Methylprednisolone Reduces Persistent Post-ischemic Inflammation in a Rat Hypoxia-Ischemia Model of Perinatal Stroke
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ORIGINAL ARTICLE
Methylprednisolone Reduces Persistent Post-ischemic Inflammation in a Rat Hypoxia-Ischemia Model of Perinatal Stroke Svetlana Altamentova 1 & Prakasham Rumajogee 1 & James Hong 1,2 & Stephanie R. Beldick 1,2 & Sei Joon Park 1 & Albert Yee 1 & Michael G. Fehlings 1,2,3,4 Received: 15 August 2019 / Revised: 12 January 2020 / Accepted: 19 February 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract In perinatal stroke, the initial injury results in a chronic inflammatory response caused by the release of proinflammatory cytokines, gliosis and microglia activation. This chronic and ongoing inflammatory response exacerbates the brain injury, often resulting in encephalopathy and cerebral palsy (CP). Using a neonatal rat model of hypoxia-ischemia (HI) at postnatal day (P)7, we demonstrated that chronic inflammation is persistent and continues into the tertiary phase of perinatal stroke and can be attenuated by the administration of methylprednisolone sodium-succinate (MPSS, 30 mg/kg), a US Food and Drug Administration (FDA) approved anti-inflammatory agent. The inflammatory response was assessed by real-time quantitative PCR and ELISA for markers of inflammation (CCL3, CCL5, IL18 and TNFα). Structural changes were evaluated by histology (LFB/H&E), while cellular changes were assessed by Iba-1, ED1, GFAP, NeuN, Olig2 and CC1 immunostaining. Functional deficits were assessed with the Cylinder test and Ladder Rung Walking test. MPSS was injected 14 days after HI insult to attenuate chronic inflammation. In neonatal conditions such as CP, P21 is a clinically relevant time-point in rodents, corresponding developmentally to a 2-year-old human. Administration of MPSS resulted in reduced structural damage (corpus callosum, cortex, hippocampus, striatum), gliosis and reactive microglia and partial restoration of the oligodendrocyte population. Furthermore, significant behavioural recovery was observed. In conclusion, we demonstrated that administration of MPSS during the tertiary phase of perinatal stroke results in attenuation of the chronic inflammatory response, leading to pathophysiological and functional recovery. This work validates the high clinical impact of MPSS to treat neonatal conditions linked to chronic inflammation. Keywords Perinatal stroke . Hypoxia-ischemia model . Methylprednisolone . Chronic inflammation
Svetlana Altamentova and Prakasham Rumajogee contributed equally to this work. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12975-020-00792-2) contains supplementary material, which is available to authorized users. * Michael G. Fehlings [email protected] 1
Division of Genetics and Development, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada
2
Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
3
Division of Neurosurgery, University of Toronto, Toronto, Ontario, Canada
4
Division of Neurosurgery, Toronto Western Hospital, University Health N
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