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J Thorac Cardiovasc Surg 1999;117:881-889
© 1999 Mosby, Inc.

SURGERY FOR ADULT CARDIOVASCULAR DISEASE

RILUZOLE PREVENTS ISCHEMIC SPINAL CORD INJURY CAUSED BY AORTIC CROSSCLAMPING

Loic Lang-Lazdunski, MDa,b*, Catherine Heurteaux, PhDb*, Nathalie Vaillant, BAb, Catherine Widmann, BAb, Michel Lazdunski, PhD, DScb

From the Department of Cardiovascular Surgery,a Paris, and the Institute of Molecular and Cellular Pharmacology,b Valbonne, France.

*These authors contributed equally to this work.

Received for publication Sept 22, 1998. Revisions requested Nov 13, 1998. Revisions received Dec 11, 1998. Accepted for publication Dec 11, 1998. Address for reprints: Michel Lazdunski, PhD, DSc, Institut de Pharmacologie Moléculaire et Cellulaire, CNRS UPR 411, 660 route des Lucioles, Sophia-Antipolis, 06560 Valbonne, France.

Background: Recent studies support the involvement of glutamate neurotoxicity in the pathophysiology of spinal cord injury induced by aortic crossclamping. We investigated the effects of riluzole, a neuroprotective drug that blocks glutamatergic neurotransmission, in a rabbit model of spinal cord ischemia.
Methods: The infrarenal aortas of New Zealand White albino rabbits (n = 40) were occluded for 40 minutes. Experimental groups were as follows: sham operation group (n = 5), control group undergoing occlusion but receiving no pharmacologic intervention (n = 10), experimental group A (n = 10) receiving 8 mg/kg riluzole intravenously 30 minutes before ischemia, experimental group B (n = 10) receiving 4 mg/kg riluzole intravenously 30 minutes before ischemia and at the onset of reperfusion, and experimental group C (n = 10) receiving 8 mg/kg riluzole intravenously at the onset of reperfusion. Neurologic status was assessed at 6, 24, and 48 hours after the operation and then daily until the fifth day. All animals were killed at 24, 48, or 120 hours after the operation. Spinal cords were harvested for histopathologic studies, immunohistochemical studies for microtubule-associated protein 2, and search for morphologic features of apoptosis by the terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate–biotin nick-end labeling staining method.
Results: All animals in the control group became paraplegic. Except for 1 rabbit in group C, all riluzole-treated animals had better neurologic function. Luxol fast blue and terminal deoxynucleotidyltransferase-mediated deoxyuridine triphosphate–biotin nick-end labeling staining methods demonstrated typical morphologic changes characteristic of necrosis and apoptosis in control animals. Riluzole prevented or attenuated ischemia-induced necrosis, apoptosis, and cytoskeletal proteolysis, depending on the dose and the timing of administration.
Conclusion: Riluzole may have therapeutic utility during high-risk operations on the thoracoabdominal aorta.






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