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The Journal of Neuroscience, July 1, 2001, 21(13):4582-4592
Neuroprotection from Delayed Postischemic Administration of a
Metalloporphyrin Catalytic Antioxidant
G. Burkhard
Mackensen1,
Manisha
Patel2,
Huaxin
Sheng1,
Carla L.
Calvi1,
Ines
Batini
-Haberle3,
Brian J.
Day2,
Li Ping
Liang2,
Irwin
Fridovich3,
James D.
Crapo2,
Robert D.
Pearlstein4, and
David S.
Warner1, 4
1 Department of Anesthesiology, Duke University Medical
Center, Durham, North Carolina 27710, 2 Department of
Medicine, National Jewish Medical and Research Center, Denver, Colorado
80206, and Departments of 3 Biochemistry and
4 Surgery, Duke University Medical Center, Durham, North
Carolina 27710
 |
ABSTRACT |
Reactive oxygen species contribute to ischemic brain injury. This
study examined whether the porphyrin catalytic antioxidant manganese
(III) meso-tetrakis
(N-ethylpyridinium-2-yl)porphyrin (MnTE-2-PyP5+) reduces oxidative stress and improves
outcome from experimental cerebral ischemia. Rats that were subjected
to 90 min focal ischemia and 7 d recovery were given
MnTE-2-PyP5+ (or vehicle) intracerebroventricularly
60 min before ischemia, or 5 or 90 min or 6 or 12 hr after reperfusion.
Biomarkers of brain oxidative stress were measured at 4 hr after
postischemic treatment (5 min or 6 hr).
MnTE-2-PyP5+, given 60 min before ischemia, improved
neurologic scores and reduced total infarct size by 70%.
MnTE-2-PyP5+, given 5 or 90 min after reperfusion,
reduced infarct size by 70-77% and had no effect on temperature.
MnTE-2-PyP5+ treatment 6 hr after ischemia reduced
total infarct volume by 54% (vehicle, 131 ± 60 mm3; MnTE-2-PyP5+, 300 ng,
60 ± 68 mm3). Protection was observed
in both cortex and caudoputamen, and neurologic scores were improved.
No MnTE-2-PyP5+ effect was observed if it was given
12 hr after ischemia. MnTE-2-PyP5+ prevented
mitochondrial aconitase inactivation and reduced
8-hydroxy-2'-deoxyguanosine formation when it was given 5 min or 6 hr
after ischemia. In mice, MnTE-2-PyP5+ reduced
infarct size and improved neurologic scores when it was given
intravenously 5 min after ischemia. There was no effect of 150 or 300 ng of MnTE-2-PyP5+ pretreatment on selective
neuronal necrosis resulting from 10 min forebrain ischemia and 5 d
recovery in rats. Administration of a metalloporphyrin catalytic
antioxidant had marked neuroprotective effects against focal ischemic
insults when it was given up to 6 hr after ischemia. This was
associated with decreased postischemic superoxide-mediated oxidative stress.
Key words:
free radical; superoxide; brain; ischemia; metalloporphyrin; rat; mouse; mimetic
 |
INTRODUCTION |
Increased superoxide anion
(O
) formation is a component of acute brain
injury. Focal cerebral ischemia (Fabian et al., 1995
; Peters et al.,
1998
) and traumatic brain injury (Kontos and Wei, 1986
) cause a
sustained increase in the formation of O
.
Indirect evidence for a sustained increase in reactive oxygen species
production in injured brain has also been derived from use of
salicylate hydroxyl radical trap microdialysis techniques after global
ischemia (Globus et al., 1995a
) and head injury (Globus et al., 1995b
) in the rat. Evidence for significant increases in
O
has been found as late as 3-4 d after
global ischemia in the gerbil (Yamaguchi et al., 1998
).
The significance of increased O
production in
the pathogenesis and evolution of acute brain injury has not been
resolved. Numerous studies have investigated the therapeutic efficacy
of antioxidant compounds in both animal models and humans (Forsman et
al., 1988
; Matsumiya et al., 1991
; Uyama et al., 1992
; Muizelaar et
al., 1993
). Results have been mixed, and issues of bioavailability of
the various compounds have not been resolved (Haun et al., 1991
).
Consequently, early enthusiasm for use of antioxidants to treat acute
brain injury diminished.
Recently, however, interest in the role of antioxidants in ischemic
brain injury has been renewed by results of studies involving murine
mutants. Upregulation of synthesis of the different superoxide dismutase (SOD) isoenzymes has been shown to substantively reduce global (Murakami et al., 1997
; Sheng et al., 2000
) and focal (Yang et
al., 1994
; Sheng et al., 1999b
) ischemic injury and traumatic brain
injury (Mikawa et al., 1996
; Pineda et al., 2001
). Consistent with this, targeted deletion of the genetic codes for Cu,Zn-SOD and
extracellular SOD (EC-SOD) worsens outcome from focal ischemia (Kondo
et al., 1997
; Sheng et al., 1999a
). These data, in conjunction with
data showing sustained reactive oxygen species formation after cerebral
injury, allow a mechanism of action for pharmacologic agents and a
therapeutic window of potential clinical relevance. In this context, we
have examined the neurochemical and histologic-neurologic effects of a
novel metalloporphyrin catalytic antioxidant, manganese(III) meso-tetrakis (N-ethylpyridinium-2-yl)porphyrin
(MnTE-2-PyP5+) (Batini
-Haberle et
al., 1998
, 1999
; Batini
-Haberle, 2001
), in rodent models of
cerebral ischemia.
 |
MATERIALS AND METHODS |
Characterization of the antioxidant properties of
MnTE-2-PyP5+ (AEOL10113). The
redox potential of MnTE-2-PyP5+ was
determined by cyclic voltametry as previously described
(Batini
-Haberle et al., 1997
, 1998
). Superoxide dismutase
activity was determined indirectly using cytochrome c reduction as
previously described (McCord and Fridovich, 1969
). Catalase activity
was determined using a Clark electrode to measure oxygen formation from
the dismutation of 1 mM hydrogen peroxide (Day et
al., 1997
). Inhibition of lipid peroxidation by iron and ascorbate in
rat brain homogenates was performed as previously described (Day et
al., 1999
).
The following studies were approved by the Duke University Animal Care
and Use Committee.
Rat focal ischemia (experiments 1-7). Male Wistar rats (age
8-10 weeks; Harlan Sprague Dawley, Indianapolis, IN) were anesthetized with sodium pentobarbital (64 mg/kg, i.p.) and positioned in a stereotactic head frame. Using aseptic technique, the skin was infiltrated with 1.0% lidocaine, and a midline scalp incision was
made. A burr hole was drilled over the left hemisphere, 7.2 mm anterior
to the interaural line and 1.4 mm lateral to the sagittal suture. An
intracerebroventricular cannula (33 ga) was positioned with the
tip in the left lateral ventricle. The cannula was fixed in place with
two cranial screws and stabilized with orthodontic cement. The wound
was closed with suture, and animals were allowed to awaken. Rats were
then returned to their cages with ad libitum access to water
(with addition of 1 mg/1 ml tetracycline) and food for recovery.
After 2-3 d of recovery, rats were fasted but allowed ad
libitum access to water for 12-16 hr before transient middle
cerebral artery occlusion (MCAO). Rats were then anesthetized with
halothane in O2. After tracheal intubation, the
lungs were mechanically ventilated to maintain normocapnia. A 22 ga
needle thermistor was percutaneously placed adjacent to the skull
beneath the temporalis, and pericranial temperature was servoregulated
at 37.5 ± 0.1°C by surface heating or cooling throughout the
anesthetic. The inspired halothane concentration was adjusted to
1.0-1.5% in 30% O2/balance N2. The tail artery was cannulated to monitor
mean arterial pressure (MAP) and sample blood. Then the animals were
prepared for filament MCAO (Zea Longa et al., 1989
). A midline cervical
incision was made, and the right common carotid artery was identified.
The external carotid artery (ECA) was isolated, and the occipital, superior thyroid, and external maxillary arteries were ligated and
divided. The internal carotid artery was dissected distally until the origin of the pterygopalatine artery was visualized. After
surgical preparation, a 20 min interval was allowed for physiological stabilization.
Five minutes before onset of MCAO, rats received heparin (50 IU, i.v.).
A nylon monofilament (diameter, 0.25 mm) prepared with a silicone tip
(Belayev et al., 1996
) was inserted into the stump of the external
carotid artery and passed distally through the internal carotid artery
(23 mm from carotid bifurcation) until a slight resistance was felt.
The filament was secured, and the wound was closed. At MCAO onset,
halothane was reduced to 0.8%.
Before removal of the filament, the inspired halothane concentration
was increased to 1%. After 90 min of MCAO, the occlusive filament was
removed, and the neck wound was closed with suture. The anesthetic
state and pericranial temperature regulation were continued for an
additional 90 min. The tail artery catheter was removed, and the wound
was closed with suture. Then, halothane was discontinued. On recovery
of the righting reflex, animals were extubated and placed in an
O2-enriched environment (40%
O2 in room air) for overnight recovery. Animals
were returned then to their home cages.
For experiment 1 (1 hr before treatment), rats (n = 13-14 per group) were randomly assigned to receive
MnTE-2-PyP5+ (150 or 300 ng in 10 µl of
vehicle) or 10 µl of vehicle (Dulbecco's PBS) via the
intracerebroventricular cannula.
MnTE-2-PyP5+ or vehicle was injected over
a 5 min interval beginning 60 min before onset of ischemia.
For experiment 2 (5 or 90 min after treatment), all rats received an
intracerebroventricular injection at two different times. Rats
(n = 16 per group) were randomly assigned to receive
the following: (1) 300 ng of MnTE-2-PyP5+
5 min after reperfusion from MCAO and vehicle 90 min later, (2) vehicle
at 5 min after MCAO and 300 ng of
MnTE-2-PyP5+ 90 min later, or (3) vehicle
only at both injection intervals. All injectate volumes were 10 µl.
Animals were awakened from anesthesia 15 min after completion of the
second injection.
For experiment 3 (6 hr after treatment), rats (n = 16 per group) underwent 90 min of MCAO as described above. Ninety minutes after onset of reperfusion, the rats were awakened from anesthesia. At
6 hr after onset of reperfusion, these animals were briefly anesthetized with halothane via snout cone and randomly assigned to
receive the following via the intracerebroventricular cannula: (1) 300 ng of MnTE-2-PyP5+, or (2) vehicle (10 µl). Rats were awakened then and allowed to recover.
In experiment 4 (12 hr after treatment), the experimental protocol was
identical to experiment 3, with the exception that 300 ng of
MnTE-2-PyP5+ or vehicle (10 µl) was
injected intracerebroventricularly at 12 hr after onset of reperfusion
(n = 15 per group).
Seven days after ischemia, rats in experiments 1-4 underwent a
standardized neurologic examination designed to evaluate sensorimotor function (Garcia et al., 1995
). With the observer blinded to group assignment, this test explored six different functions (spontaneous activity, movement symmetry, forepaw outstretching, climbing, body
proprioception, and response to vibrissae touch). The individual performance in each test was rated with a 0-3 point score. The score
that was given to each animal at the completion of the testing was the
sum of all six individual scores, 0 being the minimum (worst) and 18 being the maximum (best) score.
After neurologic evaluation, animals were weighed, anesthetized with
3-5% halothane, and decapitated. The brains were removed, frozen at
40°C in 2-methylbutane, and stored at
70°C. Serial quadruplicate 20-µm-thick coronal sections were taken using a cryotome at 660 µm intervals over the rostrocaudal extent of the infarct. The sections were dried and stained with hematoxylin and eosin.
Infarct volumes were measured by digitally sampling stained sections
with a video camera controlled by an image analyzer. The image of each
section was stored as a 1280 × 960 calibrated pixel matrix. The
digitized image was then displayed on a video monitor. With the
observer blinded to experimental conditions, infarct borders in both
cortex and subcortex were individually outlined (corpus callosum
excluded) using an operator-controlled cursor. The area of infarct (in
square millimeters) was determined by counting pixels contained within
the outlined regions of interest. Infarct volumes (in cubic
millimeters) were computed as running sums of infarct area multiplied
by the known interval (e.g., 660 µm) between sections over the extent
of the infarct calculated as an orthogonal projection.
For experiment 5, rats underwent intracerebroventricular cannula
placement and MCAO (90 min) as described above. At the time of MCAO
preparation, a radiotelemetered thermistor (type VM-FH; Mini Mitter
Co., Sunriver, OR), accuracy ± 0.1°C, was implanted into the
peritoneal cavity to track core temperature. The thermistor had been
previously calibrated (within the range of 35.0 to 40.0°C) in a
circulating water bath against a mercury thermometer. This allowed
extrapolation of temperatures from calibration points in accordance
with the radiofrequency emitted by the probe. Radiofrequency signals
from the probe were received (Telemetry Receiver model RA1010;
Data Science, St. Paul, MN), digitized, and processed through a
computer (4DX-33V, Gateway 2000; Gateway, North Sioux City, SD) with
custom-made software to determine temperature. Five minutes after
ischemia, either 10 µl of intraventricular vehicle (n = 3) or 300 ng of MnTE-2-PyP5+
(n = 3) was injected. Ninety minutes after onset
of reperfusion, the animals were allowed to awaken. Core temperature
was monitored for the subsequent 20 hr.
For experiment 6 [aconitase, fumarase, and 8-hydroxy-2'-deoxyguanosine
(8-OHdG) assays ], rats underwent 90 min MCAO. Five minutes
after onset of reperfusion, rats were treated
intracerebroventricularly with 300 ng of
MnTE-2-PyP5+ (n = 6) or
vehicle (n = 6; 10 µl). Animals were allowed to
awaken 90 min later. At 4 hr after onset of reperfusion, these rats
were anesthetized with halothane and decapitated; the brains were
removed and dissected. The hindbrain was discarded. The forebrain was divided into hemispheres, and the cortex was separated. Cortical tissue
samples were weighed and then frozen at
90°C until analytic techniques were performed within the subsequent 2 weeks.
For experiment 7, all conditions were identical to experiment 6, with
the exception of changes in timing of postischemic administration of
MnTE-2-PyP5+ and brain harvesting. In this
study, rats were awakened after recirculation from MCAO. Six hours
later, rats were anesthetized briefly with halothane by snout mask.
MnTE-2-PyP5+ (300 ng, n = 8) or vehicle (10 µl, n = 8) was injected
intracerebroventricularly, replicating the conditions in experiment 3. Rats were awakened then. At 10 hr after reperfusion, rats were killed
with a halothane overdose. The brains were dissected as described for
experiment 6 and analyzed for aconitase and fumarase activities and
8-OHdG.
For aconitase and fumarase activity assays, cortical tissue (~75 mg
samples) was homogenized with a Dounce tissue grinder (Wheaton,
Millville, NJ) in mitochondrial isolation buffer (70 mM
sucrose, 210 mM mannitol, 5 mM Tris-HCl, 1 mM EDTA, 20 µM flourocitrate, pH 7.4). After
homogenization, the suspensions were centrifuged at 600 × g for 5 min at 4°C; the supernatant was transferred to a
chilled Eppendorf tube and centrifuged at 17,000 × g
for 10 min at 4°C. Mitochondrial pellets were frozen in liquid
nitrogen and stored at
80°C for use within 2 weeks. Immediately
before aconitase and fumarase activity measurements, mitochondrial
fractions were resuspended and sonicated for 2 sec. Aconitase and
fumarase activities were measured as previously described (Patel et
al., 1996
). Aconitase activity was measured spectrophotometrically by
monitoring the formation of cis-aconitate from isocitrate at 240 nm in 50 mM Tris-HCl, pH 7.4, containing (in
mM): 0.6 MnCl2 and 20 isocitrate at 25°C (Krebs and Holzach, 1952
). Fumarase activity was
measured by monitoring the increase in absorbance at 240 nm at 25°C
in a 1 ml reaction mixture containing (in mM): 0.1 L-malate, 30 potassium phosphate, pH 7.4 (Racker, 1950
). Protein concentrations were measured using Coomassie
Plus reagents.
For measurement of 8-OHdG and 2'-deoxyguanosine (dG), cortical tissue
was homogenized for DNA extraction with a Dounce tissue grinder in a
1% SDS, 10 mM Tris, 1 mM EDTA, pH 7.4 buffer
and incubated in a 0.5 mg/ml proteinase buffer at 55°C overnight. Homogenates were incubated with RNase (0.1 mg/ml) at 50°C for 10 min
and extracted twice with chloroform-isoamyl alcohol (24:1, v/v). The
extracts were mixed with 1:15 vol of 3 M sodium acetate, pH
7.0, and 2 vol of 100% cold ethanol to precipitate DNA at
20°C for
1 hr. The samples were centrifuged at 17,000 × g for
10 min. The resultant DNA pellets were washed twice with 70% ethanol, air-dried for 3 min, and dissolved in 100 µl of 10 mM Tris, 1 mM EDTA, pH
7.4.
Cellular DNA digestion was performed as previously described (Kasai et
al., 1986
). The oxidative DNA product 8-OHdG was measured with HPLC
using an electrochemical detector (CoulArray model 5600; ESA, Inc.,
Chelmsford, MA) (Arashidani et al., 1998
; Liang et al., 2000
). Analytes
were detected on two coulometric array cell modules, each containing
four electrochemical sensors attached in series. UV detection for
dG was set at 260 nm at 0.005 AUFS (absorbance units full
scale) (model 520). Analytes were separated on a 3 µm,
150 × 4.6 mm column (YMC, Wilmington, NC). The mobile phase was
composed of 50 mM sodium acetate, 5% methanol, pH 5.2. Electrochemical detector potentials for 8-OHdG and dG were
120/230/280/420/600/750/840/900 mV (vs palladium). The flow rate
was 1.0 ml/min. The temperature of the column and detectors was
maintained at 31°C.
Mouse focal ischemia (experiments 8-9). Male C57/Bl6J mice
(The Jackson Laboratory, Bar Harbor, ME) at 8-10 weeks of age were used for these studies.
For experiment 8 (intravenous
MnTE-2-PyP5+), mice were fasted overnight
from food but allowed ad libitum access to water. Mice were
anesthetized then with 1.0-1.5% halothane in 50%
O2/balance N2. The trachea
was intubated, and the lungs were mechanically ventilated. A femoral
artery was cannulated for measurement of blood pressure and arterial
blood gases. Via a midline cervical skin incision, the right common
carotid artery was identified. The ECA was ligated and
transected. The internal carotid artery was dissected distally until
the origin of the pterygopalatine artery was visualized. Finally, the
right jugular vein was cannulated.
After surgical preparation, a 15 min interval was allowed for
physiological stabilization. Pericranial temperature was continuously monitored and servoregulated with surface heating-cooling at 37.0°C throughout the procedure. Inspired halothane concentration was adjusted
to prohibit motor response to surgical stimuli but allow support of
arterial blood pressure.
A 6-0 nylon monofilament, blunted at the tip in a flame and then
lightly coated with silicone, was inserted into the proximal external
carotid artery stump and advanced
11 µm so as to occlude the MCA.
Pilot studies were performed to define the maximal duration of MCAO
that would allow a high survival rate in the vehicle-treated group
under these experimental conditions. An MCAO interval of 90 min was
found to cause <10% mortality yet still produce a large cerebral
infarct. Accordingly, all experimental groups were subjected to 90 min
of MCAO, after which the occlusive filament was removed.
Pilot studies were also performed to determine the maximal allowable
intravenous dose of MnTE-2-PyP5+ that
would not elicit behavioral side effects. The effects of intravenous
doses as high as 5 mg/kg were examined in mice not subjected to
ischemia. No adverse effects were observed. When the same dose
was given to mice at 5 min after 90 min MCAO, behavioral changes
including proptosis, ataxia, and hypersensitivity to sound were noted
~2 hr after injection. The dose was progressively decreased until
these effects were absent in postischemic animals. That dose was found
to be 2 mg/kg. Accordingly, the following dosing groups were generated:
(1) high dose (n = 18),
MnTE-2-PyP5+ (2 mg/kg, i.v.) in 15 µl of
PBS; (2) low dose (n = 17),
MnTE-2-PyP5+ (1 mg/kg, i.v.) in 15 µl of
PBS; and (3) vehicle (n = 15), 15 µl of PBS intravenous.
Intravenous injections were made over a 5 min interval beginning 5 min
after onset of reperfusion. The arterial and jugular catheters were
removed, and the wounds were infiltrated with lidocaine and closed with
suture. Halothane was discontinued, and the mice were allowed to
awaken. When spontaneous ventilation and the righting reflex recovered,
the trachea was extubated. Mice were placed in an
O2-enriched environment (fractional inspired
O2 = 50%) for ~1 hr. During that
interval, rectal temperature was monitored and controlled at 37.0°C.
Then the mice were returned to their cages.
After 24 hr of reperfusion, all animals underwent neurologic
evaluation. Each mouse was assigned a score of 0-4, where 0 represented no observable neurological deficit; 1, failure to
extend the left forepaw; 2, circling to the left; 3, falling to the
left; and 4, cannot walk spontaneously (Yang et al., 1994
).
Neurological examination was performed by one observer blinded to group assignment.
After neurological evaluation, animals were anesthetized with halothane
and decapitated. The brains were removed and frozen at
20°C. Using
a cryotome, six 20-µm-thick coronal sections were taken at 320 µm
intervals over the rostrocaudal extent of the infarct. The sections
were dried and stained with hematoxylin and eosin.
Infarct volume was measured as described for the rat focal ischemia
studies. Infarct volumes (in cubic millimeters) were computed as
running sums of infarct area multiplied by the known interval (e.g.,
320 µm) between sections over the extent of the infarct, expressed as
an orthogonal projection.
For experiment 9 (intracerebroventricular
MnTE-2-PyP5+), procedures in mice were
identical to those described above with the following exceptions. A
right lateral ventricular cannula was placed with the following
technique. Anesthesia was provided by a subcutaneous injection of 75 mg/kg ketamine, 4 mg/kg xylazine, and 0.8 mg/kg acepromazine. After
infiltration with 0.02 ml of 1% lidocaine behind the ears and in the
scalp, the animal was placed in a stereotactic frame. The scalp was
incised. A burr hole was made over the left hemisphere, and the dura
was incised. A cannula (model 3300 PM; Plastics One, Roanoke,
VA) was placed in the left lateral ventricle using the following
coordinates: bregma
0.5 mm, lateral +1.0 mm, at a depth of
1.4 mm.
The cannula was affixed to the skull surface with an instant adhesive.
The wound was closed with suture, and the animal was removed from the
head frame and allowed to awaken. During surgical preparation for
temporary MCAO, the right jugular vein was not cannulated.
Two to three days after implantation of the cannula, mice were
surgically prepared and subjected to 50 min filament MCAO as described
for experiment 8. Five minutes after removal of the occlusive filament,
mice were randomly assigned to one of three groups: (1) high dose
(n = 16), 100 ng of
MnTE-2-PyP5+ (intracerebroventricular) in
1 µl of PBS; (2) low dose (n = 15), 50 ng of
MnTE-2-PyP5+ (intracerebroventricular) in
1 µl of PBS; or (3) vehicle (n = 15), 1 µl of PBS (intracerebroventricular).
Pilot studies were performed to define the maximal duration of MCAO
that would allow >90% survival in mice treated with
intracerebroventricular vehicle. That interval was found to be 50 min
and therefore was used in this experiment. All intracerebroventricular
injections were performed over an interval of 5 min using a 1 µl
Hamilton syringe. As in the rat, high doses of intracerebroventricular MnTE-2-PyP5+ were found to cause a rapid
onset of behavioral responses, including proptosis, ataxia, and
hypersensitivity to sound. Pilot studies determined the threshold dose
required to elicit these signs to be 200 ng. Therefore, we elected to
study one-half that dose as our high dose regimen in the outcome study.
Mice were recovered from anesthesia and allowed to survive 24 hr.
Neurologic examination and histologic processing for measurement of
infarct volume was as described for experiment 8.
Rat near-complete forebrain ischemia (experiment 10). Male
Sprague Dawley rats (age, 8-10 weeks; Harlan Sprague Dawley),
underwent placement of a left intracerebroventricular cannula as
described above. The coordinates for positioning the cannula were 1.4 mm lateral to midline and 1.5 mm posterior to bregma.
Two to three days later, the rats were anesthetized with halothane.
After orotracheal intubation, the lungs were mechanically ventilated
(30% O2/balance N2). The
inspired halothane concentration was reduced to 1.0-1.5%. Surgery was
performed with aseptic technique, and all surgical fields were
infiltrated with 1% lidocaine. The tail artery was cannulated and used
to monitor MAP and to sample blood. Via a ventral neck incision, the
right jugular vein was cannulated for blood withdrawal. The common
carotid arteries were encircled with suture. The vagus nerves and
cervical sympathetic plexus were left intact. Bilateral cortical EEG
was monitored from active subdermal electrodes positioned over the
parietal cortex bilaterally and a ground lead in the tail.
A 22 ga needle thermistor was percutaneously placed adjacent to the
skull beneath the temporalis, and pericranial temperature was
servoregulated at 37.5 ± 0.1°C by surface heating or cooling. Heparin (50 IU, i.v.) was given. Inspired halothane was reduced to
0.8%. A 20 min interval was allowed for physiological stabilization. Ventilation was adjusted to maintain normocapnia.
Rats were randomly assigned to one of three groups and received either
150 or 300 ng of intracerebroventricular
MnTE-2-PyP5+ or vehicle (10 µl) 1 hr
before onset of ischemia over 5 min.
Forebrain ischemia was caused by rapid venous blood withdrawal to
reduce MAP to 30 mmHg combined with bilateral carotid occlusion using
temporary aneurysm clips (Smith et al., 1984
; Gionet et al., 1992
).
Ischemia persisted for 10 min and was confirmed
electroencephalographically. To terminate ischemia, shed blood was
reinfused, and the aneurysm clips were removed.
NaHCO3 (0.3 mM, i.v.) was given to
counteract systemic acidosis.
The anesthetic state and pericranial temperature regulation were
continued for an additional 60 min. Then catheters were removed, and
the wounds were closed with suture. Halothane was discontinued. On
recovery of the righting reflex, animals were extubated and placed in
an oxygen-enriched environment (40% O2 in room
air) for overnight recovery. Animals were returned then to their home cages.
On the fifth postoperative day, with the observer blinded to group
assignment, motor function tests were performed according to an
established protocol, including assays of prehensile traction and
balance beam performance (Combs and D'Alecy, 1987
; Gionet et al.,
1991
). The motor score was graded on a 0-9 scale (best score = 9). Rats were anesthetized with 3-5% halothane and underwent in
situ brain fixation by intracardiac injection of buffered 10% formalin. After 24 hr, the brains were removed and stored in 10% formalin. Paraffin-embedded brain sections were serially cut (5 µm
thick) and stained with acid fuchsin-celestine blue. With the investigator blinded to group assignment, injury to the CA1 sector of
the hippocampus (bregma
4.0) was evaluated by light microscopy. Viable and nonviable neurons were manually counted, and the percentage of nonviable neurons was calculated (% dead CA1). At the level in
which the septal nuclei were widest, damage in the neocortex and
caudoputamen was graded on a 0-3 scale (0, no damaged neurons; 1, 1-30% neurons damaged; 2, 30-60% neurons damaged; 3, >60% of neurons damaged) (Coimbra et al., 1996
). Values from the hemisphere with the worst damage in each animal were used for the final analysis.
Statistical analysis. For focal ischemia (experiments 1-4,
8 and 9), subcortical, cortical, and total infarct volumes and physiologic values were compared by one-way ANOVA. For
experiments with three groups, post hoc testing was
performed with Fisher's protected least squares differences test when
indicated by a significant F ratio. Neurologic scores were
compared among groups by the Kruskal-Wallis H statistic or
Mann-Whitney U statistic. Peritoneal temperature values
were compared qualitatively (experiment 5). Aconitase and fumarase
values and 8-OHdG/dG ratios (experiments 6 and 7) were analyzed with
one-way or two-way ANOVA where appropriate. For forebrain ischemia
outcome (experiment 10), physiologic values and hippocampal CA1 damage
were compared by one-way ANOVA. Cortical and striatal selective
neuronal necrosis and total motor scores were compared among groups
using the Kruskal-Wallis H statistic or Mann-Whitney
U statistic where appropriate. Parametric data are reported
as mean ± SD. Nonparametric data are reported as median ± interquartile range. Statistical significance was assumed when
p < 0.05.
 |
RESULTS |
Biochemical characteristics of the catalytic antioxidant,
MnTE-2-PyP5+
Recent advances in our understanding of the chemical requirements
for producing more potent catalytic antioxidants have led to the
development of MnTE-2-PyP5+ (Fig.
1) (Batini
-Haberle et al., 1998
).
Manganopyridyl porphyrins have been shown to have SOD-like activity
(Pasternack et al., 1981
). However, the compound evaluated,
MnTM-4-PyP5+, had a rate constant that was
only 0.18% of that of Cu,Zn-SOD. In addition,
MnTM-4-PyP5+ had little activity in
mammalian cells, possibly because of the binding of this molecule to
DNA (Batini
-Haberle et al., 1998
). Altering the position of the
nitrogen in the pyridyl group from the para to the ortho position
(MnTE-2-PyP5+) significantly changed the
redox potential toward that of the native SOD enzymes (Table
1). This small change in structure resulted in a 20-fold increase in SOD activity, a 3-fold increase in
catalase activity, and a 15-fold increase in its ability to protect
lipids from oxidative stress. It also greatly reduced binding of this
molecule to DNA and increased its activity in mammalian biological
systems.

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Figure 1.
Structures of catalytic antioxidant porphyrins
that contain cationic, pyridyl side groups:
manganese(111)-tetrakis-(N-methylpyridinium-4-yl)porphyrin
(MnTM-4-PyP5+) or
manganese(111)-tetrakis-(N-ethylpyridinium-2-yl)porphyrin
(MnTE-2-PyP5+).
|
|
Experiment 1: MnTE-2-PyP5+ pretreatment
attenuates focal ischemia infarct size and improves neurologic
outcome
Physiologic values are summarized in Table
2. There were no significant differences
among groups, with the exception of day 7 postischemia body weight,
which was greater in the
MnTE-2-PyP5+-treated animals
(p = 0.004). Neurologic scores were improved in
MnTE-2-PyP5+-treated animals (vehicle,
10 ± 2; 150 ng, 12 ± 4; 300 ng, 13 ± 4;
p = 0.001). When administered before ischemia,
MnTE-2-PyP5+ reduced subcortical (vehicle,
86 ± 33 mm3; 150 ng, 39 ± 21 mm3; 300 ng, 34 ± 27 mm3; p < 0.0001),
cortical (vehicle, 102 ± 54 mm3; 150 ng, 22 ± 30 mm3; 300 ng, 13 ± 27 mm3; p < 0.0001), and
total (vehicle, 188 ± 82 mm3; 150 ng, 61 ± 48 mm3; 300 ng, 47 ± 51 mm3; p < 0.0001)
infarct volumes.
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Table 2.
Physiologic values for experiment 1 (rat focal
ischemia-intracerebroventricular MnTE-2-PyP5+ before
treatment)
|
|
Experiments 2-5: MnTE-2-PyP5+ rescues tissue
damage and neurologic function up to 6 hr after ischemia without
affecting temperature
In experiments 2-5, blood chemistry, MAP, and temperature values
were similar to those reported for experiment 1 without differences among groups (data not shown).
In experiment 2, 300 ng of MnTE-2-PyP5+
given at either 5 or 90 min after onset of reperfusion from 90 min of
MCAO improved neurologic scores (vehicle, 9 ± 1; 5 min, 13 ± 4; 90 min, 12 ± 3; p = 0.002) and reduced
subcortical (vehicle, 68 ± 31 mm3; 5 min, 32 ± 24 mm3; 90 min, 28 ± 14 mm3; p < 0.0001),
cortical (vehicle, 75 ± 47 mm3; 5 min, 9 ± 37 mm3; 90 min, 4 ± 11 mm3; p < 0.0001), and
total (vehicle, 143 ± 75 mm3; 5 min,
41 ± 58 mm3; 90 min, 31 ± 22 mm3; p < 0.0001) infarct volumes.
In experiment 3, MnTE-2-PyP5+ given at 6 hr after onset of reperfusion from 90 min of MCAO improved neurologic
scores (vehicle, 9 ± 1.5;
MnTE-2-PyP5+, 10.5 ± 3.0;
p = 0.05) and reduced subcortical (vehicle,
67 ± 37 mm3;
MnTE-2-PyP5+, 39 ± 31 mm3; p = 0.03), cortical
(vehicle, 64 ± 60 mm3;
MnTE-2-PyP5+, 21 ± 41 mm3; p = 0.03), and total
(vehicle, 131 ± 95 mm3;
MnTE-2-PyP5+, 60 ± 68 mm3; p = 0.02) infarct
volumes (Fig. 2).

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Figure 2.
Protection by MnTE-2-PyP5+ when
given 6 hr after ischemia. Cerebral infarct volumes and neurologic
scores were measured 7 d after a 90 min episode of transient
middle cerebral artery occlusion. At 6 hr after ischemia,
MnTE-2-PyP5+ (300 ng) or vehicle was injected into
the left lateral ventricle (n = 16 per group).
MnTE-2-PyP5+ reduced infarct size (subcortex,
p = 0.03; cortex, p = 0.03) and
improved neurologic score (18 = normal)
(p = 0.05). Open circles
represent values for individual rats. Horizontal lines
depict group mean values for infarct size and median values for
neurologic score.
|
|
In experiment 4, MnTE-2-PyP5+ or vehicle
was given at 12 hr after ischemia. There was no effect of
MnTE-2-PyP5+ on neurologic scores
(vehicle, 9 ± 1; MnTE-2-PyP5+,
9 ± 2; p = 0.93). Infarct size was not affected
by MnTE-2-PyP5+ in cortex (vehicle,
46 ± 48 mm3;
MnTE-2-PyP5+, 33 ± 41 mm3; p = 0.45) or
subcortex (vehicle, 57 ± 32 mm3;
MnTE-2-PyP5+, 61 ± 35 mm3; p = 0.76).
Total infarct volume was also similar between groups (vehicle, 103 ± 78 mm3;
MnTE-2-PyP5+, 94 ± 73 mm3; p = 0.75).
Figure 3 demonstrates the cumulative
results for the different dosing intervals of
MnTE-2-PyP5+ (experiments 1-4) depicting
mean total infarct volume in treated animals as a fraction of mean
total infarct volume in the respective vehicle-treated groups.

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Figure 3.
Mean total cerebral infarct volumes resulting from
90 min of middle cerebral artery occlusion and 7 d recovery in
rats treated with intracerebroventricular
MnTE-2-PyP5+ (300 ng; n = 13-16
per group) as a percentage of mean total infarct volume in respective
vehicle-treated controls. Values are given for the different treatment
intervals studied in experiments 1-4.
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|
Intracerebroventricular administration of
MnTE-2-PyP5+ was not found to have an
effect on body temperature. Peritoneal temperature values (experiment
5) were similar between groups when averaged over 6 hr (vehicle,
37.8 ± 1.1°C; MnTE-2-PyP5+,
37.6 ± 1.0°C) and 20 hr (vehicle, 37.7 ± 0.7°C;
MnTE-2-PyP5+, 38.1 ± 0.3°C) in
rats given MnTE-2-PyP5+ or vehicle 5 min
after onset of reperfusion from 90 min MCAO.
Experiments 6 and 7: protective effect of
MnTE-2-PyP5+ correlates with decreased indices of
oxidative stress in focal ischemia
Physiologic values during experiments 6 and 7 were similar to the
preceding experiments, and there were no differences between groups
(data not shown).
Selective inactivation of mitochondrial aconitase, but not fumarase,
was used as an index of superoxide production (Patel et al., 1996
;
Liang et al., 2000
). In the initial analysis, we examined the effect of
ischemia on aconitase and fumarase activities at 4 and 10 hr after 90 min MCAO in rats treated with vehicle only. At 4 hr after reperfusion,
aconitase was selectively inactivated in the ischemic versus
nonischemic hemisphere. Mammalian fumarase activity, previously shown
to be resistant to oxidative stress in vitro (Patel et al.,
1996
), was unchanged by ischemia. At 10 hr after ischemia, both
aconitase and fumarase activity were reduced in the ischemic versus
nonischemic hemisphere (p < 0.05). We then compared the enzymatic activities in the ischemic hemisphere as a
function of MnTE-2-PyP5+ treatment. At 4 hr after ischemia, MnTE-2-PyP5+ that was
given 5 min after reperfusion caused a 46% increase in aconitase
activity versus vehicle-treated controls and had no effect on fumarase.
At 10 hr after ischemia, MnTE-2-PyP5+ that
was given 6 hr after reperfusion caused a 32 and 16% increase in
aconitase and fumarase activities, respectively, versus values treated
with vehicle (Fig. 4).

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Figure 4.
Effects of ischemia and
MnTE-2-PyP5+ on aconitase-fumarase activities. Rats
were subjected to 90 min of middle cerebral artery occlusion and
treated with intracerebroventricular vehicle or 300 ng of
MnTE-2-PyP5+ at 5 min or 6 hr after onset of
reperfusion. Brains were sampled at 4 hr after treatment,
respectively (n = 6-8 per condition). At 4 hr after ischemia, aconitase was selectively decreased by ischemia in
the vehicle-treated group. Aconitase activity was 47% greater in
animals treated with MnTE-2-PyP5+. There was no
effect of ischemia or MnTE-2-PyP5+ on fumarase
activity. At 10 hr after ischemia, reductions in both aconitase and
fumarase activities were observed. Both aconitase and fumarase
activities were greater (32 and 16%, respectively) in
MnTE-2-PyP5+ rats versus respective vehicle-treated
controls. a, Difference from nonischemic hemisphere
(p < 0.05); b, difference
from ischemic hemisphere in vehicle-treated group
(p < 0.05). Values represent mean ± SD.
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Superoxide is a precursor of more potent oxidants such as the hydroxyl
radical, which can oxidatively damage cellular DNA. Consistent with
this, ischemia increased the 8-OHdG/dG ratio approximately threefold
when assessed at both 4 and 10 hr after ischemia. There was no effect
of MnTE-2-PyP5+ treatment on the 8-OHdG/dG
ratio in the nonischemic hemisphere at either study interval. In the
ischemic hemisphere, treatment with
MnTE-2-PyP5+ reduced the 8-OHdG/dG ratio
by 39% (p = 0.003) when given 5 min after
reperfusion and by 21% (p = 0.02) when given 6 hr after ischemia. At both treatment intervals, however, the 8-OHdG/dG ratio in the ischemic hemisphere of
MnTE-2-PyP5+-treated rats remained greater
than that in the respective nonischemic hemisphere
(p < 0.05) (Fig.
5).

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Figure 5.
Ischemia-induced oxidation of DNA and protection
by MnTE-2-PyP5+. Rats were treated with
intracerebroventricular MnTE-2-PyP5+ (300 ng) or
vehicle at 5 min or 6 hr after onset of reperfusion from 90 min middle
cerebral artery occlusion (n = 6-8 per condition).
Brains were sampled at 4 hr after treatment, respectively
(n = 6-8 per condition). The ratio of
8-hydroxy-2'-deoxyguanosine (8-OHdG) to
2'-deoxyguanosine (dG) was determined in cortical tissue
4 hr after drug-vehicle treatment. There was no effect of
MnTE-2-PyP5+ in the nonischemic hemisphere at either
study interval. Ischemia increased the 8-OHdG/dG ratio nearly threefold
at 4 hr, and this persisted at 10 hr after ischemia (see
vehicle-treated groups). Treatment with MnTE-2-PyP5+
reduced the ischemic 8-OHdG/dG ratio by 39%
(p = 0.003) when given 5 min after
reperfusion and by 21% when given 6 hr after ischemia. At both
treatment intervals, the ratio in the ischemic hemisphere of
MnTE-2-PyP5+-treated rats remained greater than in
the respective nonischemic hemisphere. a, Difference
between ischemic and nonischemic hemisphere
(p 0.02); b, difference
between treatment vehicle and MnTE-2-PyP5+ groups in
the ischemic hemisphere (p < 0.05). Values
represent mean ± SD.
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Experiment 8 (mouse focal ischemia-intravenous
MnTE-2-PyP5+ after treatment)
Recorded physiologic values are given in Table
3. There were no differences among
groups. A main effect for treatment group on neurologic score was
present (vehicle, 3 ± 0.75;
MnTE-2-PyP5+, 1 mg/kg, 3 ± 2;
MnTE-2-PyP5+, 2 mg/kg, 2 ± 2;
p = 0.04). Individual cerebral infarct volumes are
given in Figure 6. Cortical infarct
volume was reduced by MnTE-2-PyP5+
(vehicle, 46 ± 16 mm3;
MnTE-2-PyP5+, 1 mg/kg, 31 ± 21 mm3;
MnTE-2-PyP5+, 2 mg/kg, 26 ± 21 mm3; p = 0.015). An
intergroup difference was present for
MnTE-2-PyP5+ (2 mg/kg) versus vehicle
(p = 0.017). Subcortical infarct volume was also
reduced by MnTE-2-PyP (vehicle, 31 ± 10 mm3;
MnTE-2-PyP5+, 1 mg/kg, 20 ± 21 mm3;
MnTE-2-PyP5+, 2 mg/kg, 15 ± 12 mm3; p = 0.013).
Intergroup differences were present for both doses versus vehicle
(p < 0.04). Total infarct volume was reduced by MnTE-2-PyP5+ (vehicle, 77 ± 24 mm3;
MnTE-2-PyP5+, 1 mg/kg, 52 ± 33 mm3;
MnTE-2-PyP5+, 2 mg/kg, 41 ± 33 mm3; p = 0.009). An
intergroup difference was present for
MnTE-2-PyP5+ (2 mg/kg) versus vehicle
(p = 0.006).

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Figure 6.
Mice were subjected to 90 min of middle cerebral
artery occlusion. Five minutes after onset of reperfusion, 0 mg/kg
(n = 15), 1 mg/kg (n = 17), or
2 mg/kg (n = 18) MnTE-2-PyP5+
(in PBS vehicle, total injectate volume = 15 µl) was injected
intravenously. Infarct volumes for individual mice (open
circles) measured at 24 hr after ischemia are shown.
Horizontal bars indicate group mean values.
Top, Cortical infarct volume was reduced by
MnTE-2-PyP5+ (p = 0.015).
An intergroup difference was present for
MnTE-2-PyP5+ (2 mg/kg) versus vehicle
(p = 0.017). Middle,
Subcortical infarct volume was also reduced by
MnTE-2-PyP5+ (p = 0.013).
Intergroup differences were present for both doses versus vehicle
(p < 0.04). Total infarct volume was
reduced by MnTE-2-PyP5+
(p = 0.009). An intergroup difference was
present for MnTE-2-PyP5+ (2 mg/kg) versus vehicle
(p = 0.006). Bottom,
Neurologic scores for individual mice are depicted (0, normal; 4, cannot walk spontaneously). Horizontal bars indicate
group median values. A main effect for treatment group was present
(p = 0.04).
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|
Experiment 9 (mouse focal ischemia-intraventricular
MnTE-2-PyP5+ after treatment)
Physiologic values were similar to those reported for experiment
8. Values were not different among groups (data not shown). A main
effect for treatment group on neurologic scores was present (vehicle,
3 ± 1; MnTE-2-PyP5+, 50 ng, 3 ± 1; MnTE-2-PyP5+, 100 ng, 2 ± 2;
p = 0.007). Cortical infarct volume was reduced by
MnTE-2-PyP5+ (vehicle, 42 ± 8 mm3;
MnTE-2-PyP5+, 50 ng, 29 ± 12 mm3;
MnTE-2-PyP5+, 100 ng, 28 ± 16 mm3; p = 0.008).
Intergroup differences were present for both doses versus vehicle
(p < 0.04). Subcortical infarct volume was also reduced by MnTE-2-PyP5+ (vehicle, 28 ± 8 mm3;
MnTE-2-PyP5+, 50 ng, 20 ± 10 mm3;
MnTE-2-PyP5+, 100 ng, 20 ± 10 mm3; p = 0.03). Total
infarct volume was reduced by MnTE-2-PyP5+
(vehicle, 70 ± 25 mm3;
MnTE-2-PyP5+, 50 ng, 50 ± 20 mm3;
MnTE-2-PyP5+, 100 ng, 48 ± 25 mm3; p = 0.009).
Intergroup differences were present for both doses versus vehicle
(p < 0.04).
Experiment 10: MnTE-2-PyP5+ is not effective in
preventing near-complete forebrain ischemia-induced selective neuronal
necrosis
Physiologic values are summarized in Table
4. There were no significant differences
among groups. Five days after ischemia, hippocampal CA1 injury was
similar among groups (vehicle, 70 ± 33% dead neurons;
MnTE-2-PyP5+,
150 ng, 77 ± 33% dead neurons;
MnTE-2-PyP5+, 300 ng, 67 ± 34% dead
neurons; p = 0.594). Damage in the cortex (vehicle,
1 ± 1; MnTE-2-PyP5+, 150 ng, 1 ± 1; MnTE-2-PyP5+, 300 ng, 0 ± 1;
p = 0.839) and caudoputamen (vehicle, 2 ± 1; MnTE-2-PyP5+, 150 ng, 2 ± 1;
MnTE-2-PyP5+, 300 ng, 2 ± 1;
p = 0.862) was not different among groups. Total motor
score values were 8 ± 2 in all three groups.
 |
DISCUSSION |
The synthetic porphyrin catalytic antioxidant,
MnTE-2-PyP5+, caused major reduction of
ischemic brain damage when administered in a single dose 60 min before
onset of MCAO or up to 6 hr after onset of reperfusion. This benefit
was evident both histologically and neurologically in rats allowed to
survive 7 d after the ischemic insult.
MnTE-2-PyP5+ also reduced cerebral infarct
size and improved neurologic function when given intravenously or
intracerebroventricularly after reperfusion from transient MCAO in the
mouse. MnTE-2-PyP5+ preserved rat
mitochondrial aconitase activity and reduced DNA oxidation when given 5 min or 6 hr after ischemia but had no effect on body temperature. In
contrast, MnTE-2-PyP5+ had no effect on
rat selective neuronal necrosis resulting from near-complete forebrain ischemia.
MnTE-2-PyP5+ was chosen for study from a
family of metalloporphyrins. Cationic ortho N-ethylpyridyl
groups on the methine bridge carbons of the porphyrin ring system
provide electrostatic guidance for O
. The
resulting nonplanarity diminishes the interaction of
MnTE-2-PyP5+ with DNA. Furthermore, close
proximity of the positively charged groups to the manganese metal
center of this ortho isomer, when compared with the
para isomer, shifts the metal-redox potential to a more
positive value (Batini
-Haberle et al., 1999
; Spasojevic and
Batini
-Haberle, 2001
). Thus the redox potential of the
ortho isomer is +0.23 V as opposed to the para
isomer (+0.06 V) versus normal hydrogen electrode. Both of these
effects, steric and electronic, make for a powerful catalytic
antioxidant that is 20 times more active in dismuting
O
than the para analog
(Batini
-Haberle et al., 1998
). Studies with SOD-deficient Escherichia coli demonstrate that 25 µM of the ortho isomer greatly facilitates growth, whereas the para compound is toxic at
this level (Batini
-Haberle et al., 1998
).
MnTE-2-PyP5+ has five positive charges.
This may limit significant transfer across the blood-brain barrier and
into the cell. We therefore chose to first study
intracerebroventricular MnTE-2-PyP5+
injection. An initial dose of 1 µg was given. Within 1-2 min after
injection, all rats exhibited hindlimb abduction, body and head tremor,
ataxia, vertical jumping, tactile hyperreactivity, and proptosis. We
progressively decreased the MnTE-2-PyP5+
dose to 300 ng, which resulted in complete absence of the above effects. Accordingly, 300 and 150 ng were examined in the MCAO model.
Because there was little difference in histologic-neurologic outcome
in rats given these two doses of
MnTE-2-PyP5+, we believe that an
efficacious therapeutic dose may be <150 ng. In addition, some
indication of the duration of action of intracerebroventricular
MnTE-2-PyP5+ was obtained. The behavioral
side effects associated with 1 µg of MnTE-2-PyP persisted for 6-8
hr, after which animals recovered to normal behavior.
During pilot studies, intravenous administration of a single bolus of 1 mg of MnTE-2-PyP5+ in the rat did not
produce the behavioral effects described above. However, substantial
reduction in blood pressure was observed. This effect was absent in the
mouse. We therefore examined efficacy of
MnTE-2-PyP5+ that was given intravenously
in a mouse model of temporary MCAO in which confounds from systemic
hypotension would be absent. Again, substantial reduction in infarct
size and improvement in neurologic scores were observed.
The fact that administration of a catalytic antioxidant provides
substantial neuroprotection as late as 6 hr after ischemia calls into
question the source of O
this late after onset
of reperfusion. A principle source of ischemia-induced O
is the mitochondria (Piantadosi and Zhang,
1996
). Selective inactivation of aconitase by increased O
is consistent with this. Ischemia and/or
reperfusion also result in chemotactic recruitment and activation of neutrophils that synthesize and release
O
at a high rate (Hoffstein et al., 1985
;
Kochanek and Hallenbeck, 1992
). Recruitment of neutrophils occurs
within the first few hours after ischemia and/or reperfusion (Clark et
al., 1994
; Zhang et al., 1994
). Activation of microglia by cytokines
also results in O
release (Sankarapandi et
al., 1998
). Activation of microglia has been shown to begin within the
first few minutes after onset of ischemia and to persist for hours
(Ivacko et al., 1996
; Rupalla et al., 1998
). O
can also be derived from membrane-bound cyclo-oxygenase-2 (COX-2), phospholipase A, and NADPH-oxidase. Upregulation of some of these enzymes during ischemia and/or reperfusion has been documented (Gajkowska and Mossakowski, 1997
). Examination of the temporal course
of these events in experimental paradigms in which
MnTE-2-PyP5+ is administered may provide
insight into the relative importance of these factors with respect to
ischemic outcome. It is also clear that effects of
MnTE-2-PyP5+ extend into the intracellular
compartment, based on our finding that mitochondrial aconitase
activity, an enzyme in the tricarboxylic acid cycle with known
sensitivity to O
(Gardner and Fridovich, 1992
;
Liang et al., 2000
), was preserved in treated animals.
MnTE-2-PyP5+ was also shown to reduce
oxidative stress, as defined by the 8-OHdG/dG ratios, when given at 5 min after onset of reperfusion. Given the exquisite sensitivity of
mitochondrial DNA to oxidative damage, it is tempting to speculate that
a large part of the 8-OHdG signal may have been mitochondrial in
origin. However, when MnTE-2-PyP5+was
given at 6 hr after reperfusion, a 54% reduction in ischemic injury
was still observed. This suggests that oxidative injury occurring in
the first few hours after MCAO is not of singular importance to outcome
as defined at 7 d after ischemia. When treatment was initiated 6 hr after reperfusion, the mimetic was still 76% as effective as when
given at 5 min after ischemia. However, assessment of
aconitase-fumarase activities, serving as indicators of increased O
production, revealed a different pattern
when MnTE-2-PyP5+ was given 6 hr as
opposed to 5 min after ischemia. In vehicle-treated animals, aconitase
activity was reduced by ischemia when measured at both 4 and 10 hr
after ischemia, and this was, in part, preserved by
MnTE-2-PyP5+ whether it was given at 5 min
or 6 hr after ischemia. In contrast, at 4 hr after ischemia, fumarase
activity was not altered by ischemia, whereas it was reduced at 10 hr
after ischemia. Fumarase is largely resistant to direct oxidative
injury by O
(Liang et al., 2000
; Patel et al.,
1996
). Therefore, decay in its activity at 10 hr suggests general
mitochondrial dysfunction and cell death.
MnTE-2-PyP5+ partially preserved fumarase
activity when given at 6 hr after ischemia, indicating that the
compound protected at late administration intervals by less specific
mechanisms than O
scavenging alone. For
example, if delayed inflammatory mechanisms invoked by ischemia produce O
that in turn reacts with nitric oxide to
yield peroxynitrite, treatment with spin trap molecules (e.g., NXY-509)
that show preference to hydroxyl radical would not be as effective in
reducing injury (Kuroda et al., 1999
). In contrast,
MnTE-2-PyP5+ is highly reactive with
O
and also possesses potential to react with
both nitric oxide (Spasojevic et al., 2000
) and peroxynitrite
(Ferrer-Sueta et al., 1999
). This may explain its unique efficacy when
given 6 hr after reperfusion. Delayed efficacy is also consistent with
work using transgenic mice in which targeted deletion of either
COX-2 or inducible nitric oxide synthase (iNOS) was performed (Iadecola
et al., 1997
; Nogawa et al., 1997
). In those studies, cerebral
infarct sizes resulting from focal ischemia were reduced. Because
induction of COX-2 and iNOS was not seen in wild-type mice for many
hours after ischemia onset, those studies provide evidence that delayed
inflammatory events can contribute substantially to final lesion size.
MnTE-2-PyP5+ failed to alter selective
neuronal necrosis resulting from near-complete forebrain ischemia. This
came as a surprise, given reports that some free radical scavengers and
catalytic antioxidants provide outcome efficacy in
temperature-controlled models of global ischemia (Yamamoto et al.,
1997
; Soehle et al., 1998
; Lipton, 1999
). In addition, overexpression
of Cu,Zn-SOD and EC-SOD causes reduced injury in mice subjected to
global ischemia (Murakami et al., 1997
; Sheng et al., 2000
). We cannot
explain the discrepancy of results with
MnTE-2-PyP5+ given current data. There are
numerous inherent differences in the pathophysiology of global
and focal ischemia. Focal ischemia presents an ischemic penumbra with
graded blood flow (Ginsberg and Pulsinelli, 1994
), spontaneous
depolarizations (Nedergaard and Hansen, 1993
), and a greater proclivity
to neutrophil recruitment (Hayward et al., 1996
) that may in part
explain greater sensitivity to MnTE-2-PyP+. It is
unlikely, however, that lack of effects in global ischemia is
attributable to MnTE-2-PyP+ effects on intraischemic blood
flow. The two-vessel occlusion model used in our laboratory
consistently causes intraischemic blood flow to be reduced to
autoradiographically undetectable levels in rats that are given
anesthetics having marked differences in effects on cerebral blood flow
(Mackensen et al., 2000
). Furthermore, overexpression of EC-SOD does
not alter intraischemic or early reperfusion blood flow values (Sheng
et al., 2000
).
In conclusion, intrathecal administration of the porphyrin-based
catalytic antioxidant, MnTE-2-PyP5+,
caused marked reduction of focal ischemic brain injury when given as
late as 6 hr after onset of reperfusion. Pharmacologic characteristics
of the compound require further definition. However, efficacy of
delayed administration of an antioxidant is consistent with recent
evidence that production of reactive oxygen species is sustained for
substantial intervals after ischemia and provides a rational
therapeutic strategy for intervention.
 |
FOOTNOTES |
Received Feb. 1, 2001; revised April 6, 2001; accepted April 13, 2001.
This work was supported by United States Public Health Service Grants
R01 NS38944-02, U10 HL 63397, and PO1 HL 31992, and Incara
Pharmaceuticals Corporation (Research Triangle Park, NC). G.B.M. was
supported by a postdoctoral stipend through the German Academic
Exchange Service. We are grateful to Ann D. Brinkhous for
expert technical assistance.
Correspondence should be addressed to Dr. David S. Warner, Department
of Anesthesiology, Box 3094, Duke University Medical Center, Durham, NC
27710. E-mail: warne002{at}mc.duke.edu.
 |
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