title: Protective effect of stellate ganglion block on delayed cerebral vasospasm in an experimental rat model of subarachnoid hemorrhage.
abstract: Stellate ganglion block (SGB) is a blockade of sympathetic ganglia innervating the head and neck, and is known to function through vasodilation of the target region. However, the effectiveness of SGB in relieving cerebral vasospasm (CVS) through dilation of intracerebral vessels has not been evaluated. The aim of the present study is to investigate the therapeutic effects of SGB in a rat model of subarachnoid hemorrhage (SAH) complicated by delayed CVS, and explore the underlying mechanisms. The SAH model was established by double injection of autologous arterial blood into the cisterna magna. We simulated SGB by transection of the cervical sympathetic trunk (TCST), and measured changes in the diameter, perimeter and cross-sectional area of the basilar artery (BA) and middle cerebral artery (MCA) to evaluate its vasodilatory effect. To investigate the underlying mechanisms, we determined the expression level of vasoactive molecules endothelin-1 (ET-1) and calcitonin gene-related peptide (CGRP) in the plasma, and apoptotic modulators Bcl-2 and Bax in the hippocampus. We found a significant increase in the diameter, perimeter and cross-sectional area of the BA and right MCA in SAH rats subjected to TCST. Application of SGB significantly reduced the expression of ET-1 while increasing that of CGRP in SAH rats. We also found a significant increase in the expression of Bcl-2 and decrease in the expression of Bax in the hippocampus of SAH rats subjected to TCST, when compared to untreated SAH rats. The mechanism of action of SGB is likely mediated through alterations in the ratio of ET-1 and CGRP, and Bax and Bcl-2. These results suggest that SGB can alleviate the severity of delayed CVS by inducing dilation of intracerebral blood vessels, and promoting anti-apoptotic signaling. Our findings provide evidence supporting the use of SGB as an effective and well-tolerated approach to the treatment of CVS in various clinical settings.
authors.affiliation: Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical College, Xuzhou, 209 Tongshan Road, 221004, JS, China. Electronic address: hunajijiu.06@163.com.
authors.forename: Na
authors.initials: N
authors.lastname: Hu
authors.affiliation: Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical College, Xuzhou, 209 Tongshan Road, 221004, JS, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Anesthesiology, Jiangxiaqu No. 1 People׳s Hospital, Wuhan 430000, HB, China.
authors.forename: Bai-Zhao
authors.initials: BZ
authors.lastname: Chen
authors.affiliation: Jiangsu Province Key Laboratory of Anesthesiology & Jiangsu Province Key Laboratory of Anesthesia and Analgesia Application Technology, Xuzhou Medical College, Xuzhou, 209 Tongshan Road, 221004, JS, China.
authors.forename: Jin-Feng
authors.initials: JF
authors.lastname: Han
authors.affiliation: Department of Anesthesiology, the 101st Hospital of CP.L.A., Xuzhou Medical College, 101 Xing Yuan North Road, Wuxi 214044, JS, China. Electronic address: zmt1969@126.com.
authors.forename: Mai-Tao
authors.initials: MT
authors.lastname: Zhou
mesh_terms: D000818:Animals; D001340:Autonomic Nerve Block; D001488:Basilar Artery / Q000473:pathology; D015740:Calcitonin Gene-Related Peptide / Q000097:blood; D004195:Disease Models, Animal; D019332:Endothelin-1 / Q000097:blood; D006624:Hippocampus / Q000378:metabolism; D008297:Male; D020768:Middle Cerebral Artery / Q000473:pathology; D019253:Proto-Oncogene Proteins c-bcl-2 / Q000378:metabolism; D051381:Rats; D017207:Rats, Sprague-Dawley; D013233:Stellate Ganglion / Q000601:surgery; D013345:Subarachnoid Hemorrhage / Q000150:complications*; D014664:Vasodilation; D020301:Vasospasm, Intracranial / Q000378:metabolism* / Q000517:prevention & control*; D051028:bcl-2-Associated X Protein / Q000378:metabolism
chemical_list: C494828:Bax protein, rat; D019332:Endothelin-1; D019253:Proto-Oncogene Proteins c-bcl-2; D051028:bcl-2-Associated X Protein; D015740:Calcitonin Gene-Related Peptide
keywords: Cerebral vasospasm; Experimental subarachnoid hemorrhage; Rat; Stellate ganglion block