Saphenous vein phlebotomy alleviates neuroinflammatory response and oxidative stress following traumatic brain injury

Abstract

Objective: In spite of the great advances in the field of traumatic brain injury (TBI), it still remains as a global health problem. Phlebotomy has been mentioned as an effective treatment for TBI in Persian medicine. This study aimed to evaluate the possible effect of saphenous vein phlebotomy (SVP) on the alleviation of neuroinflammation and oxidative stress after TBI. Methods: Seventy-two adult male Wistar rats were randomly divided into three main groups: sham, TBI and TBI + SVP group. Animal model of TBI was made through a controlled cortical impactor (CCI) device and SVP treatment was applied 10 min after TBI. Then, neurological function, body temperature, cerebral edema, blood–brain barrier integrity, brain apoptosis, oxidative stress, and inflammation were assessed. Results: Our results indicated that SVP was associated with improvement of neurological scores 24 h post-TBI. In addition, SVP application significantly alleviated proinflammatory cytokines (IL- 1β, IL-17, and TNF-α) and oxidative stress factors as shown by reduction of malondialdehyde (MDA) and elevation of superoxide dismutase (SOD) with no significant effect on glutathione peroxidase (GPx) and nitric oxide (NO) in the brain 6 h after TBI. Besides, it reduced body temperature, attenuated severity of brain edema, and also reduced caspase-3 and number of apoptotic neurons. Conclusion: This study showed that SVP could ameliorate the severity of acute TBI, partly through alleviation of neuroinflammation, oxidative stress, and apoptosis. Further studies are necessary for more understanding the involved mechanism(s).

Keywords

• Traumatic brain injury
• Neuroinflammation
• Persian medicine
• Phlebotomy
• Bloodletting