Department of Neurology, Louisiana State University Health Sciences Center, 1501 Kings Hwy, Shreveport, USA.
Department of Cellular Biology and Anatomy, Louisiana State University Health Sciences Center, Shreveport, USA.
Neuromolecular Med. 2022 Jun;24(2):97-112. doi: 10.1007/s12017-021-08665-z. Epub 2021 May 21.
Cardiopulmonary arrest (CA) can greatly impact a patient's life, causing long-term disability and death. Although multi-faceted treatment strategies against CA have improved survival rates, the prognosis of CA remains poor. We previously reported asphyxial cardiac arrest (ACA) can cause excessive activation of the sympathetic nervous system (SNS) in the brain, which contributes to cerebral blood flow (CBF) derangements such as hypoperfusion and, consequently, neurological deficits. Here, we report excessive activation of the SNS can cause enhanced neuropeptide Y levels. In fact, mRNA and protein levels of neuropeptide Y (NPY, a 36-amino acid neuropeptide) in the hippocampus were elevated after ACA-induced SNS activation, resulting in a reduced blood supply to the brain. Post-treatment with peptide YY (PYY), a pre-synaptic NPY2 receptor agonist, after ACA inhibited NPY release and restored brain circulation. Moreover, PYY decreased neuroinflammatory cytokines, alleviated mitochondrial dysfunction, and improved neuronal survival and neurological outcomes. Overall, NPY is detrimental during/after ACA, but attenuation of NPY release via PYY affords neuroprotection. The consequences of PYY inhibit ACA-induced 1) hypoperfusion, 2) neuroinflammation, 3) mitochondrial dysfunction, 4) neuronal cell death, and 5) neurological deficits. The present study provides novel insights to further our understanding of NPY's role in ischemic brain injury.
心肺骤停 (CA) 可能会对患者的生活造成重大影响,导致长期残疾和死亡。尽管针对 CA 的多方面治疗策略提高了生存率,但 CA 的预后仍然不佳。我们之前曾报道过窒息性心脏骤停 (ACA) 可导致大脑中交感神经系统 (SNS) 过度激活,从而导致脑血流量 (CBF) 紊乱,如灌注不足,并由此导致神经功能缺损。在这里,我们报告说过度激活的 SNS 会导致神经肽 Y 水平升高。事实上,在 ACA 诱导的 SNS 激活后,海马体中的神经肽 Y(NPY,一种 36 个氨基酸的神经肽)的 mRNA 和蛋白水平升高,导致大脑的血液供应减少。在 ACA 后用肽 YY (PYY) 治疗,一种 NPY2 受体的前突触激动剂,可抑制 NPY 释放并恢复脑循环。此外,PYY 降低了神经炎症细胞因子,缓解了线粒体功能障碍,并改善了神经元的存活和神经功能结局。总之,NPY 在 ACA 期间/之后是有害的,但是通过 PYY 减轻 NPY 释放可提供神经保护。PYY 的作用可抑制 ACA 引起的 1)灌注不足、2)神经炎症、3)线粒体功能障碍、4)神经元细胞死亡和 5)神经功能缺损。本研究为进一步了解 NPY 在缺血性脑损伤中的作用提供了新的见解。