Combining Normobaric Oxygen with Ethanol or Hypothermia Prevents Brain Damage from Thromboembolic Stroke via PKC Akt NOX Modulation
In a thromboembolic stroke model after reperfusion by recombinant tissue plasminogen activator (rt PA) we aimed to determine whether therapeutic hypothermia (TH) and ethanol (EtOH) in combination with low concentration (60 of normobaric oxygen (NBO) enhanced neuroprotection, as compared to using each of these agents alone. We further aimed to elucidate a potential role of the NADPH oxidase (NOX) phosphorylated protein kinase B (Akt) and protein kinase C d (PKC d) pathway in oxidative stress and neuroprotection. In Sprague Dawley rats, a focal middle cerebral artery (MCA) occlusion was induced by an autologous embolus in the following experimental groups: rt PA treatment alone, rt PA NBO treatment, rt PA TH at 33 degC, rt PA EtOH, rt PA NBO EtOH, rt PA NBO TH, rt PA NOX inhibitor, rt PA EtOH NOX inhibitor, or rt PA EtOH Akt inhibitor. Control groups included sham operated without stroke or stroke without treatment. Infarct volume and neurological deficit were assessed at 24 h after rt PA induced reperfusion with or without treatments. ROS levels, NOX activity, and the protein expression of NOX subunits p22phox, p47phox, p67phox, gp91phox, as well as PKC d and phosphorylated Akt were measured at 3 and 24 h after rt PA induced reperfusion. Following rt PA in thromboembolic stroke rats, NBO combined with TH or EtOH more effectively decreased infarct volume and neurological deficit, as well as reactive oxygen species (ROS) production than with any of the used monotherapies. NOX activity and subunit expressions were downregulated and temporally associated with reduced PKC d and increased p Akt expression. The present study demonstrated that combining NBO with either TH or EtOH conferred similar neuroprotection via modulation of NOX activation. The results suggest a role of Akt in NOX activation and implicate an upstream PKC d pathway in the Akt regulation of NOX. It is possible to substitute EtOH for TH, thus circumventing the difficulties in clinical application of TH through the comparatively easier usage of EtOH as a potential stroke management.
Molecular Neurobiology