adrenomedullin and Infarction--Middle-Cerebral-Artery

Adrenomedullin (AM) is a vasodilating peptide involved in the regulation of circulatory homeostasis and in the pathophysiology of certain cardiovascular diseases. AM plays critical roles in blood vessels, including regulation of vascular stability and permeability. To elucidate the autocrine/paracrine function of AM in endothelial cells (EC) in vivo, a conditional knockout of AM in EC (AM(EC-KO)) was used. The amount of vascularization of the matrigel implants was lower in AM(EC-KO) mice indicating a defective angiogenesis. Moreover, ablation of AM in EC revealed increased vascular permeability in comparison with wild type (WT) littermates. In addition, AM(EC-KO) lungs exhibited significantly less tumor growth than littermate WT mice using a syngeneic model of metastasis. Furthermore, following middle cerebral artery permanent occlusion, there was a significant infarct size decrease in animals lacking endothelial AM when compared to their WT counterparts. AM is an important regulator of EC function, angiogenesis, tumorigenesis, and brain response to ischemia. Studies of AM should bring novel approaches to the treatment of vascular diseases.

Topics: Adrenomedullin; Animals; Blood Pressure; Brain; Brain Ischemia; Capillary Permeability; Cell Movement; Cell Proliferation; Endothelial Cells; Gene Expression Regulation; Infarction, Middle Cerebral Artery; Lung Neoplasms; Mice, Knockout; Neovascularization, Physiologic

Recent studies suggest the protective effects of adrenomedullin (AM) on ischemic brain damage. The present study was aimed at investigating the effects of AM and its receptor antagonist, AM₂₂₋₅₂, on ischemia-induced cerebral edema and brain swelling in rats using magnetic resonance imaging. Rats were subjected to 60 min of middle cerebral artery occlusion (MCAO) followed by reperfusion. Intravenous injection of AM (1.0 μg/kg), AM₂₂₋₅₂ (1.0 μg/kg), or saline was made before MCAO. Effects of AM injection just after reperfusion were also investigated. One day after ischemia, increases in T₂-weighted signals in the brain were clearly observed. Total edema volume, as well as brain swelling, was greatly and significantly reduced by pre-treatment of AM (reduced by 53%). Extent of brain swelling was significantly correlated with the volume of cerebral edema. The protective effect of AM against edema was more clearly observed in the cerebral cortex (reduced by 63%) than the striatum (reduced by 31%). Increased T₂ relaxation time in the cortex was recovered partially by pre-treatment of AM. Post-treatment of AM had no effects. Pre-treatment of AM₂₂₋₅₂ tended to exacerbate the edema. In another line of experiment, cocktail administration of AM with melatonin, a pineal product having neuroprotective potential as a free radical scavenger, failed to enhance the protective effects of AM alone. The present study clearly suggests the prophylactic effects of AM against cerebral edema, especially the cortical edema, in a rat stroke model.

Topics: Adrenomedullin; Animals; Brain; Brain Edema; Infarction, Middle Cerebral Artery; Magnetic Resonance Imaging; Male; Melatonin; Peptide Fragments; Rats; Rats, Wistar; Reperfusion Injury; Vasodilator Agents

Adrenomedullin (AM) and its binding protein, complement factor H (FH), are expressed throughout the brain. In this study we used a brain-specific conditional knockout for AM and a complete knockout for FH to investigate the effect of these molecules on the pathophysiology of stroke. Following 48 h of middle cerebral artery permanent occlusion, there was a statistically significant infarct size increase in animals lacking AM when compared to their wild type littermates. In contrast, lack of FH did not affect infarct volume. To investigate some of the mechanisms by which lack of AM may augment brain damage, markers of nitrosative stress, apoptosis, and autophagy were studied at the mRNA and protein levels. There was a significant increase of inducible nitric oxide synthase (iNOS), matrix metalloproteinase-9 (MMP9), fractin, and Beclin-1 in the peri-infarct area of AM-deficient mice when compared to their wild type counterparts and to contralateral and sham-operated controls. These data suggest that AM exerts a neuroprotective action in the brain and that this protection may be mediated by regulation of iNOS, matrix metalloproteases, and inflammatory mediators. In the future, substances that increase AM actions in the central nervous system may be used as potential neuroprotective agents in stroke.

Topics: Adrenomedullin; Animals; Brain Infarction; Brain Ischemia; Complement Factor H; Disease Models, Animal; Disease Progression; Infarction, Middle Cerebral Artery; Mice; Mice, Inbred C57BL; Mice, Knockout; Mice, Transgenic

Inspired from preconditioning studies, ischemic postconditioning, consisting of the application of intermittent interruptions of blood flow shortly after reperfusion, has been described in cardiac ischemia and recently in stroke. It is well known that ischemic tolerance can be achieved in the brain not only by ischemic preconditioning, but also by hypoxic preconditioning. However, the existence of hypoxic postconditioning has never been reported in cerebral ischemia.. Adult mice subjected to transient middle cerebral artery occlusion underwent chronic intermittent hypoxia starting either 1 or 5 days after ischemia and brain damage was assessed by T2-weighted MRI at 43 days. In addition, we investigated the potential neuroprotective effect of hypoxia applied after oxygen glucose deprivation in primary neuronal cultures.. The present study shows for the first time that a late application of hypoxia (5 days) after ischemia reduced delayed thalamic atrophy. Furthermore, hypoxia performed 14 hours after oxygen glucose deprivation induced neuroprotection in primary neuronal cultures. We found that hypoxia-inducible factor-1alpha expression as well as those of its target genes erythropoietin and adrenomedullin is increased by hypoxic postconditioning. Further studies with pharmacological inhibitors or recombinant proteins for erythropoietin and adrenomedullin revealed that these molecules participate in this hypoxia postconditioning-induced neuroprotection.. Altogether, this study demonstrates for the first time the existence of a delayed hypoxic postconditioning in cerebral ischemia and in vitro studies highlight hypoxia-inducible factor-1alpha and its target genes, erythropoietin and adrenomedullin, as potential effectors of postconditioning.

Topics: Adrenomedullin; Animals; Atrophy; Brain; Cells, Cultured; Cytoprotection; Disease Models, Animal; Energy Metabolism; Erythropoietin; Hypoxia-Inducible Factor 1, alpha Subunit; Hypoxia-Ischemia, Brain; Hypoxia, Brain; Infarction, Middle Cerebral Artery; Male; Mice; Nerve Degeneration; Oxidative Stress; Time Factors

To explore the influence of adrenomedullin (ADM) on apoptosis of neuron, volume of infarction and the expression of early growth response gene-1 (Egr-1) mRNA in the rat with focal ischemia/reperfusion (I/R) injury.. Fifty-four SD rats were randomly divided into sham operation group, ADM femoral vein group, internal carotid artery group and lateral cerebral ventricle group. The model was reproduced by ligating the middle cerebral artery (MCA) with a ligature for 2 hours followed by injection of ADM through femoral artery, internal carotid artery and lateral cerebral ventricle before reperfusion for 22 hours. The volume of infarction was estimated with tetrazolium chloride (TTC) staining, apoptosis of the neuron was detected by terminal deoxynucleotidyl transferase-mediated dUTP-biotin nick end labeling (TUNEL) method, the positive expression of Egr-1 mRNA was detected by in-situ hybridization.. The volume of infarction were smaller after the injection of ADM through different ways than that of I/R group. The result was better when the internal carotid artery and the lateral cerebral ventricle were used than that after injection by the way of the femoral vein (both P<0.05). There were few positive cells with TUNEL staining in the cerebral cortex and hippocampus CA1 zone in the sham operation group, and more apoptotic cells were seen in the group with focal brain I/R injury (both P<0.01). After the administration of ADM, especially through the internal carotid artery and the lateral cerebral ventricle, the number of the positive cells with TUNEL staining was decreased obviously compared with I/R group (both P<0.01). There was a little positive expression of Egr-1 mRNA in the cerebral cortex and hippocampus CA1 zone in sham operation group. The expression was enhanced in the group with focal brain I/R injury (both P<0.01). With the injection of ADM, the expression was much more enhanced, especially when internal carotid artery and the lateral cerebral ventricle were used for injection compared with those in I/R group (both P<0.01).. The injection of ADM through different ways can reduce the neural injury, decrease the apoptosis of the neurons and the volume of the infarction, and increase the expression of Egr-1 mRNA. Therefore, it is efficacious in the treatment of cerebral ischemia.

Topics: Adrenomedullin; Animals; Apoptosis; Brain; Disease Models, Animal; Early Growth Response Protein 1; Infarction, Middle Cerebral Artery; Male; Neurons; Random Allocation; Rats; Rats, Sprague-Dawley; Reperfusion Injury; RNA, Messenger

Adrenomedullin (AM) induces angiogenesis and inhibits cell apoptosis through the phosphatidylinositol 3-kinase/Akt pathway. Transplantation of mesenchymal stem cells (MSCs) has been shown to improve neurological deficits after stroke in rats. We investigated whether AM enhances the therapeutic potency of MSC transplantation.. Male Lewis rats (n=100) were subjected to 2-hour middle cerebral artery occlusion. Immediately after reperfusion, rats were assigned randomly to receive intravenous transplantation of MSCs plus subcutaneous infusion of AM for 7 days (MSC+AM group), AM infusion alone (AM group), MSC transplantation alone (MSC group), or vehicle infusion (control group). Neurological and immunohistological assessments were performed to examine the effects of these treatments.. Some engrafted MSCs were positive for neuronal and endothelial cell markers, although the number of differentiated MSCs did not differ significantly between the MSC and MSC+AM groups. The neurological score significantly improved in the MSC, AM, and MSC+AM groups compared with the control group. Importantly, improvement in the MSC+AM group was significantly greater than that in the MSC and AM groups. There was marked induction of angiogenesis in the ischemic penumbra in the MSC+AM group, followed by the AM, MSC, and control groups. AM infusion significantly inhibited apoptosis of transplanted MSCs. As a result, the number of engrafted MSCs in the MSC+AM group was significantly higher than that in the MSC group.. AM enhanced the therapeutic potency of MSCs, including neurological improvement, possibly through inhibition of MSC apoptosis and induction of angiogenesis.

Topics: Adrenomedullin; Animals; Apoptosis; Body Weight; Cell Transplantation; Disease Models, Animal; Immunohistochemistry; In Situ Nick-End Labeling; Infarction, Middle Cerebral Artery; Ischemia; Male; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Neovascularization, Pathologic; Neurons; Peptides; Phosphatidylinositol 3-Kinases; Rats; Rats, Inbred Lew; Stem Cells; Stroke; Time Factors

The effect of adrenomedullin, a vasodilatory peptide on transient middle cerebral artery (MCA) occlusion was investigated in rats.. Transient MCA occlusion for 2 hours was made by using the intra-arterial suture method, followed by reperfusion.. An intravenous infusion of adrenomedullin (1 microg/kg/min) from one hour before ischemia to one hour after ischemia significantly reduced the infarct size and improved neurological deficits (p<0.05), without affecting systemic blood pressure or other physiological parameters. The infarct size was reduced with adrenomedullin by 25.4+/-12.7%, 31.3+/-5.8%, 31.6+/-6.1% respectively at the coronal level 6, 8 and 10 mm posterior from the frontal pole. Adrenomedullin also significantly inhibited the increase in myeloperoxidase (MPO) activity in the MCA area of the ischemic hemisphere after 22-hour reperfusion (control: 0.205+/-0.054 unit/g wet tissue, adrenomedullin group: 0.047+/-0.009 unit/g wet tissue, p<0.0001).. These data suggest that adrenomedullin reduces acute ischemic brain injury and one of is neuroprotective mechanisms may be derived from inhibition of the infiltration of neutrophils into the ischemic tissue.

Topics: Adrenomedullin; Animals; Brain Ischemia; Disease Models, Animal; Infarction, Middle Cerebral Artery; Ischemic Attack, Transient; Male; Neutrophils; Peptides; Peroxidase; Rats; Rats, Wistar; Reperfusion Injury; Vasodilator Agents