Parihar Vipan K, Syage Amber, Flores Lidia, Lilagan Angelica, Allen Barrett D, Angulo Maria C, Song Joseph, Smith Sarah M, Arechavala Rebecca J, Giedzinski Erich, Limoli Charles L
Department of Radiation Oncology, University of California, Irvine, Irvine, CA, United States.
Front Cell Neurosci. 2021 Jun 28;15:668286. doi: 10.3389/fncel.2021.668286. eCollection 2021.
Despite advancements in the radiotherapeutic management of brain malignancies, resultant sequelae include persistent cognitive dysfunction in the majority of survivors. Defining the precise causes of normal tissue toxicity has proven challenging, but the use of preclinical rodent models has suggested that reductions in neurogenesis and microvascular integrity, impaired synaptic plasticity, increased inflammation, and alterations in neuronal structure are contributory if not causal. As such, strategies to reverse these persistent radiotherapy-induced neurological disorders represent an unmet medical need. AM251, a cannabinoid receptor 1 reverse agonist known to facilitate adult neurogenesis and synaptic plasticity, may help to ameliorate radiation-induced CNS impairments. To test this hypothesis, three treatment paradigms were used to evaluate the efficacy of AM251 to ameliorate radiation-induced learning and memory deficits along with disruptions in mood at 4 and 12 weeks postirradiation. Results demonstrated that acute (four weekly injections) and chronic (16 weekly injections) AM251 treatments (1 mg/kg) effectively alleviated cognitive and mood dysfunction in cranially irradiated mice. The beneficial effects of AM251 were exemplified by improved hippocampal- and cortical-dependent memory function on the novel object recognition and object in place tasks, while similar benefits on mood were shown by reductions in depressive- and anxiety-like behaviors on the forced swim test and elevated plus maze. The foregoing neurocognitive benefits were associated with significant increases in newly born (doublecortin+) neurons (1.7-fold), hippocampal neurogenesis (BrdU+/NeuN+mature neurons, 2.5-fold), and reduced expression of the inflammatory mediator HMGB (1.2-fold) in the hippocampus of irradiated mice. Collectively, these findings indicate that AM251 ameliorates the effects of clinically relevant cranial irradiation where overall neurological benefits in memory and mood coincided with increased hippocampal cell proliferation, neurogenesis, and reduced expression of proinflammatory markers.
尽管脑恶性肿瘤的放射治疗管理取得了进展,但大多数幸存者仍会出现包括持续性认知功能障碍在内的后遗症。确定正常组织毒性的确切原因已被证明具有挑战性,但临床前啮齿动物模型的使用表明,神经发生和微血管完整性的降低、突触可塑性受损、炎症增加以及神经元结构改变即便不是因果关系,也是有促成作用的。因此,逆转这些持续性放疗引起的神经障碍的策略代表了一种未满足的医疗需求。AM251是一种已知可促进成体神经发生和突触可塑性的大麻素受体1反向激动剂,可能有助于改善辐射引起的中枢神经系统损伤。为了验证这一假设,采用了三种治疗方案来评估AM251在放疗后4周和12周改善辐射引起的学习和记忆缺陷以及情绪紊乱的疗效。结果表明,急性(每周注射4次)和慢性(每周注射16次)AM251治疗(1毫克/千克)有效减轻了头部受照射小鼠的认知和情绪功能障碍。AM251的有益作用体现在对新物体识别和物体定位任务中改善了海马体和皮质依赖性记忆功能,而在强迫游泳试验和高架十字迷宫试验中,抑郁样和焦虑样行为减少表明对情绪有类似的有益作用。上述神经认知益处与受照射小鼠海马体中新生(双皮质素阳性)神经元显著增加(1.7倍)、海马体神经发生(BrdU+/NeuN+成熟神经元,2.5倍)以及炎症介质HMGB表达降低(1.2倍)相关。总体而言,这些发现表明,AM251改善了临床相关头部照射的影响,其中记忆和情绪方面的整体神经益处与海马体细胞增殖增加、神经发生以及促炎标志物表达降低相一致。