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Comparison of Systemic and Retrograde Delivery of Adenosine A2A Agonist for Attenuation of Spinal Cord Injury After Thoracic Aortic Cross-Clamping  T.

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Presentation on theme: "Comparison of Systemic and Retrograde Delivery of Adenosine A2A Agonist for Attenuation of Spinal Cord Injury After Thoracic Aortic Cross-Clamping  T."— Presentation transcript:

1 Comparison of Systemic and Retrograde Delivery of Adenosine A2A Agonist for Attenuation of Spinal Cord Injury After Thoracic Aortic Cross-Clamping  T. Brett Reece, MD, David O. Okonkwo, MD, PhD, Peter I. Ellman, MD, Thomas S. Maxey, MD, Carlos Tache-Leon, MD, Patrick S. Warren, MD, Jeffrey J. Laurent, MD, Joel Linden, PhD, Irving L. Kron, MD, Curtis G. Tribble, MD, John A. Kern, MD  The Annals of Thoracic Surgery  Volume 81, Issue 3, Pages (March 2006) DOI: /j.athoracsur Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

2 Fig 1 Venograms of the (A) anterior-posterior and (B) lateral views of the chest. Both show contrast injected into the accessory hemiazygous vein, which in turn filled the paravertebral and the epidural veins. The arrows point out the epidural veins. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

3 Fig 2 (A) Dark-field and (B) light microscopy of hematoxylin and eosin stained spinal cord sections demonstrating the filling of spinal cord parenchymal vasculature with barium sulfate. The white areas in the dark-field slide represent the contrast within the vessels in the tissue. The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

4 Fig 3 Comparison of neurologic function 12 hours and 24 hours after spinal cord ischemia-reperfusion. At 12 hours, function is significantly better in all groups receiving adenosine A2A agonist (ATL-146e) compared with control group. At 24 hours, function is significantly better in all groups receiving ATL-146e except the group who received both systemic (s) and retrograde (r) ATL. Data are expressed as mean Tarlov score ± SE. *p < compared with control and retrograde normal saline (NS) group. **p < compared with control, rNS, and rsATL groups. (Control = open bar; rATL = vertical striped bar; rNS = right-hatched bar; rNSsATL = horizontal striped bar; rsATL = left-hatched bar; sATL = solid bar.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

5 Fig 4 Neuronal viability expressed as number of neurons per high-powered field. Systemic (s) adenosine A2A agonist (ATL) with and without retrograde (r) normal saline (NS) preserved neuronal integrity significantly better than control and the group receiving systemic and retrograde normal saline. Data are expressed as mean ± SE. *p < 0.05 compared with control and rsATL. (Control = open bar; rATL = vertical striped bar; rNS = right-hatched bar; rNSsATL = horizontal striped bar; rsATL = left-hatched bar; sATL = solid bar.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

6 Fig 5 Microtubule-associated protein-2 (MAP-2) expressed as percent gray matter staining per section. All groups receiving systemic adenosine A2A agonist (ATL) therapies preserved MAP-2 staining significantly better than those not receiving systemic ATL. Data are expressed as mean percentage expression of MAP-2 ± SE. *p < 0.01 compared with control, rNS, and rATL. †p < 0.01 compared with control and rNS, and p = 0.03 versus rATL and rNSsATL. (NS = normal saline; r = retrograde; s = systemic; control = open bar; rATL = vertical striped bar; rNS = right-hatched bar; rNSsATL = horizontal striped bar; rsATL = left-hatched bar; sATL = solid bar.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

7 Fig 6 Microtubule-associated protein-2 (MAP-2) expressed as percent gray matter staining per section. All groups receiving systemic adenosine A2A agonist (ATL) therapies preserved MAP-2 staining significantly better than those not receiving systemic ATL. (A–F) The relative expression of MAP-2 is depicted for each of the groups, with the darker staining indicating the presence of more of the protein. (NS = normal saline; r = retrograde; s = systemic.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

8 Fig 7 Myeloperoxidase assay results 24 hours after spinal cord ischemia reperfusion. Myeloperoxidase is expressed as mean change in absorbance per milligram per minute ± SE. The groups receiving systemic ATL-146e had significantly less neutrophil sequestration than control.*p < 0.01 compared with control, rNS, and rATL. (NS = normal saline; r = retrograde; s = systemic; control = open bar; rATL = vertical striped bar; rNS = right-hatched bar; rNSsATL = horizontal striped bar; rsATL = left-hatched bar; sATL = solid bar.) The Annals of Thoracic Surgery  , DOI: ( /j.athoracsur ) Copyright © 2006 The Society of Thoracic Surgeons Terms and Conditions

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