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Schützen Statine vor Schlaganfall und Alzheimer? : neue Therapiemöglichkeiten im Zentralnervensystem
(2005)
Statine stellen heute Medikamente der ersten Wahl bei zu hohen Cholesterin- Blutwerten dar. Denn sie hemmen die Hydroxymethylglutaryl-CoA Reduktase (HMG-CoA Reduktase), ein wichtiges Schlüsselenzym, das für die körpereigene Herstellung von Cholesterin notwendig ist. Bei der pharmakologischen Bewertung der Statine muss allerdings auch der Cholesterinstoffwechsel im Gehirn berücksichtigt werden, dem cholesterinreichsten Organ des menschlichen Körpers. Bislang existieren nur wenige Daten zu den Effekten dieser Medikamente im zentralen Nervensystem. Im Rahmen eines Leitprojekts des Zentrums für Arzneimittelforschung, -Entwicklung und Sicherheit (ZAFES) wird derzeit die Pharmakologie der Statine im Gehirn intensiv untersucht, um die therapeutischen Einsatzmöglichkeiten von Statinen im Zusammenhang mit der Therapie von Erkrankungen, wie Schlaganfall und Alzheimer-Demenz, aufzuklären und gegebenenfalls zu erweitern.
Single long-chain omega-3 fatty acids (e.g. docosahexaenoic acid (DHA) or eicosapentaenoic acid (EPA)) are known for their neuroprotective properties associated with ischemic stroke. This pilot study aimed to test the effectiveness of an acute treatment with a long-chain omega-3 lipid emulsion (Omegaven 10%®, OGV) that contains fish oil (DHA 18 mg/ml; EPA 21 mg/ml) and α-tocopherol (0.2 mg/ml) in a transient middle cerebral artery occlusion (MCAO) model of ischemic stroke in mice. For this purpose, female CD-1 mice were anesthetized and subjected to 90 minutes of MCAO. To reflect a clinically relevant situation for an acute treatment, either after induction of stroke or after reperfusion, a single dose of OGV was injected intravenously into the tail vein (5 ml/kg b.w.). A neurological severity score was used to assess motor function and neurological outcome. Stroke-related parameters were determined 24 hours after MCAO. Microdialysis was used to collect samples from extracellular space of the striatum. Mitochondrial function was determined in isolated mitochondria or dissociated brain cells. Inflammation markers were measured in brain homogenate. According to control experiments, neuroprotective effects could be attributed to the long-chain omega-3 content of the emulsion. Intravenous injection of OGV reduced size and severity of stroke, restored mitochondrial function, and prevented excitotoxic glutamate release. Increases of pro-inflammatory markers (COX-2 and IL-6) were attenuated. Neurological severity scoring and neurochemical data demonstrated that acute OGV treatment shortly after induction of stroke was most efficient and able to improve short-term neurological outcome, reflecting the importance of an acute treatment to improve the outcome. Summarising, acute treatment of stroke with a single intravenous dose of OGV provided strong neuroprotective effects and was most effective when given immediately after onset of ischemia. As OGV is an approved fishoil emulsion for parenteral nutrition in humans, our results may provide first translational data for a possible early management of ischemic stroke with administration of OGV to prevent further brain damage.