心肺复苏后脑缺血再灌注损伤治疗理念及相关动物模型研究进展

心肺复苏后脑缺血再灌注损伤是一个复杂的病理生理变化过程,由多种损伤机制共同参与。自心肺复苏后系统性综合治疗和亚低温治疗在临床上广泛应用后,目前已有多种治疗理念在不同的动物实验和动物模型基础上被提出,包括缺血预处理、药物预处理、缺血后处理、和药物后处理,而后吸入麻醉药对心肺复苏后脑缺血再灌注损伤的保护作用受到了人们的重视,而七氟烷后处理已经成为目前研究的热点之一。为了指导临床上的心肺复苏,人们一直在利用不同动物模型,探究不同保护方法,寻找有效的脑保护药物。而各种治疗理念的提出均是建立在动物实验和动物模型的基础上,窒息性心肺复苏模型模拟围术期气道梗阻,能较贴切的复制临床上由窒息引起的心肺复苏后脑损伤,对将来指导临床复苏具有重大意义。     

Diabetes, metallothionein, and zinc interactions: a review

Epidemiological evidence, associating diabetes with zinc (Zn) deficiencies, has resulted in numerous research studies describing the effects of Zn and associated metallothionein (MT), on reducing diabetic complications associated with oxidative stress. MT has been found to have a profound effect on the reduction of oxidative stress induced by the diabetic condition. Over expression of MT in various metabolic organs has also been shown to reduce hyperglycaemia-induced oxidative stress, organ specific diabetic complications, and DNA damage in diabetic experimental animals, which have been further substantiated by the results from MT-knockout mice. Additionally, supplementation with Zn has been shown to induce in vivo MT synthesis in experimental animals and to reduce diabetes related complications in both humans and animal models. Although the results are promising, some caution regarding this topic is however necessary, due to the fact that the majority of the studies done have been animal based. Hence more human intervention trials are needed regarding the positive effects of MT and Zn before firm conclusions can be made regarding their use in the treatment of diabetes.     

Protective effects of therapeutic hypothermia on renal injury in an asphyxial cardiac arrest rat model

Cardiac arrest (CA) is a leading cause of mortality worldwide. Most of post-resuscitation related deaths are due to post-cardiac arrest syndrome (PCAS). After cardiopulmonary resuscitation (CPR), return of spontaneous circulation (ROSC) leads to renal ischemia-reperfusion injury, also known as PCAS. Many studies have focused on brain and heart injuries after ROSC, but renal failure has largely been ignored. Therefore, we investigated the protective effects of therapeutic hypothermia (TH) on asphyxial CA-induced renal injury in rats.Thirty rats were randomly divided into five groups: 1) the control group (sham); 2) the normothermic CA (nor.); 3) a normothermic CA group that received TH immediately within 2 h after CPR (Hypo. 2 hrs); 4) a normothermic CA group that received TH within 4 h after CPR (Hypo. 4 hrs); and 5) a normothermia CA group that received TH within 6 h after CPR (Hypo. 6 h). One day after CPR, all rats were sacrificed. Compared with the normothermic CA group, the TH groups demonstrated significantly increased survival rate (P < 0.05); decreased serum blood urea nitrogen, creatinine, and lactate dehydrogenase levels; and lower histological damage degree and malondialdehyde concentration in their renal tissue. Terminal deoxynucleotidyl transferase dUTP nick end labeling stain revealed that the number of apoptotic cells significantly decreased after 4 h and 6 h of TH compared to the results seen in the normothermic CA group. Moreover, TH downregulated the expression of cyclooxygenase-2 in the renal cortex compared to the normothermic CA group one day after CPR. These results suggest that TH exerts anti-apoptotic, anti-inflammatory, and anti-oxidative effects immediately after ROSC that protect against renal injury.     

Mitochondrial DNA damage and repair in neurodegenerative disorders

By producing ATP and regulating intracellular calcium levels, mitochondria are vital for the function and survival of neurons. Oxidative stress and damage to mitochondrial DNA during the aging process can impair mitochondrial energy metabolism and ion homeostasis in neurons, thereby rendering them vulnerable to degeneration. Mitochondrial abnormalities have been documented in all of the major neurodegenerative disorders-Alzheimer's, Parkinson's and Huntington's diseases, and amyotrophic lateral sclerosis. Mitochondrial DNA damage and dysfunction may be downstream of primary disease processes such as accumulation of pathogenic proteins. However, recent experimental evidence demonstrates that mitochondrial DNA damage responses play important roles in aging and in the pathogenesis of neurodegenerative diseases. Therapeutic interventions that target mitochondrial regulatory systems have been shown effective in cell culture and animal models, but their efficacy in humans remains to be established.     

Effects of Mild Chronic Intermittent Cold Exposure on Rat Organs

Cold adaptation is a body''s protective response to cold stress. Mild chronic intermittent cold (CIC) exposure has been used to generate animal models for cold adaptation studies. However, the effects of mild CIC exposure on vital organs are not completely characterized. In the present study, we exposed rats to mild CIC for two weeks, and then measured the body weights, the weights of brown adipose tissue (BAT), the levels of ATP and reactive oxygen species (ROS) in the brains, livers, hearts, muscles and BATs. Rats formed cold adaptation after exposure to CIC for two weeks. Compared to rats of the control group that were hosted under ambient temperature, rats exposed to mild CIC showed a lower average body weight, but a higher weight of brown adipose tissue (BAT). Rats exposed to CIC for two weeks also exhibited higher levels of ATP and ROS in all examined organs as compared to those of the control group. In addition, we determined the expression levels of cold-inducible RNA binding protein (Cirbp) and thioredoxin (TRX) in rat tissues after 2 weeks of CIC exposure. Both Cirbp and TRX were increased, suggesting a role of these two proteins for establishment of cold adaptation. Together, this study reveals the effects of mild CIC exposure on vital organs of rats during CIC exposure.     

Cerebral Tissue Oxidative Ischemia-Reperfusion Injury in Connection with Experimental Cardiac Arrest and Cardiopulmonary Resuscitation: Effect of Mild Hypothermia and Methylene Blue

The present investigation is an expansion of previous studies which all share a basic experimental protocol of a porcine-induced cardiac arrest (CA) of 12 min followed by 8 min of cardiopulmonary resuscitation (CPR), different experimental treatments (immediate as well as postponed induced mild hypothermia and administration of much or less cool intravenous fluids), and a follow-up period of 3 h after which the animals were sacrificed. Another group of animals was studied according to the same protocol after 12-min CA and “standard CPR.” After death (within 1 min), the brains were harvested and frozen in liquid nitrogen awaiting analysis. Control brains of animals were collected in the same way after short periods of untreated CA (0 min, 5 min, and 15–30 min). Previous studies concerning chiefly neuropathological changes were now expanded with analyses of different tissue indicators (glutathione, luminol, leucigenin, malonialdehyde, and myeloperoxidase) of cerebral oxidative injury. The results indicate that a great part of oxidative injury occurs within the first 5 min after CA. Immediate cooling by administration of much intravenous fluid results in less cerebral oxidative injury compared to less intravenous fluid administration. A 30-min postponement of induction of hypothermia results in a cerebral oxidative injury comparable to that of “standard CPR” or the oxidative injury found after 5 min of untreated CA. Intravenous administration of methylene blue (MB) during and immediately after CPR in combination with postponed cooling resulted in no statistical difference in any of the indicators of oxidative injury, except myeloperoxidase, and glutathione, when this treatment was compared with the negative controls, i.e., animals subjected to anesthesia alone.     

BR-TRG-Ⅰ型体腔热灌注治疗系统安全性评估的动物实验

目的探讨应用BR-TRG-I型体腔热灌注治疗系统进行持续循环腹腔热灌注治疗（continuous circulatory hyperthermic intraperitoneal perfusion treatment,CCHIP）对实验动物的生命体征、肝肾功能及内脏器官病理形态的影响。方法选用家猪作为实验动物,应用BR-TRG-I型体腔热灌注治疗系统建立CCHIP动物模型,分别用44℃、45℃的设定温度进行CCHIP。在CCHIP期间记录实验动物的生命体征变化;CCHIP前及治疗后1d、3d、7d和14d抽取外周血液保存备检;CCHIP结束后即刻及2周后处死动物,观察内脏器官的大体形态学改变,切取肝、肾、小肠等器官进行病理检查。结果44℃CCHIP持续1.5h对猪的生命体征、肝肾功能无明显影响,肝、肾、小肠等脏器损伤较轻,2周后恢复正常;45℃CCHIP持续1.5h对猪的生命体征影响严重,肝肾功能损害持续2周尚不能恢复正常,肝、肾、小肠等脏器病理损伤明显。结论44℃温度CCHIP1.5h安全可行,可以作为CCHIP的安全温度;45℃温度CCHIP1.5h可对实验动物肝肾功能造成严重损害,不适合作为CCHIP的治疗温度。     

Cellular senescence in the aging and diseased kidney

The program of cellular senescence is involved in both the G1 and G2 phase of the cell cycle, limiting G1/S and G2/M progression respectively, and resulting in prolonged cell cycle arrest. Cellular senescence is involved in normal wound healing. However, multiple organs display increased senescent cell numbers both during natural aging and after injury, suggesting that senescent cells can have beneficial as well as detrimental effects in organismal aging and disease. Also in the kidney, senescent cells accumulate in various compartments with advancing age and renal disease. In experimental studies, forced apoptosis induction through the clearance of senescent cells leads to better preservation of kidney function during aging. Recent groundbreaking studies demonstrate that senescent cell depletion through INK-ATTAC transgene-mediated or cell-penetrating FOXO4-DRI peptide induced forced apoptosis, reduced age-associated damage and dysfunction in multiple organs, in particular the kidney, and increased performance and lifespan. Senescence is also involved in oncology and therapeutic depletion of senescent cells by senolytic drugs has been studied in experimental and human cancers. Although studies with senolytic drugs in models of kidney injury are lacking, their dose limiting side effects on other organs suggest that targeted delivery might be needed for successful application of senolytic drugs for treatment of kidney disease. In this review, we discuss (i) current understanding of the mechanisms and associated pathways of senescence, (ii) evidence of senescence occurrence and causality with organ injury, and (iii) therapeutic strategies for senescence depletion (senotherapy) including targeting, all in the context of renal aging and disease.     

Update on animal models of diabetic retinopathy: from molecular approaches to mice and higher mammals

Diabetic retinopathy (DR) is the most common microvascular complication of diabetes and one of the major causes of blindness worldwide. The pathogenesis of DR has been investigated using several animal models of diabetes. These models have been generated by pharmacological induction, feeding a galactose diet, and spontaneously by selective inbreeding or genetic modification. Among the available animal models, rodents have been studied most extensively owing to their short generation time and the inherited hyperglycemia and/or obesity that affect certain strains. In particular, mice have proven useful for studying DR and evaluating novel therapies because of their amenability to genetic manipulation. Mouse models suitable for replicating the early, non-proliferative stages of the retinopathy have been characterized, but no animal model has yet been found to demonstrate all of the vascular and neural complications that are associated with the advanced, proliferative stages of DR that occur in humans. In this review, we summarize commonly used animal models of DR, and briefly outline the in vivo imaging techniques used for characterization of DR in these models. Through highlighting the ocular pathological findings, clinical implications, advantages and disadvantages of these models, we provide essential information for planning experimental studies of DR that will lead to new strategies for its prevention and treatment.     

The challenge of translating ischemic conditioning from animal models to humans: the role of comorbidities

Following a period of ischemia (local restriction of blood supply to a tissue), the restoration of blood supply to the affected area causes significant tissue damage. This is known as ischemia-reperfusion injury (IRI) and is a central pathological mechanism contributing to many common disease states. The medical complications caused by IRI in individuals with cerebrovascular or heart disease are a leading cause of death in developed countries. IRI is also of crucial importance in fields as diverse as solid organ transplantation, acute kidney injury and following major surgery, where post-operative organ dysfunction is a major cause of morbidity and mortality. Given its clinical impact, novel interventions are urgently needed to minimize the effects of IRI, not least to save lives but also to reduce healthcare costs. In this Review, we examine the experimental technique of ischemic conditioning, which entails exposing organs or tissues to brief sub-lethal episodes of ischemia and reperfusion, before, during or after a lethal ischemic insult. This approach has been found to confer profound tissue protection against IRI. We discuss the translation of ischemic conditioning strategies from bench to bedside, and highlight where transition into human clinical studies has been less successful than in animal models, reviewing potential reasons for this. We explore the challenges that preclude more extensive clinical translation of these strategies and emphasize the role that underlying comorbidities have in altering the efficacy of these strategies in improving patient outcomes.KEY WORDS: Comorbidities, Ischemic postconditioning, Ischemic preconditioning, Remote ischemic preconditioning     

Mechanisms of leukocyte-mediated tissue injury induced by interleukin-2

In this review we discuss the effects of interleukin-2 (IL-2) therapy on trafficking of leukocytes and platelets to normal organs. The use of animal models has allowed the elucidation of events leading to damage and/or dysfunction of normal tissues after IL-2 administration. These studies have shown that acute toxicity induced by IL-2 is mediated primarily by neutrophils. Chronic toxicity results from the adhesion and transmigration of activated lymphocytes into normal organs. Platelet-derived microvascular thrombosis also contributes to the vascular toxicity of IL-2. A better understanding of these mechanisms may lead to the development of interventions that will significantly improve the therapeutic efficacy of IL-2. Received: 22 August 1998 / Accepted: 16 October 1998     

2月龄和4月龄大鼠制备心肺复苏模型后神经功能评价及亚组评分的比较

目的：本研究旨在选择适合的大鼠,对比2月龄大鼠与4月龄大鼠CPR后神经功能评分及亚组评分,摸索利用不同月龄的大鼠CPR的可行性。方法通过严格监测SD大鼠制备模型过程中的心电、血压生理指标、测定各组大鼠不同时间点的神经功能缺失评分以及神经功能亚组评分、对比制备4月龄和2月龄大鼠心肺复苏模型的稳定性。结果电刺激致室颤,4月龄组大鼠的成模率为87.5％,远高于2月龄组大鼠,而死亡率无差异;在电刺激诱发CA过程中造成的血压变化,4月龄组大鼠明显低于2月龄组大鼠,存在极显著性差异（ P ＜0.01）;4月龄组大鼠与2月龄组大鼠CPR后各时间点的神经功能评分无统计学差异,而4月龄组大鼠与2月龄组大鼠的神经功能亚组评分在不同时间点,存在显著差异（P ＜0.05）,4月龄大鼠与2月龄大鼠对比,心肺复苏后脑损伤的程度加重。结论4月龄大鼠更适合制备心肺复苏模型,该月龄组的大鼠制备模型成模率高,脑损伤程度重,更适合于用于心肺复苏的基础研究及治疗评价。     

Increased oxidative stress during hyperglycemic cerebral ischemia

In this review, we summarize the role of hyperglycemia during cerebral ischemia. Hyperglycemia occurring during experimental and clinical stroke has been associated with increased cerebral damage. Increased oxidative stress resulting from hyperglycemia is believed to contribute to the exacerbated damage. More specifically, superoxide, nitric oxide and peroxynitrite are believed to play an important role in cerebral damage. This also involves increased recruitment of various blood cells to the ischemic zone that contribute to inflammation. We present data from our group and others that demonstrate that free radical production is increased during hyperglycemic stroke in rodents. Recent data suggest that inflammation is an important component of ischemic damage under both normo- and hyperglycemic conditions. We summarize numerous studies that indicate that a variety of antioxidant (inhibition of free radical production, scavenging of free radicals and increasing free radical degradation) and anti-inflammatory strategies decrease cerebral infarction. Finally, we compare the success of some of these strategies in clinical trials compared to the animal models.     

In vivo biodistribution of stem cells using molecular nuclear medicine imaging

Studies on stem cell are rapidly developing since these cells have great therapeutic potential for numerous diseases and has generated much promise as well as confusion due to contradictory results. Major questions in this research field have been raised as to how and in which numbers stem cells home to target tissues after administration, whether the cells engraft and differentiate, and what their long-term fate is. To answer these questions, reliable in vivo tracking techniques are essential. In vivo molecular imaging techniques using magnetic resonance imaging, bioluminescence, and scintigraphy have been applied for this purpose in experimental studies. The aim of this review is to discuss various radiolabeling techniques for early stem cell tracking, the need for validation of viability and performance of the cells after labeling, and the routes of administration in experimental animal models. In addition, we evaluate current problems and directions related to stem cell tracking using radiolabels, including a possible role for their clinical implementation.     

Asthma, the ugly duckling of lung disease proteomics?

The human respiratory system represents a vital but vulnerable system. It is a major target for many diseases such as cancer and asthma. The incidence of these diseases has increased dramatically in the last 40-50 years. In the search for possible new therapies, many experimental tools and methods have been developed to study these diseases, ranging from animal models to in vitro studies. In the last decades, genomic and proteomic approaches have gained a lot of attention. After the major scientific breakthroughs in the field of genomics, it is now widely accepted that to understand biological processes, large-scale protein studies through proteomics techniques are required. In the battle against lung cancer, the proteomics approach has already been successfully implemented. Surprisingly, only a few proteomics studies on the ever-increasing global asthma problem have been published so far. And although proteomics also has its limitations and experimental difficulties, in our opinion, proteomics can definitely contribute to the understanding of a complex disease such as asthma. Therefore, the additional values and possibilities of proteomics in asthma research should be thoroughly investigated. A close collaboration between the different scientific disciplines may eventually lead to the development of new therapeutic strategies against asthma.     

Nitrones as therapeutics

Nitrones have the general chemical formula X-CH=NO-Y. They were first used to trap free radicals in chemical systems and then subsequently in biochemical systems. More recently several nitrones, including alpha-phenyl-tert-butylnitrone (PBN), have been shown to have potent biological activity in many experimental animal models. Many diseases of aging, including stroke, cancer development, Parkinson disease, and Alzheimer disease, are known to have enhanced levels of free radicals and oxidative stress. Some derivatives of PBN are significantly more potent than PBN and have undergone extensive commercial development for stroke. Recent research has shown that PBN-related nitrones also have anti-cancer activity in several experimental cancer models and have potential as therapeutics in some cancers. Also, in recent observations nitrones have been shown to act synergistically in combination with antioxidants in the prevention of acute acoustic-noise-induced hearing loss. The mechanistic basis of the potent biological activity of PBN-related nitrones is not known. Even though PBN-related nitrones do decrease oxidative stress and oxidative damage, their potent biological anti-inflammatory activity and their ability to alter cellular signaling processes cannot readily be explained by conventional notions of free radical trapping biochemistry. This review is focused on our studies and others in which the use of selected nitrones as novel therapeutics has been evaluated in experimental models in the context of free radical biochemical and cellular processes considered important in pathologic conditions and age-related diseases.     

Glutamate Excitoxicity Is the Key Molecular Mechanism Which Is Influenced by Body Temperature during the Acute Phase of Brain Stroke

Glutamate excitotoxicity, metabolic rate and inflammatory response have been associated to the deleterious effects of temperature during the acute phase of stroke. So far, the association of temperature with these mechanisms has been studied individually. However, the simultaneous study of the influence of temperature on these mechanisms is necessary to clarify their contributions to temperature-mediated ischemic damage. We used non-invasive Magnetic Resonance Spectroscopy to simultaneously measure temperature, glutamate excitotoxicity and metabolic rate in the brain in animal models of ischemia. The immune response to ischemia was measured through molecular serum markers in peripheral blood. We submitted groups of animals to different experimental conditions (hypothermia at 33°C, normothermia at 37°C and hyperthermia at 39°C), and combined these conditions with pharmacological modulation of glutamate levels in the brain through systemic injections of glutamate and oxaloacetate. We show that pharmacological modulation of glutamate levels can neutralize the deleterious effects of hyperthermia and the beneficial effects of hypothermia, however the analysis of the inflammatory response and metabolic rate, demonstrated that their effects on ischemic damage are less critical than glutamate excitotoxity. We conclude that glutamate excitotoxicity is the key molecular mechanism which is influenced by body temperature during the acute phase of brain stroke.     

Molecular genetic system for regenerative studies using newts

Urodele newts have the remarkable capability of organ regeneration, and have been used as a unique experimental model for more than a century. However, the mechanisms underlying regulation of the regeneration are not well understood, and gene functions in particular remain largely unknown. To elucidate gene function in regeneration, molecular genetic analyses are very powerful. In particular, it is important to establish transgenic or knockout (mutant) lines, and systematically cross these lines to study the functions of the genes. In fact, such systems have been developed for other vertebrate models. However, there is currently no experimental model system using molecular genetics for newt regenerative research due to difficulties with respect to breeding newts in the laboratory. Here, we show that the Iberian ribbed newt (Pleurodeles waltl) has outstanding properties as a laboratory newt. We developed conditions under which we can obtain a sufficient number and quality of eggs throughout the year, and shortened the period required for sexual maturation from 18 months to 6 months. In addition, P. waltl newts are known for their ability, like other newts, to regenerate various tissues. We revealed that their ability to regenerate various organs is equivalent to that of Japanese common newts. We also developed a method for efficient transgenesis. These studies demonstrate that P. waltl newts are a suitable model animal for analysis of regeneration using molecular genetics. Establishment of this experimental model will enable us to perform comparable studies using these newts and other vertebrate models.     

Effects of cadmium acetate contaminated drinking water on vital organs: A histopathological and biochemical study

Cadmium (Cd) is a heavy metal with various human exposure sources. It accumulates in the liver, forming a complex with metallothionein protein and progresses to other organs. As a heavy metal, cadmium can replace calcium and other divalent ions and disturb their cascades, ultimately affecting the vital organs. Since cadmium acetate (CA) is considered more lethal than other Cd compounds, the current study examines the effect of different concentrations of CA doses in drinking water for different exposure times in murine models (Mus musculus). After the exposure period, the murine models were then examined histopathologically and biochemically. The histopathological examination of the heart, liver, and kidneys of the experimental group showed extensive degenerative effects. Atomic absorption spectroscopy was used to determine the quantity of cadmium in serum, kidney, and hepatic tissues. Sodium dodecyl sulfate-polyacrylamide gel electrophoresis analysis of hepatic proteins, especially metallothionein, directly related to Cd administration. The biochemical parameters, including creatine kinase, alanine aminotransferase, aspartate aminotransferase, total proteins, glucose, urea, uric acid, and creatinine, were also analyzed. After thorough histochemical and biochemical analysis, it was concluded that even low dose exposure of CA is hazardous to murine models with damaging effects.     

Metabolic considerations and cellular mechanism related to calcium's antihypertensive effects

Whether maintenance of normal calcium homeostasis can afford protection against the development of hypertension in humans has emerged as a controversial area of both clinical and basic cardiovascular disease research. The data that have provoked this debate are derived from epidemiological reports, human studies, animal investigations, and cellular research. Ten published reports have identified an association between greater dietary calcium consumption and lower blood pressure in humans. In both humans and experimental animals with hypertension, several end-organ defects have been identified that are consistent with an inability to maintain external calcium balance. With the provision of supplemental dietary calcium, both humans and experimental models with high blood pressure have reduced their blood pressure. A variety of membrane-associated defects of Ca2+-ATPase-dependent calcium transport have been identified in cells derived from multiple organs of both the hypertensive animal and human. These abnormalities of cellular calcium handling could account for the failure of the hypertensive subject to appropriately defend its calcium balance. More important, they provide a theoretical mechanism by which calcium, interacting with calmodulin, might favorably modify vascular smooth muscle function and, thereby, peripheral vascular resistance.