Gladstone Institute of Neurological Disease, San Francisco, CA 94158, USA.
Neuroscience Graduate Program, University of California, San Francisco, San Francisco, CA 94158, USA.
Sci Transl Med. 2022 Jul 6;14(652):eabj4310. doi: 10.1126/scitranslmed.abj4310.
Inflammatory processes induced by brain injury are important for recovery; however, when uncontrolled, inflammation can be deleterious, likely explaining why most anti-inflammatory treatments have failed to improve neurological outcomes after brain injury in clinical trials. In the thalamus, chronic activation of glial cells, a proxy of inflammation, has been suggested as an indicator of increased seizure risk and cognitive deficits that develop after cortical injury. Furthermore, lesions in the thalamus, more than other brain regions, have been reported in patients with viral infections associated with neurological deficits, such as SARS-CoV-2. However, the extent to which thalamic inflammation is a driver or by-product of neurological deficits remains unknown. Here, we found that thalamic inflammation in mice was sufficient to phenocopy the cellular and circuit hyperexcitability, enhanced seizure risk, and disruptions in cortical rhythms that develop after cortical injury. In our model, down-regulation of the GABA transporter GAT-3 in thalamic astrocytes mediated this neurological dysfunction. In addition, GAT-3 was decreased in regions of thalamic reactive astrocytes in mouse models of cortical injury. Enhancing GAT-3 in thalamic astrocytes prevented seizure risk, restored cortical states, and was protective against severe chemoconvulsant-induced seizures and mortality in a mouse model of traumatic brain injury, emphasizing the potential of therapeutically targeting this pathway. Together, our results identified a potential therapeutic target for reducing negative outcomes after brain injury.
脑损伤引起的炎症反应对恢复很重要;然而,当炎症反应不受控制时,可能会产生有害影响,这也可能解释了为什么大多数抗炎治疗在临床试验中未能改善脑损伤后的神经功能预后。在丘脑,胶质细胞的慢性激活,炎症的一个替代指标,被认为是皮质损伤后癫痫发作风险增加和认知缺陷的一个指标。此外,与神经功能缺损相关的病毒感染患者,如 SARS-CoV-2,报道的丘脑损伤比其他脑区更为常见。然而,丘脑炎症是神经功能缺损的驱动因素还是副产物尚不清楚。在这里,我们发现小鼠丘脑炎症足以模拟皮质损伤后出现的细胞和回路过度兴奋、癫痫发作风险增加以及皮质节律紊乱。在我们的模型中,丘脑星形胶质细胞中 GABA 转运体 GAT-3 的下调介导了这种神经功能障碍。此外,在皮质损伤的小鼠模型中,丘脑反应性星形胶质细胞中的 GAT-3 减少。增强丘脑星形胶质细胞中的 GAT-3 可以预防癫痫发作风险,恢复皮质状态,并对创伤性脑损伤的小鼠模型中的严重化学惊厥诱导的癫痫发作和死亡率具有保护作用,强调了靶向该途径的治疗潜力。总之,我们的研究结果确定了一种降低脑损伤后不良后果的潜在治疗靶点。