Vithayathil Joseph, Shankar Anjali, Milne Ginger L, Jensen Frances E, Talos Delia M, Dunaief Joshua L
Division of Neurology, Department of Pediatrics, Children's Hospital of Philadelphia.
Department of Neurology, University of Pennsylvania, Philadelphia, PA.
bioRxiv. 2025 Jul 3:2025.07.02.662653. doi: 10.1101/2025.07.02.662653.
Iron accumulation and lipid peroxidation are pathophysiologic mechanisms that drive neonatal hypoxic-ischemic (HI) brain injury. Characterization of spatiotemporal changes in these processes will help elucidate their role in ischemic neuronal injury as an initial step towards developing targeted interventions.
HI was induced in post-natal day 9 mice using the modified-Vannucci model. Hippocampal tissue from ipsilateral HI exposed, contralateral hypoxia exposed and sham animals was collected at 6h, 24h, 72h and 7d post-HI. Tissue was subsequently evaluated for markers of cell death (TUNEL), intracellular iron changes (FerroOrange, fluorescent and immunofluorescence), and lipid peroxidation (real time PCR, Gpx4 immunofluorescence and mass spectrometry). Mass spectrometry measured isoprostanes (15-F-IsoP) and neuroprostanes (4-F-NP) as lipid peroxidation markers of arachidonic (ARA) and docosahexaenoic acid (DHA), respectively.
Compared to sham, the HI hippocampus showed increased intracellular labile iron levels that was maximal at 6h post-HI with subsequent elevation in only neuroprostanes at 24h post-HI. TUNEL labeling peaked at 24h post-HI. At 72h, labile iron levels and lipid peroxidation declined corresponding with peak infiltration of ferritin positive microglia/macrophages and the start of TUNEL staining decline. In addition, surviving neurons had increased expression of Gpx4 peaking at 72h post-HI that normalized by 7d post-HI.
These findings suggest that following HI, an acute increase in labile iron and DHA peroxidation are correlated with markers of cell death that peak at 24h post-HI. Microglial/macrophage iron sequestration and neuronal antioxidant responses may ameliorate further injury and represent targets for neuroprotective therapies.
铁蓄积和脂质过氧化是导致新生儿缺氧缺血性(HI)脑损伤的病理生理机制。对这些过程的时空变化进行表征,将有助于阐明它们在缺血性神经元损伤中的作用,这是开发靶向干预措施的第一步。
采用改良的Vannucci模型在出生后第9天的小鼠中诱导HI。在HI后6小时、24小时、72小时和7天,收集同侧HI暴露、对侧缺氧暴露和假手术动物的海马组织。随后对组织进行细胞死亡标志物(TUNEL)、细胞内铁变化(FerroOrange、荧光和免疫荧光)以及脂质过氧化(实时PCR、Gpx4免疫荧光和质谱)的评估。质谱法分别测量花生四烯酸(ARA)和二十二碳六烯酸(DHA)的脂质过氧化标志物异前列腺素(15-F-IsoP)和神经前列腺素(4-F-NP)。
与假手术组相比,HI海马体显示细胞内不稳定铁水平升高,在HI后6小时达到最大值,随后在HI后24小时仅神经前列腺素升高。TUNEL标记在HI后24小时达到峰值。在72小时时,不稳定铁水平和脂质过氧化下降,同时铁蛋白阳性小胶质细胞/巨噬细胞的峰值浸润以及TUNEL染色开始下降。此外,存活神经元中Gpx4的表达在HI后72小时达到峰值,并在HI后7天恢复正常。
这些发现表明,HI后,不稳定铁和DHA过氧化的急性增加与细胞死亡标志物相关,细胞死亡标志物在HI后24小时达到峰值。小胶质细胞/巨噬细胞的铁螯合和神经元抗氧化反应可能减轻进一步的损伤,并代表神经保护治疗的靶点。