Abstract

Aortic aneurism open repair surgery can cause spinal cord (SC) injury with 5–15% of patients developing paraparesis or paraplegia. Using a mouse model of transient aortic cross-clamping (ACC), we have previously found that the expression of proinflammatory microRNA miR-155 increases in motoneurons (MNs) and endothelial cells (ECs) of ischemic SCs, and that global miR-155 deletion decreases the percentage of paraplegia by 37.4% at 48-h post-ACC. Here, we investigated the cell-specific contribution of miR-155 in choline acetyltransferase-positive (ChAT+) neurons (that include all MNs of the SC) and ECs to SC injury after ACC. Mice lacking miR-155 in ChAT+ neurons (MN-miR-155-KO mice) developed 24.6% less paraplegia than control mice at 48-h post-ACC. In contrast, mice lacking miR-155 in ECs (ECs-miR-155-KO mice) experienced the same percentage of paraplegia as control mice, despite presenting smaller central cord edema. Unexpectedly, mice overexpressing miR-155 in ChAT+ neurons were less likely than control mice to develop early paraplegia during the first day post-ACC, however they reached the same percentage of paraplegia at 48-h. In addition, all mice overexpressing miR-155 in ECs (ECs-miR-155-KI mice) were paraplegic at 48-h post-ACC. Altogether, our results suggest that miR-155 activity in ChAT+ neurons protects the SC against ischemic injury during the first day post-ACC before becoming deleterious during the second day, which indicates that early and late paraplegias arise from different molecular malfunctions. These results point to the need to develop specific protective therapeutics aimed at inhibiting both the early and late deleterious events after open repair surgery of aortic aneurisms.

Highlights

  • MATERIALS AND METHODSDuring thoracic-abdominal aortic aneurysm (TAAA) open chest repair (OR) surgery, the transient aortic occlusion due to aortic cross-clamping (ACC) creates a situation of acute hypoxia followed by rapid reperfusion in the spinal cord (SC), causing SC injury and paraplegia in about 5–10% of cases depending on the extent of aortic aneurism and duration of the procedure (Coselli et al, 2016, 2019; Moulakakis et al, 2018)

  • To dissociate the specific role of MNs and endothelial cells (ECs) within the neurovascular unit and the effects that miR-155 has in both cell types, we developed knock-out (KO) mice that lack the expression of miR-155 in choline acetyltransferase-positive (ChAT+) neurons, that include all MNs of the SC (MN-miR155-KO), or in ECs (EC-miR-155-KO), as well as knock-in (KI) mice that overexpress miR-155 in ChAT+ neurons (MN-miR-155-KI) or ECs (EC-miR-155-KI)

  • We have previously reported that miR-155 is primarily upregulated in MNs and ECs of the SC of mice that undergo ACC-induced paraplegia, defined as the complete loss of capability to move their hindlimbs and tail, and that mice with global deletion for miR-155 showed 37.4% less paraplegia than WT mice (Awad et al, 2018)

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Summary

MATERIALS AND METHODS

During thoracic-abdominal aortic aneurysm (TAAA) open chest repair (OR) surgery, the transient aortic occlusion due to aortic cross-clamping (ACC) creates a situation of acute hypoxia followed by rapid reperfusion in the spinal cord (SC), causing SC injury and paraplegia in about 5–10% of cases depending on the extent of aortic aneurism and duration of the procedure (Coselli et al, 2016, 2019; Moulakakis et al, 2018). We have previously shown that the expression of proinflammatory microRNA miR-155 (a.k.a. miR-155-5p) increases sharply in the SC of wild-type (WT) mice that experience paraplegia after ACC, as compared with non-paraplegic mice (Awad et al, 2018). This upregulation was primarily in motoneurons (MNs) and endothelial cells (ECs) of the SC. The percentages of fully paraplegic mice of different genotypes were compared using both a Chi-square test and a Fisher exact test.

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