Sun Na, Shen Yi, Han Wei, Shi Kaibin, Wood Kristofer, Fu Ying, Hao Junwei, Liu Qiang, Sheth Kevin N, Huang DeRen, Shi Fu-Dong
From the Departments of Neurology (N.S., Y.S., K.S., Y.F., J.H., Q.L., F.-D.S.) and Radiology (W.H.), Tianjin Neurological Institute, Tianjin Medical University General Hospital, Tianjin, China; Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ (N.S., K.W., Q.L., F.-D.S.); Department of Neurology, Yale University School of Medicine, New Haven, CT (K.N.S.); and Department of Clinical Research and Multiple Sclerosis Center, Neurology and Neuroscience Associates, Unity Health Network, Akron, OH (D.H.).
Stroke. 2016 Jul;47(7):1899-906. doi: 10.1161/STROKEAHA.115.012236. Epub 2016 May 12.
Preclinical studies and a proof-of-concept clinical study have shown that sphingosine-1-phosphate receptor (S1PR) modulator, fingolimod, improves the clinical outcome of intracerebral hemorrhage (ICH). However, the specific subtype of the S1PRs through which immune modulation provides protection in ICH remains unclear. In addition, fingolimod-induced adverse effects could limit its use in patients with stroke because of interactions with other S1PR subtypes, particularly with S1PR3. RP101075 is a selective S1PR1 agonist with superior cardiovascular safety profile. In this study, we investigated the impact of RP101075 treatment in a mouse model of ICH.
ICH was induced by injection of autologous blood in 294 male C57BL/6J and Rag2(-/-) mice. ICH mice randomly received vehicle, RP101075, or RP101075 plus S1PR1 antagonist W146 by daily oral gavage for three consecutive days, starting from 30 minutes after surgery. Neurodeficits, brain edema, brain infiltration of immune cells, blood-brain barrier integrity, and cell death were assessed after ICH.
RP101075 significantly attenuated neurological deficits and reduced brain edema in ICH mice. W146 blocked the effects of RP101075 on neurodeficits and brain edema. RP101075 reduced the counts of brain-infiltrating lymphocytes, neutrophils, and microglia, as well as cytokine expression after ICH. Enhanced blood-brain barrier integrity and alleviated neuronal death were also seen in ICH mice after RP101075 treatment.
S1PR1 modulation via RP101075 provides protection in experimental ICH. Together with the advantageous pharmacological features of RP101075, these results warrant further investigations of its mechanisms of action and translational values in ICH patients.
临床前研究及一项概念验证性临床研究表明,鞘氨醇-1-磷酸受体(S1PR)调节剂芬戈莫德可改善脑出血(ICH)的临床预后。然而,免疫调节在脑出血中发挥保护作用所通过的S1PR具体亚型仍不清楚。此外,由于与其他S1PR亚型(尤其是S1PR3)相互作用,芬戈莫德引起的不良反应可能会限制其在中风患者中的应用。RP101075是一种具有卓越心血管安全性的选择性S1PR1激动剂。在本研究中,我们调查了RP101075治疗对脑出血小鼠模型的影响。
通过向294只雄性C57BL/6J和Rag2(-/-)小鼠注射自体血诱导脑出血。脑出血小鼠在术后30分钟开始连续3天每日经口灌胃随机接受溶剂、RP101075或RP101075加S1PR1拮抗剂W146。脑出血后评估神经功能缺损、脑水肿、免疫细胞脑浸润、血脑屏障完整性和细胞死亡情况。
RP101075显著减轻脑出血小鼠的神经功能缺损并减轻脑水肿。W146阻断了RP101075对神经功能缺损和脑水肿的作用。RP101075减少了脑出血后脑浸润淋巴细胞、中性粒细胞和小胶质细胞的数量以及细胞因子表达。RP101075治疗后的脑出血小鼠还出现血脑屏障完整性增强和神经元死亡减轻的情况。
通过RP101075调节S1PR1可在实验性脑出血中提供保护。结合RP101075有利的药理学特性,这些结果值得进一步研究其作用机制及在脑出血患者中的转化价值。