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Neurosurgery ; 56(3): 590-604, 2005 Mar.
Article in English | MEDLINE | ID: mdl-15730585

ABSTRACT

OBJECTIVE: Increases in brain cyclooxygenase-2 (COX2) are associated with the central inflammatory response and with delayed neuronal death, events that cause secondary insults after traumatic brain injury. A growing literature supports the benefit of COX2-specific inhibitors in treating brain injuries. METHODS: DFU [5,5-dimethyl-3(3-fluorophenyl)-4(4-methylsulfonyl)phenyl-2(5)H)-furanone] is a third-generation, highly specific COX2 enzyme inhibitor. DFU treatments (1 or 10 mg/kg intraperitoneally, twice daily for 3 d) were initiated either before or after traumatic brain injury in a lateral cortical contusion rat model. RESULTS: DFU treatments initiated 10 minutes before injury or up to 6 hours after injury enhanced functional recovery at 3 days compared with vehicle-treated controls. Significant improvements in neurological reflexes and memory were observed. DFU initiated 10 minutes before injury improved histopathology and altered eicosanoid profiles in the brain. DFU 1 mg/kg reduced the rise in prostaglandin E2 in the brain at 24 hours after injury. DFU 10 mg/kg attenuated injury-induced COX2 immunoreactivity in the cortex (24 and 72 h) and hippocampus (6 and 72 h). This treatment also decreased the total number of activated caspase-3-immunoreactive cells in the injured cortex and hippocampus, significantly reducing the number of activated caspase-3-immunoreactive neurons at 72 hours after injury. DFU 1 mg/kg amplified potentially anti-inflammatory epoxyeicosatrienoic acid levels by more than fourfold in the injured brain. DFU 10 mg/kg protected the levels of 2-arachidonoyl glycerol, a neuroprotective endocannabinoid, in the injured brain. CONCLUSION: These improvements, particularly when treatment began up to 6 hours after injury, suggest exciting neuroprotective potential for COX2 inhibitors in the treatment of traumatic brain injury and support the consideration of Phase I/II clinical trials.


Subject(s)
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Brain Injuries/drug therapy , Cyclooxygenase Inhibitors/therapeutic use , Furans/therapeutic use , Neuroprotective Agents/therapeutic use , Animals , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Arachidonic Acids/analysis , Ataxia/drug therapy , Ataxia/etiology , Brain Chemistry , Brain Injuries/complications , Brain Injuries/psychology , Cognition Disorders/drug therapy , Cognition Disorders/etiology , Cyclooxygenase 2 , Cyclooxygenase Inhibitors/administration & dosage , Cyclooxygenase Inhibitors/pharmacology , Dinoprostone/analysis , Drug Administration Schedule , Drug Evaluation, Preclinical , Eicosanoids/analysis , Endocannabinoids , Enzyme Induction , Exploratory Behavior/drug effects , Furans/administration & dosage , Furans/pharmacology , Glycerides/analysis , Male , Maze Learning/drug effects , Neuroprotective Agents/administration & dosage , Neuroprotective Agents/pharmacology , Premedication , Prostaglandin-Endoperoxide Synthases/biosynthesis , Rats , Rats, Sprague-Dawley , Recovery of Function , Reflex, Abnormal/drug effects
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