This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Schäbitz, W.-R. Articles by Piomelli, D. Search for Related Content PubMed PubMed Citation Articles by Schäbitz, W.-R. Articles by Piomelli, D. Related Collections Acute Stroke Syndromes Other Stroke Treatment - Medical Lipid and lipoprotein metabolism

(Stroke. 2002;33:2112.)
© 2002 American Heart Association, Inc.

Case Report

Release of Fatty Acid Amides in a Patient With Hemispheric Stroke

A Microdialysis Study

Wolf-R. Schäbitz, MD; Andrea Giuffrida, PhD; Christian Berger, MD; Alfred Aschoff, MD; Markus Schwaninger, MD; Stefan Schwab, MD Daniele Piomelli, PhD

From the Departments of Neurology (W-R.S., C.B., M.S., S.S.) and Neurosurgery (A.A.), University of Heidelberg, Heidelberg, Germany, and Department of Pharmacology, University of California at Irvine (A.G., D.P.).

Correspondence to Stefan Schwab, MD, Department of Neurology, University of Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany.

Background— Excitotoxic insults such as stroke may induce release of fatty acid ethanolamides (FAEs), contributing to the downstream events in the ischemic cascade. We therefore studied release of FAEs such as anandamide, palmitylethanolamide (PEA), and oleylethanolamide (OEA) in the brain of a patient suffering from malignant hemispheric infarction treated with hypothermia.

Case Description— A patient with life-threatening hemispheric stroke was treated with moderate hypothermia (33°C) that was maintained for 3 days, followed by a 3-day rewarming period. Microdialysis was applied to measure glutamate, lactate, and glycerol by using a microdialysis analyzer. FAEs were measured by microdialysis coupled with high-performance liquid chromatography/mass spectrometry. Release of neuroprotective fatty amides occurred within the first day after ischemia and reached high concentrations for all 3 substances in tissue surrounding the primary ischemic lesion: anandamide up to 42 pmol/mL, PEA up to 120 pmol/mL, and OEA up to 242 pmol/mL. There was a significant correlation with elevation of lactate as early marker for the hypoxic insult.

Conclusions— This is the first report demonstrating release of FAEs in vivo during human stroke and may suggest contribution of the FAE signaling system to the pathophysiological events after ischemia.

Key Words: amides • cannabinoids • cerebral ischemia • fatty acids • microdialysis • stroke

This article has been cited by other articles:

				Y. F. Njie, Z. Qiao, Z. Xiao, W. Wang, and Z.-H. Song N-arachidonylethanolamide-Induced Increase in Aqueous Humor Outflow Facility Invest. Ophthalmol. Vis. Sci., October 1, 2008; 49(10): 4528 - 4534. [Abstract] [Full Text] [PDF]

				M. Rajesh, H. Pan, P. Mukhopadhyay, S. Batkai, D. Osei-Hyiaman, G. Hasko, L. Liaudet, B. Gao, and P. Pacher Pivotal Advance: Cannabinoid-2 receptor agonist HU-308 protects against hepatic ischemia/reperfusion injury by attenuating oxidative stress, inflammatory response, and apoptosis J. Leukoc. Biol., December 1, 2007; 82(6): 1382 - 1389. [Abstract] [Full Text] [PDF]

				S. Batkai, D. Osei-Hyiaman, H. Pan, O. El-Assal, M. Rajesh, P. Mukhopadhyay, F. Hong, J. Harvey-White, A. Jafri, G. Hasko, et al. Cannabinoid-2 receptor mediates protection against hepatic ischemia/reperfusion injury FASEB J, June 1, 2007; 21(8): 1788 - 1800. [Abstract] [Full Text] [PDF]

				P. Pacher, S. Batkai, and G. Kunos The Endocannabinoid System as an Emerging Target of Pharmacotherapy Pharmacol. Rev., September 1, 2006; 58(3): 389 - 462. [Abstract] [Full Text] [PDF]

				C. Benito, W.-K. Kim, I. Chavarria, C. J. Hillard, K. Mackie, R. M. Tolon, K. Williams, and J. Romero A Glial Endogenous Cannabinoid System Is Upregulated in the Brains of Macaques with Simian Immunodeficiency Virus-Induced Encephalitis J. Neurosci., March 9, 2005; 25(10): 2530 - 2536. [Abstract] [Full Text] [PDF]

				S. Patel, E. J. Carrier, W-S. V. Ho, D. J. Rademacher, S. Cunningham, D. S. Reddy, J. R. Falck, B. F. Cravatt, and C. J. Hillard The postmortal accumulation of brain N-arachidonylethanolamine (anandamide) is dependent upon fatty acid amide hydrolase activity J. Lipid Res., February 1, 2005; 46(2): 342 - 349. [Abstract] [Full Text] [PDF]

				A. Franklin, S. Parmentier-Batteur, L. Walter, D. A. Greenberg, and N. Stella Palmitoylethanolamide Increases after Focal Cerebral Ischemia and Potentiates Microglial Cell Motility J. Neurosci., August 27, 2003; 23(21): 7767 - 7775. [Abstract] [Full Text] [PDF]