Abstract

BackgroundRemote ischemic preconditioning (RIPC) initiates endogenous protective pathways in the brain from a distance and represents a new, promising paradigm in neuroprotection against cerebral ischemia-reperfusion (I/R) injury. However, the underlying mechanism of RIPC-mediated cerebral ischemia tolerance is complicated and not well understood. We reported previously that preactivation of Notch1 mediated the neuroprotective effects of cerebral ischemic preconditioning in rats subjected to cerebral I/R injury. The present study seeks to further explore the role of crosstalk between the Notch1 and NF-κB signaling pathways in the process of RIPC-induced neuroprotection.MethodsMiddle cerebral artery occlusion and reperfusion (MCAO/R) in adult male rats and oxygen-glucose deprivation and reoxygenation (OGD/R) in primary hippocampal neurons were used as models of I/R injury in vivo and in vitro, respectively. RIPC was induced by a 3-day procedure with 4 cycles of 5 min of left hind limb ischemia followed by 5 min of reperfusion each day before MCAO/R. Intracerebroventricular DAPT injection and sh-Notch1 lentivirus interference were used to inhibit the Notch1 signaling pathway in vivo and in vitro, respectively. After 24 h of reperfusion, neurological deficit scores, infarct volume, neuronal apoptosis, and cell viability were assessed. The protein expression levels of NICD, Hes1, Phospho-IKKα/β (p-IKK α/β), Phospho-NF-κB p65 (p-NF-κB p65), Bcl-2, and Bax were assessed by Western blotting.ResultsRIPC significantly improved neurological scores and reduced infarct volume and neuronal apoptosis in rats subjected to I/R injury. OGD preconditioning significantly reduced neuronal apoptosis and improved cell viability after I/R injury on days 3 and 7 after OGD/R. However, the neuroprotective effect was reversed by DAPT in vivo and attenuated by Notch1-RNAi in vitro. RIPC significantly upregulated the expression of proteins related to the Notch1 and NF-κB pathways. NF-κB signaling pathway activity was suppressed by a Notch1 signaling pathway inhibitor and Notch1-RNAi.ConclusionsThe neuroprotective effect of RIPC against cerebral I/R injury was associated with preactivation of the Notch1 and NF-κB pathways in neurons. The NF-κB pathway is a downstream target of the Notch1 pathway in RIPC and helps protect focal cerebral I/R injury.

Highlights

  • Stroke remains a leading cause of death and disability worldwide, and few clinically approved treatments are available for its most common form, ischemic stroke

  • The infarct volume was reduced by 40.2% in the remote ischemic preconditioning (RIPC) + Middle cerebral artery occlusion and reperfusion (MCAO/R) group compared with the MCAO/R group (P < 0.01, Fig. 1b)

  • We found that MCAO/R injury increased the number of NeuN/TUNEL-positive cells in the hippocampus area, while RIPC significantly downregulated the proportion of NeuN/TUNEL-positive cells compared with that of the MCAO/R group

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Summary

Introduction

Stroke remains a leading cause of death and disability worldwide, and few clinically approved treatments are available for its most common form, ischemic stroke. Ischemic preconditioning (IPC) is considered an effective prophylactic treatment for ischemic stroke. Many basic and clinical studies have confirmed that IPC can produce a significant neuroprotective effect by initiating endogenous protective mechanisms, effectively reducing cerebral ischemia-reperfusion injury [1,2,3]. Numerous clinical trials in recent years have shown that RIPC can effectively induce cerebral ischemic tolerance, thereby reducing ischemia-reperfusion injury and improving patient prognosis. Understanding the mechanisms underlying RIPC-induced neuroprotection will help minimize ischemic brain injury. Remote ischemic preconditioning (RIPC) initiates endogenous protective pathways in the brain from a distance and represents a new, promising paradigm in neuroprotection against cerebral ischemia-reperfusion (I/R) injury. The underlying mechanism of RIPC-mediated cerebral ischemia tolerance is complicated and not well understood. The present study seeks to further explore the role of crosstalk between the Notch and NF-κB signaling pathways in the process of RIPC-induced neuroprotection

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