Oinaka Hiroki, Kanamaru Hideki, Kawakita Fumihiro, Suzuki Yume, Nakajima Hideki, Nampei Mai, Suzuki Hidenori
Department of Neurosurgery, Graduate School of Medicine, Mie University, Tsu, Mie, Japan.
Neurocrit Care. 2025 Sep 4. doi: 10.1007/s12028-025-02348-4.
Periostin is an inflammation-related matricellular protein that has been reported to increase in the acute phase after subarachnoid hemorrhage (SAH) in clinical settings. However, its relationship with neuronal apoptosis, a characteristic of early brain injury, remains unknown. The purpose of this study was to investigate the involvement of periostin in SAH-induced acute neuronal apoptosis and to determine whether clarithromycin (CAM), a macrolide antibiotic known to suppress periostin expression, prevents acute neuronal apoptosis after SAH in mice.
In 141 male C57BL/6 mice undergoing endovascular perforation SAH or sham operation, vehicle or CAM (50 mg/kg) was administered subcutaneously 5 min after surgery, followed by intracerebroventricular administration of vehicle or recombinant mouse periostin (R-periostin) 30 min after surgery. The intervention effects were assessed 24 h after surgery by neurological score, Western blotting, and double immunostaining.
After induction of SAH, neurological scores worsened, and caspase-3-dependent neuronal apoptosis was increased, which was associated with upregulation of periostin expression in the left (perforation side) cerebral hemisphere compared with sham-operated animals (p < 0.01 vs. sham + vehicle group, respectively). Administration of CAM improved neurological scores and reduced caspase-3-dependent neuronal apoptosis as well as periostin expression in SAH mice (p < 0.05, p < 0.01, p < 0.01 vs. SAH + vehicle group, respectively). The protective effects of CAM on neurological scores and neuronal apoptosis after SAH were counteracted by administration of R-periostin (SAH + CAM + vehicle group vs. SAH + CAM + R-periostin group, p < 0.05 and p < 0.001, respectively). Immunohistochemical analysis confirmed overexpression of periostin in neurons after SAH, which was attenuated by CAM treatment but re-increased by administration of R-periostin.
These findings indicate that periostin-driven signaling contributes to caspase-dependent neuronal apoptosis during early brain injury after SAH. This study highlights periostin as a potential therapeutic target to attenuate SAH-induced acute neuronal apoptosis and demonstrates that CAM holds promise as an antiapoptotic agent through periostin inhibition.
骨膜蛋白是一种与炎症相关的基质细胞蛋白,临床研究报道其在蛛网膜下腔出血(SAH)后的急性期会升高。然而,其与早期脑损伤的特征性表现——神经元凋亡之间的关系尚不清楚。本研究旨在探讨骨膜蛋白在SAH诱导的急性神经元凋亡中的作用,并确定克拉霉素(CAM),一种已知可抑制骨膜蛋白表达的大环内酯类抗生素,是否能预防小鼠SAH后的急性神经元凋亡。
在141只接受血管内穿刺SAH或假手术的雄性C57BL/6小鼠中,术后5分钟皮下注射溶剂或CAM(50mg/kg),术后30分钟脑室内注射溶剂或重组小鼠骨膜蛋白(R-骨膜蛋白)。术后24小时通过神经功能评分、蛋白质免疫印迹法和双重免疫染色评估干预效果。
诱导SAH后,神经功能评分恶化,半胱天冬酶-3依赖性神经元凋亡增加,与假手术动物相比,左侧(穿刺侧)大脑半球骨膜蛋白表达上调(分别与假手术+溶剂组相比,p<0.01)。给予CAM可改善SAH小鼠的神经功能评分,减少半胱天冬酶-3依赖性神经元凋亡以及骨膜蛋白表达(分别与SAH+溶剂组相比,p<0.05, p<0.01, p<0.01)。给予R-骨膜蛋白可抵消CAM对SAH后神经功能评分和神经元凋亡的保护作用(SAH+CAM+溶剂组与SAH+CAM+R-骨膜蛋白组相比,分别为p<0.05和p<0.001)。免疫组织化学分析证实SAH后神经元中骨膜蛋白过表达,CAM治疗可使其减弱,但给予R-骨膜蛋白后又重新增加。
这些发现表明,骨膜蛋白驱动的信号传导在SAH后早期脑损伤期间促成了半胱天冬酶依赖性神经元凋亡。本研究强调骨膜蛋白是减轻SAH诱导的急性神经元凋亡的潜在治疗靶点,并证明CAM有望通过抑制骨膜蛋白成为一种抗凋亡药物。