Abstract 16: Integrin α9β1 and VCAM-1 Interaction Promotes Neutrophil Hyperactivation and Cognitive Decline Following Subarachnoid Hemorrhage

Abstract

Background: Integrin α9β1 is a transmembrane glycoprotein that is highly expressed on neutrophils and mediates transendothelial migration via vascular cell adhesion molecule-1 (VCAM-1). Neutrophils are major contributors to cerebral thrombosis and oxidative stress following subarachnoid hemorrhage (SAH); however, the mechanism by which neutrophil integrin α9 contributes to SAH pathogenesis is unclear. Here, we evaluated the mechanistic role of neutrophil integrin α9 in the post-SAH sensorimotor and cognitive recovery. Methods: SAH was induced by filament perforation in neutrophil-specific α9 -/- (α9 fl/fl Mrp8Cre +/- ) mice and littermate controls. Cognitive recovery (Y-maze, Barnes maze, and novel object recognition test) and sensorimotor recovery (modified neurological severity score, corner, and cylinder test) were performed for up to 4-weeks. Unbiased RNA sequencing (RNA-seq) was used to evaluate the potential mechanisms by which neutrophil integrin α9-VCAM-1 interactions promote SAH. Computational modeling, docking, virtual screening, and cell-free assays were used to identify small-molecule inhibitors of the integrin α9-VCAM-1 interactions. Results: Experimental SAH resulted in increased levels of neutrophil integrin α9 which was concomitant with neutrophil hyperactivation. Post-SAH neutrophil-specific α9 -/- mice exhibited improved sensorimotor and cognitive recovery, along with reduced plasma elastase and MPO levels and brain neutrophil infiltration. Mechanistically, integrin α9/VCAM-1 interactions promote neutrophil hyperactivation, extracellular signal-regulated kinase (ERK) phosphorylation, and endothelial cell apoptosis. RNA-seq data revealed that α9/VCAM-1 interactions promotes gene expression related to neutrophil inflammation, exocytosis, NF-κB signaling, and chemotaxis. Virtual screening and cell-free assay identified macitentan as a potent inhibitor of integrin α9-VCAM-1 interactions. In vitro, macitentan treatment decreased neutrophil adhesion to VCAM-1 and macitentan treatment at a dose of 5 mg/kg resulted in improved SAH outcomes. Conclusion: The results of this study describe a previously unrecognized pathway involving integrin α9 and VCAM-1 in the pathogenesis of SAH.