Conselho Nacional de Desenvolvimento Científico e Tecnológico / Traumatic brain injury (TBI) is a major cause of death and disability. This condition results in neurological and cognitive impairment. In this context, it has been demonstrated that bradykinin, the main metabolite of the kallikrein-kinins system is involved in the increased permeability of the blood-brain barrier, in edema formation and leukocyte accumulation induced by TBI. Experimental findings also indicate an connection between kinin receptors and the activity of the enzyme nicotinamide adenine dinucleotide phosphate (NADPH)-oxidase, an enzyme that produces superoxide radical. It is known that the kalikrein-kinin and NADPH-oxidase activity participate of neuroinflammation triggered by TBI. However, few studies have evaluated their effects on the development of posttraumatic cognitive impairment. Hence, the present study evaluated the role of kinin receptors (B1 and B2) and the NADPH-oxidase inhibitor (apocynin)in neuromotor deficits, memory impairment, cortical lesion volume, oxidative and inflammatory damage induced by moderate lateral fluid percussion injury in mice. Therefore, we determined the effects of kinin receptors antagonists (des - Arg9-[Leu8]-bradykinin and HOE-140) and apocynin injected subcutaneously 30 min 24 hours post trauma. The present study demonstrated that both, HOE-140 and apocynin, protected against memory impairment triggered by trauma, but showed no effects in motor dysfunction caused by TBI. It should be noted that memory improvements was not due to nonspecific effects over the memory test, because the pharmacological treatment used in this study did no alter locomotor and/or anxiety-like behavioral. Treatment with HOE-140 also attenuated the NADPH-oxidase activity, reinforcing the connection between the B2 receptor and this enzyme. Moreover, both treatments attenuated the ipsilateral cortex inflammation (levels of interleukin-1β, tumoral necrosis factor-α and nitric oxide metabolites) and oxidative damage (lipid peroxidation, protein carbonylation and inhibition of Na+, K+ ATPase) induced by tested model. On the other hand, only treatment with HOE-140 reduced the cerebral edema. The results presented in this study suggest that kinins, through of the B2 receptor and possibly through NADPH-oxidase, are involved in neuroinflammation and oxidative stress caused by trauma. Moreover, it is plausible that excessive activation of B2 receptors and subsequent activation of the enzyme NADPH-oxidase facilitate the cortical lesion progression resulting in deterioration of object recognition memory. / O traumatismo crânio encefálico (TCE) é uma das maiores causas de morte e de incapacitação, resultando frequentemente em disfunções neurológicas e prejuízo cognitivo. Neste contexto, tem sido demonstrado que a bradicinina, o principal metabólito do sistema calicreína-cininas, está envolvida no aumento da permeabilidade da barreira hematoencefálica, na formação de edema e no acúmulo de leucócitos induzidos pelo TCE. Achados experimentais também indicam uma interconexão entre os receptores das cininas e a atividade da enzima Nicotinamida Adenina Dinucleotídeo Fosfato (NADPH)-oxidase. Esta enzima é uma conhecida produtora de radical superóxido e também parece estar envolvida na toxicidade induzida pelo TCE. Embora se conheça o envolvimento do sistema calicreína-cininas e da atividade da NADPH-oxidase na neuroinflamação desencadeada pelo TCE, poucos trabalhos têm avaliado seus efeitos no desenvolvimento do déficit cognitivo pós-traumático. Diante disto, o presente estudo avaliou o papel dos receptores das cininas (B1 e B2) e da apocinina (um inibidor da NADPH-oxidase) nos déficits neuromotor e de memória, bem como no volume de lesão cortical e nas alterações oxidativas e inflamatórias induzidas pelo modelo de lesão cerebral moderada por percussão de fluido lateral em camundongos. Para tanto, avaliou-se os efeitos dos antagonistas dos receptores das cininas dos subtipos B1 (des-Arg9-[Leu8]-bradicinina) e B2 (HOE-140) e da apocinina, injetados subcutaneamente 30 min e 24 horas após o trauma. O presente estudo demonstrou que tanto o HOE-140, como a apocinina protegeram contra o prejuízo de memória desencadeado pelo trauma, mas não apresentaram efeitos estatisticamente significantes sobre a disfunção motora. Cabe salientar que os testes de ansiedade e locomoção indicam que a melhora de memória alcançada com os tratamentos não se devem a interferências inespecíficas sobre a execução do teste de memória. O tratamento com HOE-140 atenuou ainda a atividade da NADPH-oxidase, reforçando a interconexão entre o receptor B2 e a enzima. Além disso, ambos os tratamentos foram eficazes em atenuar, em córtex ipsilateral, os parâmetros inflamatórios (níveis de interleucina-1β, fator de necrose tumoral-α e de metabólitos do óxido nítrico) e o dano oxidativo (lipoperoxidação, carbonilação proteica e inibição da Na+, K+ATPase) induzidos pelo modelo estudado. Por outro lado, apenas o tratamento com HOE-140 obteve uma redução estatisticamente significante sobre o edema cerebral. Os resultados apresentados permitem concluir que as cininas, por ação do receptor B2 e possivelmente da NADPH oxidase, estão envolvidas na neuroinflamação e no estresse oxidativo. Além disso, é plausível que a excessiva ativação dos receptores B2 seguida da ativação da enzima NADPH-oxidase facilite a progressão da lesão cortical repercutindo, desta forma, na deterioração da memória de reconhecimento de objetos.

<p>Traumatic brain injury (TBI) is a leading cause of death and disability TBI survivors often suffer from severe disturbances of cognition, memory and emotions. Improving the treatment is of great importance, but as of yet no specific neuroprotective treatment has been found. After TBI there are changes in ion homeostasis and protein regulation, causing generation of reactive oxygen species (ROS). Overproduction of ROS can lead to damage cellmembranes, proteins and DNA and secondary cell death. In the present thesis experimental TBI in rats were used to study the effects of the ROS scavengers α-phenyl-N-tert-butyl-nitrone (PBN) and 2-sulfophenyl-N-tert-butyl-nitrone (S-PBN) on morphology, function, intracellular signalling and apoptosis. </p><p>Posttreatment with PBN and S-PBN resulted in attenuation of tissue loss after TBI and S-PBN improved cognitive function evaluated in the Morris water maze (MWM). Pretreatment with PBN protected hippocampal morphology, which correlated to better MWM-performance after TBI.</p><p>To detect ROS-generation in vivo, a method using 4-hydroxybenzoic acid (4-HBA) microdialysis in the injured cortex was refined. 4-HBA reacts with ROS to form 3,4-DHBA, which can be quantified using HPLC, revealing that ROS-formation was increased for 90 minutes after TBI. It was possible to attenuate the formation significantly with PBN and S-PBN treatment. </p><p>The activation of extracellular signal-regulated kinase (ERK) is generally considered beneficial for cell survival. However, persistent ERK activation was found in the injured cortex after TBI, coinciding with apoptosis-like cell death 24 h after injury. Pretreatment with the MEK-inhibitor U0126 and S-PBN significantly decreased ERK activation and reduced apoptosis-like cell death. Posttreatment with U0126 or S-PBN showed robust protection of cortical tissue.</p><p>To conclude: ROS-mediated mechanisms play an important role in secondary cell death following TBI. The observed effects of ROS in intracellular signalling may be important for defining new targets for neuroprotective intervention.</p>

Traumatic brain injury (TBI) is a leading cause of death and disability TBI survivors often suffer from severe disturbances of cognition, memory and emotions. Improving the treatment is of great importance, but as of yet no specific neuroprotective treatment has been found. After TBI there are changes in ion homeostasis and protein regulation, causing generation of reactive oxygen species (ROS). Overproduction of ROS can lead to damage cellmembranes, proteins and DNA and secondary cell death. In the present thesis experimental TBI in rats were used to study the effects of the ROS scavengers α-phenyl-N-tert-butyl-nitrone (PBN) and 2-sulfophenyl-N-tert-butyl-nitrone (S-PBN) on morphology, function, intracellular signalling and apoptosis. Posttreatment with PBN and S-PBN resulted in attenuation of tissue loss after TBI and S-PBN improved cognitive function evaluated in the Morris water maze (MWM). Pretreatment with PBN protected hippocampal morphology, which correlated to better MWM-performance after TBI. To detect ROS-generation in vivo, a method using 4-hydroxybenzoic acid (4-HBA) microdialysis in the injured cortex was refined. 4-HBA reacts with ROS to form 3,4-DHBA, which can be quantified using HPLC, revealing that ROS-formation was increased for 90 minutes after TBI. It was possible to attenuate the formation significantly with PBN and S-PBN treatment. The activation of extracellular signal-regulated kinase (ERK) is generally considered beneficial for cell survival. However, persistent ERK activation was found in the injured cortex after TBI, coinciding with apoptosis-like cell death 24 h after injury. Pretreatment with the MEK-inhibitor U0126 and S-PBN significantly decreased ERK activation and reduced apoptosis-like cell death. Posttreatment with U0126 or S-PBN showed robust protection of cortical tissue. To conclude: ROS-mediated mechanisms play an important role in secondary cell death following TBI. The observed effects of ROS in intracellular signalling may be important for defining new targets for neuroprotective intervention.

Traumatic brain injury (TBI) is a major cause of mortality and disability. As common sequelae in survivors of TBI are disabling functional, emotional and cognitive disturbances, improved treatment of TBI patients is urgently needed. At present, no neuroprotective pharmacological treatment exists. The formation of oxygen-centered free radicals, reactive oxygen species (ROS), is considered an important event in the pathophysiology of TBI. In the present thesis, the fluid percussion (FPI) and controlled cortical contusion injury models of TBI in rats were used. Two nitrone radical scavengers, α-Phenyl-N-tert -butyl nitrone (PBN) and the sulfonated analogue of PBN, 2-sulfophenyl-N-tert-butyl nitrone (S-PBN), were used as tools to study the role of ROS in TBI. Pre-treatment with PBN (30 mg/kg) improved morphological and cognitive outcome after severe controlled cortical contusion injury. Treatment with equimolar doses of PBN and S-PBN administered 30 min after FPI followed by a 24 h intravenous infusion improved morphological outcome. Only S-PBN improved cognitive outcome as assessed in the Morris Water Maze. Surprisingly, pre-treatment with PBN increased the number of apoptotic neurons at 24 hours after injury despite a reduced lesion volume. FPI resulted in an early increase in glucose uptake and a reduction in regional cerebral blood flow (rCBF) assessed by fluoro-2-deoxyglucose (FDG) and hexamethylpropylene amine oxime (HMPAO) autoradiography. At 12 h, a marked reduction in glucose uptake and rCBF ensued. These TBI-induced changes were attenuated by PBN and S-PBN pre-treatment. A method for ROS detection using 4-hydroxybenzoate in conjunction with microdialysis was evaluated. The results showed a marked increase in ROS formation as assessed by an increase in the single adduct 3,4-DHBA, lasting 90 min after injury. In a separate study, PBN and S-PBN equally reduced 3,4-DHBA formation despite no detectable brain concentrations of S-PBN at 30 or 60 min post-injury. In conclusion, ROS play an important role in the injury process after TBI. We report a method for ROS detection with potential clinical utility. Nitrones increased ROS elimination and improved functional and morphological outcome. Nitrone treatment may have a clinical potential as a neuroprotective concept in TBI.