神经血管单元分析揭示骨桥蛋白对急性缺血性脑卒中血脑屏障的有害作用。

Profiling the neurovascular unit unveils detrimental effects of osteopontin on the blood-brain barrier in acute ischemic stroke.

机构信息

Edinger Institute (Institute of Neurology), University Hospital, Goethe University, 60528, Frankfurt, Germany.

Department of Neurology, University Hospital, Goethe University, 60528, Frankfurt, Germany.

出版信息

Acta Neuropathol. 2022 Aug;144(2):305-337. doi: 10.1007/s00401-022-02452-1. Epub 2022 Jun 25.

Abstract

Blood-brain barrier (BBB) dysfunction, characterized by degradation of BBB junctional proteins and increased permeability, is a crucial pathophysiological feature of acute ischemic stroke. Dysregulation of multiple neurovascular unit (NVU) cell types is involved in BBB breakdown in ischemic stroke that may be further aggravated by reperfusion therapy. Therefore, therapeutic co-targeting of dysregulated NVU cell types in acute ischemic stroke constitutes a promising strategy to preserve BBB function and improve clinical outcome. However, methods for simultaneous isolation of multiple NVU cell types from the same diseased central nervous system (CNS) tissue, crucial for the identification of therapeutic targets in dysregulated NVU cells, are lacking. Here, we present the EPAM-ia method, that facilitates simultaneous isolation and analysis of the major NVU cell types (endothelial cells, pericytes, astrocytes and microglia) for the identification of therapeutic targets in dysregulated NVU cells to improve the BBB function. Applying this method, we obtained a high yield of pure NVU cells from murine ischemic brain tissue, and generated a valuable NVU transcriptome database ( https://bioinformatics.mpi-bn.mpg.de/SGD_Stroke ). Dissection of the NVU transcriptome revealed Spp1, encoding for osteopontin, to be highly upregulated in all NVU cells 24 h after ischemic stroke. Upregulation of osteopontin was confirmed in stroke patients by immunostaining, which was comparable with that in mice. Therapeutic targeting by subcutaneous injection of an anti-osteopontin antibody post-ischemic stroke in mice resulted in neutralization of osteopontin expression in the NVU cell types investigated. Apart from attenuated glial activation, osteopontin neutralization was associated with BBB preservation along with decreased brain edema and reduced risk for hemorrhagic transformation, resulting in improved neurological outcome and survival. This was supported by BBB-impairing effects of osteopontin in vitro. The clinical significance of these findings is that anti-osteopontin antibody therapy might augment current approved reperfusion therapies in acute ischemic stroke by minimizing deleterious effects of ischemia-induced BBB disruption.

摘要

血脑屏障(BBB)功能障碍的特征是 BBB 连接蛋白的降解和通透性增加,是急性缺血性中风的关键病理生理特征。多种神经血管单元(NVU)细胞类型的失调参与了缺血性中风中的 BBB 破坏,而再灌注治疗可能进一步加重这种破坏。因此,针对急性缺血性中风中失调的 NVU 细胞类型进行联合治疗靶向治疗,是一种有前途的保持 BBB 功能和改善临床结果的策略。然而,从同一患病中枢神经系统(CNS)组织中同时分离多种 NVU 细胞类型的方法,对于鉴定失调的 NVU 细胞中的治疗靶点至关重要,但目前还缺乏这种方法。在这里,我们提出了 EPAM-ia 方法,该方法可以方便地同时分离和分析主要的 NVU 细胞类型(内皮细胞、周细胞、星形胶质细胞和小胶质细胞),以鉴定失调的 NVU 细胞中的治疗靶点,从而改善 BBB 功能。应用该方法,我们从缺血性脑鼠组织中获得了高纯度的 NVU 细胞,并生成了有价值的 NVU 转录组数据库(https://bioinformatics.mpi-bn.mpg.de/SGD_Stroke)。NVU 转录组的分析显示,骨桥蛋白(编码蛋白)在缺血性中风后 24 小时内所有 NVU 细胞中高度上调。免疫染色证实了中风患者中骨桥蛋白的上调,与小鼠中的上调情况相当。在缺血性中风后通过皮下注射抗骨桥蛋白抗体进行治疗性靶向治疗,导致所研究的 NVU 细胞类型中骨桥蛋白的表达被中和。除了减弱的神经胶质激活外,骨桥蛋白的中和与 BBB 的保护有关,同时减少脑水肿和降低出血性转化的风险,从而改善神经功能结局和存活率。这一结果得到了体外 BBB 损伤作用的支持。这些发现的临床意义在于,抗骨桥蛋白抗体治疗可能通过最小化缺血诱导的 BBB 破坏的有害影响,增强急性缺血性中风中现有的批准的再灌注治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d56/9288377/27330c44075c/401_2022_2452_Fig1_HTML.jpg

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