Mechanistic studies on the regulation of oxidative stress by thioredoxin-interacting protein in bupivacaine-induced spinal neurotoxicity
Objective To investigate the mechanism by which thioredoxin-interacting protein(TXNIP)mediates oxidative stress in bupivacaine-induced spinal neurotoxicity.Methods A total of 48 specific pathogen-free(SPF)healthy male SD rats,weigh-ing 110-130 g,were selected.According to the random number table method,they were divided into four groups(n=12):a control group(group C),a bupivacaine group(group B),a bupivacaine+adeno-associated virus(AAV)-TXNIP short hairpin RNA(shRNA)group(group BT),and a bupivacaine+shRNA group(group BS).Intrathecal catheterization was conducted at the L5-L6 segments of rats in groups C,B,BT and BS.Rats in group C and group B were intrathecally injected with 5 µl normal saline,while those in group BT and group BS were intrathecally injected with 5 μl of AAV-TXNIP shRNA(virus titer:1.01×1012 VG/ml)and 5 μl of the nonsense con-trol sequence shRNA,respectively.Subsequently,the sheath tube was removed.When all the rats were raised to 250-300 g,the L5-L6 segment was intrathecally catheterized again.Groups B,BT,and BS were intrathecally injected with 5%bupivacaine at 0.12 µl/g for three times,with an interval of 90 min between each session.Group C was injected with the same amount of normal saline at the corre-sponding time points.After the corresponding treatments,the tail sensation and lower limb motor function of rats were measured by the percent of maximum possible effect(%MPE)converted from tail-flick latency(TFL)in rats,and the Basso Beatty Bresnahan(BBB)scor-ing method on the day of intrathecal injection of bupivacaine or an equal amount of normal saline(T0),day 1 after intrathecal injection(T1),day 2 after intrathecal injection(T2),and day 3 after intrathecal injection(T3).The injury of spinal cord tissue was observed by hema-toxylin eosin staining(H-E staining),while Nissl staining was used to observe survival neurons.The contents of malondialdehyde(MDA),superoxide dismutase(SOD),catalase(CAT),and glutathione(GSH)were detected by biochemical methods.The levels of reactive oxy-gen species(ROS)were detected by immunofluorescence staining.The levels of TXNIP messenger RNA(mRNA)were examined by real-time fluorescence quantitative polymerase chain reaction(FQ-PCR).The levels of TXNIP and glutathione peroxidase 4(GPX4)in spinal cord nerve tissue was detected by Western blot.Results Compared with group C,groups B,BT,and BS showed increases in%MPE and decreases in BBB scores at T0,T1,T2,and T3(all P<0.05);group B and group BS had an increased number of oligodendrocytes and microglia,edema or atrophy in neuronal cells,and a decreased number of survival neurons(all P<0.05);groups B,BT,and BS showed increases in the contents of MDA(all P<0.05),and decreases in the contents of SOD,GSH,and CAT(all P<0.05);groups B and BS presented increases in the levels of ROS(all P<0.05),and TXNIP mRNA levels(P<0.05);group BT showed decreases in TXNIP mRNA levels(P<0.05);and groups B and BS presented increases in TXNIP protein expression(all P<0.05),and decreases in GPX4 pro-tein expression(all P<0.05).Compared with group B,group BT showed decreases in%MPE,but increases in BBB score at T1,T2,and T3(all P<0.05),as well as reduced edema and vacuoles in the gray and white matter,with a reduced number of damaged neurons,and an el-evated number of survival neurons(P<0.05),decreases in MDA contents(P<0.05),increases in the contents of SOD,GSH and CAT(all P<0.05),decreases in the level of ROS(P<0.05),reductions in TXNIP mRNA and protein levels(all P<0.05),and increases in GPX4 pro-tein expression(P<0.05).Conclusions Bupivacaine induces spinal neurotoxicity by activating TXNIP-mediated oxidative stress.Knockdown of TXNIP can alleviate bupivacaine-induced spinal neurotoxicity by inhibiting oxidative stress.