Stable prostacyclin improves postischaemic microcirculatory changes in hypertensive rats

Endothelium-derived hyperpolarizing factor in the brain: influence of sex, vessel size and disease state

The endothelial layer of cells lining the intimal surface of blood vessels is essential for vascular function. The endothelium releases multiple vasodilator and protective factors, including nitric oxide, prostacyclin and endothelium-derived hyperpolarizing factor; an imbalance in these factors predisposes individuals to vascular diseases such as stroke. These factors are differentially regulated by vessel size, sex hormones and disease state, therefore playing differential roles in different tissues following vascular injury. In particular, the endothelium-derived hyperpolarizing factor candidate termed epoxyeicosatrienoic acid, plays a prominent role in microvessel function, especially after ischemia, thereby making this signaling pathway an attractive target for therapy in vascular disease, including stroke.

Adverse biochemical and physiological effects of prostacyclin in experimental brain oedema

BACKGROUND

Prostacyclin (PGI2) and its stable analogues are known to reduce capillary hydraulic permeability. This study explores the biochemical and physiological effects of i.v. infusion of low-dose PGI2 in an experimental model of vasogenic brain oedema.

METHODS

Twenty-seven anaesthetized and mechanically ventilated piglets with brain oedema induced by intrathecal injection of lipopolysaccharide (LPS) were used. Five of the animals received a continuous infusion of PGI2 (1 ng kg(-1) min(-1)) i.v. Four microdialysis catheters were placed in the brain to measure interstitial concentrations of glucose, lactate, and glycerol. Mean arterial pressure (MAP), intracranial pressure (ICP) and temperature were monitored continuously. Low-dose infusion of PGI2 started 1 h before the LPS injection and was constant during the study period.

RESULTS

Intracranial pressure increased significantly in animals treated with PGI2. The increase in ICP was associated with significant cerebral biochemical changes: decrease in glucose, increase in lactate, increase in lactate/glucose ratio and increase in glycerol.

CONCLUSION

In LPS-induced brain oedema i.v. infusion of low-dose PGI2 caused a further increase in ICP and a perturbation of energy metabolism, indicating cerebral ischemia and degradation of cellular membranes.

TRA-418, a novel compound having both thromboxane A(2) receptor antagonistic and prostaglandin I(2) receptor agonistic activities: its antiplatelet effects in human and animal platelets

TRA-418 is a novel compound that has been found in our screening for compounds having both thromboxane A2 (TP) receptor antagonistic and prostaglandin I2 (IP) receptor agonistic activities. In the binding assays, TRA-418 showed a 10-fold higher affinity to TP-receptors than IP-receptors. TRA-418 inhibited platelet aggregation induced by the TP-receptor agonist, U-46619 and by arachidonic acid at concentrations lower than those required for inhibition of ADP-induced aggregations. Furthermore, TRA-418 inhibited not only platelet aggregation induced by ADP alone, but also that induced by ADP in the presence of the TP-receptor antagonist, SQ-29548. When the IC50 values of TRA-418 for platelet aggregation were estimated in platelet preparations from monkeys, dogs, cats, and rats using ADP and arachidonic acid as the platelet stimulating agents, it was found that the values estimated in monkey platelets were quite similar to those estimated in human platelets. In ex vivo platelet aggregation in monkeys, TRA-418 exhibited significant inhibitory effects on arachidonic acid-induced aggregation in platelet preparations from monkeys treated at 3 micro g kg min-1 or higher doses, where neither a significant decrease in blood pressure nor a significant increase in heart rate was observed. These results are consistent with the fact that TRA-418 has a relatively potent TP-receptor antagonistic activity together with a relatively weak IP-receptor agonistic activity.

Low-dose prostacyclin improves cortical perfusion following experimental brain injury in the rat

It was recently shown that prostacyclin at a low dose reduces cortical cell death following brain trauma in the rat. Conceivably, prostacyclin with its vasodilatory, anti-aggregatory, anti-adhesive and permeability-reducing properties improved a compromised perfusion caused by post-traumatic vasoconstriction, microthrombosis and increased microvascular permeability. The objective of the present study was therefore to investigate the hemodynamic effects of low-dose prostacyclin in the traumatized rat cortex. Following a fluid percussion brain injury or a sham procedure, animals were treated with a continuous intravenous infusion of prostacyclin of 1 or 2 ng x kg(-1) x min(-1), or vehicle. Blood flow ([(14)C]-iodoantipyrine), the permeability-surface area product (PS) for [(51)Cr]-EDTA, and brain water content were measured after 3 or 48 h of treatment. Blood flow values in the injured cortex were transiently reduced to 0.42 +/- 0.2 mL x min(-1) in the vehicle group 3 h following trauma from a corresponding value of about 1.6 mL x min(-1) in the sham group, with recovery of blood flow after 48 h. Prostacyclin treatment caused a dose-dependent increase in blood flow which reached statistical significance 48 h following trauma. Brain water content and PS increased in the injured cortex post trauma and the higher dose of prostacyclin increased these parameters further at 48 h compared to the vehicle group (p < 0.05). The latter effects of prostacyclin cannot be attributed to an increase in permeability, as prostacyclin did not influence PS or brain water content following sham trauma. In fact prostacyclin has been shown to have permeability-decreasing properties. We conclude that prostacyclin improves cortical perfusion following brain trauma. The simultaneous aggravation of brain edema can be explained by an increased surface area, perhaps in combination with increased capillary hydrostatic pressure.

Effect of TTC-909 on cerebral infarction following permanent occlusion of the middle cerebral artery in stroke prone spontaneously hypertensive rats

We investigated the effect of TTC-909, a drug preparation of the stable prostaglandin I(2) analogue clinprost (isocarbacyclin methylester; methyl 5-[(1S,5S,6R,7R)-7-hydroxy-6-[(E)-(S)-3-hydroxy-1-octenyl] bicyclo[3.3.0]oct-2-en-3-yl] pentanoate) incorporated into lipid microspheres, on cerebral infarction 7 days after permanent occlusion of the middle cerebral artery (MCA) in stroke prone spontaneously hypertensive rats (SHRSP). Under the anesthesia, the MCA was permanently occluded above the rhinal fissure. In schedule 1, vehicle or TTC-909 was injected i.v. once daily over 7 days starting immediately after MCA occlusion. In schedule 2, vehicle or TTC-909 was infused for 3 h starting immediately after MCA occlusion. In schedule 3, vehicle or TTC-909 was infused for 3 h starting immediately after MCA occlusion followed by bolus injection once daily over 6 days. Seven days later, the infarct volume was estimated following hematoxylin and eosin staining. Cerebral infarction produced by permanent occlusion of MCA was limited to the cerebral cortex. While this volume was reduced significantly in case of schedule 3, the infarct volume was not reduced significantly in schedules 1 and 2. Ozagrel, a thromboxane A(2) synthetase inhibitor, had no effect on the infarct volume in schedule 3. These results suggest that cerebral infarction can be developed progressively not only during the first few hours but also after a permanent occlusion of MCA in SHRSP. TTC-909 inhibited cerebral infarction, maybe by improving cerebral blood flow and by protecting against neuronal damage.

Effect of TTC-909 in a middle cerebral artery thrombosis model in stroke-prone spontaneously hypertensive rats

We investigated the effect of TTC-909, a preparation of the stable prostaglandin I(2) analogue clinprost (isocarbacyclin methylester; methyl 5-[(1S,5S,6R,7R)-7-hydroxy-6-[(E)-(S)-3-hydroxy-1-octenyl] bicyclo[3.3.0]oct-2-en-3-yl] pentanoate) incorporated into lipid microspheres, on infarct volume 24 h after photochemically induced thrombotic occlusion of the middle cerebral artery in stroke-prone spontaneously hypertensive rats (SHR). Under anesthesia, the photosensitizing dye rose bengal (20 mg/kg) was administered intravenously and photoirradiation with green light (wavelength 540 nm) on the middle cerebral artery above the rhinal fissure was achieved using a xenon lamp for 10 min. Infarct volume 24 h after the photochemically induced thrombotic occlusion of the middle cerebral artery was significantly larger in stroke-prone SHR than in Wistar rats. When TTC-909 in doses of 100, 300 and 900 ng/kg/h was intravenously infused for 3 h, starting immediately after the end of the 10-min photoirradiation, the infarct volume was dose-dependently reduced and was statistically significant at a dose of 900 ng/kg/h (p < 0.05). Ozagrel, a thromboxane A(2) synthetase inhibitor, significantly reduced the infarct volume. The model of photochemically induced thrombotic occlusion of the middle cerebral artery in stroke-prone SHR is very useful, because the cerebral infarction is large enough and reproducible. TTC-909 may be effective for the treatment of acute ischemic stroke.

Infusion of prostacyclin following experimental brain injury in the rat reduces cortical lesion volume

Endothelial-derived prostacyclin is an important regulator of microvascular function, and its main actions are inhibition of platelet/leukocyte aggregation and adhesion, and vasodilation. Disturbances in endothelial integrity following traumatic brain injury (TBI) may result in insufficient prostacyclin production and participate in the pathophysiological sequelae of brain injury. The objective of this study was to evaluate the potential therapeutic effects of a low-dose prostacyclin infusion on cortical lesion volume, CA3 neuron survival and functional outcome following TBI in the rat. Anesthetized animals (sodium pentobarbital, 60 mg/kg, i.p.) were subjected to a lateral fluid percussion brain injury (2.5 atm) or sham injury. Following TBI, animals were randomized to receive a constant infusion of either prostacyclin (1 ng/kg x min(-1) i.v.) or vehicle over 48 h. All sham animals received vehicle (n = 6). Evaluation of neuromotor function, lesion volume, and CA3 neuronal loss was performed blindly. By 7 days postinjury, cortical lesion volume was significantly reduced by 43% in the prostacyclin-treated group as compared to the vehicle treated group (p < 0.01; n = 12 prostacyclin, n = 12 vehicle). No differences were observed in neuromotor function (48 h and 7 days following TBI), or in hippocampal cell loss (7 days following TBI) between the prostacyclin- and vehicle-treated groups. We conclude that prostacyclin in a low dose reduces loss of neocortical neurons following TBI and may be a potential clinical therapeutic agent to reduce neuronal cell death associated with brain trauma.

Effects of blood pressure on orbital and middle cerebral artery resistances in healthy pregnant women and women with preeclampsia

OBJECTIVE

The object of the study was to test the hypothesis that preeclampsia leads to an abnormal vascular response to increasing blood pressure in cerebral vessels by analyzing the relationship between mean arterial pressure and resistance index in the central retinal, ophthalmic, and middle cerebral arteries in women with normal pregnancies and women with preeclampsia.

STUDY DESIGN

Transcranial and color flow Doppler ultrasonographic studies were used to determine systolic, diastolic, and mean velocities and the resistance indexes in the central retinal, ophthalmic, and middle cerebral arteries in 24 women with normal pregnancies and 18 women with preeclampsia. In each group the relationship between the mean arterial pressure and the resistance index was determined for each artery by means of linear regression analysis. The Pearson correlation coefficients for each mean arterial pressure versus resistance index relationship were compared between the groups. In a separate analysis middle cerebral artery data obtained from 79 women with preeclampsia (with and without headache) were compared with data from the normal pregnancy group and analyzed in terms of the relationship between mean arterial pressure and resistance index.

RESULTS

The resistance index in women with normal pregnancies decreased with increasing mean arterial pressure in all 3 vessels studied (ophthalmic artery r = -0.33, central retinal artery r = -0. 43, middle cerebral artery r = -0.30). In the women with preeclampsia, however, as mean arterial pressure increased the resistance index increased in the orbital vessels and decreased in the middle cerebral artery (ophthalmic artery r = 0.54, central retinal artery r = 0.65, middle cerebral artery r = -0.25). The correlation coefficients in the women with preeclampsia were significantly different from those in the women with normal pregnancies for the ophthalmic and central retinal arteries (P =. 001) but not for the middle cerebral artery (P =.8). Within-group analysis in the patients with normal pregnancies showed no differences between the correlation coefficients of the studied vessels. In the women with preeclampsia the ophthalmic artery (P =. 02) and the central retinal artery (P =.005) were significantly different from the middle cerebral artery but not from each other. Women with preeclampsia who had headache had a different correlation coefficient for the middle cerebral artery than did those without headache (r = -0.34 versus r = 0.23; P <.001). The correlation coefficient for the middle cerebral artery for women with preeclampsia without headache was not significantly different from the central retinal artery and ophthalmic artery correlation coefficients in the general preeclampsia group.

CONCLUSIONS

Women with preeclampsia demonstrate a different relationship between blood pressure and resistance index in the ophthalmic and central retinal arteries than do women with normal pregnancies. In the middle cerebral artery, however, preeclampsia does not appear to affect the resistance index response to increasing mean arterial pressure in women with headache. In women with preeclampsia without headache the relationship seen in the ophthalmic artery and central retinal artery is preserved in the middle cerebral artery. This may indicate a failure in the autoregulatory capacity of the middle cerebral artery in the presence of headache. Alternatively, the resistance index response in the ophthalmic artery and central retinal artery may represent small-caliber vessel vasospasm that is not present in the middle cerebral artery in women with preeclampsia who have headache.

Protective effect of a prostaglandin I2 analog, TEI-7165, on ischemic neuronal damage in gerbils

TTC-909 (Clinprost), a chemically stable PGI2 analog, isocarbacyclin methyl ester (TEI-9090 or Clinprost) incorporated in lipid microspheres, when administered intravenously after brain ischemia, prevents ischemic neuronal damage possibly by modulating cerebral blood flow and platelet aggregation. However, the possibility exists that TEI-7165, which is the free acid form and a central metabolite of TEI-9090, has direct neurotrophic action in vivo, since TEI-7165 has been shown to block neuronal voltage-dependent Ca2+ channels in vitro, and a novel prostacyclin receptor showing high affinity with TEI-7165 has been detected in a variety of brain regions including the hippocampus. In the present study, we infused TEI-7165 for 7 days into the lateral ventricle of gerbils starting 2 h before or just after 3-min forebrain ischemia. TEI-7165 infusion prevented significantly the ischemia-induced shortening of response latency time as revealed by a step-down passive avoidance task. Subsequent light and electron microscopic examinations showed that pyramidal neurons in the hippocampal CA1 region, as well as synapses within the strata moleculare, radiatum and oriens of the region, were significantly more numerous in gerbils infused with TEI-7165 than in those receiving vehicle infusion. TEI-7165 infusion did not affect hippocampal blood flow or temperature. These findings, together with the previously depicted accumulation of centrally administered [3H]TEI-7165 around hippocampal neurons, suggest that TEI-7165 has a direct neuroprotective action in brain ischemia.

Neuroprotective effect of TTC-909, an isocarbacyclin methyl ester incorporated in lipid microspheres, on hippocampal delayed neuronal death of stroke-prone spontaneously hypertensive rats

TTC-909 is a newly developed isocarbacyclin methyl ester (TEI-9090) incorporated in lipid microspheres. The neuroprotective effect of TTC-909 was histologically examined in the pyramidal cell layer of the hippocampus CA1 subfield 7 days after transient forebrain ischemia using stroke-prone spontaneously hypertensive rats. TTC-909, given intravenously 10 min after the transient forebrain ischemia, dose-dependently protected against ischemia-related delayed neuronal death. The blood pressure remained unchanged following TTC-909 administration. This finding suggests that TTC-909 has a neuroprotective action on ischemic delayed neuronal death in the hippocampus.