Division of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Medical School, 7301 MSRB III, 1150 W. Medical Center Dr., Ann Arbor, MI, 48109-0644, USA.
Department of Physiology, Center for Vascular and Inflammatory Diseases, University of Maryland School of Medicine, BioPark-1, Room 211, 800 W. Baltimore Street, Baltimore, MD, 21201, USA.
Acta Neuropathol. 2017 Oct;134(4):585-604. doi: 10.1007/s00401-017-1749-z. Epub 2017 Jul 19.
Treatment of acute ischemic stroke with the thrombolytic tissue plasminogen activator (tPA) can significantly improve neurological outcomes; however, thrombolytic therapy is associated with an increased risk of intra-cerebral hemorrhage (ICH). Previously, we demonstrated that during stroke tPA acting on the parenchymal side of the neurovascular unit (NVU) can increase blood-brain barrier (BBB) permeability and ICH through activation of latent platelet-derived growth factor-CC (PDGF-CC) and signaling by the PDGF receptor-α (PDGFRα). However, in vitro, activation of PDGF-CC by tPA is very inefficient and the mechanism of PDGF-CC activation in the NVU is not known. Here, we show that the integrin Mac-1, expressed on brain microglia/macrophages (denoted microglia throughout), acts together with the endocytic receptor LRP1 in the NVU to promote tPA-mediated activation of PDGF-CC. Mac-1-deficient mice (Mac-1) are protected from tPA-induced BBB permeability but not from permeability induced by intracerebroventricular injection of active PDGF-CC. Immunofluorescence analysis demonstrates that Mac-1, LRP1, and the PDGFRα all localize to the NVU of arterioles, and following middle cerebral artery occlusion (MCAO) Mac-1 mice show significantly less PDGFRα phosphorylation, BBB permeability, and infarct volume compared to wild-type mice. Bone-marrow transplantation studies indicate that resident CD11b cells, but not bone-marrow-derived leukocytes, mediate the early activation of PDGF-CC by tPA after MCAO. Finally, using a model of thrombotic stroke with late thrombolysis, we show that wild-type mice have an increased incidence of spontaneous ICH following thrombolysis with tPA 5 h after MCAO, whereas Mac-1 mice are resistant to the development of ICH even with late tPA treatment. Together, these results indicate that Mac-1 and LRP1 act as co-factors for the activation of PDGF-CC by tPA in the NVU, and suggest a novel mechanism for tightly regulating PDGFRα signaling in the NVU and controlling BBB permeability.
急性缺血性脑卒中使用溶栓组织型纤溶酶原激活剂(tPA)治疗可以显著改善神经功能预后;然而,溶栓治疗与颅内出血(ICH)风险增加相关。此前,我们证明了在脑卒中时,tPA 在神经血管单元(NVU)的实质侧发挥作用可以通过激活潜伏血小板衍生生长因子-CC(PDGF-CC)和 PDGF 受体-α(PDGFRα)信号来增加血脑屏障(BBB)通透性和 ICH。然而,体外 tPA 对 PDGF-CC 的激活效率非常低,且 NVU 中 PDGF-CC 激活的机制尚不清楚。在这里,我们表明整合素 Mac-1,在脑小胶质细胞/巨噬细胞(整个过程中称为小胶质细胞)上表达,与 NVU 中的内吞受体 LRP1 一起,促进 tPA 介导的 PDGF-CC 激活。Mac-1 缺陷小鼠(Mac-1)对 tPA 诱导的 BBB 通透性增加具有保护作用,但对脑室内注射活性 PDGF-CC 诱导的通透性增加没有保护作用。免疫荧光分析表明,Mac-1、LRP1 和 PDGFRα 均定位于小动脉的 NVU,在大脑中动脉闭塞(MCAO)后,Mac-1 小鼠与野生型小鼠相比,PDGFRα 磷酸化、BBB 通透性和梗死体积明显减少。骨髓移植研究表明,在 MCAO 后,常驻 CD11b 细胞而非骨髓源性白细胞介导 tPA 对 PDGF-CC 的早期激活。最后,使用血栓性脑卒中伴晚期溶栓模型,我们表明在 MCAO 后 5 小时给予 tPA 溶栓后,野生型小鼠自发性 ICH 的发生率增加,而 Mac-1 小鼠即使接受晚期 tPA 治疗也能抵抗 ICH 的发生。总之,这些结果表明 Mac-1 和 LRP1 作为 tPA 在 NVU 中激活 PDGF-CC 的共同因子发挥作用,并为在 NVU 中严格调节 PDGFRα 信号和控制 BBB 通透性提供了一种新的机制。