Yuan Kaikun, Wu Qiaowei, Yao Yanting, Shao Jiang, Zhu Shiyi, Yang Jinshuo, Sun Qi, Zhao Junjie, Xu Jiayi, Wu Pei, Li Yuchen, Shi Huaizhang
Department of Neurosurgery, First Affiliated Hospital of Harbin Medical University, Harbin, 150001, People's Republic of China.
Department of Neurosurgery, Beidahuang Group General Hospital, Harbin, 150001, People's Republic of China.
Transl Stroke Res. 2024 Aug 5. doi: 10.1007/s12975-024-01282-5.
White matter injury (WMI) subsequent to subarachnoid hemorrhage (SAH) frequently leads to an unfavorable patient prognosis. Previous studies have indicated that microglial M1 polarization following SAH results in the accumulation of amyloid precursor protein (APP) and degradation of myelin basic protein (MBP), thereby catalyzing the exacerbation of WMI. Consequently, transitioning microglial polarization towards the M2 phenotype (neuroprotective state) represents a potential therapeutic approach for reversing WMI. The SIRT2 gene is pivotal in neurological disorders such as neurodegeneration and ischemic stroke. However, its function and underlying mechanisms in SAH, particularly how it influences microglial function to ameliorate WMI, remain unclear. Our investigations revealed that in post-SAH, there was a temporal increase in SIRT2 expression, predominantly in the cerebral corpus callosum area, with notable colocalization with microglia. However, following the administration of the SIRT2 inhibitor AK-7, a shift in microglial polarization towards the M2 phenotype and an improvement in both short-term and long-term neuronal functions in rats were observed. Mechanistically, CO-IP experiments confirmed that SIRT2 can interact with the receptor tyrosine kinase Axl within the TAM receptor family and act as a deacetylase to regulate the deacetylation of Axl. Concurrently, the inhibition of SIRT2 by AK-7 can lead to increased expression of Axl and activation of the anti-inflammatory pathway PI3K/Akt signaling pathway, which regulates microglial M2 polarization and consequently reduces WMI. However, when Axl expression was inhibited by the injection of the shAxl virus into the lateral ventricles, the downstream signaling pathways were significantly suppressed. Rescue experiments also confirmed that the neuroprotective effects of AK-7 can be reversed by PI3K inhibitors. These data suggest that SIRT2 influences WMI by affecting microglial polarization through the Axl/PI3K/AKT pathway, and that AK-7 could serve as an effective therapeutic drug for improving neurological functions in SAH patients.
蛛网膜下腔出血(SAH)后继发的白质损伤(WMI)常常导致患者预后不良。先前的研究表明,SAH后小胶质细胞的M1极化会导致淀粉样前体蛋白(APP)积累和髓鞘碱性蛋白(MBP)降解,从而促使WMI恶化。因此,将小胶质细胞极化转变为M2表型(神经保护状态)是一种逆转WMI的潜在治疗方法。SIRT2基因在神经退行性变和缺血性中风等神经系统疾病中起关键作用。然而,其在SAH中的功能及潜在机制,尤其是它如何影响小胶质细胞功能以改善WMI,仍不清楚。我们的研究发现,SAH后,SIRT2表达呈时间依赖性增加,主要在胼胝体区域,且与小胶质细胞有明显共定位。然而,给予SIRT2抑制剂AK-7后,观察到大鼠小胶质细胞极化向M2表型转变,且短期和长期神经元功能均得到改善。机制上,免疫共沉淀实验证实SIRT2可与TAM受体家族中的受体酪氨酸激酶Axl相互作用,并作为去乙酰化酶调节Axl的去乙酰化。同时,AK-7抑制SIRT2可导致Axl表达增加和抗炎途径PI3K/Akt信号通路激活,该通路调节小胶质细胞M2极化,进而减轻WMI。然而,当通过向侧脑室注射shAxl病毒抑制Axl表达时,下游信号通路被显著抑制。挽救实验也证实PI3K抑制剂可逆转AK-7的神经保护作用。这些数据表明,SIRT2通过Axl/PI3K/AKT途径影响小胶质细胞极化来影响WMI,且AK-7可作为改善SAH患者神经功能的有效治疗药物。
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