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1 Department of Pharmacology and Therapeutics and 2 Department of Ophthalmology and Laboratory of Visual Electrophysiology, McGill University, Montreal, Quebec H3G 1Y6; and 3 Departments of Pediatrics, Ophthalmology, and Pharmacology, Research Center of Hôpital Ste.-Justine, Montreal, Quebec, Canada H3T 1C5
Despite increasingly frequent and longer lasting hypoxic episodes
during progressive labor, the neonate is alert and vigorous at birth.
We investigated whether high levels of PGs during the perinatal period
assist in preserving neural function after such "stressful" hypoxic
events. Visual evoked potentials (VEPs) and electroretinograms (ERGs)
were recorded before and 45 min after mild moderate asphyxic hypoxia
(two 4-min asphyxic-hypoxic periods induced by interrupting ventilation
at 8-min intervals) in newborn piglets <12 h old treated or not
treated with inhibitors of PG synthase (ibuprofen or diclofenac) with
or without PG analogs. At 45 min after the hypoxic episode, P2 and
b-wave amplitudes were slightly decreased and latencies were delayed.
These changes in the VEP and ERG returned to near normal by 120 min.
Ibuprofen and diclofenac decreased brain and retinal PG levels and
markedly intensified 45 min after hypoxia-induced changes in VEP and
ERG, but cerebral and retinal blood flows improved. Combined treatment with PG synthase inhibitor in combination with
16,16-dimethyl-PGE2 (a PGE2 analog), but not
with PGI2 and PGF2
analogs, and in
combination with the EP2 receptor agonist butaprost (but
not EP1 or EP3 agonists), prevented ibuprofen-
and diclofenac-aggravated postasphyxia electrophysiological changes. In
conclusion, high levels of PGE2 in nervous tissue, via
actions on EP2 receptors, seem to contribute to
preservation of neural function in the perinate subjected to frequent
hypoxic events.
prostaglandin E2; neuroprotection; newborn; visual evoked potential
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