钾氯离子共转运蛋白 KCC2 的下调导致脊髓损伤后的痉挛。

Down-regulation of the potassium-chloride cotransporter KCC2 contributes to spasticity after spinal cord injury.

机构信息

Laboratoire Plasticité et Physio-Pathologie de la Motricité (UMR6196), Centre National de la Recherche Scientifique (CNRS) & Aix-Marseille Université, Marseille, France.

出版信息

Nat Med. 2010 Mar;16(3):302-7. doi: 10.1038/nm.2107. Epub 2010 Feb 28.

Abstract

Hyperexcitability of spinal reflexes and reduced synaptic inhibition are commonly associated with spasticity after spinal cord injury (SCI). In adults, the activation of gamma-aminobutyric acid(A) (GABAA) and glycine receptors inhibits neurons as a result of low intracellular chloride (Cl-) concentration, which is maintained by the potassium-chloride cotransporter KCC2 (encoded by Slc12a5). We show that KCC2 is downregulated after SCI in rats, particularly in motoneuron membranes, thereby depolarizing the Cl- equilibrium potential and reducing the strength of postsynaptic inhibition. Blocking KCC2 in intact rats reduces the rate-dependent depression (RDD) of the Hoffmann reflex, as is observed in spasticity. RDD is also decreased in KCC2-deficient mice and in intact rats after intrathecal brain-derived neurotrophic factor (BDNF) injection, which downregulates KCC2. The early decrease in KCC2 after SCI is prevented by sequestering BDNF at the time of SCI. Conversely, after SCI, BDNF upregulates KCC2 and restores RDD. Our results open new perspectives for the development of therapeutic strategies to alleviate spasticity.

摘要

脊髓损伤(SCI)后,脊髓反射过度兴奋和突触抑制减少通常与痉挛有关。在成年人中,γ-氨基丁酸(GABA)和甘氨酸受体的激活会抑制神经元,这是由于氯离子(Cl-)浓度低,而氯离子浓度由钾氯离子共转运蛋白 KCC2(由 Slc12a5 编码)维持。我们发现,SCI 后大鼠的 KCC2 下调,特别是在运动神经元膜中,从而使 Cl-平衡电位去极化,减少突触后抑制的强度。在完整的大鼠中阻断 KCC2 会降低霍夫曼反射的速率依赖性抑制(RDD),这在痉挛中是可以观察到的。KCC2 缺失的小鼠和鞘内注射脑源性神经营养因子(BDNF)后,完整的大鼠的 RDD 也会降低,BDNF 下调 KCC2。SCI 时将 BDNF 隔离可以防止 SCI 后早期 KCC2 的减少。相反,SCI 后,BDNF 上调 KCC2 并恢复 RDD。我们的研究结果为开发减轻痉挛的治疗策略开辟了新的前景。

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