thromboxane-b2 and Brain-Injuries

Traumatic brain injury (TBI) is the main cause of trauma-related deaths. Systemic hypotension and intracranial hypertension causes cerebral ischemia by altering metabolism of prostanoids. We describe prostanoid, pupilar and pathological response during resuscitation with hypertonic saline solution (HSS) in TBI. Method Fifteen dogs were randomized in three groups according to resuscitation after TBI (control group; lactated Ringer's (LR) group and HSS group), with measurement of thromboxane, prostaglandin, macroscopic and microscopic pathological evaluation and pupil evaluation.Result Concentration of prostaglandin is greater in the cerebral venous blood than in plasma and the opposite happens with concentration of thromboxane. Pathology revealed edema in groups with the exception of group treated with HSS.Discussion and conclusion There is a balance between the concentrations of prostaglandin and thromboxane. HSS prevented the formation of cerebral edema macroscopically detectable. Pupillary reversal occurred earlier in HSS group than in LR group.

Topics: Animals; Brain; Brain Edema; Brain Injuries; Cerebrovascular Circulation; Dogs; Fluid Therapy; Hemodynamics; Intracranial Pressure; Isotonic Solutions; Male; Prostaglandins F; Pupil; Random Allocation; Reproducibility of Results; Ringer's Lactate; Saline Solution, Hypertonic; Shock, Hemorrhagic; Thromboxane B2; Time Factors; Treatment Outcome

Models of brain injury in experimental animals have shown that the level of prostaglandins (PGs) is increased in damage brain tissue, and that PGs play an important role in secondary brain damage. Almost all previous studies of the relationship between PGs and brain injury have been carried out in animals. In the present study we show that the PGs change in humans with brain injury.. The plasma levels of thromboxane B2, 6-Keto-PGF2alpha, prostaglandin F2alpha, and prostaglandin E2 were measured by radioimmunoassay on the 1st, 3rd, 7th, and 14th days after brain injury. The same measurements were made on a control group of 26 healthy volunteers.. The levels of all four PGs were elevated, most markedly in the first week, with levels remaining high in the second week in the severely injured. On the first day levels were, on average, three times those found in the controls, with a seven-fold rise in some of the severely injured patients. Dividing the patients into three groups according to outcome, it was found that if the PGs were markedly increased to begin with and remained high, death or permanent disability was likely. In the group with good outcome, the levels dropped steadily from the initial high levels. The T/K ratio was studied. It related closely to the severity of injury, being higher in more severe injuries and decreasing with recovery. In patients who did not recover, the ratio increased steadily to its highest value on the 7th day, and remained high at the 14th.. Changes in PGs levels were closely related to the brain injury severity and its outcome, and there was a marked disturbance of the levels of PGs, which therefore appears to be an important indicator of secondary brain damage.

Topics: Acute Disease; Adolescent; Adult; Aged; Brain Injuries; Case-Control Studies; Child; Dinoprost; Dinoprostone; Female; Humans; Male; Middle Aged; Prostaglandins; Radioimmunoassay; Thromboxane B2; Time Factors

To determine the effects of reduced cerebral perfusion pressures produced by hemorrhage alone or in combination with intracranial hypertension on thromboxane A2 (TxA2) production, we undertook a randomized study in 38 anesthetized, mongrel dogs. Animals were subjected to 30 mins of hemorrhagic shock with normal (group 1) or increased (group 2) intracranial pressure (ICP). Group 1 animals (n = 22) were hemorrhaged to reduce cerebral perfusion pressure to 40 mm Hg for 30 mins. In group 2 (n = 16), cerebral perfusion pressure was reduced by the combination of less severe hypotension and intracranial hypertension (20 mm Hg). Cerebral and systemic hemodynamic measurements were recorded, including cerebral blood flow (sagittal sinus outflow method); ICP; cerebral perfusion pressure; and arterial and cerebral venous concentrations of TxB2 (double-antibody radioimmunoassay technique), the major metabolite of TxA2. Data were obtained at baseline and at the beginning and end of the 30-min shock period.. Hemorrhagic shock significantly (p less than .05) decreased cerebral blood flow in both groups. At the beginning of the shock period, cerebral blood flow was higher in group 1 than in group 2 (p less than .05) and venous-arterial differences in TxB2 increased significantly (p less than .05) in group 2, but not in group 1. At the end of the 30-min shock period, venous-arterial levels of TxB2 remained significantly (p less than .05) higher in group 2.. Increased cerebral production of TxA2 during hypotension accompanied by intracranial hypertension may contribute to the severity of neural damage produced by the combination of head trauma and shock.

Topics: Animals; Brain; Brain Injuries; Cerebrovascular Circulation; Dogs; Female; Hypotension; Intracranial Pressure; Male; Multivariate Analysis; Shock, Hemorrhagic; Thromboxane A2; Thromboxane B2

Head trauma (HT) was induced in the left hemisphere of rats by a weight drop device. Edema was maximal 24 h after HT in the injured zone, and PGE2, TXB2 and 6-keto-PGF1 alpha were elevated in both the injured and remote areas. The effect of a specific thromboxane synthetase inhibitor, OKY-046, on the outcome of HT was studied. OKY-046, 100 mg/kg, was given to rats immediately and 8 h after HT. The neurological severity score (NSS) was evaluated at 1 h after HT, and at 24 h, just prior to sacrifice. Specific gravity (SG) of both hemispheres was measured after decapitation. Prostaglandins (PGs) were extracted from the site of injury and from the frontal lobes, remote from the injury, and assayed by RIA. Basal levels of PGE2 and 6-keto-PGF1 alpha were not reduced by the drug while basal TXB2 levels were lowered. However, the increased production due to HT of all PGs, was inhibited by OKY-046, especially that of TXB2. The ratio of TXB2/6-keto-PGF1 alpha, known to affect vascular tone, was reduced by OKY-046 treatment as a result of TXA2 synthesis inhibition. Still, no effect was found on the neurological outcome (as evaluated by the NSS), or on edema formation (expressed by reduced SG). Thus, based on the present findings increased TXA2 synthesis cannot be implicated in the pathophysiology of cerebral edema or dysfunction following HT.

Topics: 6-Ketoprostaglandin F1 alpha; Acrylates; Animals; Brain Edema; Brain Injuries; Dinoprostone; Male; Methacrylates; Rats; Specific Gravity; Thromboxane B2; Thromboxane-A Synthase

In a model of closed head injury in rats, a calibrated weight drop device was allowed to fall onto the skull's convexity over the left hemisphere 1 to 2 mm lateral from the midline. Prostaglandin (PG) levels were determined in the frontal cortex region remote from the site of injury where no macroscopic damage could be seen. Differential patterns of temporal changes were evident for PGE2, PGD2, thromboxane (TX) B2, and 6-keto-PGF1 alpha in the contused hemisphere, but no changes were found in the contralateral hemisphere. The major changes in PG levels were increased levels of PGD2 and 6-keto-PGF1 alpha that persisted from 18 hours until 10 days after injury. The ratio between TXB2 and 6-keto-PGF1 alpha, which reflects the vascular tone, increased during the early postinjury period (15 minutes and 1 hour) and decreased later, up to 10 days. Thus, a sustained imbalance in favor of the vasodilator is apparent; this may suggest an improved blood supply to the region. Both PGD2 and PGI2 have protective effects in the brain. We suggest that their endogenous increase may be part of a repair mechanism at the periphery of the injured zone.

Topics: 6-Ketoprostaglandin F1 alpha; Animals; Brain Injuries; Dinoprostone; Frontal Lobe; Male; Prostaglandin D2; Prostaglandins; Prostaglandins D; Prostaglandins E; Rats; Thromboxane B2; Time Factors

Prostaglandin E2 (PGE2) and thromboxane B2 (TxB2) levels were measured in rats following experimental traumatic brain injury. Rats (n = 36) were prepared for fluid percussion brain injury under pentobarbital anesthesia. Twenty-four hours later, rats were lightly anesthetized using methoxyflurane, injured (2.3 atm), and killed 5 or 15 min later. Twelve of the rats died before and are not included in the analyses. The following groups were used for data analysis: group I (n = 6) were sham-injured rats prepared for injury but not injured: group II (n = 6) were injured and killed 5 min later; group III (n = 12) were injured and killed 15 min posttrauma. Thirty seconds prior to sacrifice by decapitation into liquid nitrogen, all rats were injected with indomethacin (3 mg/kg, intravenously [IV]) to prevent postmortem PG synthesis. After sacrifice, brains were removed, weighed, and homogenized in a small quantity of phosphate buffer with indomethacin (50 micrograms/ml). PGE2 and TxB2 levels were determined using double-label radioimmunoassays. Posttraumatic convulsions were observed in 5 of 12 rats in group III and these rats were analyzed separately. PGE2 and TxB2 levels increased significantly (p less than 0.05) in both hemisphere and brainstem 5 min posttrauma. Fifteen minutes after injury, both PGE2 and TxB2 levels remained elevated but the levels were lower than at 5 min in the rats that did not exhibit posttraumatic seizures. This decrease in PG levels at 15 min was not observed in the rats that had seizures after injury and both PGE2 and TxB2 levels remained high in hemispheres and brainstem. Thus, fluid percussion brain injury results in substantial elevations in PGE2 and TxB2 levels and posttraumatic seizures exacerbate the observed increases.

Topics: Animals; Brain Injuries; Male; Prostaglandins E; Rats; Rats, Inbred Strains; Seizures; Thromboxane B2

Recent evidence has shown that a variety of prostaglandins and leukotrienes can be produced in brain tissue after injury in animals. It has also been speculated that increases in brain prostaglandins occur in humans following injury. Ventricular cerebrospinal fluid (CSF) samples have been obtained from children with static lesions (controls) as well as children with acute brain injury and eicosanoids measured by immunologic techniques. Metabolites of prostacyclin (6-keto-PGF1 a) and thromboxane A2 (thromboxane B2) were the major eicosanoids found in CSF, and levels of these compounds were increased 3-10 times in acutely injured patients. Prostaglandin E2 was also found in lower amounts, although in one case its level was very high. Prostaglandin D2 was also present, but in low amounts. No leukotrienes were found in CSF samples that were purified by HPLC prior to immunoassay. Elevated levels of hydroxyeicosatetraenoic acids (HETEs) were observed in those samples stored frozen, but these metabolites were most probably due to autooxidation of arachidonic acid in CSF. Arachidonic acid concentration in CSF was typically found to be in the range of 10-200 ng/ml, but was found to be 5-10 fold higher in one severely injured patient. Thus, elevated free arachidonic acid and various oxygenated metabolites were observed in CSF following brain injury.

Topics: 12-Hydroxy-5,8,10,14-eicosatetraenoic Acid; 6-Ketoprostaglandin F1 alpha; Adolescent; Arachidonic Acid; Arachidonic Acids; Brain Injuries; Cerebral Ventricles; Child; Child, Preschool; Chromatography, High Pressure Liquid; Dinoprostone; Eicosanoic Acids; Humans; Hydroxyeicosatetraenoic Acids; Infant; Infant, Newborn; Leukotriene B4; Prostaglandin D2; Prostaglandins D; Prostaglandins E; SRS-A; Thromboxane B2