Cerebral ischaemia/reperfusion injury could be managed by using tramadol

ABSTRACT

Objectives: No valid treatment modality that will repair stroke damage and provide neurological recovery has yet been identified in literature. Studies demonstrated that adequate quality of life could be provided if post-stroke pain could be treated sufficiently and timely. Besides its pain relief effects, tramadol has oedema-reducing and anti-inflammatory properties. With these in mind, this study investigated the influence of tramadol in acute and/or chronic ischaemia/reperfusion (I/R) injury.

Methods: Putting aside the Control group, 23 Wistar albino rats were distributed to four groups to investigate the acute (Sham-A, TR-A) and chronic (Sham-C, TR-C) periods of I/R injury, and temporary aneurysm clips were applied to their internal carotid arteries for 30 min. Four hours after clippage, tramadol was administered to animals of TR-A and TR-C groups intraperitoneally. After sacrificing all animals, pyknotic and necrotic neuronal cells in hippocampal cornu ammonis (CA)1, CA2, CA3 and parietal cortical regions were counted, and perivascular oedema, intercellular organization disorder (IOD) and inflammatory cell infiltration were scaled histopathologically. Additionally, tissue interleukin (IL)-1β, IL-10, malondialdehyde, nitric oxide, tumour necrosis factor-α, caspase-3, beclin-1, Atg12, LC3II/LC3I levels were measured biochemically.

Results: Tramadol could minimize perivascular oedema, IOD, parietal and hippocampal neuronal necrosis, inflammatory cell infiltration in both periods of I/R injury histopathologically. Apart from inhibiting apoptosis and enhancing autophagy, tramadol had no influence on any other biochemical result.

Discussion: Tramadol can ameliorate the histopathological structure of ischaemic tissue in both periods of I/R injury in rat. We suggest further research investigating various dosages with different administration methods of tramadol in stroke should be conducted by adopting different explorative techniques.

KEYWORDS:

• Anti-inflammatory
• apoptosis
• autophagy
• cerebral ischaemia/reperfusion injury
• tramadol

Acknowledgements

The authors thank Mr Erkan Kaya and Mr Emir Kuscu for his talented aids in this study.

Declaration of interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Additional information

Notes on contributors

Bulent Bakar

Bulent Bakar MD, Associate Professor, is a graduate of Hacettepe University Medical School in 1996. He trained in neurosurgery at the Hacettepe University Medical School 1999 to 2005 years. He is an associate professor of medicine at the Kirikkale University Medical School, in the Division of Neurosurgery, Turkey since 2009. He divides his time between clinical practice, training and consulting, scholarly writing and research since 2005. He has conducted several studies of stroke, faield back syndrome, neuro-oncology and neurotrauma.