Abstract

Cyclophilin D (CypD) has been shown to play a critical role in mitochondrial permeability transition pore (mPTP) opening and the subsequent cell death cascade. Studies consistently demonstrate that mitochondrial dysfunction, including mitochondrial calcium overload and mPTP opening, is essential to the pathobiology of cell death after a traumatic brain injury (TBI). CypD inhibitors, such as cyclosporin A (CsA) or NIM811, administered following TBI, are neuroprotective and quell neurological deficits. However, some pharmacological inhibitors of CypD have multiple biological targets and, as such, do not directly implicate a role for CypD in arbitrating cell death after TBI. Here, we reviewed the current understanding of the role CypD plays in TBI pathobiology. Further, we directly assessed the role of CypD in mediating cell death following TBI by utilizing mice lacking the CypD encoding gene Ppif. Following controlled cortical impact (CCI), the genetic knockout of CypD protected acute mitochondrial bioenergetics at 6 h post-injury and reduced subacute cortical tissue and hippocampal cell loss at 18 d post-injury. The administration of CsA following experimental TBI in Ppif-/- mice improved cortical tissue sparing, highlighting the multiple cellular targets of CsA in the mitigation of TBI pathology. The loss of CypD appeared to desensitize the mitochondrial response to calcium burden induced by TBI; this maintenance of mitochondrial function underlies the observed neuroprotective effect of the CypD knockout. These studies highlight the importance of maintaining mitochondrial homeostasis after injury and validate CypD as a therapeutic target for TBI. Further, these results solidify the beneficial effects of CsA treatment following TBI.

Highlights

  • We found that brain mitochondria derived from the Cyclophilin D (CypD) knockout buffered higher calcium levels compared to mitochondria from WT mice, confirming previous research

  • The results of this study uncovered the role of CypD in the pathophysiology of traumatic brain injury (TBI), in which CypD-dependent cell death mechanisms have been implicated due to intracellular

  • We presented data that demonstrates that genetic ablation of CypD is neuroprotective following TBI

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Summary

Introduction

Secondary Mitochondrial Cascades in Traumatic Brain Injury. Traumatic brain injury (TBI) is a major health concern that affects significant numbers of people worldwide. According to the Centers for Disease Control and Prevention (CDC), in the United States alone, there are an estimated 3 million TBI-related emergency department visits, hospitalizations, and deaths yearly [1]. There are no current approved treatments for TBI due to the complexity of the secondary injury cascade following primary head injury. Known as the “powerhouse” of the cell, mitochondria are critical in regulating cellular energy homeostasis, redox balance, calcium buffering, and cell death [2]. In the secondary phase of brain injury, there is a bioenergetic collapse resulting from disrupted intracellular calcium homeostasis and increases in oxidative stress.

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