» Articles » PMID: 22397464

Mild Hypothermia of 34°C Reduces Side Effects of Rt-PA Treatment After Thromboembolic Stroke in Rats

Overview
Publisher Biomed Central
Date 2012 Mar 9
PMID 22397464
Citations 12
Authors
Affiliations
Soon will be listed here.
Abstract

Background: Hypothermia is neuroprotective in experimental stroke and may extend the so far limited therapeutic time window for thrombolysis. Therefore, hypothermia of 34°C and its effects on delayed thrombolysis including reperfusion-associated injury were investigated in a model of thromboembolic stroke (TE).

Methods: Male Wistar rats (n = 48) were subjected to TE. The following treatment groups were investigated: control group - normothermia (37°C); thrombolysis group - rt-PA 90 min after TE; hypothermia by 34°C applied 1.5 to 5 hours after TE; combination therapy- hypothermia and rt-PA. After 24 hours infarct size, brain edema and neuroscore were assessed. Protein markers for inflammation and adhesion, gelatinase activity, and blood brain barrier (BBB) disruption were determined. MRI-measurements investigated infarct evolution and blood flow parameters.

Results: The infarct volume and brain swelling were smaller in the hypothermia group compared to the other groups (p < 0.05 to p < 0.01). Thrombolysis resulted in larger infarct and brain swelling than all others. Hypothermia in combination with thrombolysis reduced these parameters compared to thrombolysis (p < 0.05). Moreover, the neuroscore improved in the hypothermia group compared to control and thrombolysis. Animals of the combination therapy performed better than after thrombolysis alone (p < 0.05). Lower serum concentration of sICAM-1, and TIMP-1 were shown for hypothermia and combination therapy. Gelatinase activity was decreased by hypothermia in both groups.

Conclusions: Therapeutic hypothermia reduced side-effects of rt-PA associated treatment and reperfusion in our model of TE.

Citing Articles

Therapeutic hypothermia is not dead, but hibernating!.

Freedman Jr R, Schock R, Peacock W Clin Exp Emerg Med. 2024; 11(3):238-242.

PMID: 39390630 PMC: 11467454. DOI: 10.15441/ceem.24.291.


A Systematic Review and Meta-Analysis of Therapeutic Hypothermia and Pharmacological Cotherapies in Animal Models of Ischemic Stroke.

Suerte A, Liddle L, Abrahart A, Khiabani E, Colbourne F Ther Hypothermia Temp Manag. 2024; 14(4):229-242.

PMID: 38946643 PMC: 11685787. DOI: 10.1089/ther.2024.0012.


The Modulatory Role of Hypothermia in Poststroke Brain Inflammation: Mechanisms and Clinical Implications.

Xu W, Geng X, Fayyaz A, Ding Y Cerebrovasc Dis. 2024; 53(6):776-788.

PMID: 38286123 PMC: 11633906. DOI: 10.1159/000536384.


Effects of Therapeutic Hypothermia Combined with Other Neuroprotective Strategies on Ischemic Stroke: Review of Evidence.

Zhang Z, Zhang L, Ding Y, Han Z, Ji X Aging Dis. 2018; 9(3):507-522.

PMID: 29896438 PMC: 5988605. DOI: 10.14336/AD.2017.0628.


Free Radical Damage in Ischemia-Reperfusion Injury: An Obstacle in Acute Ischemic Stroke after Revascularization Therapy.

Sun M, Jin H, Sun X, Huang S, Zhang F, Guo Z Oxid Med Cell Longev. 2018; 2018:3804979.

PMID: 29770166 PMC: 5892600. DOI: 10.1155/2018/3804979.


References
1.
Wang Y, Tsirka S, Strickland S, Stieg P, Soriano S, Lipton S . Tissue plasminogen activator (tPA) increases neuronal damage after focal cerebral ischemia in wild-type and tPA-deficient mice. Nat Med. 1998; 4(2):228-31. DOI: 10.1038/nm0298-228. View

2.
Shaw G, Bavani N, Dhamija A, Lindsell C . Effect of mild hypothermia on the thrombolytic efficacy of 120 kHz ultrasound enhanced thrombolysis in an in-vitro human clot model. Thromb Res. 2005; 117(5):603-8. DOI: 10.1016/j.thromres.2005.05.005. View

3.
Bernard S, Gray T, Buist M, Jones B, Silvester W, Gutteridge G . Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia. N Engl J Med. 2002; 346(8):557-63. DOI: 10.1056/NEJMoa003289. View

4.
Mokhtarani M, Mahgoub A, Morioka N, Doufas A, Dae M, Shaughnessy T . Buspirone and meperidine synergistically reduce the shivering threshold. Anesth Analg. 2001; 93(5):1233-9. DOI: 10.1097/00000539-200111000-00038. View

5.
Burggraf D, Martens H, Jager G, Hamann G . Recombinant human tissue plasminogen activator protects the basal lamina in experimental focal cerebral ischemia. Thromb Haemost. 2003; 89(6):1072-80. View