After Treatment with Methylene Blue is Effective against Delayed Encephalopathy after Acute Carbon Monoxide Poisoning

Basic Clin Pharmacol Toxicol. 2018 May;122(5):470-480. doi: 10.1111/bcpt.12940. Epub 2017 Dec 26.

Abstract

Delayed encephalopathy after acute carbon monoxide (CO) poisoning (DEACMP) is the most severe and clinically intractable complication that occurs following acute CO poisoning. Unfortunately, the mechanism of DEACMP is still vague. Growing evidence indicates that delayed cerebral damage after CO poisoning is related to oxidative stress, abnormal neuro-inflammation, apoptosis and immune-mediated injury. Our recent report indicated that methylene blue (MB) may be a promising therapeutic agent in the prevention of neuronal cell death and cognitive deficits after transient global cerebral ischaemia (GCI). In this study, we aimed to investigate the potential of MB therapy to ameliorate the signs and symptoms of DEACMP. Rats were exposed to 1000 ppm CO for 40 min. in the first step; CO was then increased to 3000 ppm, which was maintained for another 20 min. The rats were implanted with 7-day release Alzet osmotic mini-pumps subcutaneously under the back skin, which provided MB at a dose of 0.5 mg/kg/day 1 hr after CO exposure. The results showed that MB significantly suppressed oxidative damage and expression of pro-inflammatory factors, including tumour necrosis factor-α and interleukin (IL)-1β. MB treatment also suitably modulated mitochondrial fission and fusion, which is helpful in the preservation of mitochondrial function. Furthermore, MB dramatically attenuated apoptosis and neuronal death. Lastly, behavioural studies revealed that MB treatment preserved spatial learning and memory in the Barnes maze test. Our findings indicated that MB may have protective effects against DEACMP.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology
  • Antidotes / pharmacology*
  • Antioxidants / pharmacology
  • Apoptosis / drug effects
  • Behavior, Animal / drug effects
  • Brain Diseases / metabolism
  • Brain Diseases / pathology
  • Brain Diseases / physiopathology
  • Brain Diseases / prevention & control*
  • CA1 Region, Hippocampal / drug effects*
  • CA1 Region, Hippocampal / metabolism
  • CA1 Region, Hippocampal / pathology
  • CA1 Region, Hippocampal / physiopathology
  • Carbon Monoxide Poisoning / drug therapy*
  • Carbon Monoxide Poisoning / metabolism
  • Carbon Monoxide Poisoning / physiopathology
  • Cognition / drug effects
  • Disease Models, Animal
  • Inflammation Mediators / metabolism
  • Interleukin-1beta / metabolism
  • Male
  • Maze Learning / drug effects
  • Methylene Blue / pharmacology*
  • Mitochondria / drug effects
  • Mitochondria / metabolism
  • Mitochondria / pathology
  • Mitochondrial Dynamics / drug effects
  • Neurons / drug effects*
  • Neurons / metabolism
  • Neurons / pathology
  • Oxidative Stress / drug effects
  • Rats, Sprague-Dawley
  • Spatial Learning / drug effects
  • Time Factors
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Anti-Inflammatory Agents
  • Antidotes
  • Antioxidants
  • IL1B protein, rat
  • Inflammation Mediators
  • Interleukin-1beta
  • Tumor Necrosis Factor-alpha
  • Methylene Blue