孙学军
氢气对脊髓缺血损伤的治疗作用
2010-12-18 07:01
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标签:氢气

氢气的选择性抗氧化的发现,引起了氢气生物学研究的热潮,氢气治疗各类器官移植、缺血再灌注损伤、炎症研究是氢气生物学领域的主要研究内容。国内研究氢气生物学效应最多的单位是第二军医大学,其次是第四军医大学。第四军医大学已经先后发表采用呼吸氢气治疗脓毒症和脑创伤方面的论文3篇,现又发表1氢气对脊髓缺血损伤的治疗作用,这些文章的特点是,全部采用呼吸氢气的给氢气手段,都来自西京医院麻醉科。

脊髓缺血所引发一系列损伤性生化改变将导致细胞内钙聚集,氧自由基含量增高,从而损伤脊髓内神经元,造成不可逆的脊髓功能损害。脊髓缺血比脑缺血少见,主要原因为:脊髓动脉硬化比脑动脉少;脊髓供血网络丰富;脊髓对缺血有较强耐受力。由脊髓本身病变所引起的脊髓缺血,症状可为短暂性的,也可呈永久性的。脊髓缺血逐渐严重后也可呈进行性截瘫,产生感觉缺失平面及膀胱等括约肌障碍。临床上脊髓缺血是血管外科手术的常见并发症,与系统炎症综合症类似,都是麻醉科学比较关注的重要疾病类型。

第四军医大学过去一直脊髓缺血等中枢神经系统损伤方面有许多研究积累,过去我比较熟悉他们采用呼吸高压氧预适应保护脊髓缺血的工作,该文章在高压氧预适应方面是一篇经典只作,是目前国际上高压氧预适应方面引用比较高的几篇论文之一。

本研究采用兔脊髓缺血再灌注模型,通过观察呼吸氢气治疗后动物的行为学、形态学和氧化损伤相关指标的改变,证明呼吸氢气能有效治疗脊髓缺血再灌注损伤。本研究是国际上第一篇研究氢气治疗脊髓缺血损伤的研究,几个月前,第二军医大学长征医院曾经报道过注射氢气盐水治疗脊髓创伤的研究。这两个研究都来自中国,中国学者在脊髓创伤和缺血损伤方面有一些自己的特色。本研究的内容比较丰富,发表在Brain res上有一些遗憾。

 

Research highlights:

1. 2% and 4 % H2 treatment significantly attenuated spinal cord ischemia-reperfusion injury;

2. H2 treatment significantly reduced the levels of oxidative products (8-iso-PGF2α and MDA) in serum and spinal cord;

3. H2 treatment significantly upregulated the activities of antioxidant enzymes (SOD and CAT) in serum and spinal cord;

4. H2 treatment significantly decreased the levels of pro-inflammatory cytokines (TNF-α and HMGB1) in serum and spinal cord;

5. H2 treatment significantly reduced motor neuron apoptosis of spinal cord;

6. H2 inhalation may be an effective therapeutic strategy for spinal cord I/R damage

 

Beneficial Effects of Hydrogen Gas against Spinal Cord Ischemia-Reperfusion Injury in Rabbits

 

Abstract: Recently, hydrogen gas (H2) is reported to be a new therapeutic agent in organ damage induced by ischemia-reperfusion (I/R). The present study was designed to investigate the beneficial effects of H2 against spinal cord I/R injury and its associated mechanisms. Spinal cord ischemia was induced by infrarenal aortic occlusion for 20 min in male New Zealand white rabbits. Treatment with 1%, 2% or 4% H2 inhalation was given from 10 min before reperfusion to 60 min after reperfusion (total 70 min). Here, we found that I/R-challenged animals showed significant spinal cord damage characterized by the decreased numbers of normal motor neurons and hind-limb motor dysfunction, which was significantly improved by 2% and 4 % H2 treatment. Furthermore, we found that the beneficial effects of H2 treatment against spinal cord I/R injury were associated with the decreased levels of oxidative products [8-iso-prostaglandin F2α (8-iso-PGF2α) and malondialdehyde (MDA)] and pro-inflammatory cytokines [tumor necrosis factor-alpha (TNF-α) and high-mobility group box 1 (HMGB1)], as well as increased activities of antioxidant enzymes [superoxide dismutase (SOD) and catalase (CAT)] in serum and spinal cord. In addition, H2 treatment reduced motor neuron apoptosis in the spinal cord of this model. Thus, H2 inhalation may be an effective therapeutic strategy for spinal cord I/R damage.

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