Delayed loss of ETB receptor-mediated vasorelaxation after cold lesion of the rat parietal cortex

The role of endothelin and endothelin antagonists in traumatic brain injury: a review of the literature

OBJECTIVES

To date, there is increasing evidence for the role of endothelins in the pathophysiological development of cerebral vasospasms associated with a variety of neurological diseases, e.g., stroke and subarachnoid hemorrhage. In contrast, only little is known regarding the role of endothelins in impaired cerebral hemodynamics after traumatic brain injury. Therapeutic work in blocking the endothelin system has led to the discovery of a number of antagonists potentially useful in restoring cerebral blood flow after traumatic brain injury, potentially reducing the detrimental effects of secondary brain injury. Therefore, the present work provides an overview of background topics such as structures and biosynthesis of endothelins, different types as well as potential mechanisms and sites of action. In addition, the role of age for the effects of endothelins on cerebral hemodynamics after traumatic brain injury is discussed.

RESULTS

Description of data supporting the role of the endothelins play in a host of neurological deficits.

CONCLUSIONS

Endothelin antagonists may be effective as novel treatments for various neuropathologies.

Neuroprotection by erythropoietin administration after experimental traumatic brain injury

A large body of evidence indicates that the hormone erythropoietin (EPO) exerts beneficial effects in the central nervous system (CNS). To date, EPO's effect has been assessed in several experimental models of brain and spinal cord injury. This study was conducted to validate whether treatment with recombinant human EPO (rHuEPO) would limit the extent of injury following experimental TBI. Experimental TBI was induced in rats by a cryogenic injury model. rHuEPO or placebo was injected intraperitoneally immediately after the injury and then every 8 h until 2 or 14 days. Forty-eight hours after injury brain water content, an indicator of brain edema, was measured with the wet-dry method and blood-brain barrier (BBB) breakdown was evaluated by assay of Evans blue extravasation. Furthermore, extent of cerebral damage was assessed. Administration of rHuEPO markedly improved recovery from motor dysfunction compared with placebo group (P<0.05). Brain edema was significantly reduced in the cortex of the EPO-treated group relative to that in the placebo-treated group (80.6+/-0.3% versus 91.8%+/-0.8% respectively, P<0.05). BBB breakdown was significantly lower in EPO-treated group than in the placebo-treated group (66.2+/-18.7 mug/g versus 181.3+/-21 mug/g, respectively, P<0.05). EPO treatment reduced injury volume significantly compared with placebo group (17.4+/-5.4 mm3 versus 37.1+/-5.3 mm3, P<0.05). EPO, administered in its recombinant form, affords significant neuroprotection in experimental TBI model and may hold promise for future clinical applications.

CHARACTERIZATION OF THE ENDOTHELIN-B RECEPTOR EXPRESSION AND VASOMOTOR FUNCTION DURING EXPERIMENTAL CEREBRAL VASOSPASM

OBJECTIVE

Several investigations suggest a key role of endothelin (ET) in the development of cerebral vasospasm (CVS). In the cerebrovasculature, physiologically ET-dependent constriction is mediated by the ET(A) receptor, whereas activation of the endothelial ET(B) receptor results in relaxation. However, existence of a contractile ET(B) receptor was postulated after subarachnoid hemorrhage (SAH), according to gene expression studies. The aim of the present investigation is, therefore, to characterize the function and the expression of the ET(B) receptor in the cerebrovasculature during CVS.

METHODS

CVS was induced in the rat double-hemorrhage model and assessed by perfusion-weighted magnetic resonance imaging scans. Rats were sacrificed on Days 3 and 5 after SAH, and immunohistochemical staining for ET(B) receptors was performed. Isometric force of basilar artery ring segments with (E+) and without (E-) endothelial function was measured. Concentration effect curves for the ET(B) receptor agonist, sarafotoxin 6c, were constructed by cumulative application in segments under resting tension and after precontraction.

RESULTS

Immunoreactivity for the ET(B) receptor was observed exclusively in the endothelium and was not significantly altered after SAH. Under resting tension, sarafotoxin 6c did not induce significant contraction in E+ or E- segments. After precontraction, a significant relaxation was induced by sarafotoxin 6c administration in sham-operated rats (mean maximum effect, 103 +/- 10%), which decreased time dependently after SAH (Day 3, 68 +/- 3%; Day 5, 42 +/- 3%). Endothelium-dependent relaxation induced by acetylcholine, however, was not significantly reduced.

CONCLUSION

The present investigation provides evidence for the loss of the ET(B) receptor-mediated vasomotor function after SAH. Thus, antagonism of the ET(B) receptor may be undesirable for the treatment of CVS.

Endothelin receptor expression in the normal and injured spinal cord: potential involvement in injury-induced ischemia and gliosis

The endothelins (ETs) are a family of peptides that exert their biological effects via two distinct receptors, the endothelin A receptor (ET(A)R) and the endothelin B receptor (ET(B)R). To more clearly define the potential actions of ETs following spinal cord injury, we used immunohistochemistry and confocal microscopy to examine the protein expression of ET(A)R and ET(B)R in the normal and injured rat spinal cord. In the normal spinal cord, ET(A)R immunoreactivity (IR) is expressed by vascular smooth muscle cells and a subpopulation of primary afferent nerve fibers. ET(B)R-IR is expressed primarily by radial glia, a small population of gray and white matter astrocytes, ependymal cells, vascular endothelial cells, and to a lesser extent in smooth muscle cells. Fourteen days following compression injury to the spinal cord, there was a significant upregulation in both the immunoexpression and number of astrocytes expressing the ET(B)R in both gray and white matter and a near disappearance of ET(B)R-IR in ependymal cells and ET(A)R-IR in primary afferent fibers. Conversely, the vascular expression of ET(A)R and ET(B)R did not appear to change. As spinal cord injury has been shown to induce an immediate increase in plasma ET levels and a sustained increase in tissue ET levels, ETs would be expected to induce an initial marked vasoconstriction via activation of vascular ET(A)R/ET(B)R and then days later a glial hypertrophy via activation of the ET(B)R expressed by astrocytes. Strategies aimed at blocking vascular ET(A)R/ET(B)R and astrocyte ET(B)Rs following spinal cord injury may reduce the resulting ischemia and astrogliosis and in doing so increase neuronal survival, regeneration, and function.

Endothelin B receptor deficiency augments neuronal damage upon exposure to hypoxia-ischemia in vivo

The role of functional endothelin-B (ETB)-receptors on neuronal survival upon hypoxia-ischemia (HI) has been investigated in 14-day-old ETB-receptor-deficient spotting lethal (sl/sl) and wildtype (+/+) rats. Carotid ligation followed by exposure to 8% oxygen for 2 h produced distinct cortical and hippocampal neuronal damage. Damage severity 24 h after HI was mild to intermediate in +/+ rats whereas large cortical infarcts and profound apoptosis of the hippocampus evolved in sl/sl rats. The number of apoptotic cells in the dentate 24 h after HI amounted to 30 +/- 7 cells/0.1 mm(2) in sl/sl compared to 9 +/- 3 cells/0.1 mm(2) in wildtype rats (mean +/- S.E.M., n=10-11, P=0.0093). In-vitro hypoxia (15 h) resulted in a comparable increase in cell death in primary pure neuronal hippocampal cultures from both groups (49.8 +/- 1.6% in sl/sl, 51.4 +/- 0.9% in +/+, mean +/- S.E.M., n=5, P=0.0560). To conclude, absence of functional ETB receptors is associated with an increased susceptibility to HI in-vivo, which is not intrinsic to neurons. Antagonism of ETB receptors seems not to be desirable in ischemic stroke.

Time course of apoptotic cell death after experimental neurotrauma

Traumatic or ischemic brain injury may give rise to the development of secondary brain damage. In the present study the time course of TUNEL staining which is widely used to delineate apoptotic reaction pattern was followed after experimental neurotrauma in order to test the hypothesis that apoptotic cell death may be involved in the development of secondary brain damage. Neurotrauma was induced in male Wistar rats by applying a cold probe to the exposed dura over the temporo-parietal cortex. Animals were sacrificed between 1 and 72 hours after trauma and coronal sections prepared from the lesioned area and adjacent tissue. The TUNEL staining was employed to detect DNA-fragmentation and conventional HE staining of sequential slices to delineate the extent of the lesion. Occurrence of positively stained cells was detected by a computer-based quantification system and stored on hard disk. TUNEL-positive nuclei were observed as early as one hour after lesion and peaked at 3 hours. There after, the number of cells detected decreased steadily. Histological examination revealed two different types of morphology in TUNEL-positive cells. A small proportion termed type I-cells displayed additional signs of apoptotic cell death such as nuclear condensation and fragmentation while type-II were considered to undergo necrotic cell death. Thus, TUNEL staining proved to be an unspecific marker of apoptotic cell death in the present study. Nevertheless, the data suggest that apoptotic cell death does not contribute substantially to the final extent of cold induced brain tissue damage.

Differential glial and vascular expression of endothelins and their receptors in rat brain after neurotrauma

We characterized the time-course, intensity of expression and cellular origin of components of the endothelin (ET) system in the rat brain after a standardized neurotrauma (cryogenic lesion of the parietal cortex). ET mRNAs were expressed at sham level after neurotrauma, whereas immunoreactivity for ET-1 was enhanced in glia and endothelium of the lesioned hemisphere and both hippocampi. The number of ET-3 positive mononuclear cells in the lesion perimeter increased starting at 24h after injury. At 48h after neurotrauma, ET-receptor immunoreactivity was increased in astrocytes. In basilar artery endothelium, ETB-immunoreactivity was reduced at 48h to 72h recovering at 7 days whereas ETA-receptor and ET-peptide immunoreactivities were not altered. In summary, neurotrauma leads to a multicellular stimulation of endothelins in the brain along with a delayed selective loss of vascular ETB-receptors. These changes seem to be posttranscriptional and cell type specific. They favor vasoconstriction increasing the risk of late vasospasm and ischemia.

Endothelin B receptor-deficient rats as a subtraction model to study the cerebral endothelin system

Endothelins, due to their potent vasoactivity and mitogenicity, appear to play an important role in the brain, where all components of the endothelin system, peptides, receptors and converting enzyme, are expressed. To further elucidate the role of the cerebral endothelin system, astrocytes and cerebral vessels from sl/sl rats, devoid of functional endothelin B receptors, have been employed. Astrocytes from sl/sl rats display the following abnormalities as compared to wild-type (+/+) cells: (i) elevated basal extracellular endothelin-1 levels; (ii) exclusive presence of functional endothelin A receptors; (iii) increased extracellular endothelin-1 levels upon endothelin A receptor blockade; (iv) augmented basal endothelin-converting enzyme activity; (v) altered calcium response to endothelin-1. The basilar artery of sl/sl rats shows an enhanced constricting response to endothelin-1 and fails to dilate in response to endothelin-3, shifting the endothelin vasomotor balance to constriction. In conclusion, endothelin B receptors may be essential for restricting extracellular endothelin-1 levels in the brain, as well as for a balanced cerebral vasomotor action of endothelins.

Temporal profile of expression and cellular localization of inducible nitric oxide synthase, interleukin-1beta and interleukin converting enzyme after cryogenic lesion of the rat parietal cortex

We used in situ hybridization, RT PCR and immunohistochemistry to study the time course of expression and the cellular localization of inducible nitric oxide synthase (iNOS) and interleukin-1beta (IL-1beta) during the first 7 days after induction of a standardized cryogenic lesion on the right parietal cortex in male rats. Cryogenic lesion induced iNOS mRNA in the lesioned hemisphere after 6 to 72 h with a maximum (15+/-2 cells/mm2, n=4, p<0.01 vs. sham) at 24 h. Microglia, invading monocytes and granulocytes in and around the lesion expressed iNOS immunoreactivity starting at 12 h and peaking (29+/-10 cells/mm2, n=4, p<0.05 vs. sham) at 24 h after lesion. Induction of IL-1beta mRNA expression was immediate with a peak (9+/-1 cells/mm2, n=4, p<0.01 vs. sham) at 24 h after cryogenic lesion. The number of round cells with IL-1beta immunoreactivity around the lesion was maximal (8+/-2 cells/0.1 mm2, n=3, p<0.01 vs. sham) at 24 h. A weak astrocytic expression of IL-1beta-immunoreactivity was seen in sham animal brains. Astrocytic IL-1beta-expression was significantly increased in the lesion hemisphere and both hippocampi. Interleukin converting enzyme (ICE) was expressed in astrocytes and microglia around the lesion 6 h after injury. The number of ICE immunoreactive cells (8+/-2 cells/0. 1 mm2, n=3, p<0.05 vs. sham) peaked at 72 h after lesion. Neuronal expression of ICE and IL-1beta was seen in the lesion periphery 72 h and 7 days after injury. At this time, morphological features of apoptosis were evident in cells in the lesion periphery. The data indicate an early activation of microglia and monocyte invasion into the lesion hemisphere leading to multicellular expression of iNOS, ICE, and IL-1beta. These events may contribute to the expansion of neuronal damage after brain injury.