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Therapeutic Hypothermia after Cardiac Arrest Attenuates Hindlimb Paralysis and Damage of Spinal Motor Neurons and Astrocytes through Modulating Nrf2/HO-1 Signaling Pathway in Rats.

Abstract
Cardiac arrest (CA) and return of spontaneous circulation (ROSC), a global ischemia and reperfusion event, lead to neuronal damage and/or death in the spinal cord as well as the brain. Hypothermic therapy is reported to protect neurons from damage and improve hindlimb paralysis after resuscitation in a rat model of CA induced by asphyxia. In this study, we investigated roles of nuclear factor erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in the lumbar spinal cord protected by therapeutic hypothermia in a rat model of asphyxial CA. Male Sprague-Dawley rats were subjected to seven minutes of asphyxial CA (induced by injection of 2 mg/kg vecuronium bromide) and hypothermia (four hours of cooling, 33 ± 0.5 °C). Survival rate, hindlimb motor function, histopathology, western blotting, and immunohistochemistry were examined at 12, 24, and 48 h after CA/ROSC. The rats of the CA/ROSC and hypothermia-treated groups had an increased survival rate and showed an attenuated hindlimb paralysis and a mild damage/death of motor neurons located in the anterior horn of the lumbar spinal cord compared with those of the CA/ROSC and normothermia-treated groups. In the CA/ROSC and hypothermia-treated groups, expressions of cytoplasmic and nuclear Nrf2 and HO-1 were significantly higher in the anterior horn compared with those of the CA/ROSC and normothermia-treated groups, showing that cytoplasmic and nuclear Nrf2 was expressed in both motor neurons and astrocytes. Moreover, in the CA/ROSC and hypothermia-treated group, interleukin-1β (IL-1β, a pro-inflammatory cytokine) expressed in the motor neurons was significantly reduced, and astrocyte damage was apparently attenuated compared with those found in the CA/ROSC and normothermia group. Taken together, our results indicate that hypothermic therapy after CA/ROSC attenuates CA-induced hindlimb paralysis by protecting motor neurons in the lumbar spinal cord via activating the Nrf2/HO-1 signaling pathway and attenuating pro-inflammation and astrocyte damage (reactive astrogliosis).
AuthorsJi Hyeon Ahn, Tae-Kyeong Lee, Dae Won Kim, Myoung Cheol Shin, Jun Hwi Cho, Jae-Chul Lee, Hyun-Jin Tae, Joon Ha Park, Seongkweon Hong, Choong-Hyun Lee, Moo-Ho Won, Yang Hee Kim
JournalCells (Cells) Vol. 12 Issue 3 (01 26 2023) ISSN: 2073-4409 [Electronic] Switzerland
PMID36766758 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Heme Oxygenase-1
  • NF-E2-Related Factor 2
  • Hmox1 protein, rat
  • Nfe2l2 protein, rat
Topics
  • Animals
  • Male
  • Rats
  • Astrocytes (metabolism)
  • Heart Arrest (complications, therapy)
  • Heme Oxygenase-1 (metabolism)
  • Hindlimb (metabolism)
  • Hypothermia (metabolism)
  • Hypothermia, Induced (methods)
  • Motor Neurons (metabolism)
  • NF-E2-Related Factor 2 (metabolism)
  • Paralysis
  • Rats, Sprague-Dawley
  • Signal Transduction

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