Abstract

We assessed neurological outcomes, infarct volume, and the expression of nestin and caspase-3 in the hippocampal dentate gyrus following middle cerebral artery occlusion (MCAO) followed by reperfusion, with mild hypothermia (MH) treatment at the onset of ischemia in a MCAO rat model. Reperfusion began 2 hours after the MCAO model was set-up. MH treatment began at the onset of ischemia and was maintained for 4 hours. We evaluated neurological deficit score, brain infarct volumes, along with the immunohistochemical staining of nestin and caspase-3 in the sub-granular zone of the injured hemisphere on the 1st, 3rd, 7th, and 14th day after the onset of ischemia. Correlations between the number of nestin-positive (nestin+) cells, caspase-3-positive (caspase-3+) cells with infarct volume, as well as neurological deficit scores, were evaluated by linear regression. MH significantly promoted survival, reduced mortality, improved neurological deficit score, reduced brain infarct volume, increased the number of neural stem/progenitor cells and inhibited neuronal apoptosis in the sub-granular zone of the injured hemisphere. The number of nestin+ cells correlated with neurological deficit score in the normothermic group, and with infarct volume in the hypothermia group except for the first day after the onset of ischemia. The number of caspase-3+ cells correlated with the neurological deficit score but not infarct volume. The neuroprotective effects of MH may be mediated by modulating neural stem/progenitor cells and neuronal apoptotic cells in the sub-granular zone of the injured hemisphere during cerebral ischemia/reperfusion injury.

Highlights

  • Stroke is one of the most prominent causes of death and disability in adults; there are few treatments associated with this condition [1]

  • While the effects of mild hypothermia (MH) upon nestin+ cells have been studied in neonatal cerebral hypoxic ischemic injury [10,11,12,13], as well as in adult global cerebral ischemia/reperfusion injury, which represents the clinical scenario of cardiac arrest [14,15,16], results have proved to be controversial and inconsistent

  • There is very low-quality evidence to suggest against the routine induction of hypothermia as a means to improve survival in patients with acute ischemic stroke [23], MH is known to reduce mortality in different models of focal cerebral ischemia [24]

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Summary

Introduction

Stroke is one of the most prominent causes of death and disability in adults; there are few treatments associated with this condition [1]. A class VI intermediate filament protein, is expressed by neural stem cells and neural progenitor cells [5, 6]. These neural stem/progenitor cells have the potential to survive brain ischemia and participate in neurogenesis after stroke [7]. While the effects of MH upon nestin+ cells have been studied in neonatal cerebral hypoxic ischemic injury [10,11,12,13], as well as in adult global cerebral ischemia/reperfusion injury, which represents the clinical scenario of cardiac arrest [14,15,16], results have proved to be controversial and inconsistent. There have been no previous reports that have investigated the effect of MH on nestin+ cells during ischemia/reperfusion injury

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