功能获得性PPM1D突变可减轻缺血性中风。

Gain-of-function PPM1D mutations attenuate ischemic stroke.

作者信息

He Wenyan, Li Yan, Fan Junwan, Liu Yang, Yuan Meng, Cheng Si, Huang Xinying, Yan Bo, Zhang Zhuoran, Xiu Yuwen, Zhu Huimin, Lan Tian, Chang Zhilin, Jiang Yong, Li Hao, Meng Xia, Wang Yilong, Van Kaer Luc, Verkhratsky Alexei, Wang Yongjun, Shi Fu-Dong, Jin Wei-Na

机构信息

Department of Neurology, China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of innovative Drug and Device Research & Development for Cerebrovascular Diseases, Beijing, China.

Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.

出版信息

Cell Death Differ. 2025 May 21. doi: 10.1038/s41418-025-01523-6.

Abstract

Identification of genetic aberrations in stroke, the second leading cause of death worldwide, is of paramount importance for understanding the disease pathogenesis and generating new therapies. Whole-genome sequencing from 10,241 ischemic stroke patients identified eight patients carrying gain-of-function mutations on coding variants in the protein phosphatase magnesium-dependent 1 δ (PPM1D) gene. Patients carrying PPM1D mutations exhibit better stroke-related clinical phenotypes, including improvements in peripheral inflammation, fibrinogen, low-density lipoprotein, cholesterol and plateletcrit level. Experimental brain ischemia in Ppm1d-deficient (Ppm1d) mice resulted in enlarged lesions and pronounced neurological impairments. Spatial transcriptomics revealed a distinct Ppm1d-associated gene expression pattern, indicating disrupted endothelial homeostasis during ischemic brain injury. Proteomic analysis demonstrated that differentially expressed proteins in primary brain endothelial cells from Ppm1d mice were significantly enriched in the peroxisome proliferator-activated receptors (PPARs)-mediated metabolic signaling. Mechanistically, Ppm1d deficiency promoted aberrant fatty acid β-oxidation and increased oxidative stress, which impaired endothelial cell function through the PPARα pathway. A small molecule, T2755, was identified to engage Trp427 and stabilize PPM1D, thereby mitigating ischemic brain injury in mice. Collectively, we find that PPM1D protects against ischemic brain injury and validates its pharmacological stabilizer T2755 as a promising therapy for ischemic stroke. Gain-of-function PPM1D mutations attenuate ischemic cerebral injury. Whole-genome sequencing data of 10,241 ischemic stroke patients from the Third Chinese National Stroke Registry (CNSR-III) identified eight patients with gain-of-function mutations in the protein phosphatase magnesium-dependent 1 δ (PPM1D) gene (17q23.2). These mutation carriers displayed improved peripheral inflammation, decreased fibrinogen, low-density lipoprotein, cholesterol and plateletcrit level. Ppm1d-deficient (Ppm1d) mice exhibited exacerbated stroke outcomes, characterized by enlarged infarct volumes, disrupted cerebrovascular architecture, and enhanced neuro-inflammation. Mechanistically, Ppm1d deficiency induced the disturbance of endothelial fatty acid metabolism involving the PPARα pathway. Through integrated computational modeling, virtual screening, and in vitro validation, T2755 was identified as a small molecule PPM1D stabilizer. Pharmacological PPM1D stabilization with T2755 significantly attenuated ischemic brain injury in murine models.

摘要

中风是全球第二大死因,确定其基因变异对于理解疾病发病机制和开发新疗法至关重要。对10241名缺血性中风患者进行全基因组测序,发现8名患者在蛋白磷酸酶镁依赖1δ(PPM1D)基因的编码变体上携带功能获得性突变。携带PPM1D突变的患者表现出更好的中风相关临床表型,包括外周炎症、纤维蛋白原、低密度脂蛋白、胆固醇和血小板压积水平的改善。Ppm1d基因缺陷(Ppm1d)小鼠的实验性脑缺血导致病变扩大和明显的神经功能障碍。空间转录组学揭示了一种独特的与Ppm1d相关的基因表达模式,表明缺血性脑损伤期间内皮细胞稳态受到破坏。蛋白质组学分析表明,来自Ppm1d小鼠的原代脑内皮细胞中差异表达的蛋白质在过氧化物酶体增殖物激活受体(PPARs)介导的代谢信号通路中显著富集。机制上,Ppm1d缺乏促进异常脂肪酸β氧化并增加氧化应激,通过PPARα途径损害内皮细胞功能。一种小分子T2755被鉴定为与Trp427结合并稳定PPM1D,从而减轻小鼠的缺血性脑损伤。总的来说,我们发现PPM1D可预防缺血性脑损伤,并验证其药理稳定剂T2755作为缺血性中风的一种有前景的治疗方法。功能获得性PPM1D突变可减轻缺血性脑损伤。来自中国国家第三次中风登记(CNSR-III)的10241名缺血性中风患者的全基因组测序数据确定了8名患者在蛋白磷酸酶镁依赖1δ(PPM1D)基因(17q23.2)中存在功能获得性突变。这些突变携带者的外周炎症改善,纤维蛋白原、低密度脂蛋白、胆固醇和血小板压积水平降低。Ppm1d基因缺陷(Ppm1d)小鼠表现出更严重的中风结局,其特征是梗死体积增大、脑血管结构破坏和神经炎症增强。机制上,Ppm1d缺乏导致涉及PPARα途径的内皮脂肪酸代谢紊乱。通过综合计算建模、虚拟筛选和体外验证,T2755被鉴定为一种小分子PPM1D稳定剂。用T2755进行药理上的PPM1D稳定可显著减轻小鼠模型中的缺血性脑损伤。

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