Abstract

Background: Blood-brain barrier (BBB) breakdown, reactive astrogliosis, and myelin losses are the key features of vascular contributions to cognitive impairment and dementia (VCID). However, the molecular and cellular mechanisms underlying VCID are not well understood. Stimulation of Na-K-Cl cotransport 1 (NKCC1) and its downstream kinase SPAK (the STE20/SPS1-related proline/alanine-rich kinase) causes intracellular Na + overload, astrocytic hypertrophy, and swelling. In this study, we investigated the effect of SPAK inhibitor ZT-1a on bilateral carotid artery stenosis (BCAS)-mediated reactive astrogliosis, BBB breakdown, demyelination, and cerebral blood flow (CBF) in mice. Methods: BCAS was induced in male mice using two metal microcoils twined around both carotid arteries. Sham or BCAS mice receiving vehicle or a selective SPAK inhibitor ZT-1a were monitored for changes in CBF by laser speckle imaging and cognitive functions by the novel object recognition test. Expression of NKCC1 and BBB proteins, reactive astrogliosis, and demyelination were examined by immunofluorescence staining. Results: BCAS mice exhibited sustained CBF reduction and cognitive function deficits along with significant demyelination in corpus callosum and external capsule 8 weeks after BCAS procedure. Compared to sham mice, the BCAS mice showed increased NKCC1 expression in GFAP + astrocytes, reduced expression of ZO-1 and Claudin-5 in GLUT1 + endothelial cells, decreased APC + mature oligodendrocyte and NG2 + oligodendrocyte progenitor cells. Interestingly, delayed administration of ZT-1a (4-8 weeks post-BCAS) prevented BCAS-induced reactive astrogliosis, BBB breakdown, demyelination, and significantly improved CBF and cognitive functions. Conclusion: Our study demonstrates that BCAS-induced stimulation of NKCC1 involves in reactive astrogliosis, BBB breakdown, OL death, and cognitive impairment. Inhibition of the SPAK-NKCC1 cascade by pharmacological inhibitor has therapeutic potential for VCID therapy. This research was supported by NIH R01 166199 Grant (M.I.H.B.).

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