Department of Clinical Pharmacology, University Hospital of Tuebingen, Auf der Morgenstelle 8, 72076, Tuebingen, Germany.
Departments of Biochemistry and of Clinical Pharmacology, Yerevan State Medical University, 0025, Yerevan, Armenia.
Neurotherapeutics. 2019 Jul;16(3):725-740. doi: 10.1007/s13311-019-00723-6.
The contribution of the local angiotensin receptor system to neuroinflammation, impaired neurogenesis, and amyloid beta (Aβ) accumulation in Alzheimer's disease (AD) and in hypertension is consistent with the remarkable neuroprotection provided by angiotensin receptor blockers (ARBs) independent of their blood pressure-lowering effect. Considering the causal relationship between hypertension and AD and that targeting cerebrovascular pathology with ARBs does not necessarily require their systemic effects, we tested intranasal losartan in the rat model of chronic hypertension (spontaneously hypertensive stroke-prone rats, SHRSP). Intranasal losartan at a subdepressor dose decreased mortality, neuroinflammation, and perivascular content of Aβ by enhancing key players in its metabolism and clearance, including insulin-degrading enzyme, neprilysin, and transthyretin. Furthermore, this treatment improved neurologic deficits and increased brain IL-10 concentration, hippocampal cell survival, neurogenesis, and choroid plexus cell proliferation in SHRSP. Losartan (1 μM) also reduced LDH release from cultured astroglial cells in response to toxic glutamate concentrations. This effect was completely blunted by IL-10 antibodies. These findings suggest that intranasal ARB treatment is a neuroprotective, neurogenesis-inducing, and Aβ-decreasing strategy for the treatment of hypertensive stroke and cerebral amyloid angiopathy acting at least partly through the IL-10 pathway.
局部血管紧张素受体系统在阿尔茨海默病(AD)和高血压中对神经炎症、神经发生受损和淀粉样蛋白β(Aβ)积累的贡献与血管紧张素受体阻滞剂(ARBs)提供的显著神经保护作用一致,而与它们的降压作用无关。考虑到高血压和 AD 之间的因果关系,以及用 ARBs 靶向脑血管病理学不一定需要它们的全身作用,我们在慢性高血压大鼠模型(自发性高血压卒中易感性大鼠,SHRSP)中测试了鼻内氯沙坦。亚降压剂量的鼻内氯沙坦通过增强其代谢和清除的关键参与者,包括胰岛素降解酶、内肽酶和转甲状腺素蛋白,降低死亡率、神经炎症和血管周围的 Aβ含量。此外,这种治疗还改善了 SHRSP 的神经功能缺损,增加了大脑中 IL-10 浓度、海马细胞存活率、神经发生和脉络丛细胞增殖。氯沙坦(1μM)还降低了培养的星形胶质细胞对毒性谷氨酸浓度的 LDH 释放。这种作用被 IL-10 抗体完全阻断。这些发现表明,鼻内 ARB 治疗是一种治疗高血压性卒中和脑淀粉样血管病的神经保护、诱导神经发生和减少 Aβ的策略,至少部分通过 IL-10 途径发挥作用。