Department of Neurology, David Geffen School of Medicine, UCLA, Los Angeles, CA 90095, USA.
Department of Neurology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Cell. 2019 Feb 21;176(5):1143-1157.e13. doi: 10.1016/j.cell.2019.01.044.
We tested a newly described molecular memory system, CCR5 signaling, for its role in recovery after stroke and traumatic brain injury (TBI). CCR5 is uniquely expressed in cortical neurons after stroke. Post-stroke neuronal knockdown of CCR5 in pre-motor cortex leads to early recovery of motor control. Recovery is associated with preservation of dendritic spines, new patterns of cortical projections to contralateral pre-motor cortex, and upregulation of CREB and DLK signaling. Administration of a clinically utilized FDA-approved CCR5 antagonist, devised for HIV treatment, produces similar effects on motor recovery post stroke and cognitive decline post TBI. Finally, in a large clinical cohort of stroke patients, carriers for a naturally occurring loss-of-function mutation in CCR5 (CCR5-Δ32) exhibited greater recovery of neurological impairments and cognitive function. In summary, CCR5 is a translational target for neural repair in stroke and TBI and the first reported gene associated with enhanced recovery in human stroke.
我们测试了一个新描述的分子记忆系统,即 CCR5 信号通路,以研究其在中风和创伤性脑损伤 (TBI) 后的恢复中的作用。CCR5 仅在中风后表达于皮质神经元。中风后在运动前皮质中神经元敲低 CCR5 会导致运动控制的早期恢复。恢复与树突棘的保存、对侧运动前皮质的皮质投射的新模式以及 CREB 和 DLK 信号通路的上调有关。一种临床上使用的 FDA 批准的 CCR5 拮抗剂(用于 HIV 治疗)的给药会对中风后的运动恢复和 TBI 后的认知能力下降产生类似的影响。最后,在一个大型中风患者临床队列中,CCR5 (CCR5-Δ32)的天然缺失功能突变携带者表现出神经功能障碍和认知功能的更大恢复。总之,CCR5 是中风和 TBI 中神经修复的转化靶点,也是第一个报道的与人类中风后恢复增强相关的基因。