miércoles, 4 de septiembre de 2013

JCI - Amelioration of ischemic brain damage by peritoneal dialysis

JCI - Amelioration of ischemic brain damage by peritoneal dialysis

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Amelioration of ischemic brain damage by peritoneal dialysis

María del Carmen Godino1, Victor G. Romera2, José Antonio Sánchez-Tomero3, Jesus Pacheco4, Santiago Canals4, Juan Lerma4, José Vivancos5, María Angeles Moro2, Magdalena Torres1, Ignacio Lizasoain2 and José Sánchez-Prieto1
1Departamento de Bioquímica y Biología Molecular, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain.
2Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, Madrid, Spain.
3Servicio de Nefrología, Hospital Universitario de la Princesa, Madrid, Spain.
4Instituto de Neurociencias de Alicante, Universidad Miguel Hernández-Consejo Superior de Investigaciones Científicas, Sant Joan d′Alacant, Spain.
5Servicio de Neurología, Hospital Universitario de la Princesa, Madrid, Spain.
Address correspondence to: Ignacio Lizasoain, Departamento de Farmacología, Facultad de Medicina, Universidad Complutense, Madrid-28040, Spain. Phone: 34.91.3941465; Fax: 34.91.3941464; E-mail: ignacio.lizasoain@med.ucm.es. Or to: José Sánchez-Prieto, Departamento de Bioquímica y Biología Molecular, Facultad de Veterinaria, Universidad Complutense, Madrid-28040, Spain. Phone: 34.91.3943891; Fax: 34.91.3943909; E-mail: jsprieto@vet.ucm.es.
Authorship note: María del Carmen Godino and Victor G. Romera contributed equally to this work.
Published September 3, 2013
Received for publication October 11, 2012, and accepted in revised form July 3, 2013.
Ischemic stroke is a devastating condition, for which there is still no effective therapy. Acute ischemic stroke is associated with high concentrations of glutamate in the blood and interstitial brain fluid. The inability of the tissue to retain glutamate within the cells of the brain ultimately provokes neuronal death. Increased concentrations of interstitial glutamate exert further excitotoxic effects on healthy tissue surrounding the infarct zone. We developed a strategy based on peritoneal dialysis to reduce blood glutamate levels, thereby accelerating brain-to-blood glutamate clearance. In a rat model of stroke, this simple procedure reduced the transient increase in glutamate, consequently decreasing the size of the infarct area. Functional magnetic resonance imaging demonstrated that the rescued brain tissue remained functional. Moreover, in patients with kidney failure, peritoneal dialysis significantly decreased glutamate concentrations. Our results suggest that peritoneal dialysis may represent a simple and effective intervention for human stroke patients.

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