Middle Cerebral Artery Electrocoagulation Research Articles

Preclinical Evaluation of Fingolimod in Rodent Models of Stroke With Age or Atherosclerosis as Comorbidities.

Preclinical data indicate that fingolimod improves outcome post-ischaemia. This study used a rigorous study design in normal male C57BL/6JOlaHsd mice and in mice with common stroke comorbidities to further evaluate the translational potential of fingolimod. Stroke was induced via middle cerebral artery electrocoagulation in 8–9-week old mice (young mice), 18 month old mice (aged mice), and in high-fat diet-fed 22-week old ApoE−/− mice (hyperlipidaemic mice). Recovery was evaluated using motor behavioural tests 3 and 7 days after stroke. Tissue damage was evaluated at 7 days. A lower dose of fingolimod, 0.5 mg/kg, but not 1 mg/kg, increased lesion size but decreased ipsilateral brain atrophy in younger mice, without an effect on behavioural outcomes. Fingolimod-treated aged mice showed a significant improvement over saline-treated mice in the foot fault test at 7 days. Fingolimod-treated hyperlipidaemic mice showed a decreased infarct size but no difference in behavioural performance. Increasing fingolimod treatment time to 10 days showed no benefit in young mice. Pooled data showed that fingolimod improved performance in the foot fault test. Flow cytometry studies showed that fingolimod had marked effects on T cell frequencies in various tissues. The results show that the effects of fingolimod in stroke are less robust than the existing literature might indicate and may depend on the inflammatory status of the animals.

Бензиловый эфир креатина эффективен для профилактики и лечения неврологических и когнитивных нарушений при фокальной ишемии головного мозга у крыс

Введение. Ишемический инсульт головного мозга является одной из главных причин преждевременных смертей во всем мире, вызванные им когнитивные и функциональные нарушения ведут к инвалидизации. Для клинического использования в настоящее время одобрено лишь одно средство - рекомбинантный активатор плазминогена, который обеспечивает восстановление (реканализацию) мозгового кровотока. Средства эффективной нейропротекции, обеспечивающие непосредственную защиту нейронов от ишемии (предотвращение апоптоза, сохранение функциональной активности), несмотря на огромное число исследований, по-прежнему не найдены. Поиск новых подходов к профилактике и лечению острых нарушений мозгового кровообращения по-прежнему остается одной из наиболее актуальных проблем современной медицины. Цель исследования - изучение влияния бензилового эфира креатина, нового синтетического соединения, обладающего способностью проникать через гематоэнцефалический барьер и осуществлять нейропротекторное действие на неврологические и когнитивные нарушения, вызванные фокальной ишемией головного мозга у крыс линии Спрэг-Доули. Методика. Фокальную ишемию головного мозга (ФИМ) индуцировали путем хронической окклюзии левой средней мозговой артерии (СМА) в соответствии с модификацией методики A. Tamura и соавт., 1981. Использовали комбинированный наркоз: Золетил/Домитор (внутрибрюшинно (в/б) по 50 мг/кг и 0.2 мг/кг, соответственно), температуру тела поддерживали постоянной на уровне 38±0.5 oC. Окклюзию СМА производили путем биполярной высокочастотной электрокоагуляции (аппарат ЭХВЧ-25-11-С, «Медия», Россия) наиболее проксимального участка артерии, начиная с 0.5 мм от места ее отхождения от Виллизиева круга и на протяжении 2-3 мм. Процедура имитации ишемии (ложная операция) была аналогична вышеизложенной, но без электрокоагуляции СМА. Оценку степени неврологических нарушений проводили с использованием неврологической шкалы Гарсии и модифицированной шкалы тяжести неврологических нарушений (ОТНН) последовательно за 1 сут до и через 1, 3 и 7 сут после моделирования ФИМ. Для выявления когнитивных нарушений использовали водный лабиринт Морриса. Стандартный тест исследования процессов обучения и памяти применяли в версии для оценки пространственной референтной памяти, заключающейся в поиске животным скрытой под водой платформы при ориентации только по приметам окружающей обстановки. Бензиловый эфир креатина вводили внутрибрюшинно трижды - за 3, 2 и 1 ч до фокальной ишемии при профилактическом применении, либо через 1, 2 и 3 ч после моделирования ишемии при лечебном применении. Результаты. Получены приоритетные данные о том, что бензиловый эфир креатина при профилактическом введении эффективно предупреждает развитие неврологических нарушений и ослабляет когнитивные нарушения после фокальной ишемии мозга; при лечебном применении препарат ослабляет тяжесть неврологических нарушений и снижает выраженность когнитивных расстройств. Заключение. Результаты исследования позволяют рекомендовать данное производное креатина (после оценки возможной токсичности) для проведения первой фазы клинических испытаний в качестве препарата противоишемического действия. Background. Ischemic stroke is one of the main causes for premature death worldwide. Cognitive and functional disorders induced by stroke result in disability. Currently, only one agent has been approved for the clinical use, recombinant plasminogen activator, which provides recovery (recanalization) of cerebral blood flow. Despite numerous studies, an effective treatment to protect directly neurons from ischemia (preventing apoptosis, maintaining functional activity) has not been found so far. Thus, search for new approaches to prevention and treatment of acute cerebrovascular accidents remains one of the most pressing challenges of modern medicine. The aim of this work was to study the effect of creatine benzyl ester, a new synthetic compound capable for penetrating the blood-brain barrier to provide neuroprotection, on neurological and cognitive disorders induced by focal cerebral ischemia in Sprague-Dawley rats. Methods. Focal cerebral ischemia was induced by chronic occlusion of the left middle cerebral artery (MCA) by a A. Tamura et al. (1981) modified method. Combined intraperitoneal (i.p.) anesthesia with Zoletil/Domitor (50 mg/kg and 0.2 mg/kg, respectively) was used. Body temperature was maintained at 38±0.5 oC. MCA occlusion was performed by bipolar high-frequency electrocoagulation (EKVCh-25-11-C, Media, Russia) of the most proximal part of the artery, from 0.5 mm from the place where it originates from the circle of Willis and over 2-3 mm. The sham ischemia procedure was similar to that described above but without MCA electrocoagulation. Severity of neurological disorders was assessed with the Garcia neurological scale and a modified scale for severity of neurological disorders (OTTN) one day before and at 1, 3, and 7 days following ischemia. Cognitive impairment was assessed with the Morris water maze, a standard test for learning and memory. This test was used in a version for studying spatial reference memory, which consists of finding a platform hidden under the water by the animal guided only by surrounding marks. Creatine benzyl ester was injected i.p. three times, 3, 2 and 1 h before focal ischemia for prevention or 1, 2 and 3 h after ischemia for treatment. Results. The study produced priority data showing that preventive administration of creatine benzyl ester effectively abolished the development of neurological disorders and alleviated the cognitive impairment after focal cerebral ischemia whereas the therapeutic treatment restricted the severity of neurological and cognitive disorders. Conclusion. The results of the study supported recommendation of this creatine derivative (after assessing potential toxicity) for the first phase of clinical trials as an anti-ischemic drug.

Spontaneous Neuronal Plasticity in the Contralateral Motor Cortex and Corticospinal Tract after Focal Cortical Infarction in Hypertensive Rats

Objectives: In this study, we investigated the spontaneous neural plasticity on the contralateral side in hypertensive rats, including the expression of nerve growth factors (synaptophysin [SYN] and growth-associated protein 43 [GAP-43]), and the association between nerve fiber sprouting and redistribution, and the recovery of motor functions following sensorimotor cortical infarction. Methods: Initially, Sprague-Dawley rats were induced with renal hypertension by the bilateral renal arteries clips method. Further, they were induced with cerebral ischemia by the middle cerebral artery electrocoagulation method; 70 male rats completed the study. We compared the changes in the corticospinal tract (CST) and the expressions of SYN and GAP-43 on the contralateral side in rats with cerebral infarction using immunohistochemical staining, western blot, and biotinylated dextran amine (BDA) tracing analyses. The recovery of motor function in rats after cortical infarction was evaluated by the foot-fault and beam-walk tests. Results: The motor behavior tests revealed that the motor function of rats could recover to various degrees after focal cortical infarction. Compared with the sham-operated group, the SYN and GAP-43 levels increased in the motor cortex of the opposite hemisphere within 28 days after middle cerebral artery occlusion (MCAO). The increase in SYN and GAP-43 expressions presented differently in layers Ⅱ, Ⅲ, and Ⅴ. The amount of BDA-positive fibers also increased significantly in the denervated cervical spinal gray matter on day 56 post-MCAO. Conclusions: The increases in SYN and GAP-43 on the contralateral side of the motor cortex could promote CST sprouting and rewiring in the spinal cord gray matter and also spontaneous motor function recovery after cortical infarction.

297 Dual Action of No Synthases on Blood Flow and Infarct Volume Consecutive to Neonatal Focal Cerebral Ischemia

Research into neonatal ischemic brain damage is impeded by the lack of a complete understanding of the initial hemodynamic mechanisms resulting in a lesion, particularly that of NO-mediated vascular mechanisms....

A Modified Model of Middle Cerebral Artery Electrocoagulation in Mice

A Modified Model of Middle Cerebral Artery Electrocoagulation in Mice

Dual action of NO synthases on blood flow and infarct volume consecutive to neonatal focal cerebral ischemia

Research into neonatal ischemic brain damage is impeded by the lack of a complete understanding of the initial hemodynamic mechanisms resulting in a lesion, particularly that of NO-mediated vascular mechanisms. In a neonatal stroke rat model, we recently show that collateral recruitment contributes to infarct size variability.Non-specific and selective NO synthase (NOS) inhibition was evaluated on cerebral blood-flow changes and outcome in a P7 rat model of arterial occlusion (left middle cerebral artery electrocoagulation with 50min occlusion of both common carotid arteries). Blood-flow changes were measured by using ultrasound imaging with sequential Doppler recordings in both internal carotid arteries and basilar trunk. Cortical perfusion was measured by using laser Doppler flowmetry. We showed that global NOS inhibition significantly reduced collateral support and cortical perfusion (collateral failure), and worsened the ischemic injury in both gender. Conversely, endothelial NOS inhibition increased blood-flows and aggravated volume lesion in males, whereas in females blood-flows did not change and infarct lesion was significantly reduced. These changes were associated with decreased phosphorylation of neuronal NOS at Ser847 in males and increased phosphorylation in females at 24h, respectively. Neuronal NOS inhibition also increased blood-flows in males but not in females, and did not significantly change infarct volumes compared to their respective PBS-treated controls.In conclusion, both nNOS and eNOS appear to play a key role in modulating arterial blood flow during ischemia mainly in male pups with subsequent modifications in infarct lesion.

Visualization by mass spectrometry of 2‐dimensional changes in rat brain lipids, includingN‐acylphosphatidylethanolamines, during neonatal brain ischemia

Spatial synthesis of N-acyl-phosphatidylethanolamines (NAPEs) and N-acylethanolamines (NAEs) during ischemia-reperfusion in neonatal rats has been investigated and compared to the spatial degradation of other phospholipids. Ischemia was induced in anesthetized Wistar P7 rat pups by left middle cerebral artery electrocoagulation combined with a transient and concomitant occlusion of both common carotid arteries. Pups were sacrificed after 24 and 48 h. Sham-treated animals were sacrificed after 48 h. The frozen brains were sliced and subjected to desorption electrospray ionization imaging mass spectrometry. There was a remarkable increase in the levels of many species of NAPEs in the whole injured area at both time points, and a clear but minor increase in selected NAEs. In the ischemic area, the sodium adducts of phosphatidylcholine and of lyso-phosphatidylcholine accumulated and the potassium adduct of phosphatidylcholine disappeared, indicating breakdown of the Na(+)/K(+) pump. Free fatty acids, e.g., arachidonic and docosahexaenoic acids, tended to be more abundant in the periphery than in the center of the ischemic area and showed different spatial distribution. NAPEs are synthesized in the whole ischemic area where the cells seem to be dead and other phospholipids are degraded. Free fatty acids can be found in the periphery of the ischemic area.

Impact of intracranial blood-flow redistribution on stroke size during ischemia–reperfusion in 7-day-old rats

We evaluated color-coded pulsed Doppler ultrasound imaging for the assessment of intracranial blood flow in two models of cerebral ischemia in 7-day-old (P7) rats. Blood-flow velocities (BFVs) were measured in the internal carotid arteries and basilar trunk upstream from the circle of Willis, and in the posterior cerebral arteries downstream (1) before, (2) during left middle cerebral artery electrocoagulation and 50 min-transient either one (I/R-1) or both (I/R-2) common carotid (CCA) arteries occlusion, and (3) after release of CCA(s) occlusion. At 48 h after ischemia 41–48% (I/R-1 model) and 24% (I/R-2 model) of rats did not present a lesion. Those rats displayed increased mean BFV in both right internal carotid artery and basilar trunk in I/R-1 model, and increased mean BFV in the basilar trunk (BT) in I/R-2 model. In contrast, no significant changes in mean BFV were observed in lesioned rats. Furthermore, mean BFV in the BT was inversely correlated to the size of the lesion ( r 2 = 0.75, p < 0.0001) in the I/R-2 model. Thus, we demonstrated the protective role of collateral support in P7 rodents. Ultrasound imaging can evidence the establishment or not of the cerebral collateral recruitment, leading to the presence or absence of a lesion. This novel approach should greatly help preclinical studies to reduce animal variability.

Comparación de la lesión producida en tres modelos animales de isquemia cerebral focal permanente mediante resonancia magnética

Animal models of brain ischemia are essential to reveal the full aspects of cerebrovascular pathologies. The perfect animal model that reflects every aspect of stroke pathophysiology does not exist, hence there is a need for a proper selection of the animal model in order to interpret properly the results from experimental research. To characterize and compare the temporal evolution of three common models of focal brain ischemia using magnetic resonance imaging (MRI) techniques. Thirty Sprague-Dawley rats were distributed into three groups, each of them submitted to one of the following surgery procedures: middle cerebral artery (MCA) intracranial suture, MCA electrocoagulation, and MCA intraluminal suture. Each rat was subjected to an MRI study at days 1, 2, 3, 4, 7 and 14 post-surgery. T2 weighted images were obtained in order to calculate both lesion volumes and edema. Infarct volume and edema were maximal for the intraluminal model (peaks of mean 297 ± 163 mm3 and mean 17 ± 9%, respectively) compared to intracranial suture (178 ± 62 mm3 and 9 ± 6%, respectively) and electrocoagulation (181 ± 45 mm3 and 9 ± 6%, respectively) models. The intraluminal occlusion of the MCA model, although yields in the highest mortality rate (28%), it is the more suitable for long term studies, mainly because of the absence of craniotomy. In the electrocoagulation model a non ischemic lesion region is observed which leads to an abnormal lesion evolution as compared with the other two models.

Bilateral Changes After Neonatal Ischemia in the P7 Rat Brain

Neurogenesis persists throughout life in the rodent subventricular zone (SVZ) and subgranular zone (SGZ) and increases in the adult after brain injury. In this study, postnatal day 7 rats underwent middle cerebral artery electrocoagulation and transient homolateral common carotid artery occlusion, a lesioning protocol that resulted in ipsilateral (IL) forebrain ischemic injury, leading to a cortical cavity 3 weeks later. The effects of neonatal ischemia on hemispheric damage, cell death, cell proliferation, and neurogenesis were examined 4 hours to 6 weeks later by the terminal deoxynucleotidyl transferase dUTP nick-end labeling assay and immunohistochemistry of Ki-67 in proliferating cells and of doublecortin, a microtubule-associated protein expressed only by immature neurons. Neonatal ischemic injury resulted in persistent reduced IL and transient reduced contralateral (CL) hemispheric areas, a consequence of sustained and transient cell death in the IL and CL areas, respectively. Ki-67 immunostaining revealed 3 peaks of newly generated cells in the dorsal SVZ and SGZ in the IL side and also in the CL side at 48 hours and 7 and 28 days after ischemia. Double immunofluorescence revealed that most of the Ki-67-positive cells were astrocytes at 48 hours. Ischemic injury also stimulated SVZ neurogenesis, based on increased doublecortin immunostaining in both SVZs at 7 to 14 days after injury. Doublecortin-positive neurons remained visible around the lesion at 21 days but displayed an immature shape in discrete chains or clusters. Although unilateral ischemic damage was produced, results indicate successful regenerative changes in the CL hemisphere, allowing anatomical recovery.

Oxygen Glucose Deprivation Switches the Transport of tPA Across the Blood–Brain Barrier From an LRP-Dependent to an Increased LRP-Independent Process

Despite uncontroversial benefit from its thrombolytic activity, the documented neurotoxic effect of tissue plasminogen activator (tPA) raises an important issue: the current emergency stroke treatment might not be optimum if exogenous tPA can enter the brain and thus add to the deleterious effects of endogenous tPA within the cerebral parenchyma. Here, we aimed at determining whether vascular tPA crosses the blood-brain barrier (BBB) during cerebral ischemia, and if so, by which mechanism. First, BBB permeability was assessed in vivo by measuring Evans Blue extravasation following intravenous injection at 0 or 3 hours after middle cerebral artery electrocoagulation in mice. Second, the passage of vascular tPA was investigated in an in vitro model of BBB, subjected or not to oxygen and glucose deprivation (OGD). We first demonstrated that after focal permanent ischemia in mice, the BBB remains impermeable to Evans Blue in the early phase (relative to the therapeutic window of tPA), whereas at later time points massive Evans Blue extravasation occurs. Then, the passage of tPA during these 2 phases, was investigated in vitro and we show that in control conditions, tPA crosses the intact BBB by a low-density lipoprotein (LDL) receptor-related protein (LRP)-dependent transcytosis, whereas OGD leads to an exacerbation of tPA passage, which switches to a LRP-independent process. We evidence 2 different mechanisms through which vascular tPA can reach the brain parenchyma, depending on the state of the BBB. As discussed, these data show the importance of taking the side effects of blood-derived tPA into account and offer a basis to improve the current thrombolytic strategy.

Inflammatory responses in the cerebral cortex after ischemia in the P7 neonatal Rat.

The contribution of inflammatory response to the pathogenesis of ischemic lesions in the neonate is still uncertain. This study described the chronological sequence of inflammatory changes that follow cerebral ischemia with reperfusion in the neonatal P7 rat. P7 rats underwent left middle cerebral artery electrocoagulation associated with 1-hour left common carotid artery occlusion. The spatiotemporal pattern of cellular responses was characterized immunocytochemically with the use of antibodies against rat endogenous immunoglobulins to visualize the area of the breakdown of the blood-brain barrier. Infiltration of neutrophils and T lymphocytes was demonstrated by antibodies against myeloperoxidase and a pan-T cell marker, respectively. Antibodies ED1 and OX-42 were applied to identify microglial cells and macrophages. The response of astrocytes was shown with antibodies against glial fibrillary acidic protein. Cell survival was assessed by Bcl-2 expression. Cell death was demonstrated by DNA fragmentation with the use of the terminal deoxynucleotidyl transferase-mediated dUTP biotin nick end labeling (TUNEL) assay and Bax immunodetection. Endogenous immunoglobulin extravasation through the blood-brain barrier occurred at 2 hours of recirculation and persisted until 1 month after ischemia. Neutrophil infiltration began at 24 hours and peaked at 72 to 96 hours (30+/-3.4 neutrophils per 0.3 mm(2); P<0.0001), then disappeared at 14 days after ischemia. T cells were observed between 24 and 96 hours of reperfusion. Resident microglia-macrophages exhibited morphological remnants and expressed the cell death inhibitor Bcl-2 at 24 hours of recirculation. They became numerous within the next 48 hours and peaked at 7 days after ischemia. Phenotypic changes of resident astrocytes were apparent at 24 hours, and they proliferated between 48 hours and 7 days after ischemia. Progressively inflammatory cells showed DNA fragmentation and the cell death activator Bax expression. Cell elimination continued until there was a complete disappearance of the frontoparietal cortex. These data demonstrate that perinatal ischemia with reperfusion triggers acute inflammatory responses with granulocytic cell infiltration, which may be involved in accelerating the destructive processes.