Wang Xiaoying, Lee Sun-Ryung, Arai Ken, Lee Seong-Ryong, Tsuji Kiyoshi, Rebeck G William, Lo Eng H
Neuroprotection Research Laboratory, Departments of Radiology and Neurology, Massachusetts General Hospital, Charlestown, and Program in Neuroscience, Harvard Medical School, Boston, Massachusetts, USA.
Nat Med. 2003 Oct;9(10):1313-7. doi: 10.1038/nm926. Epub 2003 Sep 7.
Although thrombolysis with tissue plasminogen activator (tPA) is a stroke therapy approved by the US Food and Drug Administration, its efficacy may be limited by neurotoxic side effects. Recently, proteolytic damage involving matrix metalloproteinases (MMPs) have been implicated. In experimental embolic stroke models, MMP inhibitors decreased cerebral hemorrhage and injury after treatment with tPA. MMPs comprise a family of zinc endopeptidases that can modify several components of the extracellular matrix. In particular, the gelatinases MMP-2 and MMP-9 can degrade neurovascular matrix integrity. MMP-9 promotes neuronal death by disrupting cell-matrix interactions, and MMP-9 knockout mice have reduced blood-brain barrier leakage and infarction after cerebral ischemia. Hence it is possible that tPA upregulates MMPs in the brain, and that subsequent matrix degradation causes brain injury. Here we show that tPA upregulates MMP-9 in cell culture and in vivo. MMP-9 levels were lower in tPA knockouts compared with wild-type mice after focal cerebral ischemia. In human cerebral microvascular endothelial cells, MMP-9 was upregulated when recombinant tPA was added. RNA interference (RNAi) suggested that this response was mediated by the low-density lipoprotein receptor-related protein (LRP), which avidly binds tPA and possesses signaling properties. Targeting the tPA-LRP signaling pathway in brain may offer new approaches for decreasing neurotoxicity and improving stroke therapy.
尽管组织型纤溶酶原激活剂(tPA)溶栓是美国食品药品监督管理局批准的一种中风治疗方法,但其疗效可能会受到神经毒性副作用的限制。最近,涉及基质金属蛋白酶(MMPs)的蛋白水解损伤被认为与此有关。在实验性栓塞性中风模型中,MMP抑制剂可减少tPA治疗后的脑出血和损伤。MMPs是一个锌内肽酶家族,可修饰细胞外基质的多种成分。特别是,明胶酶MMP-2和MMP-9可破坏神经血管基质的完整性。MMP-9通过破坏细胞与基质的相互作用促进神经元死亡,MMP-9基因敲除小鼠在脑缺血后血脑屏障渗漏和梗死减少。因此,tPA可能会上调脑中的MMPs,随后的基质降解会导致脑损伤。在此我们表明,tPA在细胞培养和体内均可上调MMP-9。局灶性脑缺血后,与野生型小鼠相比,tPA基因敲除小鼠的MMP-9水平较低。在人脑血管内皮细胞中,添加重组tPA后MMP-9上调。RNA干扰(RNAi)表明,这种反应是由低密度脂蛋白受体相关蛋白(LRP)介导的,该蛋白可与tPA紧密结合并具有信号传导特性。针对脑中的tPA-LRP信号通路可能会为降低神经毒性和改善中风治疗提供新方法。