Berberine Attenuates Cerebral Vasospasm After Experimental Subarachnoid Hemorrhage Via Modulating AMPK/Rho Pathway

Purpose: Our goal is to clarify the effectiveness of berberine BBR on cerebral vasospasm induced by subarachnoid hemorrhage. Methods: Thirty male Sprague-Dawley rats 350–400 g were randomly allocated to five groups sham group, SAH, BBR, SAH+BBR1 or SAH+BBR2. Experimental SAH model was induced by applying autologous blood into the cisterna magna at interval of 48 hours. To evaluate early and late effects of BBR, we allocated BBR treated groups as SAH+BBR1 and SAH+BBR2 respectively, received BBR at a dose of 20 mg/kg 15 minutes and 6 hours after first SAH induction . Rats were sacrificed on 72-hour after the study onset. Cross-sections of basilar artery was investigated by histologically. Total antioxidant status TAS and total oxidant status TOS of brain tissue were studied by spectrophotometric assay. Oxidative stress index OSI was calculated. NAPPH Oxidase 4 NOX4 enzyme levels were measured by ELISA method. Endothelial nitric oxide synthase e-NOS , phosphorylated e-NOS pe-NOS , AMP-activated protein kinase AMPK , phosphorylated AMPK pAMPK , Rho kinase and cingulin protein expressions were detected by Western blot analysis. Results: SAH+BBR1 and SAH+BBR2 groups significantly demonstrated lower OSI values, increased basilar artery cross-sectional luminal area in comparison with the SAH group. Increased Phosho-eNOS, eNOS, P-AMPK levels and Cingulin expression, decreased Nox4 and Rho-kinase levels were shown in BRB treated SAH groups relative to the SAH group. Conclusion: Berberine might be a neuroprotective agent to improve impaired cerebrovascular spasm.

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  • 1. Cahill J, Calvert JW, Zhang JH. Mechanisms of early brain injury after subarachnoid hemorrhage. J Cereb Blood Flow Metab 2006;26:1341– 1353. [CrossRef]
  • 2. Park S, Yamaguchi M, Zhou C, Calvert JW, Tang J, Zhang JH. Neurovascular protection reduces early brain injury after subarachnoid hemorrhage. Stroke 2004;35:2412–2417. [CrossRef]
  • 3. Archavlis E, Carvi Y, Nievas M. Cerebral vasospasm: a review of current developments in drug therapy and research. J Pharm Technol Drug Res 2013;2:1–18. [CrossRef]
  • 4. Yano T, Matsui T, Tamura A, Uji M, Tsukita S. The association of microtubules with tight junctions is promoted by cingulin phosphorylation by AMPK. J Cell Biol 2013;203:605–614. [CrossRef]
  • 5. Spindler V, Schlegel N, Waschke J. Role of GT Pases in control of microvascular permeability. Cardiovasc Res 2010;87:243–253. [CrossRef]
  • 6. Citi S, Pulimeno P, Paschoud S. Cingulin, paracingulin, and PLEKHA7: signaling and cytoskeletal adaptors at the apical junctional complex. Ann N Y Acad Sci 2012;1257:125–132. [CrossRef]
  • 7. Fujii M, Duris K, Altay O, Soejima Y, Sherchan P, Zhang JH. Inhibition of Rho kinase by hydroxyfasudil attenuates brain edema after subarachnoid hemorrhage in rats. Neurochem Int 2012;60:327–333. [CrossRef]
  • 8. Terry S, Nie M, Matter K, Balda MS. Rho signaling and tight junction functions. Physiology (Bethesda) 2010;25:16–26. [CrossRef]
  • 9. Ronnett GV, Ramamurthy S, Kleman AM, LE Landree, Aja S. AMPK in the brain: its roles in energy balance and neuroprotection. J Neurochem 2009;109:17–23. [CrossRef]
  • 10. Kulkarni SK, Dhir A. Berberine: a plant alkaloid with therapeutic potential for central nervous system disorders Phytother Res 2010;24:317–324. [CrossRef]
  • 11. Ahmed T, Gilani AUH, Abdollahi M, et al. Berberine and neurodegeneration: A review of literature. Pharmacol Rep 2015;67:970–979. [CrossRef]
  • 12. Xie X, Chang X, Chen L, et al. Berberine ameliorates experimental diabetesinduced renalinflammation and fibronectin by inhibiting the activation of RhoA/ROCK signaling. Mol Cell Endocrinol 2013;381:56–65. [CrossRef]
  • 13. Wang Y, Huang Y, Lam KS, et al. Berberine prevents hyperglycemiainduced endothelial injury and enhances vasodilatation via adenosine monophosphate-activated protein kinase and endothelial nitric oxide synthase. Cardiovasc Res 2009;82:484–492. [CrossRef]
  • 14. Chen Z, Peng IC, Sun W, et al. AMP activated protein kinase functionally phosphorylates endothelial nitric oxide synthaseSer633. Circ Res 2009;104:496–505. [CrossRef]
  • 15. Dudhani RV, Kyle M, Dedeo C, Riordan M, Deshaies EM. A low mortality rat model to assess delayed cerebral vasospasm after experimental subarachnoid hemorrhage. J Vis Exp 2013;71:e4157. [CrossRef]
  • 16. Zhou XQ, Zeng XN, Kong H, Sun XL. Neuroprotective effects of berberine on stroke models in vitro and in vivo. Neurosci Lett 2008;447:31–6. [CrossRef]
  • 17. Zuccarello M, Kassell NF, Sasaki T, Fujiwara S, Nakagomi T, Lehman RM. Barrier disruption in the major cerebral arteries after experimental subarachnoid hemorrhage in spontaneously hypertensive and normotensive rats. Neurosurgery 1987;21:515–22. [CrossRef]
  • 18. Koźniewska E, Michalik R, Rafałowska J, et al. Mechanisms of vascular dysfunction after subarachnoid hemorrhage. J Physiol Pharmacol 2006;57:145–160. https://pubmed.ncbi.nlm.nih.gov/17244946/
  • 19. Sasaki T, Kassell N, Zuccarello M, et al. Barrier disruption in the major cerebral arteries during the acute stage after experimental SAH. Neurosurgery 1986;19:177–184. [CrossRef]
  • 20. Osuka K, Watanabe Y, Usuda N, Atsuzawa K, Yoshida J, Takayasu M. Modification of endothelial nitric oxide synthase through AMPK after experimental subarachnoid hemorrhage J Neurotrauma 2009;26:1157–1165. [CrossRef]
  • 21. Jeon H, Ai J, Sabri M, et al. Neurological and neurobehavioral assessment of experimental subarachnoid hemorrhage. BMC Neurosci 2009;10:103. [CrossRef]
  • 22. Chen S, Feng H, Sherchan P, et al. Controversies and evolving new mechanisms in subarachnoid hemorrhage. Prog Neurobiol 2014;115:64–91. [CrossRef]
  • 23. Hanggi D, Steiger HJ. Nitric oxide in subarachnoid haemorrhage and its therapeutics implications. Acta Neurochir 2006;148:605–613. [CrossRef]
  • 24. Sabri M, Lass E, Macdonald RL. Early brain injury: a common mechanism in subarachnoid hemorrhage and global cerebral ischemia. Stroke Res Treat 2013;2013:394036. [CrossRef]
  • 25. Nagata D, Mogi M, Walsh K. AMP-activated protein kinase (AMPK) signaling in endothelial cells is essential for angiogenesis in response to hypoxic stress. J Biol Chem 2003;278:31000–31006. [CrossRef]
  • 26. Zhang L, Li Z, Feng D, et al. Involvement of Nox2 and Nox4 NADPH oxidases in early brain injury after subarachnoid hemorrhage. Free Radic Res 2017;51:316–328. [CrossRef]
  • 27. Higashi M, Shimokawa H, Hattori T, et al. Long-term inhibition of Rho-kinase suppresses Angiotensin II-induced cardiovascular hypertrophy in rats: in vivo effect on endothelial NADPH oxidase system. Circulation research 2003;93:767–775. [CrossRef]
  • 28. Sabri M, Ai J, Lass E, D’abbondanza J, Macdonald RL. Genetic elimination of eNOS reduces secondary complications of experimental subarachnoid hemorrhage. J Cereb Blood Flow Metab 2013;33:1008–1014. [CrossRef]
  • 29. Yao L, Romero MJ, Toque HA, Yang G, Caldwell RB, Caldwell RW. The role of RhoA/Rho kinase pathway in endothelial dysfunction. J Cardiovasc Dis Res 2010;1:165–170. [CrossRef]
  • 30. Ayer RE, Zhang JH. Oxidative stress in subarachnoid haemorrhage: significance in acute brain injury and vasospasm. Acta Neurochir Suppl 2008;104:33–41. [CrossRef]
  • 31. Won SJ, Tang XN, Suh SW, Yenari MA, Swanson RA. Hyperglycemia promotes tissue plasminogen activator induced hemorrhage by increasing superoxide production. Ann Neurol 2011;70:583–590. [CrossRef]
  • 32. Vallet P, Charnay Y, Steger K, et al. Neuronal expression of the NADPH oxidase NOX4, and its regulation in mouse experimental brain ischemia. Neuroscience 2005;132:233–238. [CrossRef]
  • 33. Daou BJ, Koduri S, Thompson BG, Chaudhary N, Pandey AS. Clinical and experimental aspects of aneurysmal subarachnoid hemorrhage. CNS Neurosci Ther 2019;25:1096–1112. [CrossRef]