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Am J Physiol Heart Circ Physiol (January 28, 2005). doi:10.1152/ajpheart.01274.2004
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Submitted on December 17, 2004
Accepted on January 24, 2005

Epileptic seizures cause extended postictal cerebral vascular dysfunction that is prevented by HO-1 overexpression

Helena Parfenova1*, Pierluigi Carratu1, Dilyara Tcheranova1, Alex Fedinec1, Massroor Pourcyrous1, and Charles W Leffler1

1 Physiology and Pediatrics, Vascular Biology Center, University of Tennessee Health Science Center, Memphis, TN, USA

* To whom correspondence should be addressed. E-mail: hparf{at}physio1.utmem.edu.

The extended postictal state is characterized by neurological problems in patients. Inadequate blood supply to the brain and impaired cerebral autoregulation may contribute to seizure-induced neuronal damage. Recent evidence in newborn pigs indicates that activation of the anti-oxidative enzyme, heme oxygenase (HO), at the onset of seizures is necessary for increased cerebral blood flow during the ictal episode and for normal cerebral vascular functioning during the immediate postictal period. We hypothesized that seizures cause prolonged postictal cerebral vascular dysfunction that can be accentuated by HO inhibition and rescued by HO overexpression. Cerebral vascular responses to endothelium-dependent (hypercapnia, bradykinin) and endothelium-independent (isoproterenol, sodium nitroprusside) stimuli were assessed 48 h after bicuculline-induced seizures in: a) saline-control newborn piglets, b) HO-inhibited animals (HO was inhibited by tin protoporphyrin, SnPP, 3 mg/kg i.v.), and c) HO-overexpressing piglets (HO-1 was upregulated by cobalt protoporphyrin, CoPP, 50 mg/kg i.p.) Extended alterations of HO expression in cerebral microvessels were confirmed by measuring CO production and HO-1/HO-2 proteins. Our data provide evidence that seizures cause a severe, sustained, postictal cerebral vascular dysfunction as reflected by impaired vascular reactivity to physiologically relevant dilators. During the delayed postictal state, vascular reactivity to all dilator stimuli was reduced in saline-control and, to a greater extent, in HO-inhibited animals. In CoPP-treated piglets, no reduction in postictal cerebral vascular reactivity was observed. These findings may indicate that CoPP prevents postictal cerebral vascular dysfunction by upregulating HO-1, a finding that might have implications for preventing postictal neurological complications.




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