EA4475 - "Pharmacologie de la Circulation Cérébrale", Faculté de Pharmacie de Paris, Université Paris Descartes, Université Sorbonne Paris Cité, 4 avenue de l'Observatoire, 75006, Paris, France.
Mol Neurobiol. 2018 Dec;55(12):9156-9168. doi: 10.1007/s12035-018-1063-3. Epub 2018 Apr 12.
Benefits from thrombolysis with recombinant tissue plasminogen activator (rt-PA) after ischemic stroke remain limited due to a narrow therapeutic window, low reperfusion rates, and increased risk of hemorrhagic transformations (HT). Experimental data showed that rt-PA enhances the post-ischemic activation of poly(ADP-ribose)polymerase (PARP) which in turn contributes to blood-brain barrier injury. The aim of the present study was to evaluate whether PJ34, a potent PARP inhibitor, improves poor reperfusion induced by delayed rt-PA administration, exerts vasculoprotective effects, and finally increases the therapeutic window of rt-PA. Stroke was induced by thrombin injection (0.75 UI in 1 μl) in the left middle cerebral artery (MCA) of male Swiss mice. Administration of rt-PA (0.9 mg kg) or saline was delayed for 4 h after ischemia onset. Saline or PJ34 (3 mg kg) was given intraperitoneally twice, just after thrombin injection and 3 h later, or once, 3 h after ischemia onset. Reperfusion was evaluated by laser Doppler, vascular inflammation by immunohistochemistry of vascular cell adhesion molecule-1 (VCAM-1) expression, and vasospasm by morphometric measurement of the MCA. Edema, cortical lesion, and sensorimotor deficit were evaluated. Treatment with PJ34 improved rt-PA-induced reperfusion and promoted vascular protection including reduction in vascular inflammation (decrease in VCAM-1 expression), HT, and MCA vasospasm. Additionally, the combined treatment significantly reduced brain edema, cortical lesion, and sensorimotor deficit. In conclusion, the combination of the PARP inhibitor PJ34 with rt-PA after cerebral ischemia may be of particular interest in order to improve thrombolysis with an extended therapeutic window.
溶栓治疗缺血性脑卒中仍有一定的局限性,主要是因为溶栓治疗时间窗较窄、再灌注率低、出血性转化(HT)风险增加。实验数据表明,rt-PA 可增强缺血后多聚(ADP-核糖)聚合酶(PARP)的激活,进而导致血脑屏障损伤。本研究旨在评估 PARP 抑制剂 PJ34 是否能改善延迟 rt-PA 给药引起的再灌注不良,发挥血管保护作用,最终增加 rt-PA 的治疗窗。通过向雄性瑞士小鼠左侧大脑中动脉(MCA)内注射凝血酶(0.75 UI 在 1 μl 中)诱导卒中。rt-PA(0.9 mg/kg)或生理盐水在缺血发作后 4 小时给予。盐水或 PJ34(3 mg/kg)分别于凝血酶注射后立即和 3 小时后腹腔内给药 2 次,或于缺血发作后 3 小时给予 1 次。通过激光多普勒评估再灌注,通过血管细胞黏附分子-1(VCAM-1)表达的免疫组织化学评估血管炎症,通过 MCA 的形态测量评估血管痉挛。评估脑水肿、皮质损伤和感觉运动功能缺损。PJ34 治疗可改善 rt-PA 诱导的再灌注,并促进血管保护,包括减少血管炎症(VCAM-1 表达减少)、HT 和 MCA 血管痉挛。此外,联合治疗还显著减轻脑水肿、皮质损伤和感觉运动功能缺损。总之,PARP 抑制剂 PJ34 与缺血后 rt-PA 联合应用可能具有特别的意义,可以扩大溶栓治疗的治疗窗。