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伴侣蛋白介导的自噬(CMA)通过减少脓毒症相关性脑病(SAE)中的神经元死亡来缓解认知障碍。

Chaperone-mediated autophagy (CMA) alleviates cognitive impairment by reducing neuronal death in sepsis-associated encephalopathy (SAE).

机构信息

Department of Critical Care Medicine, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China; Department of Anaesthesiology and Perioperative Medicine, Xijing Hospital, the Fourth Military Medical University, Xi'an, Shaanxi, China.

Institute of Neurosciences, The Fourth Military Medical University, Xi'an, Shaanxi, China.

出版信息

Exp Neurol. 2023 Jul;365:114417. doi: 10.1016/j.expneurol.2023.114417. Epub 2023 Apr 19.

Abstract

Sepsis-associated encephalopathy (SAE) is a common and severe complication of sepsis, which causes long-term neurological deficits, such as cognitive impairment. Despite extensive research, there is still lack of specific treatments for SAE. Chaperone-mediated autophagy (CMA), a selective type of autophagy, has been reported to be related to cognitive dysfunctions in many neurodegenerative diseases. The aim of this study was to investigate the alteration of CMA activity in the hippocampus of SAE mice and explore the neuroprotective effect of enhanced CMA. Cecal ligation and puncture (CLP) was conducted to induce SAE. In the contextual fear conditioning test, the ratio of freezing time of CLP mice significantly decreased compared with that of the mice in the Sham group, indicating cognitive impairment in SAE mice. The expression of lysosome-associated membrane protein type 2A (Lamp2a) and chaperone heat shock cognate 71 kDa protein (Hsc70), positive markers for CMA activity, decreased in hippocampal neurons of SAE mice. Although overexpression of Lamp2a in neurons via adeno-associated virus injection in the hippocampus had little effect on the mortality of septic mice, this intervention significantly alleviated the memory impairments in contextual fear conditioning test, Y-maze test and novel objective recognition test, and attenuated the neural death observed in SAE mice. We further demonstrated that the overexpression of Lamp2a in the hippocampus increased the expression of phosphorylated cyclic-AMP response element binding protein (p-CREB), brain-derived neurotrophic factor (BDNF) and B-cell lymphoma-2 (Bcl-2), and suppressed the expression of cleaved caspase-3. Taken together, our study results suggested that the upregulation of CMA activity ameliorated cognitive impairments and neuron loss in SAE mice partially through the p-CREB-BDNF/Bcl-2 signaling pathways, providing a potential therapeutic target for SAE.

摘要

脓毒症相关性脑病(SAE)是脓毒症的一种常见且严重的并发症,可导致认知障碍等长期神经功能缺损。尽管进行了广泛的研究,但对于 SAE 仍然缺乏特异性治疗方法。伴侣介导的自噬(CMA)是一种选择性自噬,已有研究报道其与许多神经退行性疾病中的认知功能障碍有关。本研究旨在探讨 SAE 小鼠海马区 CMA 活性的变化,并探索增强 CMA 的神经保护作用。采用盲肠结扎穿孔(CLP)法诱导 SAE。在情景恐惧条件反射试验中,CLP 组小鼠的冻结时间比例明显低于假手术组,表明 SAE 小鼠存在认知障碍。SAE 小鼠海马神经元中溶酶体相关膜蛋白 2A(Lamp2a)和伴侣热休克同源 71kDa 蛋白(Hsc70)的表达,即 CMA 活性的阳性标志物,均降低。虽然通过腺相关病毒注射在海马区过表达神经元中的 Lamp2a 对脓毒症小鼠的死亡率几乎没有影响,但这种干预显著改善了情景恐惧条件反射试验、Y 迷宫试验和新物体识别试验中的记忆障碍,并减轻了 SAE 小鼠观察到的神经死亡。我们进一步证明,海马区 Lamp2a 的过表达增加了磷酸化环 AMP 反应元件结合蛋白(p-CREB)、脑源性神经营养因子(BDNF)和 B 细胞淋巴瘤-2(Bcl-2)的表达,同时抑制了裂解型半胱天冬酶-3 的表达。综上,我们的研究结果表明,CMA 活性的上调部分通过 p-CREB-BDNF/Bcl-2 信号通路改善了 SAE 小鼠的认知障碍和神经元丢失,为 SAE 提供了一个潜在的治疗靶点。

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