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Updated: May 30, 2026
Pre-Chiasmatic, Single Injection of Autologous Blood to Induce Experimental Subarachnoid Hemorrhage in a Rat Model
Published on: June 18, 2021
Combinatorial administration of insulin and vitamin C alleviates the cerebral vasospasm after experimental
Shouchun Li1, Jinghui Xue, Jixin Shi
1Department of Neurosurgery, First Affiliated Hospital of Chinese PLA General Hospital, Beijing, PR China.
Insights
Combined insulin and vitamin C treatment effectively relieved cerebral vasospasm (CVS) after subarachnoid hemorrhage (SAH) in rabbits. This therapy potentially works by increasing insulin receptor alpha expression and nitric oxide levels, unlike single treatments.
Area of Science:
- Neuroscience
- Pharmacology
- Vascular Biology
Background:
- Cerebral vasospasm (CVS) is a critical complication following spontaneous subarachnoid hemorrhage (SAH).
- Current treatments for SAH and CVS have limitations, with high mortality rates persisting.
- Effective therapeutic strategies for CVS remain an unmet clinical need.
Purpose of the Study:
- To investigate the therapeutic effects of insulin and vitamin C, individually and in combination, on CVS following SAH.
- To explore the underlying mechanisms involving insulin receptor alpha (InRα) and nitric oxide (NO) pathways.
Main Methods:
- SAH was induced in rabbits, followed by treatments with insulin, vitamin C, or a combination.
- Vascular cross-sectional area of the basilar artery was measured to assess vasospasm.
- Expression of InRα in vascular endothelial cells and levels of NO in serum and cerebrospinal fluid were analyzed.
Main Results:
- SAH induced significant basilar artery spasm, reducing vascular cross-sectional area.
- Insulin or vitamin C alone did not significantly alleviate vasospasm compared to the SAH group.
- Combination therapy with insulin and vitamin C prevented vasospasm, maintaining normal vascular area, and normalized InRα expression and NO levels.
Conclusions:
- Combined insulin and vitamin C treatment effectively ameliorated CVS post-SAH in rabbits.
- The therapeutic effect is potentially mediated by upregulation of InRα expression and restoration of NO levels.
- Insulin or vitamin C monotherapy was insufficient to relieve CVS.
Background:
Cerebral vasospasm (CVS) is a common serious complication after the spontaneous subarachnoid hemorrhage (SAH). Despite recent advances in medical and surgical treatments, the 30-day mortality rate of SAH remains high, and there is lack of especially effective clinical treatment to alleviate and improve CVS. The present study has investigated the therapeutic effect of insulin and vitamin C on CVS after SAH.
Results:
Five days after SAH, there is obvious basilar artery spasm in SAH group, whose average vascular cross-sectional area (233,099 ± 16,750 μm²) is significantly smaller than that in control group (462,128 ± 74,756 μm²), which is also significantly different from those in SAH + insulin group (221,114 ± 43,457 μm²) and SAH + vitamin C group (237,820 ± 21,703 μm²). SAH + insulin + vitamin C group shows no evident vasospasm and maintains a vascular cross-sectional area of 425,530 ± 45,503 μm², which is significantly different from that in SAH group. Insulin receptor α (InRα) expression is significantly downregulated in the vascular endothelial cells of SAH, SAH + insulin, and SAH + vitamin C groups (P < 0.01) but remains unchanged in vascular endothelial cells of SAH + insulin + vitamin C group (P > 0.05). Five days after SAH, serum and cerebrospinal fluid NO levels in SAH, SAH + insulin, and SAH + vitamin C groups decrease significantly (P < 0.01) compared to that in control group, whereas the reduction is not evident in SAH + insulin + vitamin C group (P > 0.05).
Conclusion:
Combinatorial treatment with insulin and vitamin C has effectively relieved the CVS after SAH in rabbit, possibly through increasing the InRα expression and NO level, whereas treatment with insulin or vitamin C alone fails to do so.
