AUTHOR=Ren Siying , Han Shanshan , Wang Likun , Huang Yuanxin , Wu Jing , Wu Guofeng TITLE=Minimally Invasive Surgery for ICH Evacuation Combined With Deferoxamine Treatment Increased Perihematomal Claudin-5 and ZO-1 Expression Levels and Decreased BBB Permeability in Rabbits JOURNAL=Frontiers in Neurology VOLUME=Volume 13 - 2022 YEAR=2022 URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2022.835494 DOI=10.3389/fneur.2022.835494 ISSN=1664-2295 ABSTRACT=Objective: To investigate the role of minimally invasive surgery (MIS) in intracerebral hemorrhage (ICH) evacuation combined with deferoxamine (DFX) treatment on perihematomal tight junction proteins (claudin-5 and ZO-1) expression levels and blood-brain barrier (BBB) permeability in rabbits. Methods: We randomly assigned 65 male rabbits (weight: 1.9–2.6 kg) to a normal control group (NC group, 13 rabbits), hemorrhage model group (HM group, 13 rabbits), DFX treatment group (DFX group, 13 rabbits), MIS group (MIS group, 13 rabbits), and MIS combined with DFX treatment group (MIS+DFX group, 13 rabbits). ICH was established in all of the groups except NC group. MIS was performed to evacuate the hematoma 6 h after the ICH model was created in the MIS and MIS+DFX groups. The DFX and MIS+DFX groups were treated with DFX (100 mg/kg, dissolved in 2 mL of 0.9% saline solution, administered intramuscularly) at 2 h, followed by every 12 h for 7 d. The same dose of 0.9% saline solution was administered to the NC, HM, and MIS groups at the same time points. Neurological deficit (i.e., Purdy’s score) was recorded. On day 7, the rabbits were sacrificed and the perihematomal brain tissue was harvested to test the iron concentration, brain water content (BWC), tight junction proteins (claudin-5 and ZO-1) expression, and BBB permeability. Results: Purdy’s score, iron concentration, and BWC were lower in the MIS and MIS+DFX groups compared to HM and DFX groups. The MIS+DFX group showed a significant decrease in these indicators. The use of MIS to evacuate the hematoma led to an increased expression levels of claudin-5 and ZO-1 as well as decreased BBB permeability. The MIS+DFX group exhibited a remarkable increase in claudin-5 and ZO-1 expression levels and a significant decrease in BBB permeability. Conclusions: MIS combined with DFX treatment could increase the expression levels of perihematomal tight junction proteins (claudin-5 and ZO-1) expression , reduce BBB permeability, and improve the neurological function. MIS combined with DFX treatment may also prevent secondary brain damage following ICH.