Neuroprotective effects of inter-alpha inhibitor proteins after hypoxic-ischemic brain injury in neonatal rats

Hypoxic-ischemic (HI) brain injury is one of the most common neurological problems occurring in the perinatal period. Hypothermia is the only approved intervention for neonatal HI encephalopathy. However, this treatment is only partially protective, has a narrow therapeutic time window after birth a...

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Veröffentlicht in:Experimental neurology 2019-07, Vol.317, p.244-259
Hauptverfasser: Chen, Xiaodi, Nakada, Sakura, Donahue, John E., Chen, Ray H., Tucker, Richard, Qiu, Joseph, Lim, Yow-Pin, Stopa, Edward G., Stonestreet, Barbara S.
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container_title Experimental neurology
container_volume 317
creator Chen, Xiaodi
Nakada, Sakura
Donahue, John E.
Chen, Ray H.
Tucker, Richard
Qiu, Joseph
Lim, Yow-Pin
Stopa, Edward G.
Stonestreet, Barbara S.
description Hypoxic-ischemic (HI) brain injury is one of the most common neurological problems occurring in the perinatal period. Hypothermia is the only approved intervention for neonatal HI encephalopathy. However, this treatment is only partially protective, has a narrow therapeutic time window after birth and only can be used to treat full-term infants. Consequently, additional therapies are critically needed. Inflammation is an important contributing factor to the evolution of HI brain injury in neonates. Inter-alpha Inhibitor Proteins (IAIPs) are immunomodulatory proteins with anti-inflammatory properties. We have previously shown that IAIPs reduce neuronal cell death and improve behavioral outcomes when given after carotid artery ligation, but before hypoxia in male neonatal rats. The objective of the current study was to investigate the neuroprotective effects of treatment with IAIPs given immediately or 6 h after HI in both male and female neonatal rats. HI was induced with the Rice-Vannucci method in postnatal (P) day 7 rats. After ligation of the right common carotid artery, P7 rats were exposed to 90 min of hypoxia (8% oxygen). Human plasma-derived IAIPs or placebo (phosphate buffered saline) was given at zero, 24, and 48 h after HI. Brains were perfused, weighed and fixed 72 h after HI at P10. In a second, delayed treatment group, the same procedure was followed except that IAIPs or placebo were given at 6, 24 and 48 h after HI. Separate sham-operated, placebo-treated groups were exposed to identical protocols but were not exposed to carotid artery ligation and remained in room air. Rat sex was recorded. The effects of IAIPs on HI brain injury were examined using histopathological scoring and immunohistochemical analyses of the brain and by using infarct volume measurements on frozen tissue of the entire brain hemispheres ipsilateral and contralateral to HI injury. IAIPs given immediately after HI improved (P 
doi_str_mv 10.1016/j.expneurol.2019.03.013
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Hypothermia is the only approved intervention for neonatal HI encephalopathy. However, this treatment is only partially protective, has a narrow therapeutic time window after birth and only can be used to treat full-term infants. Consequently, additional therapies are critically needed. Inflammation is an important contributing factor to the evolution of HI brain injury in neonates. Inter-alpha Inhibitor Proteins (IAIPs) are immunomodulatory proteins with anti-inflammatory properties. We have previously shown that IAIPs reduce neuronal cell death and improve behavioral outcomes when given after carotid artery ligation, but before hypoxia in male neonatal rats. The objective of the current study was to investigate the neuroprotective effects of treatment with IAIPs given immediately or 6 h after HI in both male and female neonatal rats. HI was induced with the Rice-Vannucci method in postnatal (P) day 7 rats. After ligation of the right common carotid artery, P7 rats were exposed to 90 min of hypoxia (8% oxygen). Human plasma-derived IAIPs or placebo (phosphate buffered saline) was given at zero, 24, and 48 h after HI. Brains were perfused, weighed and fixed 72 h after HI at P10. In a second, delayed treatment group, the same procedure was followed except that IAIPs or placebo were given at 6, 24 and 48 h after HI. Separate sham-operated, placebo-treated groups were exposed to identical protocols but were not exposed to carotid artery ligation and remained in room air. Rat sex was recorded. The effects of IAIPs on HI brain injury were examined using histopathological scoring and immunohistochemical analyses of the brain and by using infarct volume measurements on frozen tissue of the entire brain hemispheres ipsilateral and contralateral to HI injury. IAIPs given immediately after HI improved (P < 0.050) histopathological brain injury across and within the cingulate, caudate/putamen, thalamus, hippocampus and parietal cortex in males, but not in females. In contrast, IAIPs given immediately after HI reduced (P < 0.050) infarct volumes of the hemispheres ipsilateral to HI injury in similarly both the males and females. Treatment with IAIPs also resulted in higher (P < 0.050) brain weights compared with the placebo-treated HI group, reduced (P < 0.050) neuronal and non-neuronal cell death in the cortex and total hemisphere, and also increased the total area of oligodendrocytes determined by CNPase in the ipsilateral hemisphere and corpus callosum (P < 0.050) of male, but not female subjects exposed to HI. Delayed treatment with IAIPs 6 h after HI did not improve histopathological brain injury in males or females, but resulted in higher (P < 0.050) brain weights compared with the placebo-treated HI males. Therefore, treatment with IAIPs immediately after HI improved brain weights and reduced neuropathological brain injury and cell death in male rats, and reduced infarct volume in both male and female neonatal rats. We conclude that IAIPs exert neuroprotective effects after exposure to HI in neonatal rats and may exhibit some sex-related differential effects. •Neuroinflammation is a key mechanism underlying hypoxic-ischemic (HI) brain injury.•Inter-alpha inhibitor proteins (IAIPs) are immunomodulatory molecules.•IAIPs reduce HI-related neuronal and non-neuronal cell death in male neonatal rats.•IAIPs attenuate HI-related brain infarction volume in neonatal rats.]]></description><identifier>ISSN: 0014-4886</identifier><identifier>EISSN: 1090-2430</identifier><identifier>DOI: 10.1016/j.expneurol.2019.03.013</identifier><identifier>PMID: 30914159</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Alpha-Globulins - pharmacology ; Animals ; Animals, Newborn ; Apoptosis ; Brain ; Brain - drug effects ; Brain - pathology ; Female ; Humans ; Hypoxia-ischemia ; Hypoxia-Ischemia, Brain - pathology ; Inter-alpha inhibitor protein ; Male ; Neonate ; Neuroprotection ; Neuroprotective Agents - pharmacology ; Pathological score ; Rats ; Rats, Wistar</subject><ispartof>Experimental neurology, 2019-07, Vol.317, p.244-259</ispartof><rights>2019 Elsevier Inc.</rights><rights>Copyright © 2019 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c541t-37f77cde3cd38fba89e254830522f29d5b257da22f44dbda8fa9d85bfeeab89c3</citedby><cites>FETCH-LOGICAL-c541t-37f77cde3cd38fba89e254830522f29d5b257da22f44dbda8fa9d85bfeeab89c3</cites><orcidid>0000-0002-6532-7683</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.expneurol.2019.03.013$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,314,780,784,885,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30914159$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chen, Xiaodi</creatorcontrib><creatorcontrib>Nakada, Sakura</creatorcontrib><creatorcontrib>Donahue, John E.</creatorcontrib><creatorcontrib>Chen, Ray H.</creatorcontrib><creatorcontrib>Tucker, Richard</creatorcontrib><creatorcontrib>Qiu, Joseph</creatorcontrib><creatorcontrib>Lim, Yow-Pin</creatorcontrib><creatorcontrib>Stopa, Edward G.</creatorcontrib><creatorcontrib>Stonestreet, Barbara S.</creatorcontrib><title>Neuroprotective effects of inter-alpha inhibitor proteins after hypoxic-ischemic brain injury in neonatal rats</title><title>Experimental neurology</title><addtitle>Exp Neurol</addtitle><description><![CDATA[Hypoxic-ischemic (HI) brain injury is one of the most common neurological problems occurring in the perinatal period. Hypothermia is the only approved intervention for neonatal HI encephalopathy. However, this treatment is only partially protective, has a narrow therapeutic time window after birth and only can be used to treat full-term infants. Consequently, additional therapies are critically needed. Inflammation is an important contributing factor to the evolution of HI brain injury in neonates. Inter-alpha Inhibitor Proteins (IAIPs) are immunomodulatory proteins with anti-inflammatory properties. We have previously shown that IAIPs reduce neuronal cell death and improve behavioral outcomes when given after carotid artery ligation, but before hypoxia in male neonatal rats. The objective of the current study was to investigate the neuroprotective effects of treatment with IAIPs given immediately or 6 h after HI in both male and female neonatal rats. HI was induced with the Rice-Vannucci method in postnatal (P) day 7 rats. After ligation of the right common carotid artery, P7 rats were exposed to 90 min of hypoxia (8% oxygen). Human plasma-derived IAIPs or placebo (phosphate buffered saline) was given at zero, 24, and 48 h after HI. Brains were perfused, weighed and fixed 72 h after HI at P10. In a second, delayed treatment group, the same procedure was followed except that IAIPs or placebo were given at 6, 24 and 48 h after HI. Separate sham-operated, placebo-treated groups were exposed to identical protocols but were not exposed to carotid artery ligation and remained in room air. Rat sex was recorded. The effects of IAIPs on HI brain injury were examined using histopathological scoring and immunohistochemical analyses of the brain and by using infarct volume measurements on frozen tissue of the entire brain hemispheres ipsilateral and contralateral to HI injury. IAIPs given immediately after HI improved (P < 0.050) histopathological brain injury across and within the cingulate, caudate/putamen, thalamus, hippocampus and parietal cortex in males, but not in females. In contrast, IAIPs given immediately after HI reduced (P < 0.050) infarct volumes of the hemispheres ipsilateral to HI injury in similarly both the males and females. Treatment with IAIPs also resulted in higher (P < 0.050) brain weights compared with the placebo-treated HI group, reduced (P < 0.050) neuronal and non-neuronal cell death in the cortex and total hemisphere, and also increased the total area of oligodendrocytes determined by CNPase in the ipsilateral hemisphere and corpus callosum (P < 0.050) of male, but not female subjects exposed to HI. Delayed treatment with IAIPs 6 h after HI did not improve histopathological brain injury in males or females, but resulted in higher (P < 0.050) brain weights compared with the placebo-treated HI males. Therefore, treatment with IAIPs immediately after HI improved brain weights and reduced neuropathological brain injury and cell death in male rats, and reduced infarct volume in both male and female neonatal rats. We conclude that IAIPs exert neuroprotective effects after exposure to HI in neonatal rats and may exhibit some sex-related differential effects. •Neuroinflammation is a key mechanism underlying hypoxic-ischemic (HI) brain injury.•Inter-alpha inhibitor proteins (IAIPs) are immunomodulatory molecules.•IAIPs reduce HI-related neuronal and non-neuronal cell death in male neonatal rats.•IAIPs attenuate HI-related brain infarction volume in neonatal rats.]]></description><subject>Alpha-Globulins - pharmacology</subject><subject>Animals</subject><subject>Animals, Newborn</subject><subject>Apoptosis</subject><subject>Brain</subject><subject>Brain - drug effects</subject><subject>Brain - pathology</subject><subject>Female</subject><subject>Humans</subject><subject>Hypoxia-ischemia</subject><subject>Hypoxia-Ischemia, Brain - pathology</subject><subject>Inter-alpha inhibitor protein</subject><subject>Male</subject><subject>Neonate</subject><subject>Neuroprotection</subject><subject>Neuroprotective Agents - pharmacology</subject><subject>Pathological score</subject><subject>Rats</subject><subject>Rats, Wistar</subject><issn>0014-4886</issn><issn>1090-2430</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU2P0zAQhi0EYsvCX4AcuST4s7EvSKvV8iGt4AJny7HHxFVqBzuptv8ely4VnDjNWPPMOzN-EXpDcEcw2b7bdfAwR1hzmjqKieow6zBhT9CGYIVbyhl-ijYYE95yKbdX6EUpO4yx4rR_jq4YVoQToTYofjmJzDktYJdwgAa8r1lpkm9CXCC3ZppHU_MxDGFJufnNhlga42u5GY9zegi2DcWOsA-2GbIJsfK7NR9raCKkaBYzNdks5SV65s1U4NVjvEbfP9x9u_3U3n_9-Pn25r61gpOlZb3ve-uAWcekH4xUQAWXDAtKPVVODFT0ztQH525wRnqjnBSDBzCDVJZdo_dn3Xkd9uAsxCWbSc857E0-6mSC_rcSw6h_pIPeCs65YlXg7aNATj9XKIve1wthmky9Zy2aEiWF6DnFFe3PqM2plAz-MoZgfXJL7_TFLX1yS2Omq1u18_XfW176_thTgZszAPWvDgGyLjZAtOBCri5pl8J_h_wCIv6wLg</recordid><startdate>20190701</startdate><enddate>20190701</enddate><creator>Chen, Xiaodi</creator><creator>Nakada, Sakura</creator><creator>Donahue, John E.</creator><creator>Chen, Ray H.</creator><creator>Tucker, Richard</creator><creator>Qiu, Joseph</creator><creator>Lim, Yow-Pin</creator><creator>Stopa, Edward G.</creator><creator>Stonestreet, Barbara S.</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-6532-7683</orcidid></search><sort><creationdate>20190701</creationdate><title>Neuroprotective effects of inter-alpha inhibitor proteins after hypoxic-ischemic brain injury in neonatal rats</title><author>Chen, Xiaodi ; Nakada, Sakura ; Donahue, John E. ; Chen, Ray H. ; Tucker, Richard ; Qiu, Joseph ; Lim, Yow-Pin ; Stopa, Edward G. ; Stonestreet, Barbara S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c541t-37f77cde3cd38fba89e254830522f29d5b257da22f44dbda8fa9d85bfeeab89c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Alpha-Globulins - pharmacology</topic><topic>Animals</topic><topic>Animals, Newborn</topic><topic>Apoptosis</topic><topic>Brain</topic><topic>Brain - drug effects</topic><topic>Brain - pathology</topic><topic>Female</topic><topic>Humans</topic><topic>Hypoxia-ischemia</topic><topic>Hypoxia-Ischemia, Brain - pathology</topic><topic>Inter-alpha inhibitor protein</topic><topic>Male</topic><topic>Neonate</topic><topic>Neuroprotection</topic><topic>Neuroprotective Agents - pharmacology</topic><topic>Pathological score</topic><topic>Rats</topic><topic>Rats, Wistar</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chen, Xiaodi</creatorcontrib><creatorcontrib>Nakada, Sakura</creatorcontrib><creatorcontrib>Donahue, John E.</creatorcontrib><creatorcontrib>Chen, Ray H.</creatorcontrib><creatorcontrib>Tucker, Richard</creatorcontrib><creatorcontrib>Qiu, Joseph</creatorcontrib><creatorcontrib>Lim, Yow-Pin</creatorcontrib><creatorcontrib>Stopa, Edward G.</creatorcontrib><creatorcontrib>Stonestreet, Barbara S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Experimental neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chen, Xiaodi</au><au>Nakada, Sakura</au><au>Donahue, John E.</au><au>Chen, Ray H.</au><au>Tucker, Richard</au><au>Qiu, Joseph</au><au>Lim, Yow-Pin</au><au>Stopa, Edward G.</au><au>Stonestreet, Barbara S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neuroprotective effects of inter-alpha inhibitor proteins after hypoxic-ischemic brain injury in neonatal rats</atitle><jtitle>Experimental neurology</jtitle><addtitle>Exp Neurol</addtitle><date>2019-07-01</date><risdate>2019</risdate><volume>317</volume><spage>244</spage><epage>259</epage><pages>244-259</pages><issn>0014-4886</issn><eissn>1090-2430</eissn><abstract><![CDATA[Hypoxic-ischemic (HI) brain injury is one of the most common neurological problems occurring in the perinatal period. Hypothermia is the only approved intervention for neonatal HI encephalopathy. However, this treatment is only partially protective, has a narrow therapeutic time window after birth and only can be used to treat full-term infants. Consequently, additional therapies are critically needed. Inflammation is an important contributing factor to the evolution of HI brain injury in neonates. Inter-alpha Inhibitor Proteins (IAIPs) are immunomodulatory proteins with anti-inflammatory properties. We have previously shown that IAIPs reduce neuronal cell death and improve behavioral outcomes when given after carotid artery ligation, but before hypoxia in male neonatal rats. The objective of the current study was to investigate the neuroprotective effects of treatment with IAIPs given immediately or 6 h after HI in both male and female neonatal rats. HI was induced with the Rice-Vannucci method in postnatal (P) day 7 rats. After ligation of the right common carotid artery, P7 rats were exposed to 90 min of hypoxia (8% oxygen). Human plasma-derived IAIPs or placebo (phosphate buffered saline) was given at zero, 24, and 48 h after HI. Brains were perfused, weighed and fixed 72 h after HI at P10. In a second, delayed treatment group, the same procedure was followed except that IAIPs or placebo were given at 6, 24 and 48 h after HI. Separate sham-operated, placebo-treated groups were exposed to identical protocols but were not exposed to carotid artery ligation and remained in room air. Rat sex was recorded. The effects of IAIPs on HI brain injury were examined using histopathological scoring and immunohistochemical analyses of the brain and by using infarct volume measurements on frozen tissue of the entire brain hemispheres ipsilateral and contralateral to HI injury. IAIPs given immediately after HI improved (P < 0.050) histopathological brain injury across and within the cingulate, caudate/putamen, thalamus, hippocampus and parietal cortex in males, but not in females. In contrast, IAIPs given immediately after HI reduced (P < 0.050) infarct volumes of the hemispheres ipsilateral to HI injury in similarly both the males and females. Treatment with IAIPs also resulted in higher (P < 0.050) brain weights compared with the placebo-treated HI group, reduced (P < 0.050) neuronal and non-neuronal cell death in the cortex and total hemisphere, and also increased the total area of oligodendrocytes determined by CNPase in the ipsilateral hemisphere and corpus callosum (P < 0.050) of male, but not female subjects exposed to HI. Delayed treatment with IAIPs 6 h after HI did not improve histopathological brain injury in males or females, but resulted in higher (P < 0.050) brain weights compared with the placebo-treated HI males. Therefore, treatment with IAIPs immediately after HI improved brain weights and reduced neuropathological brain injury and cell death in male rats, and reduced infarct volume in both male and female neonatal rats. We conclude that IAIPs exert neuroprotective effects after exposure to HI in neonatal rats and may exhibit some sex-related differential effects. •Neuroinflammation is a key mechanism underlying hypoxic-ischemic (HI) brain injury.•Inter-alpha inhibitor proteins (IAIPs) are immunomodulatory molecules.•IAIPs reduce HI-related neuronal and non-neuronal cell death in male neonatal rats.•IAIPs attenuate HI-related brain infarction volume in neonatal rats.]]></abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30914159</pmid><doi>10.1016/j.expneurol.2019.03.013</doi><tpages>16</tpages><orcidid>https://orcid.org/0000-0002-6532-7683</orcidid><oa>free_for_read</oa></addata></record>
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subjects Alpha-Globulins - pharmacology
Animals
Animals, Newborn
Apoptosis
Brain
Brain - drug effects
Brain - pathology
Female
Humans
Hypoxia-ischemia
Hypoxia-Ischemia, Brain - pathology
Inter-alpha inhibitor protein
Male
Neonate
Neuroprotection
Neuroprotective Agents - pharmacology
Pathological score
Rats
Rats, Wistar
title Neuroprotective effects of inter-alpha inhibitor proteins after hypoxic-ischemic brain injury in neonatal rats
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