State Key Laboratory of Natural Medicines, School of Life Science and Technology, China Pharmaceutical University, Nanjing, China.
State Key Laboratory of Natural Medicines, School of Life Science and Technology, China Pharmaceutical University, Nanjing, China.
Med. 2024 Jun 14;5(6):622-644.e8. doi: 10.1016/j.medj.2024.03.018. Epub 2024 Apr 24.
BACKGROUND: Ischemic stroke is a major cause of worldwide death and disability, with recombinant tissue plasminogen activator being the sole effective treatment, albeit with a limited treatment window. The cyclic GMP-AMP synthase (cGAS) and stimulator of interferon genes (STING) pathway is emerging as the major DNA-sensing pathway to invoke immune responses in neuroinflammatory disorders. METHODS: By performing a series of neurobehavioral assessments, electrophysiological analysis, high-throughput sequencing, and cell-based assays based on the transient middle cerebral artery occlusion (tMCAO) mouse stroke model, we examined the effects and underlying mechanisms of genetic and pharmacological inhibition of the cGAS-STING pathway on long-term post-stroke neurological functional outcomes. FINDINGS: Blocking the cGAS-STING pathway, even 3 days after tMCAO, significantly promoted functional recovery in terms of white matter structural and functional integrity as well as sensorimotor and cognitive functions. Mechanistically, the neuroprotective effects via inhibiting the cGAS-STING pathway were contributed not only by inflammation repression at the early stage of tMCAO but also by modifying the cell state of phagocytes to facilitate remyelination at the sub-acute phase. The activation of the cGAS-STING pathway significantly impeded post-stroke remyelination through restraining myelin debris uptake and degradation and hindering oligodendrocyte differentiation and maturation. CONCLUSIONS: Manipulating the cGAS-STING pathway has an extended treatment window in promoting long-term post-stroke functional recovery via facilitating remyelination in a mouse stroke model. Our results highlight the roles of the cGAS-STING pathway in aggregating stroke pathology and propose a new way for improving functional recovery after ischemic stroke. FUNDING: This work was primarily funded by the National Key R&D Program of China.
背景:缺血性脑卒中是全球范围内死亡和残疾的主要原因,重组组织纤溶酶原激活物是唯一有效的治疗方法,但治疗窗口有限。环鸟苷酸-腺苷酸合酶(cGAS)和干扰素基因刺激物(STING)途径作为主要的 DNA 感应途径,在神经炎症性疾病中引发免疫反应。
方法:通过对短暂性大脑中动脉闭塞(tMCAO)小鼠脑卒中模型进行一系列神经行为评估、电生理分析、高通量测序和基于细胞的测定,我们研究了 cGAS-STING 途径的遗传和药理学抑制对长期脑卒中后神经功能结局的影响及其潜在机制。
发现:即使在 tMCAO 后 3 天阻断 cGAS-STING 途径,也能显著促进白质结构和功能完整性以及感觉运动和认知功能的恢复。从机制上讲,通过抑制 cGAS-STING 途径的神经保护作用不仅归因于 tMCAO 早期的炎症抑制,还归因于修饰吞噬细胞的细胞状态,以促进亚急性期的髓鞘再生。cGAS-STING 途径的激活通过抑制髓鞘碎片摄取和降解以及阻碍少突胶质细胞分化和成熟,显著阻碍脑卒中后的髓鞘再生。
结论:在小鼠脑卒中模型中,通过促进髓鞘再生,操纵 cGAS-STING 途径在促进长期脑卒中后功能恢复方面具有延长的治疗窗口。我们的结果强调了 cGAS-STING 途径在聚集脑卒中病理方面的作用,并提出了一种改善缺血性脑卒中后功能恢复的新方法。
资金:本工作主要由国家重点研发计划资助。
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