Ken-ichi Kawano

ME3277, a GPIIb/IIIa antagonist reduces cerebral infarction without enhancing intracranial hemorrhage in photothrombotic occlusion of rabbit middle cerebral artery.

GPIIb/IIIa antagonists are expected to have a beneficial effect on acute cerebral infarction, however, the occurrence of intracranial hemorrhage has not been as widely investigated. A rabbit focal thrombotic occlusion model of the middle cerebral artery was established by creating a photochemical reaction between green light and Rose Bengal. Hemorrhagic transformation was common in the area of cerebral infarction. Using this model, the effect of a GPIIb/IIIa antagonist, ME3277 (low dose, (L); 0.15 mg/kg + 0.125 mg/kg·h, middle dose, (M); 0.3 mg/kg + 0.25 mg/kg·h and high dose, (H); 0.6 mg/kg + 0.5 mg/kg·h), aspirin (20 mg/kg) and sodium ozagrel (thromboxane A2 synthase inhibitor, 1 mg/kg + 2 mg/kg·h) were evaluated. Drugs were intravenously administrated 30 minutes after the photochemical reaction for 24 hours. Aspirin inhibited the ex vivo platelet aggregation induced by arachidonic acid and collagen but not by adenosine diphosphate (ADP), while sodium ozagrel only inhibited the arachidonic acid-induced aggregation. ME3277 dose-dependently inhibited the platelet aggregation induced by all the inducers (approximately 60% in L, 80% in M, and 90% in H). At 24 hours of middle cerebral artery (MCA) occlusion, infarct volume was significantly reduced by aspirin and each dose of ME3277. These agents improved neurologic deficits, with ME3277 being more potent than aspirin. Sodium ozagrel did not alter the infarct volume nor neurologic deficits. No drug was found to worsen hemorrhage volume despite increasing bleeding time (2–3 fold) in the skin. In this model, the occluded artery was spontaneously recanalized and re-thrombosed frequently. One mechanism by which antiplatelet agents reduced infarct volume was inhibition of rethrombosis of the MCA. These results suggest that treatment with a GPIIb/IIIa antagonist is a useful intervention for acute cerebral infarction prolonging dose bleeding time to 3 times the basal value.

A novel MCA occlusion model of photothrombotic ischemia with cyclic flow reductions: development of cerebral hemorrhage induced by heparin

Intracerebral hemorrhage is the major complication associated with antithrombotic and thrombolytic therapy. Despite efforts directed toward achieving hemorrhagic infarction, an ideal animal model of cerebral hemorrhage has not yet to be established. Using the photothrombotic technique in rabbits, we developed a model of cerebral hemorrhage by inducing cyclic flow reductions in the middle cerebral artery (MCA). Furthermore, the hemorrhage increased 4-fold after infusion of heparin at a dose prolonging activated partial thromboplastin time by about three times that of control animals. The photothrombotic occlusion of the MCA is based on a thrombosis induced by endothelial injury through singlet oxygen produced by Rose Bengal injection and green light irradiation (Acta Neuropathol. 72 (1987) 315; Acta Neuropathol. 72 (1987) 326; J. Pharmacol. Toxicol. Methods. 29 (1993) 165). Using a pulse Doppler flowmeter, spontaneous reperfusion of the MCA after the thrombotic occlusion following cyclic flow reductions was observed within 2 h in the majority of animals. This model is unusual with respect to the development of clinical stroke, because of the MCA cyclic flow reductions. Thus it is different from permanent or ischemia/reperfusion MCA occlusion in rodents and may be suitable for studying hemorrhagic risks associated with the use of antithrombotic agents.

Cerebral hemorrhage due to heparin limits its neuroprotective effects: studies in a rabbit model of photothrombotic middle cerebral artery occlusion.

We investigated the efficacy of heparin on cerebral ischemic damage in a rabbit model of middle cerebral artery (MCA) photothrombosis and in the same model, cerebral hemorrhage induced by heparin as its side effect was also investigated. Using a photothrombosis model in rabbits, 38 animals were divided into four groups, heparin low-dose I and II, heparin high-dose and vehicle. In heparin low-dose I (n=10) or II (n=7), heparin was administered for 23.5 or 22 h, respectively, starting 30 or 120 min after the start of photo-irradiation to induce thrombosis. In high-dose (n=7), heparin was administered 30 min after the start of photo-irradiation for 23.5 h. In the vehicle treated group (control), 14 animals were infused continuously with saline for 23.5 h. Heparin at low and high doses prolonged Activated partial thromboplastin time (aPTT) by about 3 and 10 times compared with control group. The results show that cerebral hemorrhage was present in all animals, gross hemorrhage was observed in one animal each of the heparin low-dose I and high-dose groups, and in three animals of the heparin low-dose II group, while no gross hemorrhage was observed in control group. In heparin low-dose I, the size of cerebral infarction was significantly (P<0.01) reduced and neurological deficits were significantly (P<0.01) improved. In contrast, in heparin high-dose, the infarct size significantly increased, especially in the cortex (P<0.0001), and neurological deficits were significantly (P<0.01) worsened. In heparin low-dose II, the size of cerebral hemorrhage significantly (P<0.001) increased compared with the control group. In conclusion, using a photothrombotic model in the rabbit MCA, we have investigated the antithrombotic benefits and hemorrhagic risks associated with heparin. Of unique feature of our model is the fact that in a single animal model, we could evaluate doses of heparin which reduce cerebral infarction and doses which can promote cerebral hemorrhage. This model can be extended to determine both benefits and risks of antithrombotic agents.

Superiority of platelet integrin GPIIb-IIIa receptor antagonist over aspirin in preventing cyclic flow reductions in the guinea pig middle cerebral artery.

We established a photothrombotic occlusion model in the guinea pig middle cerebral artery. In this model, the middle cerebral artery was recanalized within 10 to 20 min after thrombotic occlusion, with subsequent cyclic flow reductions. Cyclic flow reductions in the middle cerebral artery are expected to manage cerebral infarction by modulating arterial patency. Therefore, we evaluated the effect of several antiplatelet agents on the frequency of cyclic flow reductions and subsequent cerebral infarction using this model. A platelet integrin GPIIb-IIIa receptor antagonist, ME3277 (sodium hydrogen [4-[(4,5,6,7-tetrahydrothieno[3,2c]pyridin-2-yl) carbonylamino] acetyl-o-phenylene] dioxydiacetate, 0.3, 1 and 3 mg/kg i.v.) dose-dependently inhibited the ex vivo platelet aggregation induced by ADP (5 microM), collagen (0.8 and 20 microg/ml) and arachidonic acid (100 microM). While the same doses of ME3277 reduced the frequency of the cyclic flow reductions and increased the total patency time of the middle cerebral artery, time to thrombotic occlusion was prolonged only at the highest dose, 3 mg/kg. ME3277 (0.3-3 mg/kg) significantly reduced the infarct volume and improved the neurological deficit at 24 h. In contrast, aspirin (30 mg/kg) did not affect these variables in spite of complete inhibition of platelet aggregation induced by arachidonic acid and collagen (0.8 microg/ml). A thromboxane A2 synthetase inhibitor, sodium ozagrel, significantly increased the total patency time and reduced the infarct volume at 30 mg/kg. Inhibition of prostaglandin I2 generation could explain the effectiveness of sodium ozagrel but not aspirin in this model. These results suggest that platelet integrin GPIIb-IIIa receptor antagonists are more beneficial than aspirin for the treatment of cerebral thrombosis.

Oral Intake of Beet Extract Provides Protection Against Skin Barrier Impairment in Hairless Mice

The epidermis acts as a functional barrier against the external environment. Disturbances in the function of this barrier cause water loss and increase the chances of penetration by various irritable stimuli, leading to skin diseases such as dry skin, atopic dermatitis, and psoriasis. Ceramides are a critical natural element of the protective epidermal barrier. The aim of this study was to evaluate whether the oral intake of beet (Beta vulgaris) extract, a natural product rich in glucosylceramide (GlcCer), may prevent disturbance in skin barrier function. When HR‐1 hairless mice were fed a special diet (HR‐AD), transepidermal water loss (TEWL) from the dorsal skin increased, with a compensatory increase in water intake after 5 weeks. Mice fed with HR‐AD had dry skin with erythema and showed increased scratching behaviour. Histological examinations revealed a remarkable increase in the thickness of the skin at 8 weeks. Supplemental addition of beet extract, which contained GlcCer at a final concentration of 0.1%, significantly prevented an increase TEWL, water intake, cumulative scratching time, and epidermal thickness at 8 weeks. These results indicate that oral intake of beet extract shows potential for preventing skin diseases associated with impaired skin barrier function. Copyright

Increased cerebral infarction by cyclic flow reductions: studies in the guinea pig MCA thrombosis model

We have developed a photochemical model of thrombotic middle cerebral artery (MCA) occlusion in the guinea pig for investigating factors contributing to the development of cerebral infarction. In this model, cyclic flow reductions (CFRs) after recanalization of the MCA are a common observation and might contribute to the development of cerebral infarction. Therefore, we sought to measure the time course of recanalization of the guinea pig MCA after the artery had been occluded by a thrombus. Thrombotic occlusion of the MCA was induced by photochemical reaction between intravenously administered rose bengal and transluminal green light for 10, 15, 20, or 30 min. After the thrombotic occlusion of MCA and subsequent spontaneous thrombolysis, blood flow in the MCA gradually recovered to preocclusion level but with frequent CFRs. The recovery of MCA blood flow or duration of CFRs was dependent on the duration of photochemical reaction (extent of endothelial injury); thus, for a 30-min photochemical reaction, CFRs were still observed 24 h after photochemical reaction. In separate experiments, we also investigated the effect of permanent occlusion of the MCA, which was induced by electrocoagulation in the vessel on cerebral infarction. The infarct volume in the permanent occlusion model was smaller than the maximum value in the thrombotic occlusion model (12.5 vs. 17.4%; P < 0.05, n = 6). CFRs may constitute an important factor contributing to the extent of cerebral infarction.We have developed a photochemical model of thrombotic middle cerebral artery (MCA) occlusion in the guinea pig for investigating factors contributing to the development of cerebral infarction. In this model, cyclic flow reductions (CFRs) after recanalization of the MCA are a common observation and might contribute to the development of cerebral infarction. Therefore, we sought to measure the time course of recanalization of the guinea pig MCA after the artery had been occluded by a thrombus. Thrombotic occlusion of the MCA was induced by photochemical reaction between intravenously administered rose bengal and transluminal green light for 10, 15, 20, or 30 min. After the thrombotic occlusion of MCA and subsequent spontaneous thrombolysis, blood flow in the MCA gradually recovered to preocclusion level but with frequent CFRs. The recovery of MCA blood flow or duration of CFRs was dependent on the duration of photochemical reaction (extent of endothelial injury); thus, for a 30-min photochemical reaction, CFRs were still observed 24 h after photochemical reaction. In separate experiments, we also investigated the effect of permanent occlusion of the MCA, which was induced by electrocoagulation in the vessel on cerebral infarction. The infarct volume in the permanent occlusion model was smaller than the maximum value in the thrombotic occlusion model (12.5 vs. 17.4%; P < 0.05, n = 6). CFRs may constitute an important factor contributing to the extent of cerebral infarction.

Thromboxane A2 synthase inhibitor enhanced antithrombotic efficacy of GPIIb–IIIa receptor antagonist without increasing bleeding

The advantage of platelet integrin GPIIb-IIIa receptor antagonists in the prevention of thrombotic occlusion was clearly proven in patients who underwent interventional treatment of the coronary artery, but its value in cerebral ischemia is still under investigation. The expectation of intracranial hemorrhage on strong inhibition of platelet function restricts its application in cerebral ischemia. To minimize bleeding while keeping antithrombotic activity, we have tried to find an appropriate approach using a combination of platelet integrin GPIIb-IIIa receptor antagonist and some other antithrombotic agents. The time to thrombotic occlusion was measured using a photothrombotic occlusion model of guinea pig middle cerebral artery. A platelet integrin GPIIb-IIIa receptor antagonist, ME3277 (sodium hydrogen [4-[(4,5,6,7-tetrahydrothieno [3,2-c] pyridin-2-yl) carbonylamino] acetyl-o-phenylene] dioxydiacetate), delayed occlusion time from 7.3 min in vehicle to 15.0, 20.6 and 25.9 min (P<0.05) at 0.1, 0.3 and 1 mg/kg, respectively. ME3277 profoundly inhibited ex vivo platelet aggregation and the highest dose of ME3277 prolonged (3.5 folds, P<0.01) the bleeding time measured in the hind paw. A thromboxane A(2) synthase inhibitor, sodium ozagrel, significantly delayed occlusion time to 19.5 min at 30 mg/kg (P<0.05) while it did not affect bleeding time or platelet aggregation. ME3277 (0.1 mg/kg) in combination with 10 mg/kg sodium ozagrel synergistically delayed occlusion time (sodium ozagrel alone; 7.9 min, combination; 26.1 min, P<0.05 vs. ME3277 alone). Sodium ozagrel did not affect ex vivo platelet aggregation or bleeding time when combined with 0.1 mg/kg of ME3277. This synergy was cancelled by combination with 30 mg/kg aspirin (14.7 min). A thromboxane A(2) receptor antagonist, vapiprost (0.1 mg/kg), did not enhance the antithrombotic efficacy of ME3277. These results imply that local prostacyclin production enhances the in vivo antithrombotic effect of the platelet integrin GPIIb-IIIa receptor antagonist. Therefore, the thromboxane A(2) synthase inhibitor allowed a reduction in the dose level of the platelet integrin GPIIb-IIIa receptor antagonist for cerebral thrombosis, which resulted in a reduced risk of bleeding.

A novel guinea pig model with cyclic flow reductions following thrombotic cerebral ischemia

Cyclic flow reductions (CFRs), a phenomenon indicated with repeating rethrombosis following thrombolysis in clotted vessel has been observed in coronal, carotid and popliteal arteries in various species when they were occluded with vessel damage, suggesting the presence of CFRs in the acute phase of stroke in man. Although much effort has been directed toward rethrombosis or ischemia-reperfusion injuries in acute strokes, a therapy for CFRs in strokes has not been established because of the lack of ideal animal models. We have established a novel guinea pig model with CFRs in the middle cerebral artery (MCA) using a photothrombotic technique, in which the MCA was spontaneously recanalized within 20 min after the first occlusion with subsequent CFRs. We also investigated the effects of antiplatelet agents and the anticoagulant heparin using this model. All tested antiplatelet agents inhibited CFRs, whereas an anticoagulant did not. These results show that this model is unique with respect to its development of MCA cyclic flow reductions, and may be suitable for investigating mechanisms and therapeutic reagents of CFRs in the MCA.

Respiratory effects of halothane and AMPA receptor antagonist synergy in rats

The influence of N-methyl-D-aspartate (NMDA) or alpha-amino-3-hydroxy-5-methylisoxazole-4-propionate (AMPA) receptor antagonists in combination with halothane anaesthesia on the respiratory system was investigated. Under 1.5% halothane anaesthesia, respiratory parameters including respiratory rate, minute volume, tidal volume, inspiratory and expiratory duration were measured before and after drug administration in rats. The AMPA receptor antagonists, 6-(1H-imidazol-1-yl)-7-nitro-2,3-(1H,4H)-quinoxalinedione hydrochloride, YM90K (5 and 10 mg/kg) and 2,3-dihydroxy-6-nitro-7-sulfamoyl-benzo(F)quinoxaline (NBQX, 15 mg/kg), which were administered intravenously for 30 min, significantly reduced the respiratory rate (P < 0.01) and minute volume (P < 0.01) and increased the tidal volume (P < 0.05) compared with values obtained before drug administration. None of these drugs affected respiratory parameters in the absence of anaesthesia. A NMDA receptor antagonist, MK-801 (0.5 mg/kg), which was administered intravenously for 30 min, also significantly reduced respiratory rate (P < 0.01), minute volume (P < 0.01) and tidal volume (P < 0.01) and prolonged inspiratory duration (P < 0.05). These results suggest that both AMPA and NMDA receptor antagonists cause respiratory depression under halothane anaesthesia in rats, although the mechanisms may be different for the two types of antagonists.

Reduction in myocardial infarct size by YM866, a modified tissue-type plasminogen activator, after coronary artery thrombotic occlusion in rats

A modified tissue‐type plasminogen activator (t‐PA), YM866, which is characterized by its relatively long half‐life, was studied in a rat model of myocardial infarction and compared with alteplase, a native‐type t‐PA. Acute myocardial infarction was induced by thrombotic occlusion of the left coronary artery using a combination of green light irradiation (540 nm) and intravenous injection of rose bengal (a photosensitizer dye). Infarct size measurements were done 24 h after irradiation. YM866 at doses of 0.25 and 1 mg/kg was administered by i.v. bolus injection, whereas alteplase at a dose of 7.5 mg/kg was administered by 10% i.v. bolus followed immediately by 90% i.v. infusion for 60 min. When these agents were administered 3 min after elevation of the ST‐segment on a lead‐II electrocardiogram, infarct size in the YM866 1 mg/kg group (22.3 ± 4.2%, mean ± SEM) and alteplase‐treatment group (23.7 ± 5.9%) was significantly smaller than infarct size in the control group (41.7 ± 3.3%, P < 0.05 each). When these agents were administered 10 min after ST‐segment elevation (both), only YM866 showed an infarct size‐limiting effect (21.3 ± 5.3%, P < 0.05). i.v. bolus injection of YM866 showed equivalent infarct‐limiting effect to i.v. bolus plus i.v. infusion administration of alteplase. Bolus injection of YM866 also appeared more useful than the bolus plus infusion of alteplase in terms of the therapeutic time window. These findings suggest YM866 to be an effective and easily administered thrombolytic agent. Drug Dev. Res. 51:200–205, 2000.