ziconotide and Ischemic-Attack--Transient

In the mammalian central nervous system, transient global ischemia of specific duration causes selective degeneration of CA1 pyramidal neurons in hippocampus. Many of the ischemia-induced pathophysiologic cascades that destroy the neurons are triggered by pre- and postsynaptic calcium entry. Consistent with this, many calcium channel blockers have been shown to be neuroprotective in global models of ischemia. omega-Conotoxin MVIIA, a selective N-type VGCC blocker isolated from the venom of Conus magus, protects CA1 neurons in the rat model of global ischemia, albeit transiently. The mechanism by which this peptide renders neuroprotection is unknown. We performed high-resolution receptor autoradiography with the radiolabeled peptide and observed highest binding in stratum lucidum of CA3 subfield, known to contain inhibitory neurons potentially important in the pathogenesis of delayed neuronal death. This finding suggested that the survival of stratum lucidum inhibitory neurons might be the primary event, leading to CA1 neuroprotection after ischemia. Testing of this hypothesis required the reproduction of its neuroprotective effects in the gerbil model of global ischemia. Surprisingly, we found that omega-MVIIA did not attenuate CA1 hippocampal injury after 5 min of cerebral ischemia in gerbil. Possible reasons are discussed. Lastly, we show that the peptide can be used as a synaptic marker in assessing short and long-term changes that occur in hippocampus after ischemic injury.

Topics: Animals; Autoradiography; Biomarkers; Calcium; Calcium Channel Blockers; Calcium Channels, N-Type; Excitatory Postsynaptic Potentials; Gerbillinae; Hippocampus; Interneurons; Ion Transport; Ischemic Attack, Transient; Male; Nerve Tissue Proteins; Neurons; Neuroprotective Agents; omega-Conotoxin GVIA; omega-Conotoxins; Rats; Reperfusion Injury; Species Specificity; Time Factors

The neuroprotective efficacy of the selective N-type voltage-sensitive calcium channel blocker, SNX-111, was evaluated in spontaneously hypertensive rats subjected to 60 min of focal cerebral ischemia by permanent ligation of the right common carotid artery and temporary occlusion of the right middle cerebral artery. Intravenous infusion of 167 microg/kg per min SNX-111 for 30 min (5 mg/kg), initiated immediately after reperfusion, significantly reduced cortical infarct volumes measured 24 h after the ischemic insult.

Topics: Animals; Brain Damage, Chronic; Calcium Channel Blockers; Drug Evaluation, Preclinical; Hypertension; Ischemic Attack, Transient; Male; Membrane Potentials; Mollusk Venoms; Neuroprotective Agents; omega-Conotoxins; Peptides; Rats; Rats, Inbred SHR

Diffusion-weighted magnetic resonance imaging (DWI) is capable of noninvasively imaging acute cerebral ischemia. We demonstrate the utility of this technique by evaluating SNX-111, a novel N-type calcium channel blocker with potential neuroprotective properties, in a rodent model of transient focal ischemia. Twenty-four Sprague-Dawley rats weighing between 310-350 g underwent occlusion of the middle cerebral artery (MCAO) for 105 min followed by 22.5 h of reperfusion. Thirty minutes following MCAO, animals were randomized to receive SNX-111 5 mg/kg intravenously over 1 h vs. placebo. DWI and T2-weighted MRIs (T2W) were performed at 0.5, 1.5 and 24 h after the onset of ischemia. Area fractions of increased signal intensity on the DWI and T2W images were measured. DWI area fractions at 1.5 and 24 h were also normalized to the initial, pre-treatment scans. Apparent diffusion coefficients (ADC) were calculated from fitted maps. Tri-phenyl tetrazolium chloride (TTC) staining was performed on brains at 24 h and infarct area fractions were measured. SNX-111 treated animals showed significantly improved 1.5-h DWI scan ratios compared to controls (ratios of 1.06 +/- 0.25 vs. 2.98 +/- 0.78 SNX vs. controls respectively, P < 0.05). A trend toward improved DWI ratios was seen by 24 h in the SNX-111 group (2.5 +/- 0.75 vs. 4.12 +/- 1.6, N.S.) DWI, T2W and TTC area fractions at 24 h also showed trends favoring a neuroprotective effect of SNX-111. Bright areas on DWI corresponded to ADC decreases of about 30% compared to the non-ischemic hemisphere. These decreases were the same in both treatment groups and at each time point. DWI, T2W and TTC area fractions at 24 h were strongly correlated (r = 0.98, DWI and TTC; r = 0.99, T2W and TTC; r = 0.97, T2W and DWI, P < 0.0001). We conclude that in this ischemic model, SNX-111 provides early neuroprotection and that serial DWI is a useful way of demonstrating this.

Topics: Animals; Calcium Channel Blockers; Cerebral Infarction; Data Interpretation, Statistical; Diffusion; Disease Models, Animal; Image Processing, Computer-Assisted; Ischemic Attack, Transient; Linear Models; Magnetic Resonance Imaging; Neuroprotective Agents; omega-Conotoxins; Peptides; Rats; Rats, Sprague-Dawley; Time Factors

Although a number of studies have demonstrated the neuroprotective effects of antagonists of postsynaptic N-methyl-D-aspartate (NMDA) and non-NMDA receptors in cerebral ischemia, little is known about the treatment of cerebral infarction through presynaptic blocking of extracellular glutamate release. We evaluated the effects of a presynaptic selective N-type calcium channel antagonist (SNX-111, given intravenously by continuous infusion at 5 mg/kg/h from 20 min prior to occlusion until 2 h postocclusion) on blood flow, extracellular glutamate, and infarct volume in rats with permanent occlusions of the right middle cerebral and right common carotid arteries plus 1-h transient occlusion of the left common carotid artery. There was no significant difference in CBF in the occluded cortex during the experiment between the treated and vehicle groups. SNX-111 significantly reduced total amount of extracellular glutamate during the experiment and the peak value of the glutamate after occlusion from 44.2 +/- 15.8 microM (mean +/- SD) to 21.4 +/- 11.4 microM (p < 0.01). Infusion of SNX-111 also significantly reduced the cortical volume of infarction from 47.2 +/- 5.8 to 19.9 +/- 7.3% (p < 0.0001). These results suggest that SNX-111 has a protective effect against focal ischemia through the inhibition of glutamate release from presynaptic sites, although SNX-111 may also affect the release of other neurotransmitters.

Topics: Animals; Blood Pressure; Calcium Channel Blockers; Carotid Arteries; Cerebral Arteries; Cerebrovascular Circulation; Constriction; Glutamic Acid; Ischemic Attack, Transient; Kinetics; Male; omega-Conotoxins; Peptides; Rats; Rats, Sprague-Dawley

Topics: Animals; Brain; Calcium Channel Blockers; Cerebral Infarction; Ischemic Attack, Transient; Male; omega-Conotoxins; Peptides; Rats; Rats, Wistar

Calcium influx is believed to play a critical role in the cascade of biochemical events leading to neuronal cell death in a variety of pathological settings, including cerebral ischemia. The synthetic omega-conotoxin peptide SNX-111, which selectively blocks depolarization-induced calcium fluxes through neuronal N-type voltage-sensitive calcium channels, protected the pyramidal neurons in the CA1 subfield of the hippocampus from damage caused by transient forebrain ischemia in the rat model of four-vessel occlusion. SNX-111 provided neuroprotection when a single bolus injection was administered intravenously up to 24 hr after the ischemic insult. These results suggest that the window of opportunity for therapeutic intervention after cerebral ischemia may be much longer than previously thought and point to the potential use of omega-conopeptides and their derivatives in the prevention or reduction of neuronal damage resulting from ischemic episodes due to cardiac arrest, head trauma, or stroke. Microdialysis studies showed that SNX-111 was 3 orders of magnitude less potent in blocking potassium-induced glutamate release in the hippocampus than the conopeptide SNX-230, which, in contrast to SNX-111, failed to show any efficacy in the four-vessel occlusion model of ischemia. These results imply that the ability of a conopeptide to block excitatory amino acid release does not correlate with its neuroprotective efficacy.

Topics: Animals; Calcium Channels; Dizocilpine Maleate; Dose-Response Relationship, Drug; Drug Administration Schedule; Glutamates; Glutamic Acid; Hippocampus; Ischemic Attack, Transient; Male; Neurons; omega-Conotoxins; Peptides; Potassium; Prosencephalon; Pyramidal Tracts; Rats; Rats, Inbred F344; Reperfusion; Time Factors