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(Stroke. 2003;34:2489.)
© 2003 American Heart Association, Inc.
Original Contributions |
From the Departments of Neurosurgery (B.H., M.A.Y., R.M.S., G.K.S.), Neurology and Neurological Sciences (M.A.Y., R.M.S., G.K.S.), and Biological Sciences (R.M.S.), Stanford Stroke Center (B.H., M.A.Y., R.M.S., G.K.S.) and Stanford Neurosciences Program (B.H., M.A.Y., R.M.S., G.K.S.), Stanford University, Stanford, Calif.
Correspondence to Gary K. Steinberg, MD, PhD, R281, Department of Neurosurgery, Stanford University School of Medicine, 300 Pasteur Dr, Stanford, CA 94305-5327. E-mail gsteinberg{at}stanford.edu
Background and Purpose Ischemic injury and reperfusion increases superoxide (O2-) production and reduces the ability of neurons to scavenge free radicals, leading to the release of cytochrome c and apoptosis. Here we test whether overexpression with the use of gene therapy of the antioxidant glutathione peroxidase (Gpx), delivered before or after experimental stroke, is protective against ischemic injury.
Methods Sixty-two rats underwent middle cerebral artery occlusion for 1 hour. Defective herpes simplex viral vectors expressing Gpx/lacZ or lacZ alone (control) were delivered into each striatum 12 hours before or 2 or 5 hours after ischemia onset.
Results Striatal neuron survival at 2 days was improved by 36% when Gpx was delivered 12 hours before ischemia onset, 26% with a 2-hour delay, and 25% when delayed 5 hours. After ischemia, Gpx overexpression significantly reduced cytosolic translocation of cytochrome c and increased the proportion of Bcl-2positive cells compared with cells transfected with control vector. Bax and activated caspase-3, while present in control-transfected neurons after ischemia, were rarely noted in Gpx-transfected cells.
Conclusions Expression from these herpes simplex viral vectors begins 4 to 6 hours after injection, which suggests a 9- to 11-hour temporal therapeutic window for Gpx. This is the first study to show that overexpression of Gpx with the use of gene therapy protects against experimental stroke, even with postischemic transfection, and the neuroprotective mechanism involves attenuation of apoptosis-related events.
Key Words: apoptosis cytochrome c gene therapy glutathione peroxidase ischemia neuroprotection
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