Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management

Hong, Dae Ki; Park, Yoo Seok; Woo, Ji Sun; Kim, Ju Hee; Beom, Jin Ho; Chung, Sung Phil; You, Je Sung; Suh, Sang Won

doi:10.3390/ijms22105114

Open AccessArticle

Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management

by

Dae Ki Hong

^1,†,

Yoo Seok Park

^2,†

,

Ji Sun Woo

³,

Ju Hee Kim

³,

Jin Ho Beom

²,

Sung Phil Chung

³

,

Je Sung You

^3,*

and

Sang Won Suh

^1,*

¹

Department of Physiology, College of Medicine, Hallym University, Chuncheon 24252, Korea

²

Department of Emergency Medicine, Severance Hospital 50, College of Medicine, Yonsei University, Yonsei-ro, Seoul 03722, Korea

³

Department of Emergency Medicine, Gangnam Severance Hospital 211, College of Medicine, Yonsei University, Eonju-ro, Seoul 06273, Korea

^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally.

Int. J. Mol. Sci. 2021, 22(10), 5114; https://doi.org/10.3390/ijms22105114

Submission received: 6 April 2021 / Revised: 6 May 2021 / Accepted: 11 May 2021 / Published: 12 May 2021

(This article belongs to the Special Issue Cellular and Molecular Targets in Acute Ischemic Stroke)

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Abstract

Sudden cardiac arrest leads to a significantly increased risk of severe neurological impairment and higher mortality rates in survivors due to global brain tissue injury caused by prolonged whole-body ischemia and reperfusion. The brain undergoes various deleterious cascading events. Among these damaging mechanisms, neuroinflammation plays an especially crucial role in the exacerbation of brain damage. Clinical guidelines indicate that 33 °C and 36 °C are both beneficial for targeted temperature management (TTM) after cardiac arrest. To clarify the mechanistic relationship between TTM and inflammation in transient global ischemia (TGI) and determine whether 36 °C produces a neuroprotective effect comparable to 33 °C, we performed an experiment using a rat model. We found that TTM at 36 °C and at 33 °C attenuated neuronal cell death and apoptosis, with significant improvements in behavioral function that lasted for up to 72 h. TTM at 33 °C and 36 °C suppressed the propagation of inflammation including the release of high mobility group box 1 from damaged cells, the activation and polarization of the microglia, and the excessive release of activated microglia-induced inflammatory cytokines. There were equal neuroprotective effects for TTM at 36 °C and 33 °C. In addition, hypothermic complications and should be considered safe and effective after cardiac arrest.

Keywords: post cardiac arrest care; targeted temperature management; high mobility box protein 1; apoptosis; inflammation; microglia

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MDPI and ACS Style

Hong, D.K.; Park, Y.S.; Woo, J.S.; Kim, J.H.; Beom, J.H.; Chung, S.P.; You, J.S.; Suh, S.W. Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management. Int. J. Mol. Sci. 2021, 22, 5114. https://doi.org/10.3390/ijms22105114

AMA Style

Hong DK, Park YS, Woo JS, Kim JH, Beom JH, Chung SP, You JS, Suh SW. Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management. International Journal of Molecular Sciences. 2021; 22(10):5114. https://doi.org/10.3390/ijms22105114

Chicago/Turabian Style

Hong, Dae Ki, Yoo Seok Park, Ji Sun Woo, Ju Hee Kim, Jin Ho Beom, Sung Phil Chung, Je Sung You, and Sang Won Suh. 2021. "Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management" International Journal of Molecular Sciences 22, no. 10: 5114. https://doi.org/10.3390/ijms22105114

APA Style

Hong, D. K., Park, Y. S., Woo, J. S., Kim, J. H., Beom, J. H., Chung, S. P., You, J. S., & Suh, S. W. (2021). Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management. International Journal of Molecular Sciences, 22(10), 5114. https://doi.org/10.3390/ijms22105114

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Transient Global Ischemia-Induced Brain Inflammatory Cascades Attenuated by Targeted Temperature Management

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