title: Apoptotic cell death in the hippocampus due to prolonged hypothermic circulatory arrest: comparison of cyclosporine A and cycloheximide on neuron survival.
abstract: OBJECTIVE
  To determine whether cyclosporine A (CsA) or cycloheximide (CHX) can reduce neuronal apoptosis in the hippocampus in a chronic animal model of hypothermic circulatory arrest (HCA).
  
  
  METHODS
  Twenty-eight pigs (28-33 kg) underwent 90 min of HCA at 20 degrees C. In a blinded study, animals were randomized to placebo (n=12), 5 mg/kg CsA (n=8), or 1 mg/kg CHX (n=8). After elective sacrifice 7 days postoperatively, brains were perfusion-fixed and the left hippocampus was examined for evidence of neuronal cell death. An in situ double-labeling method was used on cryosections to unequivocally identify apoptotic nuclei by the simultaneous visualization of DNA fragmentation and apoptotic chromatin condensation. Sections were also examined by immunocytochemistry for upregulation of the pro-apoptotic proteins Bax, activated caspase 3, and glyceraldehyde-3-phosphate dehydrogenase.
  
  
  RESULTS
  Apoptotic nuclear degradation was clearly present in the CA1, CA2 and CA3 subregions of the hippocampus after HCA. However, there was also morphological evidence for an accompanying necrotic-like cell death. There was no significant difference between the number of apoptotic nuclei observed in CSA-treated animals, mean value 4.4+/-1.63 SEM or CHX-treated animals, mean value 4.0+/-1.92 SEM, and age-matched control HCA pigs, mean value 4.85+/-1.69 SEM, (P>0.10).
  
  
  CONCLUSIONS
  The data clearly demonstrate apoptotic cell death in pigs after HCA by simultaneously demonstrating in situ end labeling (TUNEL reaction) and apoptotic chromatin condensation using a nucleic acid-binding dye. Since CsA shows promising neuroprotective effects in behavioral studies, and since the peak of HCA-induced apoptosis occurs earlier than 7 days, further studies will be required to determine whether CsA can improve neuronal survival in the first few days after HCA. CHX was not effective in reducing apoptosis in this model.
authors.affiliation: Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA. nadine.tatton@mssm.edu
authors.forename: N A
authors.initials: NA
authors.lastname: Tatton
authors.forename: C
authors.initials: C
authors.lastname: Hagl
authors.forename: S
authors.initials: S
authors.lastname: Nandor
authors.forename: S
authors.initials: S
authors.lastname: Insolia
authors.forename: D
authors.initials: D
authors.lastname: Spielvogel
authors.forename: R B
authors.initials: RB
authors.lastname: Griepp
mesh_terms: D000818:Animals; D017209:Apoptosis; D002470:Cell Survival / Q000187:drug effects; D002843:Chromatin; D016616:Cryoultramicrotomy; D003513:Cycloheximide / Q000494:pharmacology*; D016572:Cyclosporine / Q000494:pharmacology*; D053938:DNA Fragmentation; D005260:Female; D006324:Heart Arrest, Induced; D006624:Hippocampus / Q000187:drug effects* / Q000473:pathology*; D007150:Immunohistochemistry; D009474:Neurons / Q000187:drug effects* / Q000473:pathology*; D011500:Protein Synthesis Inhibitors / Q000494:pharmacology*; D011518:Proto-Oncogene Proteins / Q000032:analysis; D019253:Proto-Oncogene Proteins c-bcl-2; D013552:Swine; D051028:bcl-2-Associated X Protein
chemical_list: D002843:Chromatin; D011500:Protein Synthesis Inhibitors; D011518:Proto-Oncogene Proteins; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein; D016572:Cyclosporine; D003513:Cycloheximide