Abstract
Background: Resuscitation from cardiac arrest (CA) results in systemic cytokines response, and neuroinflammation. Thalidomide has been reported to selectively decrease tumor necrosis factor alpha (TNFa) and shown to be neuroprotective. Hypothesis: Thalidomide would decrease systemic and organ-specific cytokine response and biomarkers of injury after CA in rats. Methods: Adult male rats were subjected to 10 min ventricular fibrillation CA. Three groups were studied (n=4-6 per group): naives, CA treated with vehicle and CA treated with thalidomide (CA+T, 50 mg/kg i.p.). TNFa was assessed at 3 h in the cortex, hippocampus, striatum, cerebellum, plasma, heart and lung (Luminex). NSE and S100b were used to assess neuronal and glial injury, cardiac troponin I (cTnI) cardiac ichemia and IFABP to assess intestinal damage (ELISA). Results: CA resulted in a robust increase of TNFa in plasma (Figure 1) and tissues (Figure 2) with no differences between CA and CA+T groups in any region. NSE, S100b, cTnI and IFABP were increased after CA or CA+T vs. naives (all p<0.05) without differences between CA vs. CA+T. Conclusions: CA resulted in an early massive TNFa response systemically and in target organs, with increased biomarkers of organ injury. Thalidomide in a dose reported previously to improve outcome of in vivo models of brain ischemia did not decrease TNFa levels in plasma, brain or extracerebral organs, or biomarkers of injury in our model of experimental CA. Cytokine response to CA was identified as a therapeutic target for future interventions on systemic and end-organ levels. Other promising anti-TNFa strategies incl. anti-TNFa antibodies are currently being evaluated in CA models.
Published Version
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