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Targeted Temperature Management at 33°C or 36°C Produces Equivalent Neuroprotective Effects in the Middle Cerebral Artery Occlusion Rat Model of Ischemic Stroke

 Jung Ho Lee  ;  Jisoo Lim  ;  Yong Eun Chung  ;  Sung Phil Chung  ;  Incheol Park  ;  Chul Hoon Kim  ;  Je Sung You 
 Shock, Vol.50(6) : 714-719, 2018 
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Targeted temperature management (TTM, 32°C to 36°C) is one of the most successful achievements in modern resuscitation medicine. It has become standard treatment for survivors of sudden cardiac arrest to minimize secondary brain damage. TTM at 36°C is just as effective as TTM at 33°C and is actually preferred because it reduces adverse TTM-associated effects. TTM also likely has direct neuroprotective effects in ischemic brains in danger of stroke. It remains unclear, however, whether higher temperature TTM is equally effective in protecting the brain from the effects of stroke. Here, we asked whether TTM at 36°C is as effective as TTM at 33°C in improving outcomes in a middle cerebral artery occlusion (MCAO) model of ischemic stroke. After dividing rats randomly into MCAO, MCAO+33°C TTM, MCAO+36°C TTM, and sham groups, we subjected all of them except for the sham group to MCAO for 3 h (for the behavioral tests) or 4 h (for all other biochemical analyses). We found TTM protocols at both 33°C and 36°C to produce comparable reductions of infarct volumes in the MCAO territory and equally attenuate the extracellular release of high mobility group box 1 in postischemic brains. Both the TTM conditions prevent the mRNA induction of a major pro-inflammatory cytokine, tissue necrosis factor-α, in the ischemic penumbra region. Finally, both the TTM protocols produce similar improvements in neurological outcomes in rats, as measured by a battery of behavior tests 21 h after the start of reperfusion. These data acquired in a rat MCAO model suggest TTM at 36°C has excellent therapeutic potential for improving clinical outcomes for patients with acute ischemic stroke.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pharmacology (약리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
김철훈(Kim, Chul Hoon) ORCID logo https://orcid.org/0000-0002-7360-429X
박인철(Park, In Cheol) ORCID logo https://orcid.org/0000-0001-7033-766X
유제성(You, Je Sung) ORCID logo https://orcid.org/0000-0002-2074-6745
이정호(Lee, Jeong Ho)
정성필(Chung, Sung Pil) ORCID logo https://orcid.org/0000-0002-3074-011X
정용은(Chung, Yong Eun) ORCID logo https://orcid.org/0000-0003-0811-9578
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