Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology (GIST), Gwangju, 61005, Republic of Korea.
Transl Stroke Res. 2023 Aug;14(4):499-512. doi: 10.1007/s12975-022-01059-8. Epub 2022 Jul 9.
Long-term disabilities induced by stroke impose a heavy burden on patients, families, caregivers, and public health systems. Extensive studies have demonstrated the therapeutic value of neuromodulation in enhancing post-stroke recovery. Among them, chemogenetic neuromodulation activated by clozapine-N-oxide (CNO) has been proposed as the potential tool of neuromodulation. However, recent evidence showed that CNO does not cross the blood - brain barrier and may in fact have low binding affinity for chemogenetic tool. Thus, clozapine (CLZ) has been suggested for use in chemogenetic neuromodulation, in place of CNO, because it readily crosses the blood-brain barrier. Previously we reported that low doses of CLZ (0.1 mg/kg) successfully induced neural responses without off-target effects. Here, we show that low-dose clozapine (0.1 mg/kg) can induce prolonged chemogenetic activation while avoiding permeability issues and minimizing off-target effects. In addition, clozapine-induced excitatory chemogenetic neuromodulation (CLZ-ChemoNM) of sensory-parietal cortex with hsyn-hM3Dq-YFP-enhanced motor recovery in a chronic capsular infarct model of stroke in rats, improving post-stroke behavioral scores to 56% of pre-infarct levels. Longitudinal 2-deoxy-2-[18F]-fluoro-D-glucose microPET (FDG-microPET) scans showed that a reduction in diaschisis volume and activation of corticostriatal circuits were both correlated with post-stroke recovery. We also found c-Fos increases in bilateral cortices and BDNF increases in the cortices and striatum after CLZ-ChemoNM, indicating an increase in neural plasticity. These findings suggest the translational feasibility of CLZ-ChemoNM for augmenting recovery in chronic stroke.
中风引起的长期残疾给患者、家庭、护理人员和公共卫生系统带来了沉重的负担。大量研究表明,神经调节在促进中风后恢复方面具有治疗价值。其中,氯氮平-N-氧化物(CNO)激活的化学遗传神经调节被提出作为神经调节的潜在工具。然而,最近的证据表明,CNO 不能穿过血脑屏障,实际上可能对化学遗传工具的结合亲和力较低。因此,氯氮平(CLZ)已被提议用于化学遗传神经调节,以替代 CNO,因为它容易穿过血脑屏障。我们之前报道,低剂量的 CLZ(0.1mg/kg)可以成功诱导神经反应而没有脱靶效应。在这里,我们表明,低剂量的氯氮平(0.1mg/kg)可以诱导长期的化学遗传激活,同时避免通透性问题并最小化脱靶效应。此外,氯氮平诱导的感觉-顶叶皮层兴奋性化学遗传神经调节(CLZ-ChemoNM)在大鼠慢性囊状梗死模型中增强了运动恢复,将中风后的行为评分提高到梗死前水平的 56%。纵向 2-脱氧-2-[18F]-氟-D-葡萄糖微 PET(FDG-microPET)扫描显示,失联络体积的减少和皮质纹状体回路的激活均与中风后的恢复相关。我们还发现,CLZ-ChemoNM 后双侧皮质和皮质纹状体中的 c-Fos 增加以及 BDNF 的增加,表明神经可塑性增加。这些发现表明 CLZ-ChemoNM 具有增强慢性中风后恢复的转化可行性。