sphingosine-phosphorylcholine and Vasospasm--Intracranial

The sphingosylphosphorylcholine-Rho-kinase pathway plays an important role in Ca(2+) sensitization of vascular smooth muscle contraction. Eicosapentaenoic acid (EPA) inhibits sphingosylphosphorylcholine -Rho-kinase-activated Ca(2+)-sensitization in vitro and in subarachnoid hemorrhage (SAH) models in vivo and has also been shown to inhibit the occurrence of cerebral vasospasm (CIV) after the onset of SAH in a prospective, nonrandomized study. The current prospective, multicenter, randomized study was performed to confirm the preventive effects of EPA on CIV in patients with SAH.. The trial population comprised 162 patients who underwent surgical clipping within 72 hours of the onset of SAH. Of these patients, 81 received 2700 mg/day EPA from the day after surgery until day 30 (EPA group), and 81 did not receive EPA (control group). The primary end point was the occurrence of symptomatic vasospasm (SV) or cerebral infarction caused by CIV.. The occurrences of SV (15% vs. 30%; P = 0.022) and CIV (7% vs. 21%; P = 0.012) were lower in the EPA group. Multivariate analysis revealed an adjusted odds ratio of 0.39 (95% confidence interval, 0.17-0.89; P = 0.028) for SV inhibition by EPA and 0.27 (95% confidence interval, 0.09-0.72; P = 0.012) for CIV inhibition.. These results indicate that oral EPA reduces the frequency of SV and CIV after the onset of aneurysmal SAH.

Topics: Aged; Arachidonic Acid; Cardiovascular Agents; Combined Modality Therapy; Eicosapentaenoic Acid; Female; Humans; Male; Middle Aged; Odds Ratio; Phosphorylcholine; Prospective Studies; rho-Associated Kinases; Signal Transduction; Sphingosine; Subarachnoid Hemorrhage; Treatment Outcome; Vasospasm, Intracranial

Hyperlipidemia is a risk factor for abnormal cerebrovascular events. Rafts are cholesterol-enriched membrane microdomains that influence signal transduction. We previously showed that Rho-kinase-mediated Ca(2+) sensitization of vascular smooth muscle (VSM) induced by sphingosylphosphorylcholine (SPC) has a pivotal role in cerebral vasospasm. The goals of the study were to show SPC-Rho-kinase-mediated VSM contraction in vivo and to link this effect to cholesterol and rafts. The SPC-induced VSM contraction measured using a cranial window model was reversed by Y-27632, a Rho-kinase inhibitor, in rats fed a control diet. The extent of SPC-induced contraction correlated with serum total cholesterol. Total cholesterol levels in the internal carotid artery (ICA) were significantly higher in rats fed a cholesterol diet compared with a control diet or a β-cyclodextrin diet, which depletes VSM cholesterol. Western blotting and real-time PCR revealed increases in flotillin-1, a raft marker, and flotillin-1 mRNA in the ICA in rats fed a cholesterol diet, but not in rats fed the β-cyclodextrin diet. Depletion of cholesterol decreased rafts in VSM cells, and prevention of an increase in cholesterol by β-cyclodextrin inhibited SPC-induced contraction in a cranial window model. These results indicate that cholesterol potentiates SPC-Rho-kinase-mediated contractions of importance in cerebral vasospasm and are compatible with a role for rafts in this process.

Topics: Amides; Animals; Antihypertensive Agents; Basilar Artery; beta-Cyclodextrins; Carotid Artery, Internal; Cholesterol; Dietary Fats; Male; Membrane Microdomains; Membrane Proteins; Muscle Contraction; Muscle, Smooth, Vascular; Phosphorylcholine; Pyridines; Rats; Rats, Sprague-Dawley; rho-Associated Kinases; Signal Transduction; Sphingosine; Vasospasm, Intracranial

Inflammation has an important function in the development of cerebral vasospasm after subarachnoid hemorrhage (SAH); however, the mediators of this inflammatory response have not been clearly identified. In this study, we have investigated the potential function of two sphingolipids, which occur naturally in plasma and serum, sphingosylphosphorylcholine (SPC) and sphingosine 1-phosphate (S1P), to act as proinflammatory mediators in cerebral artery vascular smooth muscle (VSM) cells. In rat cerebral arteries, SPC but not S1P activated p38 mitogen-activated protein kinase (MAPK). Using transcription factor arrays, two proinflammatory transcription factors activated by SPC in cerebral arteries were identified--nuclear factor-κB and CCAAT-enhancer-binding protein. Both these transcription factors were activated by SPC in a p38MAPK-dependent manner. To determine whether this contributed to vascular inflammation, an inflammatory protein array was performed, which showed that SPC increased release of the chemokine monocyte chemoattractant protein-1 (MCP-1) in cultured rat VSM cells. This increase in MCP-1 expression was confirmed in cerebral arteries. The S1P did not increase MCP-1 release. Taken together, our results suggest that SPC, but not S1P, can act as a proinflammatory mediator in cerebral arteries. This may contribute to inflammation observed after SAH and may be part of the initiating event in vasospasm.

Topics: Animals; Blood Platelets; Blotting, Western; Cells, Cultured; Cerebral Arteries; Chemokine CCL2; Electrophoretic Mobility Shift Assay; Enzyme Activation; Enzyme-Linked Immunosorbent Assay; Fluorescent Antibody Technique; Inflammation; Inflammation Mediators; Lysophospholipids; Male; Muscle, Smooth, Vascular; NF-kappa B; p38 Mitogen-Activated Protein Kinases; Phosphorylcholine; Rats; Rats, Sprague-Dawley; Sphingosine; Subarachnoid Hemorrhage; Transcription Factors; Up-Regulation; Vasospasm, Intracranial

Rho-kinase (ROK)-mediated Ca2+ sensitization of vascular smooth muscle (VSM) contraction plays a pivotal role in cerebral vasospasm (CV). We previously demonstrated that sphingosylphosphorylcholine (SPC) induces Ca2+ sensitization through sequential activation of the Src family protein tyrosine kinases (Src-PTKs) and ROK in vitro, and that Ca2+ sensitization is inhibited by eicosapentaenoic acid (EPA) through the selective inactivation of Src-PTK. In this study, we examined whether SPC induced CV in vivo, and, if it did, whether EPA would inhibit CV, as induced by SPC or in an in vivo model of subarachnoid hemorrhage (SAH).. Changes in the diameter of the canine basilar artery were investigated by angiography after administering SPC into the cisterna magna. Then, Y27632, a specific Rho-kinase inhibitor, or EPA was injected intracisternally and the effects of both agents were investigated. In another experiment using a single-hemorrhage model, Y27632 or EPA was injected on day 7 after SAH and the changes in the diameter of the canine basilar artery were investigated.. At cerebrospinal fluid concentrations of 100 and 300 micromol/l, SPC induced severe vasoconstriction (maximum vasoconstriction by SPC (100 micromol/l): 61.8 +/- 8.2%), which was markedly reversed by Y27632 (96.3 +/- 4.4%) or EPA (92.6 +/- 12.8%). SAH caused severe vasospasm on day 7 (67.6 +/- 7.8%), which was significantly blocked by Y27632 (95.5 +/- 10.6%) or EPA (90.0 +/- 4.4%).. SPC is a novel mediator of ROK-induced CV in vivo. The inhibition of CV induced by SPC or after SAH by EPA suggests beneficial roles of EPA in the treatment of CV. Our findings are compatible with the notion that the SPC-ROK pathway may be involved in CV.

Topics: Animals; Basilar Artery; Benzopyrans; Cerebral Angiography; Cisterna Magna; Disease Models, Animal; Dogs; Eicosapentaenoic Acid; Female; Injections; Male; Phosphorylcholine; Protein Kinase Inhibitors; rho-Associated Kinases; Signal Transduction; Sphingosine; Subarachnoid Hemorrhage; Time Factors; Vasoconstriction; Vasodilator Agents; Vasospasm, Intracranial

Topics: Animals; Calcium Signaling; Cattle; Cerebral Arteries; Heterotrimeric GTP-Binding Proteins; Humans; Intracellular Signaling Peptides and Proteins; Lysophospholipids; Models, Cardiovascular; Muscle Contraction; Muscle, Smooth, Vascular; Myosin-Light-Chain Phosphatase; Phosphoprotein Phosphatases; Phosphorylcholine; Protein Kinase C; Protein Serine-Threonine Kinases; Receptors, Cell Surface; rho-Associated Kinases; rhoA GTP-Binding Protein; Signal Transduction; Sphingosine; Vasospasm, Intracranial