Enhanced brain release of erythropoietin, cytokines and NO during carotid clamping

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• 作者：Stephana Carelli ; Giorgio Ghilardi ; Paola Bianciardi…
• 关键词：Carotid endarterectomy ; Erythropoietin ; Nitric oxide ; Neuroprotection
• 刊名：Neurological Sciences
• 出版年：2016
• 出版时间：February 2016
• 年：2016
• 卷：37
• 期：2
• 页码：243-252
• 全文大小：960 KB
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• 作者单位：Stephana Carelli (1)
  Giorgio Ghilardi (1)
  Paola Bianciardi (1)
  Elisa Latorre (1)
  Federico Rubino (1)
  Marina Bissi (2)
  Anna Maria Di Giulio (1)
  Michele Samaja (1)
  Alfredo Gorio (1)
  
  1. Department of Health Sciences, University of Milan, via A. Di Rudinì, 8, 20142, Milan, Italy
  2. AO San Paolo, via Antonio Di Rudinì 8, 20142, Milan, Italy
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Neurology
  Neuroradiology
  Neurosurgery
  Psychiatry
  
• 出版者：Springer Milan
• ISSN：1590-3478

文摘

Although effective and safe, carotid endarterectomy (CEA) implies a reduced blood flow to the brain and likely an ischemia/reperfusion event. The high rate of uneventful outcomes associated with CEA suggests the activation of brain endogenous protection mechanisms aimed at limiting the possible ischemia/reperfusion damage. This study aims at assessing whether CEA triggers protective mechanisms such as brain release of erythropoietin and nitric oxide. CEA was performed in 12 patients; blood samples were withdrawn simultaneously from the surgically exposed ipsilateral jugular and leg veins before, during (2 and 40 min) and after clamp removal (2 min). Plasma antioxidant capacity, carbonylated proteins, erythropoietin, nitrates and nitrites (NOx) were determined. No changes in intraoperative EEG, peripheral and transcranial blood oxygen saturation were detectable, and no patients showed any neurologic sign after the intervention. Antioxidant capacity and protein carbonylation in plasma were unaffected. Differently, erythropoietin, VEGF, TNF-α and NOx increased during clamping in the jugular blood (2 and 40 min), while no changes were observed in the peripheral circulation. These results show that blood erythropoietin, VEGF, TNF-α, and NOx increased in the brain during uncomplicated CEA. This may represent an endogenous self-activated neuroprotective mechanism aimed at the prevention of ischemia/reperfusion damage. Keywords Carotid endarterectomy Erythropoietin Nitric oxide Neuroprotection