Corbett D, Nurse S, Colbourne F
Division of Basic Medical Sciences, Faculty of Medicine, Memorial University of Newfoundland, St John's, Canada.
Stroke. 1997 Nov;28(11):2238-42; discussion 2243. doi: 10.1161/01.str.28.11.2238.
Previous studies from this laboratory have shown that mild intraischemic or prolonged (i.e., 12 to 24 hours) postischemic hypothermia conveys long-lasting (1 to 6 months) protection against CA1 injury. However, these studies have used young animals (aged approximately 3 to 5 months). Stroke incidence rises sharply in late middle age at a time when changes in brain chemistry could alter the response to neuroprotective treatments. Therefore, we evaluated the efficacy of hypothermia in an older population (aged 18 to 20 months) of gerbils.
Three groups of gerbils were exposed to a 5-minute episode of global ischemia or sham occlusion. One group was cooled during ischemia (mean brain temperature of 32 degrees C). A second group was maintained at normothermia (36.4 degrees C) during occlusion and the first hour of reperfusion. Beginning 1.0 hour after occlusion, these gerbils were gradually cooled to 32 degrees C and maintained at this level before gradual rewarming to 37 degrees C at 25 hours after ischemia. The third ischemic group was kept at normothermia during surgery and the first hour of reperfusion. After surgery, all animals were tested for acute (i.e., within 30 hours of ischemia) changes in locomotor activity as well as for chronic (i.e., 5, 10, and 30 days after ischemia) habituation deficits in an open field test.
Both intraischemic and postischemic hypothermia provided robust protection (P < .0001) of hippocampal CA1 neurons when assessed 30 days after ischemia. However, intraischemic hypothermia was more effective than postischemic hypothermia in providing behavioral protection.
This study demonstrates that both intraischemic and prolonged postischemic hypothermia provide robust and lasting (30-day survival) histological protection against a severe ischemic insult. The extent of behavioral protection with postischemic hypothermia was less than that previously observed in younger animals. This suggests that neuroprotective treatments in young animals may lose efficacy as a result of aging.
本实验室先前的研究表明,轻度缺血期间或长时间(即12至24小时)缺血后低温可对CA1损伤提供持久(1至6个月)的保护。然而,这些研究使用的是幼龄动物(约3至5个月龄)。在中年后期,中风发病率急剧上升,此时脑化学变化可能会改变对神经保护治疗的反应。因此,我们评估了低温对老年沙鼠群体(18至20个月龄)的疗效。
三组沙鼠经历5分钟的全脑缺血发作或假闭塞。一组在缺血期间进行降温(平均脑温32摄氏度)。第二组在闭塞期间和再灌注的第一个小时维持正常体温(36.4摄氏度)。从闭塞后1.0小时开始,这些沙鼠逐渐降温至32摄氏度,并维持在该水平,直至缺血后25小时逐渐复温至37摄氏度。第三组缺血组在手术期间和再灌注的第一个小时保持正常体温。手术后,所有动物均接受急性(即缺血后30小时内)运动活动变化测试,以及慢性(即缺血后5、10和30天)旷场试验中的习惯化缺陷测试。
在缺血后30天评估时,缺血期间和缺血后低温均对海马CA1神经元提供了强有力的保护(P <.0001)。然而,缺血期间低温在提供行为保护方面比缺血后低温更有效。
本研究表明,缺血期间和长时间缺血后低温均对严重缺血性损伤提供了强有力且持久(30天存活)的组织学保护。缺血后低温的行为保护程度低于先前在幼龄动物中观察到的程度。这表明幼龄动物中的神经保护治疗可能会因衰老而失去疗效。