title: An adenosine A2A agonist, ATL-146e, reduces paralysis and apoptosis during rabbit spinal cord reperfusion.
abstract: BACKGROUND
  We hypothesized that systemic ATL-146e, an adenosine A(2A) agonist, would decrease spinal cord reperfusion inflammatory stress and inhibit apoptosis and that these effects would correlate with improved neurologic functional outcome.
  
  
  METHODS
  Thirty rabbits underwent cross-clamping of the infrarenal aorta for 45 minutes. One group of animals (n = 14) received 0.06 microg/kg per minute of ATL-146e infused intravenously for 3 hours, beginning 15 minutes before reperfusion. A second group of animals (n = 16) underwent spinal cord ischemia with saline vehicle alone and served as ischemic controls. Animals (n = 9, 11) from each group survived for 48 hours and assessed for neurologic impairment with the Tarlov (0-5) scoring system. Four animals from each group were humanely killed at the end of the 3-hour treatment period, and the remainder killed after 48 hours' survival. In all animals, lumbar spinal cord tissue specimens were frozen for subsequent Western blot analysis of heat shock protein 70 (HSP 70), and for the p85 fragment of poly (ADP-ribose) polymerase (PARP). Neuronal viability indices were determined at 48 hours with hematoxylin and eosin staining.
  
  
  RESULTS
  There was improvement in neurologic function in rabbits receiving ATL-146e (P <.001) compared with ischemic controls. At the end of the 3-hour treatment period there was a 46% (P <.05) decrease in HSP 70 expression in the ATL-146e group compared with the control group, but no difference in PARP expression. At 48 hours, there was no difference between control and ATL-146e groups in HSP 70 expression, but there was a 65% (P <.05) reduction in PARP in the spinal cords of animals that had received ATL-146e. There was a significant improvement in neuronal viability indices in animals receiving ATL-146e compared with ischemic controls (P <.05).
  
  
  CONCLUSIONS
  Systemic ATL-146e infusion during reperfusion after spinal cord ischemia results in preservation of hindlimb motor function. There is evidence of decreased spinal cord inflammatory stress immediately after treatment with ATL-146e as indicated by reduced HSP 70 induction. Treatment with ATL-146e is associated with a reduction in neuronal apoptosis as suggested by a substantial decrease in the fragmentation of PARP at 48 hours. These results suggest that inflammation during reperfusion and subsequent apoptosis contribute to paralysis after restoration of blood flow to the ischemic spinal cord.
authors.affiliation: Department of Surgery, Division of Thoracic and Cardiovascular Surgery, The University of Virginia Health System, Charlottesville 22908, USA.
authors.forename: D C
authors.initials: DC
authors.lastname: Cassada
authors.forename: C G
authors.initials: CG
authors.lastname: Tribble
authors.forename: V E
authors.initials: VE
authors.lastname: Laubach
authors.forename: B N
authors.initials: BN
authors.lastname: Nguyen
authors.forename: J M
authors.initials: JM
authors.lastname: Rieger
authors.forename: J
authors.initials: J
authors.lastname: Linden
authors.forename: A K
authors.initials: AK
authors.lastname: Kaza
authors.forename: S M
authors.initials: SM
authors.lastname: Long
authors.forename: I L
authors.initials: IL
authors.lastname: Kron
authors.forename: J A
authors.initials: JA
authors.lastname: Kern
mesh_terms: D000818:Animals; D017209:Apoptosis / Q000187:drug effects*; D003509:Cyclohexanecarboxylic Acids / Q000494:pharmacology*; D007511:Ischemia / Q000150:complications / Q000209:etiology*; D010243:Paralysis / Q000517:prevention & control*; D058906:Purinergic P1 Receptor Agonists; D011687:Purines / Q000494:pharmacology*; D011817:Rabbits; D043705:Receptor, Adenosine A2A; D015424:Reperfusion / Q000009:adverse effects*; D013116:Spinal Cord / Q000098:blood supply*
chemical_list: C431129:ATL 146e; D003509:Cyclohexanecarboxylic Acids; D058906:Purinergic P1 Receptor Agonists; D011687:Purines; D043705:Receptor, Adenosine A2A