Artesunate Provides Neuroprotection against Cerebral Ischemia-Reperfusion Injury via the TLR-4/NF-κB Pathway in Rats

Biol Pharm Bull. 2021 Mar 1;44(3):350-356. doi: 10.1248/bpb.b20-00604. Epub 2020 Dec 25.

Abstract

Inflammation has an important role in ischemia-reperfusion (I/R) injury. Artesunate (ART) has anti-microbial and anti-inflammatory pharmacological activities, and it is used for various types of serious malaria, including cerebral malaria. ART maintains a high concentration in the brain but little is known about the neuroprotective effect of ART against brain I/R injury. We studied the neuroprotection of ART against brain I/R injury and its underlying mechanism. In this study, rats were subjected to middle cerebral artery occlusion (MCAO) for 2 h. After 24 h of reperfusion, neurological deficits, cerebrum water content, infarct volume, hematoxylin-eosin (H&E)-staining, myeloperoxidase (MPO) activity, and proinflammatory cytokine levels were measured. Administration of 20, 40, 80, and 160 mg/kg ART intraperitoneally (i.p.) 10 min after MCAO significantly decreased brain water content and improved neurological deficits in a dose-dependent manner. An 80 mg/kg dosage was optimal. ART significantly reduced infarct volume, suppressed MPO activity and diminished the expressions of toll-like receptor (TLR)-4, MyD88, nuclear factor-κB (NF-κB), tumor necrosis factor (TNF)-α, and interleukin (IL)-6 in the area of the ischemic cortex. The neuroprotective action of ART against focal cerebral I/R injury might be due to the attenuation of inflammation through the TLR-4/NF-κB pathway.

Keywords: artesunate; cerebral; inflammation; ischemia–reperfusion.

MeSH terms

  • Animals
  • Artesunate / pharmacology
  • Artesunate / therapeutic use*
  • Brain / drug effects
  • Brain / immunology
  • Brain / pathology
  • Infarction, Middle Cerebral Artery / drug therapy*
  • Infarction, Middle Cerebral Artery / immunology
  • Infarction, Middle Cerebral Artery / pathology
  • Interleukin-6 / immunology
  • Male
  • Neuroprotective Agents / pharmacology
  • Neuroprotective Agents / therapeutic use*
  • Neutrophils / drug effects
  • Neutrophils / immunology
  • Rats
  • Rats, Sprague-Dawley
  • Reperfusion Injury / drug therapy*
  • Reperfusion Injury / immunology
  • Reperfusion Injury / pathology
  • Toll-Like Receptor 4 / immunology
  • Transcription Factor RelA / immunology
  • Tumor Necrosis Factor-alpha / immunology

Substances

  • Il6 protein, rat
  • Interleukin-6
  • Neuroprotective Agents
  • Tlr4 protein, rat
  • Toll-Like Receptor 4
  • Transcription Factor RelA
  • Tumor Necrosis Factor-alpha
  • Artesunate