Arun Peethambaran, Rossetti Franco, DeMar James C, Wang Ying, Batuure Andrew B, Wilder Donna M, Gist Irene D, Morris Andrew J, Sabbadini Roger A, Long Joseph B
Blast-Induced Neurotrauma Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States.
Division of Cardiovascular Medicine, Lexington VA Medical Center, College of Medicine, University of Kentucky, Lexington, KY, United States.
Front Neurol. 2020 Dec 15;11:611816. doi: 10.3389/fneur.2020.611816. eCollection 2020.
Exposure to blast overpressure waves is implicated as the major cause of ocular injuries and resultant visual dysfunction in veterans involved in recent combat operations. No effective therapeutic strategies have been developed so far for blast-induced ocular dysfunction. Lysophosphatidic acid (LPA) is a bioactive phospholipid generated by activated platelets, astrocytes, choroidal plexus cells, and microglia and is reported to play major roles in stimulating inflammatory processes. The levels of LPA in the cerebrospinal fluid have been reported to increase acutely in patients with traumatic brain injury (TBI) as well as in a controlled cortical impact (CCI) TBI model in mice. In the present study, we have evaluated the efficacy of a single intravenous administration of a monoclonal LPA antibody (25 mg/kg) given at 1 h post-blast for protection against injuries to the retina and associated ocular dysfunctions. Our results show that a single 19 psi blast exposure significantly increased the levels of several species of LPA in blood plasma at 1 and 4 h post-blast. The anti-LPA antibody treatment significantly decreased glial cell activation and preserved neuronal cell morphology in the retina on day 8 after blast exposure. Optokinetic measurements indicated that anti-LPA antibody treatment significantly improved visual acuity in both eyes on days 2 and 6 post-blast exposure. Anti-LPA antibody treatment significantly increased rod photoreceptor and bipolar neuronal cell signaling in both eyes on day 7 post-blast exposure. These results suggest that blast exposure triggers release of LPAs, which play a major role promoting blast-induced ocular injuries, and that a single early administration of anti-LPA antibodies provides significant protection.
暴露于爆炸超压波被认为是近期参与战斗行动的退伍军人眼部受伤及由此导致视觉功能障碍的主要原因。迄今为止,尚未开发出针对爆炸所致眼部功能障碍的有效治疗策略。溶血磷脂酸(LPA)是一种由活化血小板、星形胶质细胞、脉络丛细胞和小胶质细胞产生的生物活性磷脂,据报道在刺激炎症过程中起主要作用。据报道,创伤性脑损伤(TBI)患者以及小鼠的控制性皮质撞击(CCI)TBI模型中,脑脊液中LPA水平会急剧升高。在本研究中,我们评估了在爆炸后1小时单次静脉注射单克隆LPA抗体(25mg/kg)对视网膜损伤及相关眼部功能障碍的保护作用。我们的结果表明,单次19psi爆炸暴露在爆炸后1小时和4小时显著提高了血浆中几种LPA的水平。抗LPA抗体治疗在爆炸暴露后第8天显著降低了视网膜中的胶质细胞活化,并保留了神经元细胞形态。视动测量表明,抗LPA抗体治疗在爆炸暴露后第2天和第6天显著提高了双眼的视力。抗LPA抗体治疗在爆炸暴露后第7天显著增加了双眼视杆光感受器和双极神经元细胞信号。这些结果表明,爆炸暴露触发了LPA的释放,LPA在促进爆炸所致眼部损伤中起主要作用,并且单次早期给予抗LPA抗体可提供显著保护。