals (P<.001). A lower dose of felbamate (100 mg/kg post hoc) showed only a nonsignificant reduction of neuronal death. In the 200-mg/kg group, felbamate serum concentrations peaked at 162 microg/mL and were above 100 microg/mL for at least 3 hours, and brain levels reached 150 microg/mL at 1 hour. In the 100-mg/kg group, blood serum levels were well below 100 microg/mL.
These results suggest that felbamate given post hoc is remarkably effective in preventing delayed apoptosis secondary to global ischemia but that effective neuroprotection requires doses higher than those used for anticonvulsant treatment.
非氨酯是一种新型抗惊厥药,可与N-甲基-D-天冬氨酸受体的甘氨酸位点结合,已证实在体外和体内均具有神经保护特性。在缺氧缺血性大鼠幼崽模型中,非氨酯可选择性降低海马颗粒细胞的延迟性死亡。本研究探讨其在全脑缺血沙土鼠模型中的神经保护潜力,该模型中有充分证据表明缺血会引发CA1区细胞凋亡。
沙土鼠双侧颈动脉闭塞5分钟,然后给予非氨酯(100或200mg/kg静脉注射)或赋形剂。3天后处死动物,在立体定位确定的水平上计数海马CA1区存活和死亡神经元的数量。
颈动脉夹闭解除后给予非氨酯(200mg/kg静脉注射)未改变脑温,但可使CA1区神经元死亡从未用药沙土鼠背侧海马每切片332±60个细胞减少至非氨酯治疗动物的62±12个细胞(P<0.001)。较低剂量的非氨酯(事后给予100mg/kg)仅显示出神经元死亡的非显著性降低。在200mg/kg组中,非氨酯血清浓度在162μg/mL达到峰值,至少3小时内高于100μg/mL,脑内浓度在1小时时达到150μg/mL。在100mg/kg组中,血清水平远低于100μg/mL。
这些结果表明,事后给予非氨酯在预防全脑缺血继发的延迟性凋亡方面非常有效,但有效的神经保护需要高于抗惊厥治疗所用的剂量。