University Medical Center Goettingen, Department of Neurology, Goettingen, Germany.
Department of Neurocritical Care, First Stage Rehabilitation and Weaning, Reichshof-Eckenhagen, Germany; University of Duisburg-Essen Medical School, Department of Neurology, Essen, Germany; Institute of Neurophysiology, Medical Faculty, University of Cologne, Cologne, Germany.
Neuropharmacology. 2020 Dec 15;181:108357. doi: 10.1016/j.neuropharm.2020.108357. Epub 2020 Oct 13.
Lithium induces neuroprotection against cerebral ischemia, although the underlying mechanisms remain elusive. We have previously suggested a role for lithium in calcium regulation and (extra)cerebral vessel relaxation under non-ischemic conditions. Herein, we aimed to investigate whether or not lithium contributes to post-stroke stabilization of the blood-brain barrier (BBB) in mice. Using an oxygen-glucose-deprivation (OGD) model, we first analyzed the impact of lithium treatment on endothelial cells (EC) in vitro. Indeed, such treatment of EC exposed to OGD resulted in increased cell survival as well as in enhanced expression of tight junction proteins and P-glycoprotein. Additional in vivo studies demonstrated an increased stabilization of the BBB upon lithium treatment in stroke mice, as shown by a reduced Evans blue extravasation and an elevation of tight junction protein expression. Furthermore, stabilization of the BBB as a consequence of lithium treatment was associated with an inhibition of matrix metalloproteinase-9 activity, independent of calveolin-1 regulation. In line with this, flow cytometry analysis revealed that lithium treatment led to a decreased neutrophil invasion and an increased T cell extravasation from the blood compartment towards the brain parenchyma. We finally identified the pro-survival MAPK/ERK1/2 pathway as the key regulator of the impact of lithium on the BBB. In conclusion, we demonstrate for the first time that lithium is able to enhance post-stroke BBB integrity. Importantly, our work delivers novel insights into the exact mechanism of lithium-induced acute neuroprotection, providing critical information for future clinical trials involving lithium treatment in stroke patients.
锂能诱导脑缺血的神经保护作用,但其潜在机制仍不清楚。我们之前曾提出,锂在非缺血条件下对钙调节和(脑外)血管舒张有作用。在此,我们旨在研究锂是否有助于改善小鼠中风后的血脑屏障(BBB)稳定性。通过氧葡萄糖剥夺(OGD)模型,我们首先分析了锂处理对体外内皮细胞(EC)的影响。事实上,OGD 暴露下的 EC 经锂处理后,细胞存活率增加,紧密连接蛋白和 P-糖蛋白的表达增强。此外,在中风小鼠中,锂处理后 BBB 的稳定性增加,如 Evans 蓝渗出减少和紧密连接蛋白表达升高所示。此外,锂处理导致 BBB 稳定与基质金属蛋白酶-9 活性的抑制有关,与钙网蛋白-1 的调节无关。与此一致,流式细胞术分析显示,锂处理导致中性粒细胞浸润减少,T 细胞从血液向脑实质的渗出增加。我们最终确定了促生存 MAPK/ERK1/2 通路是锂对 BBB 影响的关键调节因子。总之,我们首次证明锂能够增强中风后 BBB 的完整性。重要的是,我们的工作为锂诱导的急性神经保护的确切机制提供了新的见解,为未来涉及中风患者锂治疗的临床试验提供了关键信息。