The potential therapeutic effect of guanosine after cortical focal ischemia in rats

Background and Purpose: Stroke is a devastating disease. Both excitotoxicity and oxidative stress play important roles in ischemic brain injury, along with harmful impacts on ischemic cerebral tissue. As guanosine plays an important neuroprotective role in the central nervous system, the purpose of this study was to evaluate the neuroprotective effects of guanosine and putative cerebral events following the onset of permanent focal cerebral ischemia. Methods: Permanent focal cerebral ischemia was induced in rats by thermocoagulation. Guanosine was administered immediately, 1 h, 3 h and 6 h after surgery. Behavioral performance was evaluated by cylinder testing for a period of 15 days after surgery. Brain oxidative stress parameters, including levels of ROS/RNS, lipid peroxidation, antioxidant nonenzymatic levels (GSH, vitamin C) and enzymatic parameters (SOD expression and activity and CAT activity), as well as glutamatergic parameters (EAAC1, GLAST and GLT1, glutamine synthetase) were analyzed. Results: After 24 h, ischemic injury resulted in impaired function of the forelimb, caused brain infarct and increased lipid peroxidation. Treatment with guanosine restored these parameters. Oxidative stress markers were affected by ischemic insult, demonstrated by increased ROS/RNS levels, increased SOD expression with reduced SOD activity and decreased nonenzymatic (GSH and vitamin C) antioxidant defenses. Guanosine prevented increased ROS/RNS levels, decreased SOD activity, further increased SOD expression, increased CAT activity and restored vitamin C levels. Ischemia also affected glutamatergic parameters, illustrated by increased EAAC1 levels and decreased GLT1 levels; guanosine reversed the decreased GLT1 levels and did not affect the EAAC1 levels. Conclusion: The effects of brain ischemia were strongly attenuated by guanosine administration. The cellular mechanisms involved in redox and glutamatergic homeostasis, which were both affected by the ischemic insult, were also modulated by guanosine. These observations reveal that guanosine may represent a potential therapeutic agent in cerebral ischemia by preventing oxidative stress and excitotoxicity

Elevated glutamate and lactate predict brain death after severe head trauma

Objective: Clinical neurological assessment is challenging for severe traumatic brain injury (TBI) patients in the acute setting. Waves of neurochemical abnormalities that follow TBI may serve as fluid biomarkers of neurological status. We assessed the cerebrospinal fluid (CSF) levels of glutamate, lactate, BDNF, and GDNF, to identify potential prognostic biomarkers of neurological outcome. Methods: This cross-sectional study was carried out in a total of 20 consecutive patients (mean [SD] age, 29 [13] years; M/F, 9:1) with severe TBI Glasgow Coma Scale ≤ 8 and abnormal computed tomography scan on admission. Patients were submitted to ventricular drainage and had CSF collected between 2 and 4 h after hospital admission. Patients were then stratified according to two clinical outcomes: deterioration to brain death (nonsurvival, n = 6) or survival (survival, n = 14), within 3 days after hospital admission. CSF levels of brain-derived substances were compared between nonsurvival and survival groups. Clinical and neurological parameters were also assessed. Results: Glutamate and lactate are significantly increased in nonsurvival relative to survival patients. We tested the accuracy of both biomarkers to discriminate patient outcome. Setting a cutoff of >57.75, glutamate provides 80.0% of sensitivity and 84.62% of specificity (AUC: 0.8214, 95% CL: 54.55–98.08%; and a cutoff of >4.65, lactate has 100% of sensitivity and 85.71% of specificity (AUC: 0.8810, 95% CL: 54.55–98.08%). BDNF and GDNF did not discriminate poor outcome. Interpretation: This early study suggests that glutamate and lactate concentrations at hospital admission accurately predict death within 3 days after severe TBI

Therapeutic potential of the novel hybrid molecule JM-20 against focal cortical ischemia in rats

Context: Despite the great mortality and morbidity of stroke, treatment options remain limited. We previously showed that JM-20, a novel synthetic molecule, possessed a strong neuroprotective effect in rats subjected to transient middle cerebral artery occlusion. However, to verify the robustness of the pre-clinical neuroprotective effects of JM-20 to get good prognosis in the translation to the clinic, it is necessary to use other experimental models of brain ischemia. Aims: To evaluate the neuroprotective effects of JM-20 following the onset of permanent focal cerebral ischemia induced in rats by thermocoagulation of blood into pial blood vessels of cerebral cortices. Methods: Ischemic lesion was induced by thermocoagulation of blood into pial blood vessels of primary motor and somatosensory cortices. Behavioral performance was evaluated by the cylinder testing for a period of 2, 3 and 7 days after surgery, and was followed by histopathological study in brain cortex stained with hematoxylin- eosin. Results: Ischemic injury resulted in impaired function of the forelimb evidenced by high asymmetry punctuation, and caused histopathological alterations indicative of tissue damage at cerebral cortex. JM-20 treatment (4 and 8 mg/kg) significantly decreased asymmetry scores and histological alterations with a marked preservation of cortical neurons. Conclusions: The effects of permanent brain ischemia were strongly attenuated by JM-20 administration, which expands and improves the current preclinical data of JM-20 as neuroprotector against cerebral ischemia, and strongly support the examination of its translation to the clinic to treat acute ischemic stroke

Avaliação de parâmetros neuroquímicos em fatias de hipocampo de rato submetidas à privação de oxigênio e glicose

Mesmo a isquemia sendo a terceira causa de morte em países industrializados, os mecanismos relacionados a esta doença ainda continuam polêmicos e obscuros. Utilizou-se a técnica de privação de oxigênio e glicose (OGD) em fatias do hipocampo de rato para investigar parâmetros mitocondriais, neurais, astrogliais e metabólicos no período de isquemia e durante o período de reoxigenação. Os resultados mostraram uma diminuição na atividade mitocondrial durante o período isquêmico que foi mantido durante todo o período de reoxigenação. Analisando o sobrenadante destas fatias submetidas à OGD, foi observado que os níveis de LDH, NSE e GFAP se elevaram. Com relação aos níveis de lactato, verificou-se sua diminuição durante todos os períodos. Os níveis de S100B estavam elevados somente durante o período de reoxigenação. Este aumento pode ser tanto um mecanismo de neuroproteção desta proteína frente ao insulto ou ainda uma liberação por dano celular astrocitário. Além disso, foi observado um grande aumento nos níveis de glutamato durante a isquemia e este aumento retornou no período de reoxigenação. Por fim, houve uma diminuição na captação de glutamato somente no período de reoxigenação. Todos estes resultados podem ser conseqüência de uma hiper-estimulação dos receptores glutamatérgicos devido ao insulto isquêmico. Em resumo, nosso estudo mostrou alterações em diversos parâmetros neuroquímicos específicos tanto no período isquêmico quanto na reoxigenação, mostrando que cada tipo celular, reage diferentemente frente ao insulto isquêmico na técnica de OGD in vitro.Stroke is the third cause of mortality in industrialized countries, and the mechanisms related to this disease are polemic and unclear. Oxygen and glucose deprivation (OGD) in acute rat hippocampal slices was performed to investigate mitochondrial, neural, astroglial and metabolic neurochemical parameters at different ischemic and reoxygenation periods. Results showed the mitochondrial activity decrease due energy failure during ischemic insult and reoxygenation time. In the supernatant medium, LDH, NSE and glutamate levels were increased and the lactate decrease by the lack of energy observed in the ischemic period. Parameters such as GFAP, S100B and glutamate uptake suffered alterations only at the reoxygenation period. These results have shown the vulnerability of neurons facing ischemic insult. Meanwhile, it was also observed a delayed injure of astrocytes only at reoxygenation time, which demonstrate the difference between cell types at OGD. In summary, our finding has shown altered at specific neurochemical parameters in OGD in vitro which features the ischemic episodes and reoxygenation periods

Efeitos neuroprotetores da guanosina e da inosina frente às ações neurotóxicas da isquemia cerebral in vivo

A isquemia cerebral é uma doença grave, sendo a segunda causa mais comum de morte e a principal causa de incapacidade em todo o mundo. A redução repentina do fluxo sanguíneo cerebral leva à diminuição do fornecimento de oxigênio e de glicose, resultando em uma falha no metabolismo energético cerebral. Este desequilíbrio no metabolismo energético é claramente o elemento chave no processo isquêmico, resultando em danos celulares e comprometimento das funções neurológicas. A excitotoxicidade glutamatérgica, o estresse oxidativo e processo inflamatório desempenham papéis importantes na lesão cerebral isquêmica, levando a danos teciduais que comprometem a integridade do tecido durante a isquemia. A guanosina e a inosina são conhecidas por desempenhar um papel neuroproteção ao sistema nervoso central, agindo como um modulador negativo do sistema glutamatérgico e possuindo efeitos tróficos em células neurais. Desta forma, nesta tese, avaliaram-se diversos mecanismos que são modulados pela guanosina e inosina em modelos experimentais de isquemia cerebral in vivo. Inicialmente, demonstrou-se que a guanosina é efetiva na neuroproteção contra a isquemia cerebral focal em ratos, causando redução de danos neuronais e astrogliais, diminuindo a peroxidação lipídica e o volume de enfarte cerebral e, consequentemente, recuperando a função motora do membro anterior debilitado pela isquemia. Esta neuroproteção estaria envolvida na manutenção do ambiente redox celular, na modulação da resposta inflamatória e na modulação do sistema glutamatérgico, mecanismos ligados à lesão isquêmica. A isquemia cerebral causou um aumento do número total de células micróglias e também uma maior ativação destas células, efeito inibido pela administração de guanosina. Nesta tese, também investigamos os efeitos agudos relacionados à neuroproteção da administração de guanosina e de inosina como reposição volêmica em um modelo de choque hemorrágico (que, potencialmente, diminui a perfusão sanguínea cerebral) em suínos. A guanosina e a inosina foram capazes de diminuir os níveis de glutamato mais rapidamente do que o controle e de modular o ambiente de citocinas pró-inflamatórias, diminuindo os níveis de IL-1β e TNF-α (apenas inosina) após choque hemorrágico. Esta supressão pode estar associada com diminuição na morte neuronal tardia, o que implicaria em uma melhora no prejuízo cognitivo que ocorre choque hemorrágico. No geral, nosso trabalho representa uma importante contribuição para o conhecimento sobre os possíveis mecanismos neuroprotetores da guanosina e da inosina em modelos de isquemia cerebral.Cerebral ischemia is a devastating disease, being the second most common cause of death and the major cause of disability worldwide. The sudden reduction in cerebral blood flow leads to decreased oxygen and glucose supplies, resulting in a failure of cellular bioenergetics. Disruption of brain energetics metabolism is clearly a key element in stroke, resulting in cellular damage and impairment of neurological functions. Glutamate excitotoxicity, oxidative stress and neuroinflammation play important roles in ischemic brain injury, with harmful impacts on ischemic cerebral tissue. As guanosine and inosine play an important neuroprotective role in the central nervous system, exerting glutamatergic system antagonism and trophic effects on neural cells, in this study, it was evaluated the neuroprotective effects of guanosine and inosine against in vivo cerebral ischemia models. Initially, we demonstrated that guanosine was neuroprotective against cerebral focal ischemia in rats causing reduction of neuronal and astroglial damage, decreasing lipid peroxidation and cerebral infarct volume, and consequently recovery in the function of impaired forelimb. These neuroprotection could be involved in the maintenance of the cellular redox environment, modulating the inflammatory response and the glutamatergic systems. Furthermore, ischemia increased the total number of microglial cells, and changed the morphological characteristics. These effects were inhibited by guanosine treatment. Additionally, it was also investigated the acute neuroprotective effects of guanosine and inosine as a fluid resuscitation in a model of hemorrhagic shock in swines. The treatment with guanosine or inosine was able to decrease glutamate levels faster than control group and also was able to modulate the proinflammatory cytokines environment, decreasing IL-1β and TNF-α (only inosine) levels after hemorrhagic shock. These effects could be associated with reduction delayed neuronal cell damage, improving cognitive impairment that occurs in hemorrhagic shock. Overall, our work represents an important contribution to the knowledge regarding the putative neuroprotective mechanisms of guanosine and inosine in cerebral ischemia models

Avaliação de parâmetros neuroquímicos em fatias de hipocampo de rato submetidas à privação de oxigênio e glicose

Mesmo a isquemia sendo a terceira causa de morte em países industrializados, os mecanismos relacionados a esta doença ainda continuam polêmicos e obscuros. Utilizou-se a técnica de privação de oxigênio e glicose (OGD) em fatias do hipocampo de rato para investigar parâmetros mitocondriais, neurais, astrogliais e metabólicos no período de isquemia e durante o período de reoxigenação. Os resultados mostraram uma diminuição na atividade mitocondrial durante o período isquêmico que foi mantido durante todo o período de reoxigenação. Analisando o sobrenadante destas fatias submetidas à OGD, foi observado que os níveis de LDH, NSE e GFAP se elevaram. Com relação aos níveis de lactato, verificou-se sua diminuição durante todos os períodos. Os níveis de S100B estavam elevados somente durante o período de reoxigenação. Este aumento pode ser tanto um mecanismo de neuroproteção desta proteína frente ao insulto ou ainda uma liberação por dano celular astrocitário. Além disso, foi observado um grande aumento nos níveis de glutamato durante a isquemia e este aumento retornou no período de reoxigenação. Por fim, houve uma diminuição na captação de glutamato somente no período de reoxigenação. Todos estes resultados podem ser conseqüência de uma hiper-estimulação dos receptores glutamatérgicos devido ao insulto isquêmico. Em resumo, nosso estudo mostrou alterações em diversos parâmetros neuroquímicos específicos tanto no período isquêmico quanto na reoxigenação, mostrando que cada tipo celular, reage diferentemente frente ao insulto isquêmico na técnica de OGD in vitro.Stroke is the third cause of mortality in industrialized countries, and the mechanisms related to this disease are polemic and unclear. Oxygen and glucose deprivation (OGD) in acute rat hippocampal slices was performed to investigate mitochondrial, neural, astroglial and metabolic neurochemical parameters at different ischemic and reoxygenation periods. Results showed the mitochondrial activity decrease due energy failure during ischemic insult and reoxygenation time. In the supernatant medium, LDH, NSE and glutamate levels were increased and the lactate decrease by the lack of energy observed in the ischemic period. Parameters such as GFAP, S100B and glutamate uptake suffered alterations only at the reoxygenation period. These results have shown the vulnerability of neurons facing ischemic insult. Meanwhile, it was also observed a delayed injure of astrocytes only at reoxygenation time, which demonstrate the difference between cell types at OGD. In summary, our finding has shown altered at specific neurochemical parameters in OGD in vitro which features the ischemic episodes and reoxygenation periods