• Neurocritical care · Feb 2015

    Only Very Early Oxygen Therapy Attenuates Posthemorrhagic Edema Formation and Blood-Brain Barrier Disruption in Murine Intracerebral Hemorrhage.

    • Wei Zhou, Marilena Marinescu, and Roland Veltkamp.
    • Department of Neurology, University Heidelberg, INF 400, 69120, Heidelberg, Germany, wei.zhou@gmx.de.
    • Neurocrit Care. 2015 Feb 1; 22 (1): 121-32.

    Background And PurposePerihematomal edema exacerbates the mass effect of hematoma and contributes to early neurological deterioration after intracerebral hemorrhage (ICH). Oxygen therapy has protective effects on the blood-brain barrier (BBB). We aimed to examine the effects of oxygen therapy on edema formation and BBB permeability after ICH.MethodsICH was induced in mice by injecting autologous blood (30 µL) or collagenase (0.03 U) intrastriatally. Development of posthemorrhagic edema formation and BBB disruption was characterized by wet-dry-weight assays and sodium- fluorescein fluorospectrometry 1d, 3d, and 7d after ICH induction. In subsequent experiments, mice received air, normobaric (NBO), or hyperbaric oxygen (HBO; 3ata) for 60 min starting either 30, 60, or 120 min after ICH induction. Expression of occludin, claudin-5, zonula occludens-1, matrix metalloproteinases (MMPs), and hypoxia-inducible factor-1α (HIF-1α) was measured by Western blot and zymography.ResultsPosthemorrhagic edema formation (water content: blood-injection model 80.6 ± 0.3 %; collagenase injection model 83.3 ± 0.7 %) and BBB disruption (interhemispheric ratio of extravasated sodium fluorescein: blood-injection model 1.75 ± 0.07; collagenase injection model 3.02 ± 0.15) peaked 3d after ICH. NBO and HBO initiated within 30 min of ICH induction attenuated edema formation and BBB disruption (interhemispheric ratio of fluorescein; blood-injection air 1.75 ± 0.12, NBO 1.52 ± 0.08, HBO 1.49 ± 0.09; collagenase: air 3.04 ± 0.23, NBO 2.25 ± 0.21, HBO 2.17 ± 0.23) 3d after ICH, whereas delayed oxygen therapy had no effect. Early oxygen therapies prevented occludin degradation, MMP-9 activation, and reduced HIF-1α expression.ConclusionVery early oxygen therapy can attenuate edema formation and BBB disruption after ICH, but the brief therapeutic time window suggests that the translational potential is limited.

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