CKLF1作为缺血性脑卒中治疗的潜在靶点

缺血性脑卒中是一种血液循环障碍疾病,可导致严重的神经功能缺损.卒中病人中约有87％的病例为缺血性卒中.神经炎症是中风损伤的主要病理状态之一.CKLF1是2001年发现的非经典CC型趋化因子,对单核细胞、中性粒细胞和淋巴细胞表现出很强的趋化活性.CKLF1在胎儿大脑中含量最高,但在健康成人阶段不存在.越来越多的证据表明,...     

丙戊酸与缺血性脑卒中相关研究进展

动脉粥样硬化和缺血性脑损伤是防治缺血性脑卒中所面临的两大难题,而细胞炎症损伤是它们的共同诱因。丙戊酸作为组蛋白去乙酰化酶抑制剂,具有抑制细胞炎症因子释放及保护神经的作用,所以丙戊酸可能是防治缺血性脑卒中的潜在治疗药物。本文从组蛋白去乙酰化酶对缺血性脑卒中的影响以及丙戊酸的抗炎机制两个方面进行综述。     

中药通过调节小胶质细胞激活改善缺血性脑卒中

炎症反应是造成脑卒中继发性脑损伤的关键因素之一。小胶质细胞作为脑内免疫细胞,在脑卒中的炎症反应具有重要作用。传统观念认为小胶质细胞促进炎症反应加重脑损伤。近年来的研究发现激活的小胶质细胞还能产生抗炎作用来加速脑损伤修复。因此,目前的研究将小胶质细胞分为促炎的M1型和抗炎的M2型。结合目前缺血性脑卒中的神经保护剂相对较少,靶向调控小胶质细胞的极化可能成为脑卒中新的治疗策略。研究发现中药能够通过抑制M1型小胶质细胞,并促进M2型的小胶质细胞来改善缺血性脑损伤,从而展现出对缺血性脑卒中的治疗潜力。本文综述了中药通过调节小胶质细胞极化表型来治疗脑卒中的相关研究,以期为缺血性脑卒中药物开发提供新的思路。     

中药通过调节小胶质细胞激活改善缺血性脑卒中（英文）

炎症反应是造成脑卒中继发性脑损伤的关键因素之一.小胶质细胞作为脑内免疫细胞,在脑卒中的炎症反应具有重要作用.传统观念认为小胶质细胞促进炎症反应加重脑损伤.近年来的研究发现,激活的小胶质细胞还能产生抗炎作用来加速脑损伤修复.因此,目前的研究将小胶质细胞分为促炎的M1型和抗炎的M2型.结合目前缺血性脑卒中的神经保护剂相对较少,靶向调控小胶质细胞的极化可能成为脑卒中新的治疗策略.研究发现中药能够通过抑制M1型小胶质细胞,并促进M2型的小胶质细胞来改善缺血性脑损伤,从而展现出对缺血性脑卒中的治疗潜力.本文综述中药通过调节小胶质细胞极化表型来治疗脑卒中的相关研究,以期为缺血性脑卒中药物开发提供新的思路.     

GSK-3β对缺血性脑卒中病理过程调控作用的研究进展

糖原合成酶激酶-3β(glycogen synthase kinase-3β,GSK-3β)作为机体最重要的激酶之一,广泛地参与了缺血性脑卒中的病理过程。因此,正确认识脑卒中后GSK-3β的功能并加以利用,由此寻求减轻组织损伤和改善神经功能的方法是提高脑卒中治疗的重要途径。该文就GSK-3β对缺血性脑卒中后的氧化应激、炎症、自噬、凋亡等病理过程的调控机制进行综述,为缺血性脑卒中提供新的研究方向和潜在的临床治疗靶点。     

基于自噬溶酶体形成机制调控缺血性脑卒中后神经元自噬流

脑卒中是由脑血管阻塞或出血引发的急性脑血管病，约84%的临床脑卒中患者由脑缺血引起。研究表明，自噬广泛参与并显著影响脑卒中病理生理进程。自噬是一个将陈旧蛋白质、损伤细胞器及多余胞质组分等呈递给溶酶体进行降解的代谢过程，其包括自噬的激活、自噬体的形成和成熟、自噬体与溶酶体融合、自噬产物在自噬溶酶体内消化和降解等过程。自噬流通常被定义为自噬/溶酶体信号机制。最近发现，自噬流障碍是导致缺血性脑卒中后神经元损伤的重要原因，而在自噬过程中任一步骤发生障碍均可导致自噬流损伤。本文重点对自噬体-溶酶体融合的机制，以及该机制在缺血性脑卒中后发生障碍的致病机理进行详细阐述，以期基于自噬体-溶酶体融合机制对神经元自噬流进行调节，进而诱导缺血性脑卒中后的神经保护。本文可为脑卒中病理机制研究指明方向，为脑卒中治疗探寻新的线索。     

内源性神经干细胞促进缺血性脑卒中后神经修复的研究进展

神经干细胞自1992年被发现以来,已成为治疗神经系统各类疾病的新希望。缺血性脑卒中因其高发病率、高致死率和高致残率而倍受关注。损伤后的大脑自我修复能力有限,因此只能适度改善神经功能,而加快神经再生才能从根本上阻止神经系统疾病的发生和发展。值得关注的是,部分患者在发病数月后可表现出脑修复能力,提示可能存在内源性的神经修复。本文对近年来内源性神经干细胞在缺血性脑卒中后的神经再生及相关调控因素的研究进展进行综述,为促进缺血性脑卒中后的神经修复提供新的治疗思路。     

食欲素与缺血性脑卒中关系的研究进展

缺血性脑卒中是严重威胁我国人民生命和健康的疾病,具有高发病率、高死亡率和高致残率。食欲素是下丘脑分泌的一种神经肽,包括食欲素A和食欲素B有调节能量平衡、刺激食欲、内分泌、睡眠-苏醒、心血管系统的功能。近年来有研究发现食欲素通过对血糖、血压、炎症以及缺血性脑卒中后抑郁及认知功能的调节,进而影响缺血性脑卒中的预后。本文将对食欲素与缺血性脑卒中的关系做一综述。     

自噬流障碍在缺血性脑卒中后的神经损伤机制

自噬是一种细胞分解代谢途径,通过降解长寿或错误折叠的蛋白质以及受损的细胞器,以维持细胞内稳态和正常细胞功能。相反,自噬流发生障碍会影响细胞内蛋白质和细胞器的降解,破坏细胞稳态,最终导致神经元死亡。研究表明,缺血性脑卒中所致脑损伤的主要原因是能量消耗、氧化应激和炎症,它们与应激后神经元自噬流的改变显著相关。该文回顾了自噬流障碍在缺血性脑卒中后的神经损伤机制及其相关的治疗药物与手段。     

神经血管单元和Notch信号通路在缺血性卒中后的作用

缺血性卒中是临床常见疾病,且致死致残率高,幸存的患者预后多不同程度的患有偏瘫等后遗症,但目前还没有好的治疗方法。很长一段时间以来,卒中后的治疗关注点在于神经元的保护,割裂了神经元和周围细胞的联系。2001年,"神经血管单元"概念的提出为缺血性卒中的临床治疗提供了新的角度。此外,有研究表明Notch信号通路参与了神经、血管再生过程,对于卒中后神经血管单元的修复有调节作用。因此,本文从神经血管单元和Notch信号通路两个切入点综述了二者在缺血性卒中发生后的作用。     

Antagonistic effect of C19 on migration of vascular smooth muscle cells and intimal hyperplasia induced by chemokine-like factor 1

A chemokine-like factor 1 (CKLF1) is a recently discovered chemokine with broad-spectrum biological functions in inflammation and autoimmune diseases. C19 as a CKLF1’s C-terminal peptide has been reported to exert inhibitory effects in a variety of diseases. However, the roles of CKLF1 and C19 on vascular smooth muscle cell (VSMC) migration and neointima formation still remain elusive. The effects of CKLF1 and C19 on VSMC migration and neointimal formation were investigated in cultured VSMCs and balloon-injured rat carotid arteries based on techniques including adenovirus-induced CKLF1 overexpression, gel based perivascular administration of C19, Boyden chamber, scratch-wound assay, real-time PCR, western blot and immunohistochemical analysis. CKLF1 was noticed to accumulate preferentially in neointima after the injury and colocalize with VSMCs. Luminal delivery of CKLF1 adenovirus to arteries exacerbated intimal thickening while perivascular administration of C19 to injured arteries attenuated this problem. In cultured primary VSMCs, CKLF1 overexpression up-regulated VSMC migration, which was down-regulated by C19. These data suggest that CKLF1 has a pivotal role in intimal hyperplasia by mediating VSMC migration. C19 was demonstrated to inhibit CKLF1-mediatated chemotaxis and restenosis. Thus further studies on C19 may provide a new treatment perspective for atherosclerosis and post-angioplasty restenosis.     

Chemokines and their receptors in the brain: pathophysiological roles in ischemic brain injury

Chemokines constitute a large family of structurally-related small cytokines originally identified as factors regulating the migration of leukocytes in inflammatory and immune responses. Production of chemokines and their receptors in the brain has been reported under various pathological conditions. We revealed that mRNA expression for monocyte chemoattractant protein-1 (MCP-1) and macrophage inflammatory protein-1alpha (MIP-1alpha), members of the CC chemokines, was induced in the rat brain after focal cerebral ischemia, and that intracerebroventricular injection of viral macrophage inflammatory protein-II (vMIP-II), a broad-spectrum chemokine receptor antagonist, reduced infarct volume in a dose-dependent manner. These findings suggest that brain chemokines are involved in ischemic injury, and that chemokine receptors are potential targets for therapeutic intervention in stroke. Another potential target to suppress the harmful effect of chemokines is the signal transmission system(s) regulating the chemokine production. However, very little is known about how the production of chemokines is regulated in the ischemic brain. We examined the induction of MCP-1 production by excitotoxic injury via activation of NMDA receptors in the cortico-striatal slice cultures, and found that excitotoxic injury induced MCP-1 production in the slice culture. Almost all of the MCP-1 immunoreactivity was located on astrocytes. On the other hand, NMDA-treatment failed to increase the MCP-1 production in the enriched astrocyte cultures, indicating that NMDA dose not directly act on astrocytes. Some signal(s) is likely sent from the injured neurons to astrocytes to induce the MCP-1 production. These results showed that organotypic slice cultures are useful to investigate the molecular mechanism regulating the chemokine production in the injured brain.     

TIPE2, a Novel Regulator of Immunity,Protects against Experimental Stroke

The inflammatory responses accompanying stroke are recognized to contribute to secondary ischemic injury. TIPE2 is a very recently identified negative regulator of inflammation that maintains immune homeostasis. However, it is unknown whether TIPE2 is expressed in the brain and contributes to the regulation of cerebral diseases. In this study, we explored the potential roles of TIPE2 in cerebral ischemia/reperfusion injury. TIPE2^−/− mice were used to assess whether TIPE2 provides neuroprotection following cerebral ischemia/reperfusion induced by middle cerebral artery occlusion (MCAO), and in vitro primary cerebral cell cultures were used to investigate the expression and regulation of TIPE2. Our results show that genetic ablation of the Tipe2 gene significantly increased the cerebral volume of infarction and neurological dysfunction in mice subjected to MCAO. Flow cytometric analysis revealed more infiltrating macrophages, neutrophils, and lymphocytes in the ischemic hemisphere of TIPE2^−/− mice. The responses to inflammatory cytokines and chemokines were significantly increased in TIPE2^−/− mouse brain after MCAO. We further observed that TIPE2 was highly induced in WT mice after cerebral ischemia and was expressed mainly in microglia/macrophages, but not in neurons and astrocytes. Finally, we found that regulation of TIPE2 expression was associated with NADPH oxidase activity. These findings demonstrate, for the first time, that TIPE2 is involved in the pathogenesis of stroke and suggest that TIPE2 plays an essential role in a signal transduction pathway that links the inflammatory immune response to specific conditions after cerebral ischemia. Targeting TIPE2 may be a new therapeutic strategy for stroke treatment.     

The immunomodulatory sphingosine 1-phosphate analog FTY720 reduces lesion size and improves neurological outcome in a mouse model of cerebral ischemia

Cerebral ischemia is accompanied by fulminant cellular and humoral inflammatory changes in the brain which contribute to lesion development after stroke. A tight interplay between the brain and the peripheral immune system leads to a biphasic immune response to stroke consisting of an early activation of peripheral immune cells with massive production of proinflammatory cytokines followed by a systemic immunosuppression within days of cerebral ischemia that is characterized by massive immune cell loss in spleen and thymus. Recent work has documented the importance of T lymphocytes in the early exacerbation of ischemic injury. The lipid signaling mediator sphingosine 1-phosphate-derived stable analog FTY720 (fingolimod) acts as an immunosuppressant and induces lymphopenia by preventing the egress of lymphocytes, especially T cells, from lymph nodes. We found that treatment with FTY720 (1 mg/kg) reduced lesion size and improved neurological function after experimental stroke in mice, decreased the numbers of infiltrating neutrophils, activated microglia/macrophages in the ischemic lesion and reduced immunohistochemical features of apoptotic cell death in the lesion.     

Protective Effect of Shikonin in Experimental Ischemic Stroke: Attenuated TLR4, p-p38MAPK, NF-κB, TNF-α and MMP-9 Expression, Up-Regulated Claudin-5 Expression, Ameliorated BBB Permeability

Inflammatory damage plays an important role in cerebral ischemic pathogenesis and represents a new target for treatment of stroke. Shikonin has gained attention for its prominent anti-inflammatory property, but up to now little is known about shikonin treatment in acute ischemic stroke. The aim of this study was to evaluate the potential neuroprotective role of shikonin in cerebral ischemic injury, and investigate whether shikonin modulated inflammatory responses after stroke. Focal cerebral ischemia in male ICR mice was induced by transient middle cerebral artery occlusion. Shikonin (10 and 25 mg/kg) was administered by gavage once a day for 3 days before surgery and another dosage after operation. Neurological deficit, infarct volume, brain edema, blood–brain barrier (BBB) dysfunction, and inflammatory mediators were evaluated at 24 and 72 h after stroke. Compared with vehicle group, 25 mg/kg shikonin significantly improved neurological deficit, decreased infarct volume and edema both at 24 and 72 h after transient ischemic stroke, our data also showed that shikonin inhibited the pro-inflammatory mediators, including TLR4, TNF-α, NF-κB, and phosphorylation of p38MAPK in ischemic cortex. In addition, shikonin effectively alleviated brain leakage of Evans blue, up-regulated claudin-5 expression, and inhibited the over-expressed MMP-9 in ischemic brain. These results suggested that shikonin effectively protected brain against ischemic damage by regulating inflammatory responses and ameliorating BBB permeability.     

Derivation of Injury-Responsive Dendritic Cells for Acute Brain Targeting and Therapeutic Protein Delivery in the Stroke-Injured Rat

Research with experimental stroke models has identified a wide range of therapeutic proteins that can prevent the brain damage caused by this form of acute neurological injury. Despite this, we do not yet have safe and effective ways to deliver therapeutic proteins to the injured brain, and this remains a major obstacle for clinical translation. Current targeted strategies typically involve invasive neurosurgery, whereas systemic approaches produce the undesirable outcome of non-specific protein delivery to the entire brain, rather than solely to the injury site. As a potential way to address this, we developed a protein delivery system modeled after the endogenous immune cell response to brain injury. Using ex-vivo-engineered dendritic cells (DCs), we find that these cells can transiently home to brain injury in a rat model of stroke with both temporal and spatial selectivity. We present a standardized method to derive injury-responsive DCs from bone marrow and show that injury targeting is dependent on culture conditions that maintain an immature DC phenotype. Further, we find evidence that when loaded with therapeutic cargo, cultured DCs can suppress initial neuron death caused by an ischemic injury. These results demonstrate a non-invasive method to target ischemic brain injury and may ultimately provide a way to selectively deliver therapeutic compounds to the injured brain.     

Enhanced neurogenesis and cell migration following focal ischemia and peripheral stimulation in mice

Peripheral stimulation and physical therapy can promote neurovascular plasticity and functional recovery after CNS disorders such as ischemic stroke. Using a rodent model of whisker-barrel cortex stroke, we have previously demonstrated that whisker activity promotes angiogenesis in the penumbra of the ischemic barrel cortex. This study explored the potential of increased peripheral activity to promote neurogenesis and neural progenitor migration toward the ischemic barrel cortex. Three days after focal barrel cortex ischemia in adult mice, whiskers were manually stimulated (15 min x 3 times/day) to enhance afferent signals to the ischemic barrel cortex. 5-Bromo-2'-deoxyuridine (BrdU, i.p.) was administered once daily to label newborn cells. At 14 days after stroke, whisker stimulation significantly increased vascular endothelial growth factor and stromal-derived factor-1 expression in the penumbra. The whisker stimulation animals showed increased doublecortin (DCX) positive and DCX/BrdU-positive cells in the ipsilateral corpus of the white matter but no increase in BrdU-positive cells in the subventricular zone, suggesting a selective effect on neuroblast migration. Neurogenesis indicated by neuronal nuclear protein and BrdU double staining was also enhanced by whisker stimulation in the penumbra at 30 days after stroke. Local cerebral blood flow was better recovered in mice that received whisker stimulation. It is suggested that the enriched microenvironment created by specific peripheral stimulation increases regenerative responses in the postischemic brain and may benefit long-term functional recovery from ischemic stroke.     

Synthetic Oligodeoxynucleotides Containing Multiple Telemeric TTAGGG Motifs Suppress Inflammasome Activity in Macrophages Subjected to Oxygen and Glucose Deprivation and Reduce Ischemic Brain Injury in Stroke-Prone Spontaneously Hypertensive Rats

The immune system plays a fundamental role in both the development and pathobiology of stroke. Inflammasomes are multiprotein complexes that have come to be recognized as critical players in the inflammation that ultimately contributes to stroke severity. Inflammasomes recognize microbial and host-derived danger signals and activate caspase-1, which in turn controls the production of the pro-inflammatory cytokine IL-1β. We have shown that A151, a synthetic oligodeoxynucleotide containing multiple telemeric TTAGGG motifs, reduces IL-1β production by activated bone marrow derived macrophages that have been subjected to oxygen-glucose deprivation and LPS stimulation. Further, we demonstrate that A151 reduces the maturation of caspase-1 and IL-1β, the levels of both the iNOS and NLRP3 proteins, and the depolarization of mitochondrial membrane potential within such cells. In addition, we have demonstrated that A151 reduces ischemic brain damage and NLRP3 mRNA levels in SHR-SP rats that have undergone permanent middle cerebral artery occlusion. These findings clearly suggest that the modulation of inflammasome activity via A151 may contribute to a reduction in pro-inflammatory cytokine production by macrophages subjected to conditions that model brain ischemia and modulate ischemic brain damage in an animal model of stroke. Therefore, modulation of ischemic pathobiology by A151 may have a role in the development of novel stroke prevention and therapeutic strategies.     

Peripheral administration of human adrenomedullin and its binding protein attenuates stroke-induced apoptosis and brain injury in rats

Stroke is a leading cause of death and the primary medical cause of acquired adult disability worldwide. The progressive brain injury after acute stroke is partly mediated by ischemia-elicited inflammatory responses. The vasoactive hormone adrenomedullin (AM), upregulated under various inflammatory conditions, counterbalances inflammatory responses. However, regulation of AM activity in ischemic stroke remains largely unknown. Recent studies have demonstrated the presence of a specific AM binding protein (that is, AMBP-1) in mammalian blood. AMBP-1 potentiates AM biological activities. Using a rat model of focal cerebral ischemia induced by permanent middle cerebral artery occlusion (MCAO), we found that plasma levels of AM increased significantly, whereas plasma levels of AMBP-1 decreased significantly after stroke. When given peripherally early after MCAO, exogenous human AM in combination with human AMBP-1 reduced brain infarct volume 24 and 72 h after MCAO, an effect not observed after the treatment by human AM or human AMBP-1 alone. Furthermore, treatment of human AM/AMBP-1 reduced neuron apoptosis and morphological damage, inhibited neutrophil infiltration in the brain and decreased serum levels of S100B and lactate. Thus, human AM/AMBP-1 has the ability to reduce stroke-induced brain injury in rats. AM/AMBP-1 can be developed as a novel therapeutic agent for patients with ischemic stroke.