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Ischemic preconditioning provides long-lasting neuroprotection against ischemic stroke: The role of Nrf2.
Experimental Neurology ( IF 4.6 ) Pub Date : 2019-12-05 , DOI: 10.1016/j.expneurol.2019.113142
Tuo Yang 1 , Yang Sun 1 , Qianqian Li 1 , Senmiao Li 1 , Yejie Shi 1 , Rehana K Leak 2 , Jun Chen 3 , Feng Zhang 1
Affiliation  

BACKGROUND AND PURPOSE A major gap in the field of ischemic preconditioning (IPC) is whether or not long-lasting neuroprotection can be achieved. Moreover, the specific mechanisms underlying IPC and how they can be translated into the clinic remain uncertain. To fill these gaps, we tested the hypothesis that IPC exerts long-lasting structural and functional neuroprotection against ischemic stroke through the master gatekeeper of antioxidant defenses, nuclear factor erythroid 2-related factor 2 (Nrf2). We also tested whether the brain could be pharmaceutically preconditioned with a potent and blood-brain barrier-permeable Nrf2 activator, 2-cyano-3,12-dioxo-oleana-1,9(11)-dien-28-trifluoethyl amide (CDDO-TFEA). METHODS IPC was induced by transient middle cerebral artery occlusion (MCAO) for 12 min, and ischemic stroke was generated by MCAO for 60 min in wild-type (WT) or Nrf2 knockout (KO) mice. Sensorimotor function, learning/memory skills, and brain tissue loss were measured up to 35 days after stroke. Primary rodent cortical neurons from wildtype (WT) and Nrf2 KO mice were subjected to lethal oxygen-glucose deprivation (OGD) or a brief OGD episode as a preconditioning (PC) stimulus before OGD. Cell viability/death, lipid electrophile generation, and Nrf2 activation were measured. CDDO-TFEA or its vehicle was administered in vivo for three consecutive days before MCAO. Tissue loss and neurological tests were performed 35 days after stroke. RESULTS IPC significantly reduced sensorimotor deficits, post-stroke cognitive impairments, and brain tissue loss, 35 days after MCAO in WT mice. These enduring protective effects of IPC were inhibited in Nrf2 KO mice. In neuronal cultures, PC also endowed primary neurons with ischemic tolerance against OGD-induced cell death, an effect that was abolished by loss of Nrf2 expression in KO neurons. PC induced the generation of low levels of lipid electrophiles and led to activation of the Nrf2 pathway. The mechanism underlying IPC may be translatable, as exogenous administration of the Nrf2 activator CDDO-TFEA significantly reduced neurological dysfunction and ischemic brain damage after MCAO. CONCLUSIONS IPC provides long-lasting neuroprotection against ischemic brain injury and post-stroke cognitive dysfunction. Nrf2 activation plays a key role in this beneficial outcome and is a promising therapeutic target for the attenuation of ischemic brain injury.

中文翻译:

缺血预处理可提供针对缺血性卒中的持久神经保护作用:Nrf2的作用。

背景和目的在缺血预处理(IPC)领域中的主要差距是能否实现长期的神经保护。此外,IPC的具体机制以及如何将其转化为临床仍然不确定。为了填补这些空白,我们测试了以下假设:IPC通过抗氧化剂防御的主要守门人核因子红系2相关因子2(Nrf2)对缺血性中风发挥持久的结构和功能性神经保护作用。我们还测试了大脑是否可以用强效且血脑屏障可渗透的Nrf2活化剂,2-氰基-3,12-二氧代-oleana-1,9(11)-dien-28-三氟乙酰胺(CDDO)进行药物预处理。 -TFEA)。方法通过短暂性大脑中动脉闭塞(MCAO)诱导IPC 12分钟,MCAO在野生型(WT)或Nrf2基因敲除(KO)小鼠中产生了60分钟的缺血性中风。在中风后最多35天测量感觉运动功能,学习/记忆技能和脑组织损失。在OGD之前,对野生型(WT)和Nrf2 KO小鼠的主要啮齿动物皮层神经元进行致命的氧-葡萄糖剥夺(OGD)或短暂的OGD发作作为预处理(PC)刺激。测量了细胞活力/死亡,亲脂脂质的产生和Nrf2的激活。在MCAO之前,连续三天在体内施用CDDO-TFEA或其媒介物。脑卒中后35天进行组织丢失和神经系统检查。结果IPC显着降低了WT小鼠MCAO后35天的感觉运动缺陷,中风后认知障碍和脑组织丢失。IPC的这些持久保护作用在Nrf2 KO小鼠中被抑制。在神经元文化中,PC还赋予原代神经元对OGD诱导的细胞死亡的缺血耐受性,这种作用因KO神经元中Nrf2表达的丧失而被取消。PC诱导生成低水平的亲脂性脂质,并导致Nrf2途径的激活。IPC的潜在机制可能是可翻译的,因为外源性施用Nrf2激活剂CDDO-TFEA可显着降低MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。在神经元文化中,PC还赋予原代神经元对OGD诱导的细胞死亡的缺血耐受性,这种作用因KO神经元中Nrf2表达的丧失而被取消。PC诱导生成低水平的亲脂性脂质,并导致Nrf2途径的激活。IPC的潜在机制可能是可翻译的,因为外源性施用Nrf2激活剂CDDO-TFEA可显着降低MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。在神经元文化中,PC还赋予原代神经元对OGD诱导的细胞死亡的缺血耐受性,这种作用因KO神经元中Nrf2表达的丧失而被取消。PC诱导生成低水平的亲脂性脂质,并导致Nrf2途径的激活。IPC的潜在机制可能是可翻译的,因为外源给予Nrf2激活剂CDDO-TFEA可以显着降低MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。KO神经元中Nrf2表达的丧失消除了这种作用。PC诱导生成低水平的亲脂性脂质,并导致Nrf2途径的激活。IPC的潜在机制可能是可翻译的,因为外源性施用Nrf2激活剂CDDO-TFEA可显着降低MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。KO神经元中Nrf2表达的丧失消除了这种作用。PC诱导生成低水平的亲脂性脂质,并导致Nrf2途径的激活。IPC的潜在机制可能是可翻译的,因为外源性施用Nrf2激活剂CDDO-TFEA可显着降低MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。Nrf2激活剂CDDO-TFEA的外源给药显着降低了MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。Nrf2激活剂CDDO-TFEA的外源给药显着降低了MCAO后的神经功能障碍和缺血性脑损伤。结论IPC对缺血性脑损伤和中风后认知功能障碍提供了长期的神经保护作用。Nrf2激活在这一有益的结果中起关键作用,并且是减轻缺血性脑损伤的有希望的治疗靶标。
更新日期:2019-12-05
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