1.Artesunate alleviates hypoxic-ischemic brain damage in neonatal rats by inhibiting NLRP3 inflammasome activation and inflammatory cytokine secretion.
Yinli CAO ; Yazhou SUN ; Qingyang CUI ; Xiaojing HE ; Zhenzhen LI
Chinese Journal of Cellular and Molecular Immunology 2023;39(5):410-415
		                        		
		                        			
		                        			Objective To investigate the protective effect of artesunate on hypoxic-ischemic brain damage (HIBD) and its mechanism in neonatal rats. Methods 7-day-old neonatal SD rats were randomly divided into sham operation group, model group, artesunate 5 mg/kg group, artesunate 10 mg/kg group, artesunate 20 mg/kg group and dexamethasone 6 mg/kg group, with 18 rats in each group. HIBD models were established in groups except for the sham operation group. The sham operation group only needed to separate the left common carotid artery without ligation and nitrogen-oxygen mixed gas ventilation. Each group was injected with drug intraperitoneally right after surgery and the rats in the sham operation group and the model group were injected with an equal volume of normal saline (once a day for a total of 5 times). One hour after the last injection, the rats in each group were scored for neurological defects. After the rats were sacrificed, the brain water content was measured and the pathological changes of the brain tissues of rats were observed. Terminal-deoxynucleotidyl transferase mediated nick end labeling (TUNEL) was used to detect the neuronal cell apoptosis, and ELISA was applied to detect the levels of IL-1β, IL-6 and TNF-α in brain tissues and peripheral blood of each group of rats. Western blot analysis was adopted to detect the protein expression levels of NLR family pyrin domain containing 3 (NLRP3), apoptosis-associated speck-like protein containing CARD (ASC) and caspase-1 in the rats brain tissues of each group. Results Compared with the model group, the neurological deficit score was decreased; the pathological damage of brain tissues was relieved; the brain water content was significantly reduced; the apoptosis number of hippocampal neurons was decreased significantly; the levels of IL-1β, IL-6 and TNF-α in brain tissues and peripheral blood were significantly reduced; the protein expression levels of NLRP3, ASC and caspase-1 were significantly lowered in the middle-dose and high-dose artesunate groups and the dexamethasone group. Conclusion Artesunate can improve the neurological function, relieve the brain damage, and alleviate the brain edema in neonatal rats with HIBD. It can protect the HIBD, which may be related to the inhibition of NLRP3 inflammasome activation and reduction of inflammatory cytokine secretion.
		                        		
		                        		
		                        		
		                        			Animals
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		                        			Rats
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		                        			Animals, Newborn
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		                        			Artesunate/pharmacology*
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		                        			Brain/metabolism*
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		                        			Caspases/metabolism*
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		                        			Dexamethasone
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		                        			Hypoxia-Ischemia, Brain/pathology*
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		                        			Inflammasomes
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		                        			Interleukin-6/metabolism*
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		                        			NLR Family, Pyrin Domain-Containing 3 Protein/metabolism*
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		                        			Rats, Sprague-Dawley
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		                        			Tumor Necrosis Factor-alpha/metabolism*
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		                        			Water/metabolism*
		                        			
		                        		
		                        	
2.Brain-Derived Glia Maturation Factor β Participates in Lung Injury Induced by Acute Cerebral Ischemia by Increasing ROS in Endothelial Cells.
Fei-Fei XU ; Zi-Bin ZHANG ; Yang-Yang WANG ; Ting-Hua WANG
Neuroscience Bulletin 2018;34(6):1077-1090
		                        		
		                        			
		                        			Brain damage can cause lung injury. To explore the mechanism underlying the lung injury induced by acute cerebral ischemia (ACI), we established a middle cerebral artery occlusion (MCAO) model in male Sprague-Dawley rats. We focused on glia maturation factor β (GMFB) based on quantitative analysis of the global rat serum proteome. Polymerase chain reaction, western blotting, and immunofluorescence revealed that GMFB was over-expressed in astrocytes in the brains of rats subjected to MCAO. We cultured rat primary astrocytes and confirmed that GMFB was also up-regulated in primary astrocytes after oxygen-glucose deprivation (OGD). We subjected the primary astrocytes to Gmfb RNA interference before OGD and collected the conditioned medium (CM) after OGD. We then used the CM to culture pulmonary microvascular endothelial cells (PMVECs) acquired in advance and assessed their status. The viability of the PMVECs improved significantly when Gmfb was blocked. Moreover, ELISA assays revealed an elevation in GMFB concentration in the medium after OGD. Cell cultures containing recombinant GMFB showed increased levels of reactive oxygen species and a deterioration in the state of the cells. In conclusion, GMFB is up-regulated in astrocytes after ACI, and brain-derived GMFB damages PMVECs by increasing reactive oxygen species. GMFB might thus be an initiator of the lung injury induced by ACI.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Brain
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			pathology
		                        			;
		                        		
		                        			Brain Ischemia
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		                        			complications
		                        			;
		                        		
		                        			pathology
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		                        			Bronchoalveolar Lavage Fluid
		                        			;
		                        		
		                        			Cell Hypoxia
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		                        			physiology
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		                        			Cells, Cultured
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		                        			Cerebrovascular Circulation
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		                        			physiology
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		                        			Chromatography, High Pressure Liquid
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		                        			Culture Media, Conditioned
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		                        			pharmacology
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		                        			Disease Models, Animal
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		                        			Endothelial Cells
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		                        			metabolism
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		                        			Gene Expression Regulation
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		                        			physiology
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		                        			Glia Maturation Factor
		                        			;
		                        		
		                        			metabolism
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		                        			In Situ Nick-End Labeling
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		                        			Lung Injury
		                        			;
		                        		
		                        			etiology
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		                        			metabolism
		                        			;
		                        		
		                        			pathology
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		                        			Male
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		                        			Neuroglia
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		                        			metabolism
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		                        			Neurologic Examination
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		                        			Peroxidase
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		                        			metabolism
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		                        			Proteome
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		                        			RNA Interference
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		                        			physiology
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		                        			RNA, Small Interfering
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		                        			genetics
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		                        			metabolism
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		                        			Rats
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		                        			Rats, Sprague-Dawley
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		                        			Reactive Oxygen Species
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		                        			metabolism
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		                        			Tandem Mass Spectrometry
		                        			
		                        		
		                        	
3.Clinics in diagnostic imaging (193). Sporadic Creutzfeldt-Jakob disease (sCJD).
Jun Si Yuan LI ; Kheng Choon LIM ; Winston Eng Hoe LIM ; Robert Chun CHEN
Singapore medical journal 2018;59(12):634-641
		                        		
		                        			
		                        			A 68-year-old man presented with a three-week history of rapidly progressive dementia, gait ataxia and myoclonus. Subsequent electroencephalography showed periodic sharp wave complexes, and cerebrospinal fluid assay revealed the presence of a 14-3-3 protein. A probable diagnosis of sporadic Creutzfeldt-Jakob disease was made, which was further supported by magnetic resonance (MR) imaging of the brain showing asymmetric signal abnormality in the cerebral cortices and basal ganglia. The aetiology, clinical features, diagnostic criteria, various MR imaging patterns and radiologic differential diagnosis of sporadic Creutzfeldt-Jakob disease are discussed in this article.
		                        		
		                        		
		                        		
		                        			Aged
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		                        			Brain
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		                        			pathology
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		                        			Cerebral Cortex
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		                        			Cerebrospinal Fluid
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		                        			metabolism
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		                        			Creutzfeldt-Jakob Syndrome
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		                        			diagnostic imaging
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		                        			Dementia
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		                        			physiopathology
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		                        			Diagnosis, Differential
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		                        			Diffusion Magnetic Resonance Imaging
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		                        			Electroencephalography
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		                        			Humans
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		                        			Hypoxia-Ischemia, Brain
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		                        			diagnostic imaging
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		                        			Male
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		                        			Prion Diseases
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		                        			physiopathology
		                        			
		                        		
		                        	
4.Recombinant Human Erythropoietin Augments Neovascularization Responses in a Neonatal Rat Model of Premature Brain Damage by Phosphatidylinositol 3 Kinase/Akt Pathway.
Da-Fan YU ; Li-Hua ZHU ; Li JIANG
Chinese Medical Journal 2017;130(7):854-858
BACKGROUNDRecombinant human-erythropoietin (rh-EPO) has therapeutic efficacy for premature infants with brain damage during the active rehabilitation and anti-inflammation. In the present study, we found that the rh-EPO was related to the promotion of neovascularization. Our aim was to investigate whether rh-EPO augments neovascularization in the neonatal rat model of premature brain damage through the phosphatidylinositol 3 kinase (PI3K)/protein kinase B (Akt) signaling pathway.
METHODSPostnatal day 5 (PD5), rats underwent permanent ligation of the right common carotid artery and were exposed to hypoxia for 2 h. All the rat pups were randomized into five groups as follows: (1) control group; (2) hypoxia-ischemic (HI) group; (3) HI + LY294002 group; (4) HI + rh-EPO group; and (5) HI + rh-EPO + LY294002 group. The phospho-Akt protein was tested 90 min after the whole operation, and CD34, vascular endothelial growth factor receptor 2 (VEGFR2), and vascular endothelial growth factor (VEGF) were also tested 2 days after the whole operation.
RESULTSIn the hypoxic and ischemic zone of the premature rat brain, the rh-EPO induced CD34+ cells to immigrate to the HI brain zone (P < 0.05) and also upregulated the VEGFR2 protein expression (P < 0.05) and VEGF mRNA level (P < 0.05) through the PI3K/Akt (P < 0.05) signaling pathway when compared with other groups.
CONCLUSIONSThe rh-EPO treatment augments neovascularization responses in the neonatal rat model of premature brain damage through the PI3K/Akt signaling pathway. Besides, the endogenous EPO may exist in the HI zone of rat brain and also has neovascularization function through the PI3K/Akt signaling pathway.
Animals ; Animals, Newborn ; Antigens, CD34 ; metabolism ; Brain ; drug effects ; metabolism ; pathology ; Disease Models, Animal ; Erythropoietin ; genetics ; metabolism ; therapeutic use ; Female ; Humans ; Hypoxia-Ischemia, Brain ; drug therapy ; metabolism ; Neovascularization, Physiologic ; drug effects ; Phosphatidylinositol 3-Kinase ; metabolism ; Pregnancy ; Proto-Oncogene Proteins c-akt ; metabolism ; Rats ; Rats, Sprague-Dawley ; Recombinant Proteins ; genetics ; metabolism ; therapeutic use ; Signal Transduction ; drug effects ; Vascular Endothelial Growth Factor A ; genetics ; Vascular Endothelial Growth Factor Receptor-2 ; metabolism
5.Role of c-Jun N-terminal kinase-mediated FOXO3a nuclear translocation in neuronal apoptosis in neonatal rats with hypoxic-ischemic brain damage.
De-Yuan LI ; Jin-Lin WU ; Li-Li LUO ; Li-Na QIAO ; Zhong-Qiang LIU ; Guo-Yan LU ; Yang WANG
Chinese Journal of Contemporary Pediatrics 2017;19(4):458-462
OBJECTIVETo explore the mechanisms of neuroprotective effects of c-Jun N-terminal kinase (JNK)/FOXO3a transcription factor signaling pathway inhibition on hypoxic-ischemic neuronal apoptosis in neonatal rats with hypoxic-ischemic brain damage (HIBD).
METHODSSixty-four 7-day-old Sprague-Dawley rats were divided into four groups: hypoxia-ischemia (HI), sham-operated, JNK specific inhibitor AS601245-treated, and DMSO vehicle. Rats' cerebral cortexes were collected at 24 hours after HI. Western blot was used to detect the protein expression of JNK, p-JNK, FOXO3a, nuclear and cytoplasmic FOXO3a, Bim, and CC3. TUNEL staining was used to detect the apoptotic cells.
RESULTSCompared with the sham-operated group, p-JNK protein increased (P<0.01), nuclear protein of FOXO3a increased (P<0.01), cytoplasmic protein decreased (P<0.01), and pro-apoptotic proteins Bim and CC3 increased 24 hours after HI (P<0.01). Compared with the HI and DMSO vehicle groups, p-JNK protein was reduced (P<0.01), nuclear protein of FOXO3a was also reduced (P<0.01), cytoplasmic protein increased (P<0.01), and Bim and CC3 proteins decreased (P<0.01) in the AS601245-treated group 24 hours after HI. TUNEL positive cells were reduced in the AS601245-treated rats compared with the HI and DMSO vehicle groups 24 hours after HI (P<0.01).
CONCLUSIONSJNK activity increases in the neonatal rat brain with HI damage. JNK activity inhibition can inhibit FOXO3a translocation from cytoplasm to nucleus and downregulate the levels of pro-apoptotic proteins Bim and CC3, leading to the reduction of neuronal apoptosis.
Active Transport, Cell Nucleus ; Animals ; Animals, Newborn ; Apoptosis ; Cell Nucleus ; metabolism ; Female ; Forkhead Box Protein O3 ; metabolism ; Hypoxia-Ischemia, Brain ; pathology ; JNK Mitogen-Activated Protein Kinases ; physiology ; Male ; Neurons ; pathology ; Rats ; Rats, Sprague-Dawley
6.Neuroprotective effects of electroacupuncture on hypoxic-ischemic encephalopathy in newborn rats are associated with increased expression of GDNF-RET and protein kinase B.
Tao XU ; Neng-Gui XU ; Zhong-Hua YANG ; Yan-Zhen WAN ; Qing-Long WU ; Kang-Bai HUANG
Chinese journal of integrative medicine 2016;22(6):457-466
OBJECTIVETo explore the neuroprotective effects of electroacupuncture (EA) on hypoxic-ischemic encephalopathy (HIE) and to further investigate the role of glial cell line-derived neurotrophic factor (GDNF) family receptor member RET (rearranged during transfection) and its key downstream phosphatidylinositol 3 kinase (PI-3K)/protein kinase B (Akt) pathway in the process.
METHODSA total of 220 seven-day-old SD rats (of either sex, from 22 broods) were randomly divided into two groups, one (30 rats) for sham-surgery group and the other (190 rats) for HIE model group. The HIE model was established using the left common carotid artery ligation method in combination with hypoxic treatment. The successfully established rats were randomly divided into five groups, including control model group, EA group, sham-EA group, antagonist group and antagonist plus electroacupuncture group, with 35 rats in each group. Baihui (GV 20), Dazhui (GV 14), Quchi (LI 11) and Yongquan (KI 1) acupoints were chosen for acupuncture. EA was performed at Baihui and Quchi for 10 min once a day for continuous 1, 3, 7 and 21 days, respectively. The rats were then killed after the operation and injured cerebral cortex was taken for the measurement of neurologic damage by hematoxylin-eosin (HE) staining and the degenerative changes of cortical ultrastructure by transmission electron microscopy. RET mRNA level and Akt protein level were detected by real-time reverse-transcription polymerase chain reaction (RT-PCR) and western blot analysis, respectively.
RESULTSEA could ameliorate neurologic damage of the first somatic sensory area (S1Tr) and alleviate the degenerative changes of ultrastructure of cortical neurons in rats subjected to HIE. And the longer acupuncture treatment lasted, the better its therapeutic effect would be. This was accompanied by gradually increased expression of GDNF family receptor RET at the mRNA level and its downstream signaling Akt at the protein level in the ischemic cortex.
CONCLUSIONEA has neuroprotective effects on HIE and could be a potential therapeutic strategy for HIE in the neonate. Activation of RET/Akt signaling pathway might be involved in this process.
Animals ; Blotting, Western ; Cerebral Cortex ; pathology ; ultrastructure ; Electroacupuncture ; Female ; Glial Cell Line-Derived Neurotrophic Factor ; genetics ; metabolism ; Hypoxia-Ischemia, Brain ; genetics ; pathology ; therapy ; Male ; Nerve Degeneration ; pathology ; Neurons ; pathology ; ultrastructure ; Neuroprotective Agents ; therapeutic use ; Proto-Oncogene Proteins c-akt ; genetics ; metabolism ; Proto-Oncogene Proteins c-ret ; genetics ; metabolism ; RNA, Messenger ; genetics ; metabolism ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction
7.The neuroprotective role of exogenous TERT gene in neonatal rats with hypoxic-ischemic brain damage.
Feng-Yan ZHAO ; Yi QU ; Li ZHANG ; Lan HUANG ; Hai-Ting LIU ; Jiao LI ; De-Zhi MU
Chinese Journal of Contemporary Pediatrics 2016;18(12):1296-1301
OBJECTIVETo study the effect of telomerase reverse transcriptase (TERT) on cell apoptosis in neonatal rat brains after hypoxic-ischemic brain injury (HIBD).
METHODSA total of 72 neonatal rats were divided into sham, vehicle, HIBD and TERT groups. HIBD was induced by Rice method in the later three groups. The neonatal rats in the vehicle and TERT groups were injected with plasmids containing mock or full length TERT by an intracerebroventricular injection 30 minutes after hypoxic-ischemic (HI) injury. Pathological changes of brain tissue were observed by hematoxylin and eosin (HE) staining. Western blot was used to detect the protein expression of TERT, apoptosis-inducing factor (AIF) and cleaved caspase 3 (CC3). Apoptotic cells were detected by TUNEL staining.
RESULTSWestern blot showed that TERT protein was dramatically increased in the vehicle, HIBD and TERT groups compared with the sham group. Compared with the vehicle and HIBD groups, TERT protein in the TERT group was significantly upregulated. Compared with the sham group, there was a significant increase in apoptotic index and expression of AIF and CC3 proteins in the vehicle and HIBD groups (p<0.01). The TERT group showed decreased expression of AIF and CC3 proteins and apoptotic index compared with the vehicle and HIBD groups (p<0.01).
CONCLUSIONSTERT can inhibit cell apoptosis induced by HI and might have a neuroprotective role in developing brain with HIBD.
Animals ; Animals, Newborn ; Apoptosis ; Caspase 3 ; metabolism ; Hypoxia-Ischemia, Brain ; pathology ; therapy ; Male ; Rats ; Rats, Sprague-Dawley ; Telomerase ; genetics
8.Effects of umbilical cord blood mononuclear cells transplantation via lateral ventricle on the neural apoptosis and the expression of Bax and Bcl-2 proteins in neonatal rats with hypoxic-ischemic brain damage.
Shao-Zhen YAN ; Xiao-Li WANG ; Hai-Yu WANG ; Peng DONG ; Yan-Song ZHAO
Chinese Journal of Contemporary Pediatrics 2016;18(9):862-866
OBJECTIVETo explore the effects of umbilical cord blood mononuclear cells (UCBMC) transplantation on the neuronal apoptosis and the expression of Bcl-2 and Bax proteins in neonatal rats with hypoxic-ischemic brain damage (HIBD).
METHODSSeven-day-old Sprague-Dawley neonatal rats were randomly divided into normal control (N)+normal saline (NS), HIBD+NS, N+UCBMC, and HIBD+UCBMC groups. HIBD model was prepared using the classical Rice-Vannucci method. Twenty-four hours after HIBD, UCBMC were transplanted in the N+UCBMC and HIBD+UCBMC groups. Seven days after transplantation, NeuN/Cleaved-Caspase-3 double immunofluorescence staining and TUNEL methods were used to observe neural apoptosis in the cortex. The expression levels of Bax and Bcl-2 proteins were examined by Western blot analysis.
RESULTSThere were more NeuNcleaved Caspase-3DAPIand TUNELDAPIcells in the HIBD+NS group compared with the N+NS and N+UCBMC groups (P<0.01). There were less NeuNcleaved Caspase-3DAPIand TUNELDAPIcells in the HIBD+UCBMC group compared with the HIBD+NS group (P<0.01). The concentration of Bax protein was higher and that of Bcl-2 proteins was lower in the HIBD+NS group compared with the N+NS and N+UCBMC groups (P<0.01). The concentration of Bax protein in HIBD+UCBMC group was lower than that in the HIBD+NS group (P<0.01). The concentration of Bcl-2 protein was higher compared with the HIBD+NS, N+NS and N+UCBMC groups (P<0.05).
CONCLUSIONSUCBMC transplantation via lateral ventricle can upregulate the expression of Bcl-2 protein and down-regulate the expression of Bax protein, thus alleviating brain neural apoptosis in neonatal rats with HIBD.
Animals ; Animals, Newborn ; Apoptosis ; Caspase 3 ; metabolism ; Cord Blood Stem Cell Transplantation ; methods ; Female ; Hypoxia-Ischemia, Brain ; metabolism ; pathology ; therapy ; Male ; Neurons ; pathology ; Proto-Oncogene Proteins c-bcl-2 ; analysis ; Rats ; Rats, Sprague-Dawley ; bcl-2-Associated X Protein ; analysis
9.Progress on Hypoxic-ischemic Brain Damage Associated with CCR2 and CCL2.
Yu-jia LUO ; Ru-bo LI ; Shi-yu MA ; Meng-yan LÜ
Journal of Forensic Medicine 2016;32(1):54-57
		                        		
		                        			
		                        			Hypoxic-ischemic brain damage (HIBD) is referred to a common type of cerebral damage, which is caused by injury, leading to shallow bleeding in the cortex with intact cerebral pia mater. In recent years, studies show that a various kinds of immune cells and immune cellular factors are involved in the occurrence of HIBD. CC chemokine receptor 2 (CCR2) is a representative of CC chemokine receptor, and is widely distributed in cerebral neuron, astrocyte, and microglial cells, and is the main chemo-tactic factor receptor in brain tissue. CC chemokine ligand 2 (CCL2) is a kind of basophilic protein and the ligand of CCR2, and plays an important role in inflammation. In order to provide evidence for correlational studies in HIBD, this review will introduce the biological characteristics of CCR2 and CCL2, and illustrate the relationship between the immunoreactivity and HIBD.
		                        		
		                        		
		                        		
		                        			Animals
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		                        			Brain Injuries/pathology*
		                        			;
		                        		
		                        			Cerebral Cortex/physiopathology*
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		                        			Chemokine CCL2/metabolism*
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		                        			Chemokines, CC/metabolism*
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		                        			Hypoxia-Ischemia, Brain/metabolism*
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		                        			Macrophage Inflammatory Proteins/metabolism*
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		                        			RNA, Messenger/metabolism*
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		                        			Rats
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		                        			Rats, Sprague-Dawley
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		                        			Receptors, CCR2/metabolism*
		                        			
		                        		
		                        	
10.Effects of caffeine citrate on myelin basic protein in neonatal rats with hypoxic-ischemic brain damage.
Fa-Lin XU ; Hui-Qing CHENG ; Cai-Hong WANG ; Yan-Hua ZHANG ; Jia-Jia GUO
Chinese Journal of Contemporary Pediatrics 2015;17(9):984-988
OBJECTIVETo study the effects of caffeine citrate on myelin basic protein (MBP) expression in the cerebral white matter of neonatal rats with hypoxic-ischemic brain damage (HIBD) and the related mechanism.
METHODSForty-eight seven-day-old Sprague-Dawley neonatal rats were randomly assigned to 3 groups: sham operation (n=16), HIBD (n=16) and HIBD+caffeine citrate (n=16). The rats in the HIBD and HIBD+caffeine citrate groups were subjected to left common carotid artery ligation, and then were exposed to 80 mL/L oxygen and 920 mL/L nitrogen for 2 hours to induce HIBD. The rats in the sham operation group were only subjected to a sham operation, without the left common carotid artery ligation or hypoxia exposure. Caffeine citrate (20 mg/kg) was injected intraperitoneally before hypoxia ischemia (HI) and immediately, 24 hours, 48 hours and 72 hours after HI. The other two groups were injected intraperitoneally with an equal volume of normal saline at the corresponding time points. On postnatal day 12, the expression of MBP in the left subcortical white matter was detected by immunohistochemistry, and the levels of adenosine A1 receptor mRNA and A2a receptor mRNA in the left brain were detected by real-time PCR.
RESULTSThe expression of MBP in the left subcortical white matter in the HIBD group was lower than in the sham operation group (P<0.05). The MBP expression in the HIBD+caffeine citrate group was significantly higher than in the HIBD group, but was still lower than the sham operation group (P<0.05). Real-time PCR showed that the adenosine A1 receptor mRNA expression was significantly higher in the HIBD group than in the sham operation group, and it was significantly lower in the HIBD+caffeine citrate group than in the HIBD group (P<0.05).
CONCLUSIONSCaffeine citrate can improve brain white matter damage following HIBD in neonatal rats and the protection mechanism might be related with the down-regulation of adenosine A1 receptor expression.
Animals ; Animals, Newborn ; Caffeine ; pharmacology ; Citrates ; pharmacology ; Female ; Hypoxia-Ischemia, Brain ; drug therapy ; metabolism ; pathology ; Male ; Myelin Basic Protein ; analysis ; RNA, Messenger ; analysis ; Rats ; Rats, Sprague-Dawley ; Receptor, Adenosine A1 ; genetics ; Receptor, Adenosine A2A ; genetics ; White Matter ; chemistry
            
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