Clobenpropit Protects Propofol-Induced Neuronal Apoptosis
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European Review for Medical and Pharmacological Sciences 2018; 22: 8013-8020 Histamine H3 receptor antagonist Clobenpropit protects propofol-induced apoptosis of hippocampal neurons through PI3K/AKT pathway W. HE1, Q.-H. YUAN2, Q. ZHOU3 1Department of Anaesthesiology, Mianyang Central Hospital, Mianyang, China 2Department of Pathology, Mianyang Central Hospital, Mianyang, China 3Department of Anaesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, China Abstract. – OBJECTIVE: The aim of the study anesthetic effect is mainly achieved by exciting was to explore whether histamine H3 receptor gamma-aminobutyric acid (GABA) or inhibit- antagonist Clobenpropit could protect propo- ing N-methyl-D-aspartate (NMDA)2,3. However, fol-induced neurotoxicity in hippocampal neu- studies have found that anesthetics have toxic rons. MATERIALS AND METHODS: Hippocampal effects on neurons in developmental stage, which neurons were extracted from neonatal rats and may lead to neuronal apoptosis and brain dam- induced with propofol. MTT (3-(4,5-dimethylthi- age4. General anesthesia has been applied for azol-2-yl)-2,5-diphenyl tetrazolium bromide) as- nearly two centuries5. With the increased amount say was performed to detect apoptotic rate of of surgeries, anesthesia complications such as neurons. Western blot was conducted to detect protein levels of cleaved-caspase-3 and Bax/ postoperative cognitive dysfunction have been Bcl2. After LY294002 treatment, the PI3K path- focused on. In particular, the potential influences way antagonist was applied in neurons, protein of anesthetics on learning and memory functions levels of cleaved-caspase-3 and Bax/Bcl2 were of children have been well concerned throughout detected by Western blot as well. the world6,7. Propofol has been clinically applied RESULTS: Propofol treatment remarkably in- for induction and maintenance of anesthesia since duced neuronal apoptosis. Clobenpropit allevi- ated cell apoptosis induced by propofol. Pro- 1989. It has become an extremely useful drug for tein expressions of cleaved-caspase-3 and Bax/ inducing and maintaining general anesthesia due Bcl2 were remarkably downregulated in neurons to its rapid onset and recovery after withdrawal8. treated with Clobenpropit. LY294002 induction The anesthetic effect of propofol mainly relies remarkably reverses the protective role of Clo- on activating the type A receptor of GABA and benpropit in neuronal apoptosis, manifesting as inhibiting the NMDA receptor to some extent2,9. downregulated PI3K and p-AKT after LY294002 treatment. The balance of GABA activation and NMDA CONCLUSIONS: Clobenpropit protects propo- inhibition maintains the survival and apoptosis fol-induced neuronal apoptosis through activat- of neurons10. During the developmental process ing PI3K/AKT pathway. of central nervous system, it is very sensitive Key Words: to the external stimuli and the long-term cogni- Clobenpropit, Propofol, PI3K/AKT, Apoptosis. tive function may be influenced. Propofol exerts relative small side effects on central nervous system in comparison with other anesthetics11. Introduction However, recent investigations12,13 have pointed out that propofol administration may induce neu- With the development of surgical techniques, rotoxicity in both in vivo and in vitro models. the number of infants, children, and pregnant It is reported that administration of propofol women undergoing surgeries have also increased, alone or in combination with other drugs induc- leading to the great concern on the side effects of es neuronal death in the experimental animals, anesthetics, especially on immature brains1. The leading to subsequent learning and memory im- Corresponding Author: Qin Zhou, BM; e-mail: [email protected] 8013 W. He, Q.-H. Yuan, Q. Zhou pairment14. There are many developmental events survival, etc. are regulated by PI3K28. AKT, also during neurogenesis, and propofol administration known as protein kinase B (PKB), is an essential may affect neuronal functions at specific stages. target kinase downstream of PI3K. Phosphory- Propofol may be involved in various cellular lation at the Ser473 site activates AKT, which in processes. Although many studies have found turn activates a series of apoptosis-regulated pro- that propofol induces neurotoxicity in the brains teins (e.g., Bad, Caspase-9, etc.) to inhibit apop- of growing animals, the specific mechanism, tosis and promote cell survival29. This study aims however, has not been well understood. Current to investigate the protective role of histamine H3 studies 15-17 believed that the neurotoxic effects receptor antagonist in propofol-induced neuronal of propofol may involve in neural stem cell sur- apoptosis, and the potential mechanism of PI3K/ vival and neurogenesis, mitochondrial damage, AKT pathway. Our results provide a reference for calcium signal abnormalities, microRNAs-me- anesthesia medication in infants. diated mechanisms, BDNF dysregulation and inflammatory factors. In-depth studies are still required for fully investigations. Histamine is an Materials and Methods important neurotransmitter or neuromodulator in the brain. There are four histamine receptors that Extraction of Hippocampal have been already discovered, namely H1, H2, Neurons in Rats H3, and H4. Among them, H1 mainly presents This study was approved by the Animal Ethics in the postsynaptic membrane, whereas H3 re- Committee of Mianyang Central Hospital Animal ceptor mainly presents in the presynaptic mem- Center. The neonatal rats with 18-day-old were brane18-20. H3 receptors can negatively regulate sacrificed by decapitation. After immersing in 75% the synthesis and release of histamine, while H4 alcohol for at least 2 min, the head skin was cut to receptors are currently reported to be involved expose the bilateral cerebral hemispheres. The in the immune response21, 22. Histamine exerts cerebral hemispheres were placed in D-Hank’s various neuromodulation effects on sleep, wake- buffer on ice for harvesting hippocampal tissues. fulness, learning, memory and feeding through The remaining meninges, blood vessels and other its different receptors23. Histamine H3 receptor tissues on the hippocampus were removed and antagonist can promote the synthesis and release washed with cold D-Hank’s. The hippocampus of histamine. Many studies24 have shown that H3 tissues were gently cut and the D-Hank’s contain- receptor antagonist is a very promising therapeu- ing hippocampus tissues were transferred into a tic drug in the treatment of neurological diseases, centrifuge tube. The mixture was centrifuged at such as epilepsy, sleep disorders and memory dis- 900 rpm/min for 5 min. The supernatant was dis- orders. For example, Pitolisant was the first clini- carded and the centrifugation was repeated once cally used H3 receptor antagonist in the treatment with the same procedure. After the supernatant of sleep disorders, showing a good therapeutic was discarded, 3-time volume of membrane pro- effect. Histamine H3 receptor antagonists can tease was added into the hippocampus tissues, fol- reduce neuronal apoptosis and cerebral infarction lowed by digestion for 15 to 20 min. The mixture volume after ischemia25. The histamine receptor was shaken every 5 min. DMED containing 10% antagonist Clobenpropit protects NMDA-induced FBS was added to terminate the digestion. The neuronal excitatory damage by elevating GABA filtered cells were collected into a centrifuge tube concentration26. So far, the effects and mecha- and centrifuged at 900 rpm/min for 5 min. The nisms of histamine H3 receptor and its antagonist supernatant was discarded and the cell suspension on propofol-induced neuronal apoptosis are rarely was prepared by blowing. The cell suspension reported. Phosphatidylinositol 3-kinase (P13K) is was transferred to a culture flask and placed in an an important cellular signal transduction mole- incubator for different adherent culture conditions. cule27. P13K can be activated by stimulation with Non-adherent neurons were harvested subsequent- extracellular signals, such as growth factors, cyto- ly and the glial cells were isolated due to a faster kines, and hormones. Activation of P13K produc- adherence speed. es 3,4-diphosphophosphatidylinositol (PIP2) and 3,4,5-trisphosphonylphosphatidylinositol (PIP3). Extraction of Total Protein PIP3 subsequently activates multiple target pro- From Neurons teins in cells as a second messenger. Finally, the The medium containing neurons was dis- processes of cell proliferation, differentiation, carded and dried with absorbent paper. Pre- 8014 Clobenpropit protects propofol-induced neuronal apoptosis cooled phosphate-buffered saline (PBS) was Results added in each well for cell wash for a total of three times, with 1 min each time. Neurons Effects of Propofol on were lysed on ice for 30 min and shaken every Neuronal Apoptosis 3-5 min. After complete lysis, lysate and cell MTT assay was conducted after neurons were debris were collected in a centrifuge tube, fol- exposed to different concentrations of propofol lowed by centrifugation at 4°C, 12000 rpm/min for detecting apoptotic rate. The data showed for 5 min. The supernatant was collected and that the apoptotic rate of neurons remarkably preserved in -80°C. increased in a concentration-dependent manner (Figure 1). Specifically, neurons were induced MTT (3-(4,5-dimethylthiazol-2-yl)-2,5- with 0.1 μM, 1 μM, 10 μM, 100 μM and 1000 Diphenyl Tetrazolium Bromide) Assay μM propofol for 24 hours. Neuronal apopto-