Blood-brain Barrier Breach Research Articles

Blood-brain barrier breach after acute cerebral hypoxia in infants

Background. Neuronal lesion, including hypoxic-ischemic damage to the central nervous system (CNS) in perinatal period, leads to the release of neuron-specific enolase (NSE) into peripheral bloodstream. Consequently, NSE can be considered as a biological marker of nervous system injury. Based on NSE level analysis, timely rehabilitation for newborns can be provided, thereby reducing the likelihood of complications associated with CNS injury.Objective: retrospective assessment of NSE level in peripheral blood over a 24-week period in infants of different gestational age with perinatal hypoxic-ischemic CNS damage.Material and methods. The study included 49 newborns who had suffered perinatal hypoxic-ischemic CNS lesion. Gestation period differed from 32 to 41 weeks. The control group consisted of 28 healthy full-term infants. NSE levels were measured using enzyme immunoassay. Patients of the main group were additionally divided into subgroups depending on Apgar scores at the 1st minute after birth, gestational age, as well as predominant CNS lesion – hemorrhagic with intraventricular hemorrhages or ischemic with periventricular leukomalacia.Results. Throughout the observation period, NSE concentrations were inversely correlated with Apgar scores: lower Apgar indicators were associated with higher NSE levels. In addition, the subgroup of 32–33-week gestational age had significantly higher NSE concentrations compared with 34–36-week, 37–41-week subgroups, and control group. NSE levels in infants with periventricular leukomalacia were consistently lower than those in newbornes with intraventricular hemorrhage starting from the 1st week. Notably, a delayed increase in serum NSE concentrations was observed at the 4th week.Conclusion. The obtained data indicate that blood-brain barrier permeability for NSE is preserved during perinatal hypoxicischemic CNS injury. Serum NSE concentration measurement can serve as a valuable tool in clinical practice for assessing the effectiveness of therapy at the stages of treatment and rehabilitation.

Analysis of ischemic stroke-mediated effects on blood–brain barrier properties along the arteriovenous axis assessed by intravital two-photon imaging

Early breach of the blood–brain barrier (BBB) and consequently extravasation of blood-borne substances into the brain parenchyma is a common hallmark of ischemic stroke. Although BBB breakdown is associated with an increased risk of cerebral hemorrhage and poor clinical prognosis, the cause and mechanism of this process are largely unknown. The aim of this study was to establish an imaging and analysis protocol which enables investigation of the dynamics of BBB breach in relation to hemodynamic properties along the arteriovenous axis. Using longitudinal intravital two-photon imaging following photothrombotic induction of ischemic stroke through a cranial window, we were able to study the response of the cerebral vasculature to ischemia, from the early critical hours to the days/weeks after the infarct. We demonstrate that disruption of the BBB and hemodynamic parameters, including perturbed blood flow, can be studied at single-vessel resolution in the three-dimensional space as early as 30 min after vessel occlusion. Further, we show that this protocol permits longitudinal studies on the response of individual blood vessels to ischemia over time, thus enabling detection of (maladaptive) vascular remodeling such as intussusception, angiogenic sprouting and entanglement of vessel networks. Taken together, this in vivo two-photon imaging and analysis protocol will be useful in future studies investigating the molecular and cellular mechanisms, and the spatial contribution, of BBB breach to disease progression which might ultimately aid the development of new and more precise treatment strategies for ischemic stroke.

Understanding the link between neurotropic viruses, BBB permeability, and MS pathogenesis.

Neurotropic viruses can infiltrate the CNS by crossing the blood-brain barrier (BBB) through various mechanisms including paracellular, transcellular, and "Trojan horse" mechanisms during leukocyte diapedesis. These viruses belong to several families, including retroviruses; human immunodeficiency virus type 1 (HIV-1), flaviviruses; Japanese encephalitis (JEV); and herpesviruses; herpes simplex virus type 1 (HSV-1), Epstein-Barr virus (EBV), and mouse adenovirus 1 (MAV-1). For entering the brain, viral proteins act upon the tight junctions (TJs) between the brain microvascular endothelial cells (BMECs). For instance, HIV-1 proteins, such as glycoprotein 120, Nef, Vpr, and Tat, disrupt the BBB and generate a neurotoxic effect. Recombinant-Tat triggers amendments in the BBB by decreasing expression of the TJ proteins such as claudin-1, claudin-5, and zona occludens-1 (ZO-1). Thus, the breaching of BBB has been reported in myriad of neurological diseases including multiple sclerosis (MS). Neurotropic viruses also exhibit molecular mimicry with several myelin sheath proteins, i.e., antibodies against EBV nuclear antigen 1 (EBNA1) aa411-426 cross-react with MBP and EBNA1 aa385-420 was found to be associated with MS risk haplotype HLA-DRB1*150. Notably, myelin protein epitopes (PLP139-151, MOG35-55, and MBP87-99) are being used to generate model systems for MS such as experimental autoimmune encephalomyelitis (EAE) to understand the disease mechanism and therapeutics. Viruses like Theiler's murine encephalomyelitis virus (TMEV) are also commonly used to generate EAE. Altogether, this review provide insights into the viruses' association with BBB leakiness and MS along with possible mechanistic details which could potentially use for therapeutics.

Pericytes are protective in experimental pneumococcal meningitis through regulating leukocyte infiltration and blood–brain barrier function

BackgroundBrain pericytes participate in the regulation of cerebral blood flow and the maintenance of blood–brain barrier integrity. Because of their perivascular localization, their receptor repertoire, and their potential ability to respond to inflammatory and infectious stimuli by producing various cytokines and chemokines, these cells are also thought to play an active role in the immune response to brain infections. This assumption is mainly supported by in vitro studies, investigations in in vivo disease models are largely missing. Here, we analysed the role of brain pericytes in pneumococcal meningitis, in vitro and in vivo in two animal models of pneumococcal meningitis.MethodsPrimary murine and human pericytes were stimulated with increasing concentrations of different serotypes of Streptococcus pneumoniae in the presence or absence of Toll-like receptor inhibitors and their cell viability and cytokine production were monitored. To gain insight into the role of pericytes in brain infection in vivo, we performed studies in a zebrafish embryo model of pneumococcal meningitis in which pericytes were pharmacologically depleted. Furthermore, we analyzed the impact of genetically induced pericyte ablation on disease progression, intracranial complications, and brain inflammation in an adult mouse model of this disease.ResultsBoth murine and human pericytes reacted to pneumococcal exposure with the release of selected cytokines. This cytokine release is pneumolysin-dependent, TLR-dependent in murine (but not human) pericytes and can be significantly increased by macrophage-derived IL-1b. Pharmacological depletion of pericytes in zebrafish embryos resulted in increased cerebral edema and mortality due to pneumococcal meningitis. Correspondingly, in an adult mouse meningitis model, a more pronounced blood–brain barrier disruption and leukocyte infiltration, resulting in an unfavorable disease course, was observed following genetic pericyte ablation. The degree of leukocyte infiltration positively correlated with an upregulation of chemokine expression in the brains of pericyte-depleted mice.ConclusionsOur findings show that pericytes play a protective role in pneumococcal meningitis by impeding leukocyte migration and preventing blood–brain barrier breaching. Thus, preserving the integrity of the pericyte population has the potential as a new therapeutic strategy in pneumococcal meningitis.

Head Kinematics, Blood Biomarkers, and Histology in Large Animal Models of Traumatic Brain Injury and Hemorrhagic Shock.

Traumatic brain injury (TBI) and severe blood loss resulting in hemorrhagic shock (HS) are each leading causes of mortality and morbidity worldwide, and present additional treatment considerations when they are comorbid (TBI+HS) as a result of competing pathophysiological responses. The current study rigorously quantified injury biomechanics with high precision sensors and examined whether blood-based surrogate markers were altered in general trauma as well as post-neurotrauma. Eighty-nine sexually mature male and female Yucatan swine were subjected to a closed-head TBI+HS (40% of circulating blood volume; n = 68), HS only (n = 9), or sham trauma (n = 12). Markers of systemic (e.g., glucose, lactate) and neural functioning were obtained at baseline, and at 35 and 295 min post-trauma. Opposite and approximately twofold differences existed for both magnitude (device > head) and duration (head > device) of quantified injury biomechanics. Circulating levels of neurofilament light chain (NfL), glial fibrillary acidic protein (GFAP), and ubiquitin C-terminal hydrolase L1 (UCH-L1) demonstrated differential sensitivity for both general trauma (HS) and neurotrauma (TBI+HS) relative to shams in a temporally dynamic fashion. GFAP and NfL were both strongly associated with changes in systemic markers during general trauma and exhibited consistent time-dependent changes in individual sham animals. Finally, circulating GFAP was associated with histopathological markers of diffuse axonal injury and blood-brain barrier breach, as well as variations in device kinematics following TBI+HS. Current findings therefore highlight the need to directly quantify injury biomechanics with head mounted sensors and suggest that GFAP, NfL, and UCH-L1 are sensitive to multiple forms of trauma rather than having a single pathological indication (e.g., GFAP = astrogliosis).

Neutrophils as a potential therapeutic target in Alzheimer's disease.

Alzheimer's disease (AD) is the leading cause of dementia in the United States. Sporadic or late-onset AD remains incompletely understood, with age as the current greatest risk factor. Inflammation in general and neutrophils, a potent mediator of inflammation, have been shown to exacerbate AD associated dementia. This review explores the latest research on neutrophils in AD mouse models and in human cohort studies and discusses current gaps in research and needs for future studies. AD mouse models have shown neutrophil chemotactic migration towards amyloid beta plaques in the brain. Capillary blood flow stalling decreases blood perfusion to associated brain regions and mouse studies have demonstrated that anti-Ly6G antibodies lead to a decrease in capillary blood flow stalling and memory improvement. Several recent transcriptomic studies of blood and brain tissue from persons with AD have shown an upregulation in neutrophil-related genes, and studies have demonstrated neutrophil involvement in brain capillary adhesion, blood brain barrier breaching, myeloperoxidase release, and the propensity for neutrophil extracellular trap release in AD. Neutrophil-derived inflammation and regulation are a potential potent novel therapeutic target for AD progression. Future studies should further investigate neutrophil functionality in AD. In addition, other aspects of AD that may impact neutrophils including the microbiome and the APOE4 allele should be studied.

Secondary Degeneration of Oligodendrocyte Precursor Cells Occurs as Early as 24 h after Optic Nerve Injury in Rats.

Optic nerve injury causes secondary degeneration, a sequela that spreads damage from the primary injury to adjacent tissue, through mechanisms such as oxidative stress, apoptosis, and blood-brain barrier (BBB) dysfunction. Oligodendrocyte precursor cells (OPCs), a key component of the BBB and oligodendrogenesis, are vulnerable to oxidative deoxyribonucleic acid (DNA) damage by 3 days post-injury. However, it is unclear whether oxidative damage in OPCs occurs earlier at 1 day post-injury, or whether a critical 'window-of-opportunity' exists for therapeutic intervention. Here, a partial optic nerve transection rat model of secondary degeneration was used with immunohistochemistry to assess BBB dysfunction, oxidative stress, and proliferation in OPCs vulnerable to secondary degeneration. At 1 day post-injury, BBB breach and oxidative DNA damage were observed, alongside increased density of DNA-damaged proliferating cells. DNA-damaged cells underwent apoptosis (cleaved caspase3+), and apoptosis was associated with BBB breach. OPCs experienced DNA damage and apoptosis and were the major proliferating cell type with DNA damage. However, the majority of caspase3+ cells were not OPCs. These results provide novel insights into acute secondary degeneration mechanisms in the optic nerve, highlighting the need to consider early oxidative damage to OPCs in therapeutic efforts to limit degeneration following optic nerve injury.

Flufenamic acid improves survival and neurologic outcome after successful cardiopulmonary resuscitation in mice

BackgroundBrain injury is the main cause of high mortality and disability after successful cardiopulmonary resuscitation (CPR) from sudden cardiac arrest (CA). The transient receptor potential M4 (TRPM4) channel is a novel target for ameliorating blood–brain barrier (BBB) disruption and neuroinflammation. Herein, we tested whether flufenamic acid (FFA), which is reported to block TRPM4 with high potency, could confer neuroprotection against brain injury secondary to CA/CPR and whether its action was exerted by blocking the TRPM4 channel.MethodsWild-type (WT) and Trpm4 knockout (Trpm4−/−) mice subjected to 10-min CA/CPR were randomized to receive FFA or vehicle once daily. Post-CA/CPR brain injuries including neurologic deficits, survival rate, histological damage, edema formation, BBB destabilization and neuroinflammation were assessed.ResultsIn WT mice subjected to CA/CPR, FFA was effective in improving survival and neurologic outcome, reducing neuropathological injuries, attenuating brain edema, lessening the leakage of IgG and Evans blue dye, restoring tight junction protein expression and promoting microglia/macrophages from the pro-inflammatory subtype toward the anti-inflammatory subtype. In comparison to WT mice, Trpm4−/− mice exhibited less neurologic deficiency, milder histological impairment, more BBB integrity and more anti-inflammatory microglia/macrophage polarization. As expected, FFA did not provide a benefit of superposition compared with vehicle in the Trpm4−/− mice after CA/CPR.ConclusionsFFA mitigates BBB breach and modifies the functional status of microglia/macrophages, thereby improving survival and neurologic deficits following CA/CPR. The neuroprotective effects occur at least partially by interfering with the TRPM4 channel in the neurovascular unit. These results indicate the significant clinical potential of FFA to improve the prognosis for CA victims who are successfully resuscitated.

Limbic Responses Following Shock Wave Exposure in Male and Female Mice.

Blast traumatic brain injury (bTBI) presents a serious threat to military personnel and often results in psychiatric conditions related to limbic system dysfunction. In this study, the functional outcomes for anxiety- and depressive-like behaviors and neuronal activation were evaluated in male and female mice after exposure to an Advanced Blast Simulator (ABS) shock wave. Mice were placed in a ventrally exposed orientation inside of the ABS test section and received primary and tertiary shock wave insults of approximately 15 psi peak pressure. Evans blue staining indicated cases of blood-brain barrier breach in the superficial cerebral cortex four, but not 24 h after blast, but the severity was variable. Behavioral testing with the elevated plus maze (EPM) or elevated zero maze (EZM), sucrose preference test (SPT), and tail suspension test (TST) or forced swim test (FST) were conducted 8 days–3.5 weeks after shock wave exposure. There was a sex difference, but no injury effect, for distance travelled in the EZM where female mice travelled significantly farther than males. The SPT and FST did not indicate group differences; however, injured mice were less immobile than sham mice during the TST; possibly indicating more agitated behavior. In a separate cohort of animals, the expression of the immediate early gene, c-Fos, was detected 4 h after undergoing bTBI or sham procedures. No differences in c-Fos expression were found in the cerebral cortex, but female mice in general displayed enhanced c-Fos activation in the paraventricular nucleus of the thalamus (PVT) compared to male mice. In the amygdala, more c-Fos-positive cells were observed in injured animals compared to sham mice. The observed sex differences in the PVT and c-Fos activation in the amygdala may correlate with the reported hyperactivity of females post-injury. This study demonstrates, albeit with mild effects, behavioral and neuronal activation correlates in female rodents after blast injury that could be relevant to the incidence of increased post-traumatic stress disorder in women.

A three-dimensional human brain spheroid model for studying sonoporation-induced drug penetration beyond the blood-brain barrier

Ultrasound (US)-targeted microbubble (MB) cavitation (UTMC) facilitates delivery of cell-impermeant drugs across the blood brain barrier (BBB). The effects of UTMC on extravascular cells, and the extent of payload penetration, are unknown. Spheroids were generated using neurons and astrocytes derived from human iPSCs, primary human brain- microglia, endothelial cells (ECs) and pericytes, and placed in a water tank with lipid MBs. US (1 MHz frequency, 250 kPa peak negative pressure, 10 μs pulse duration, 10 ms pulse interval) was delivered for 10 s. Immunostaining showed ECs and pericytes at the spheroid periphery, with high expression of membranous ZO-1. BBB functionality was confirmed with histamine treatment, which increased permeability to Texas red dextran (TRD) (28.8% increase, p = 0.0015). TRD penetrated up to 100 μm beyond the BBB upon UTMC (12% increase compared to 0 kPa control). Inhibition of endothelial nitric oxide synthase with L-NAME reduced UTMC-induced TRD penetration (19% decrease, p < 0.05). Sonoporation, as shown by uptake of propidium iodide, occurred in cells beyond the BBB. In our novel 3D spheroid model with intact BBB, UTMC caused nitric-oxide dependent BBB breach. This is the first report of UTMC causing “remote” sonoporation of cells not in direct contact with MBs and bears further study.

A Preliminary Report: The Hippocampus and Surrounding Temporal Cortex of Patients With Schizophrenia Have Impaired Blood-Brain Barrier.

Though hippocampal volume reduction is a pathological hallmark of schizophrenia, the molecular pathway(s) responsible for this degeneration remains unknown. Recent reports have suggested the potential role of impaired blood-brain barrier (BBB) function in schizophrenia pathogenesis. However, direct evidence demonstrating an impaired BBB function is missing. In this preliminary study, we used immunohistochemistry and serum immunoglobulin G (IgG) antibodies to investigate the state of BBB function in formalin-fixed postmortem samples from the hippocampus and surrounding temporal cortex of patients with schizophrenia (n = 25) and controls without schizophrenia (n = 27) matched for age, sex, and race. Since a functional BBB prevents the extravasation of IgGs, detection of IgGs in the parenchyma is used as direct evidence of BBB breakdown. We also developed a semi-quantitative approach to quantify the extent of IgG leak and therein BBB breach. Analysis of our immunohistochemistry data demonstrated a significantly higher incidence of IgG leak in patients with schizophrenia compared to controls. Further, BBB permeability was significantly higher in advanced-age patients with schizophrenia than both advanced-age controls and middle-aged patients with schizophrenia. Male patients with schizophrenia also demonstrated a significant increase in IgG permeability compared to control males. Interestingly, the extravasated IgGs also demonstrated selective immunoreactivity for neurons. Based on these observations, we suggest that BBB dysfunction and IgG autoantibodies could be two key missing pathoetiological links underwriting schizophrenia hippocampal damage.

17\u03b1-Ethinyl estradiol-3-sulfate increases survival and hemodynamic functioning in a large animal model of combined traumatic brain injury and hemorrhagic shock: a randomized control trial

BackgroundTraumatic brain injury (TBI) and severe blood loss resulting in hemorrhagic shock (HS) represent leading causes of trauma-induced mortality, especially when co-occurring in pre-hospital settings where standard therapies are not readily available. The primary objective of this study was to determine if 17α-ethinyl estradiol-3-sulfate (EE-3-SO4) increases survival, promotes more rapid cardiovascular recovery, or confers neuroprotection relative to Placebo following TBI + HS.MethodsAll methods were approved by required regulatory agencies prior to study initiation. In this fully randomized, blinded preclinical study, eighty (50% females) sexually mature (190.64 ± 21.04 days old; 28.18 ± 2.72 kg) Yucatan swine were used. Sixty-eight animals received a closed-head, accelerative TBI followed by removal of approximately 40% of circulating blood volume. Animals were then intravenously administered EE-3-SO4 formulated in the vehicle at 5.0 mg/mL (dosed at 0.2 mL/kg) or Placebo (0.45% sodium chloride solution) via a continuous pump (0.2 mL/kg over 5 min). Twelve swine were included as uninjured Shams to further characterize model pathology and replicate previous findings. All animals were monitored for up to 5 h in the absence of any other life-saving measures (e.g., mechanical ventilation, fluid resuscitation).ResultsA comparison of Placebo-treated relative to Sham animals indicated evidence of acidosis, decreased arterial pressure, increased heart rate, diffuse axonal injury and blood–brain barrier breach. The percentage of animals surviving to 295 min post-injury was significantly higher for the EE-3-SO4 (28/31; 90.3%) relative to Placebo (24/33; 72.7%) cohort. EE-3-SO4 also restored pulse pressure more rapidly post-drug administration, but did not confer any benefits in terms of shock index. Primary blood-based measurements of neuroinflammation and blood brain breach were also null, whereas secondary measurements of diffuse axonal injury suggested a more rapid return to baseline for the EE-3-SO4 group. Survival status was associated with biological sex (female > male), as well as evidence of increased acidosis and neurotrauma independent of EE-3-SO4 or Placebo administration.ConclusionsEE-3-SO4 is efficacious in promoting survival and more rapidly restoring cardiovascular homeostasis following polytraumatic injuries in pre-hospital environments (rural and military) in the absence of standard therapies. Poly-therapeutic approaches targeting additional mechanisms (increased hemostasis, oxygen-carrying capacity, etc.) should be considered in future studies.

Selective affinity of extravasated brain-reactive IgG autoantibodies for pyramidal neurons is linked to brain amyloid beta deposition, neuronal dysfunction, and cognitive decline.

Amyloid beta plaques (APs) containing amyloid beta peptides (Aβ), blood-brain barrier (BBB) breakdown, and progressive cognitive decline are hallmarks of Alzheimer's disease (AD) pathology. Pathophysiological changes that initiate and perpetuate these hallmarks remain unresolved. We hypothesize that chronic extravasation of immunoglobulin Gs (IgGs) and Aβ via chronically impaired BBB promotes their interaction with pyramidal neurons (PNs). This interaction impairs PN function, consequentially initiates and perpetuates these AD-associated hallmarks. We tested our hypothesis associating neurocognitive decline with BBB breakdown in humans and a mouse model. In humans, antemortem neurocognitive status and postmortem BBB breakdown in their Brodmann area 39/40 were analyzed [AD, mild cognitive impairment (MCI), and no cognitive impairment (NCI) subjects, n=15]. Additionally, we tested the association between chronic BBB compromise, Aβ injection, and long-term memory in CD1 mice (10 months, male, n=33) with Pertussis toxin (PT) injection-induced BBB breach. This mouse-model comprised three injection groups: Saline only, PT+Saline, and PT+Aβ42. We used the immunohistochemistry technique and image-analysis software to track and quantify the fate of blood-borne Aβ42 in mouse brain by injecting synthetic, fluorescent-tagged monomeric Aβ42 (F-Aβ42). We used Lashley's III Maze and Water Maze to evaluate the impact of BBB breach and Aβ42 injection on animals' long-term memory. Brodmann areas 39/40 of AD subjects showed a greater incidence and extent of BBB breach than MCI and NCI subjects. Cognitive test results demonstrating reduced cognitive function for Brodmann areas 39/40 correlated with the extent of BBB breach. Likewise, PT+Aβ42 mice exhibited increased BBB permeability and selectively heightened immunoreactivity between PNs and extravasated IgGs compared to other groups. Since these IgGs target "self" epitopes in the brain parenchyma, we refer to this subset of IgGs as brain-reactive autoantibodies (BrAbs). Additionally, in PT+Aβ42 mice, we observed intraneuronal accumulations of F-Aβ42 in cortical and hippocampal PNs and significant impairment in long-term memory. In AD pathogenesis, BBB compromise induces chronic extravasation of BrAbs and Aβ, an event that serves as a mechanistic link that initiates and perpetuates Aβ deposition in PNs. Deposition of Aβ may perturb PN function and lead to progressive cognitive decline.

Blood brain barrier dysfunction caused by repeated Endothelin-1 injection leads to irreversible memory impairment.

Vascular dysfunction is being increasingly recognized as a major contributor to dementia burden. Repeated occurrence of vascular insults in small vessels results in Blood Brain Barrier (BBB) dysfunction potentially contributing to cognitive impairments. The small vessel infracts is seen as white matter hyperintensities in MRI of many patients. Postmortem studies have shown BBB damage in dementia including AD and accumulation blood-derived proteins as well as loss of BBB associated cells like pericytes. In view of such a scenario we wanted to establish an animal model to study multiple small vessel insults impacting BBB leading to learning and memory deficits. C57/BL6J mice aged 4-5 months was implanted with cannula on left side of the hemisphere. ET-1 (Endothelin- 1), a 21 amino acid vasoconstricting peptide was infused through guide cannula into the intracerebroventricular space of lateral ventricle. Mice were injected for 3 doses of ET-1 at intervals of 3 weeks over a period of 9 weeks. The animals were assessed for associative learning and spatial memory deficits with different behavioral task. Animals were perfused and brain was processed for immunohistochemistry to assess vascular pathology. To simulate the clinical conditions the animals were injected over a period of three weeks to make sure that animal completely recovers from first vascular insult and then subsequent insults were given. There was BBB leakage, discrepancies in the blood vessel integrity and loss of pericytes after multiple ET-1 injection. Further there was significant memory deficits in novel object task, contextual fear conditioning test and Morris water maze. Our results demonstrated that chronic vascular insults cause BBB dysfunction and cognitive deficits seen as memory impairment. We were able to establish that repeated vasoconstriction by ET-1 in small vessels leads to BBB breach resulting in irreversible learning and memory deficits. This animal model could help us to study molecular underpinnings of white matter hyperintensities.

Abstract 13414: Studying Sonoporation-Induced Drug Payload Penetration Beyond the Blood-Brain Barrier Using Multi-Cellular Human Brain Spheroids

Introduction: Ultrasound-targeted microbubble cavitation ( UTMC ) facilitates delivery of cell-impermeant drugs across the endothelial barrier, such as the blood brain barrier ( BBB ) . Using cultured endothelial cell ( EC ) monolayers, we reported that UTMC causes sonoporation and inter-endothelial gaps, which may mediate vascular hyperpermeability, although mechanisms are incompletely understood. Further, the effects of UTMC on extravascular cells, and extent of payload penetration are unknown, as the monolayer does not recapitulate the 3D multicellular environment. Here, we established a 3D multicellular human brain spheroid model to study UTMC bioeffects and underlying mechanisms. Methods: Spheroids were generated using neurons and astrocytes derived from human iPSCs, primary human brain- microglia, ECs and pericytes, and placed in a water tank with lipid microbubbles ( MBs ). Ultrasound (1 MHz frequency, 250-500 kPa peak negative pressures, 10 μs pulse duration, 10 ms pulse interval) was delivered for 20 s and spheroids were immediately collected. Immunostaining was used to localize cell types; propidium iodide (PI) uptake to mark sonoporation; calcein-AM and sytox to detect cell viability; and Texas red dextran (TRD) (10 kDa) to quantify permeability, using confocal microscopy. Results: Immunostaining showed ECs and pericytes at the spheroid periphery, with high expression of membranous ZO-1. BBB functionality was confirmed with histamine treatment, which increased permeability to TRD (28.8% increase in TRD mean intensity, p =0.0015). Interestingly, PI uptake (sonoporation) occurred in cells beyond the BBB. TRD penetrated up to ~100 μm beyond the BBB upon UTMC (12.2% increase). Inhibition of endothelial nitric oxide synthase with L-NAME reduced UTMC-induced TRD penetration (19% decrease, p =0.0458). Conclusions: In this novel 3D human brain spheroid model with intact BBB, UTMC caused nitric-oxide dependent BBB breach. Moreover, this is the first report of UTMC causing “remote” sonoporation of cells not in direct contact with MBs, which bears further study. Our model allows the study of mechanisms mediating UTMC efficacy for targeted delivery of drugs across the endothelial barrier, which should facilitate its clinical translation.

Cordycepin confers long-term neuroprotection via inhibiting neutrophil infiltration and neuroinflammation after traumatic brain injury

BackgroundThe secondary injury caused by traumatic brain injury (TBI), especially white matter injury (WMI), is highly sensitive to neuroinflammation, which further leads to unfavored long-term outcomes. Although the cross-talk between the three active events, immune cell infiltration, BBB breakdown, and proinflammatory microglial/macrophage polarization, plays a role in the vicious cycle, its mechanisms are not fully understood. It has been reported that cordycepin, an extract from Cordyceps militaris, can inhibit TBI-induced neuroinflammation although the long-term effects of cordycepin remain unknown. Here, we report our investigation of cordycepin’s long-term neuroprotective function and its underlying immunological mechanism.MethodsTBI mice model was established with a controlled cortical impact (CCI) method. Cordycepin was intraperitoneally administered twice daily for a week. Neurological outcomes were assessed by behavioral tests, including grid walking test, cylinder test, wire hang test, and rotarod test. Immunofluorescence staining, transmission electron microscopy, and electrophysiology recording were employed to assess histological and functional lesions. Quantitative-PCR and flow cytometry were used to detect neuroinflammation. The tracers of Sulfo-NHS-biotin and Evans blue were assessed for the blood-brain barrier (BBB) leakage. Western blot and gelatin zymography were used to analyze protein activity or expression. Neutrophil depletion in vivo was performed via using Ly6G antibody intraperitoneal injection.ResultsCordycepin administration ameliorated long-term neurological deficits and reduced neuronal tissue loss in TBI mice. Meanwhile, the long-term integrity of white matter was also preserved, which was revealed in multiple dimensions, such as morphology, histology, ultrastructure, and electrical conductivity. Cordycepin administration inhibited microglia/macrophage pro-inflammatory polarization and promoted anti-inflammatory polarization after TBI. BBB breach was attenuated by cordycepin administration at 3 days after TBI. Cordycepin suppressed the activities of MMP-2 and MMP-9 and the neutrophil infiltration at 3 days after TBI. Moreover, neutrophil depletion provided a cordycepin-like effect, and cordycepin administration united with neutrophil depletion did not show a benefit of superposition.ConclusionsThe long-term neuroprotective function of cordycepin via suppressing neutrophil infiltration after TBI, thereby preserving BBB integrity and changing microglia/macrophage polarization. These findings provide significant clinical potentials to improve the quality of life for TBI patients.

Reproducibility and Characterization of Head Kinematics During a Large Animal Acceleration Model of Traumatic Brain Injury.

Acceleration parameters have been utilized for the last six decades to investigate pathology in both human and animal models of traumatic brain injury (TBI), design safety equipment, and develop injury thresholds. Previous large animal models have quantified acceleration from impulsive loading forces (i.e., machine/object kinematics) rather than directly measuring head kinematics. No study has evaluated the reproducibility of head kinematics in large animal models. Nine (five males) sexually mature Yucatan swine were exposed to head rotation at a targeted peak angular velocity of 250 rad/s in the coronal plane. The results indicated that the measured peak angular velocity of the skull was 51% of the impulsive load, was experienced over 91% longer duration, and was multi- rather than uni-planar. These findings were replicated in a second experiment with a smaller cohort (N = 4). The reproducibility of skull kinematics data was mostly within acceptable ranges based on published industry standards, although the coefficients of variation (8.9% for peak angular velocity or 12.3% for duration) were higher than the impulsive loading parameters produced by the machine (1.1 vs. 2.5%, respectively). Immunohistochemical markers of diffuse axonal injury and blood–brain barrier breach were not associated with variation in either skull or machine kinematics, suggesting that the observed levels of variance in skull kinematics may not be biologically meaningful with the current sample sizes. The findings highlight the reproducibility of a large animal acceleration model of TBI and the importance of direct measurements of skull kinematics to determine the magnitude of angular velocity, refine injury criteria, and determine critical thresholds.

Traumatic brain injury does not disrupt costimulatory blockade-induced immunological tolerance to glial-restricted progenitor allografts

BackgroundCell transplantation-based treatments for neurological disease are promising, yet graft rejection remains a major barrier to successful regenerative therapies. Our group and others have shown that long-lasting tolerance of transplanted stem cells can be achieved in the brain with systemic application of monoclonal antibodies blocking co-stimulation signaling. However, it is unknown if subsequent injury and the blood-brain barrier breach could expose the transplanted cells to systemic immune system spurring fulminant rejection and fatal encephalitis. Therefore, we investigated whether delayed traumatic brain injury (TBI) could trigger graft rejection.MethodsGlial-restricted precursor cells (GRPs) were intracerebroventricularly transplanted in immunocompetent neonatal mice and co-stimulation blockade (CoB) was applied 0, 2, 4, and 6 days post-grafting. Bioluminescence imaging (BLI) was performed to monitor the grafted cell survival. Mice were subjected to TBI 12 weeks post-transplantation. MRI and open-field test were performed to assess the brain damage and behavioral change, respectively. The animals were decapitated at week 16 post-transplantation, and the brains were harvested. The survival and distribution of grafted cells were verified from brain sections. Hematoxylin and eosin staining (HE) was performed to observe TBI-induced brain legion, and neuroinflammation was evaluated immunohistochemically.ResultsBLI showed that grafted GRPs were rejected within 4 weeks after transplantation without CoB, while CoB administration resulted in long-term survival of allografts. BLI signal had a steep rise following TBI and subsequently declined but remained higher than the preinjury level. Open-field test showed TBI-induced anxiety for all animals but neither CoB nor GRP transplantation intensified the symptom. HE and MRI demonstrated a reduction in TBI-induced lesion volume in GRP-transplanted mice compared with non-transplanted mice. Brain sections further validated the survival of grafted GRPs and showed more GRPs surrounding the injured tissue. Furthermore, the brains of post-TBI shiverer mice had increased activation of microglia and astrocytes compared to post-TBI wildtype mice, but infiltration of CD45+ leukocytes remained low.ConclusionsCoB induces sustained immunological tolerance towards allografted cerebral GRPs which is not disrupted following TBI, and unexpectedly TBI may enhance GRPs engraftment and contribute to post-injury brain tissue repair.

Role of Viral Infections in Multiple Sclerosis Pathogenesis among Indian Population.

The role of viral infections in multiple sclerosis (MS) pathogenesis is unclear. Certain neurotropic viruses previously linked with MS among white population were studied including Epstein-Barr virus, human herpesvirus-6 (HHV-6) and MS-associated retrovirus (MSRV). Sixty-two MS patients (37 had a recent clinical relapse) and 65 controls with other neurological disorders were included. Blood and cerebrospinal fluid (CSF) samples were obtained and processed with the primary objective of determining whether there was intrathecal multiplication of viruses under study (EBV, HHV6 A and B and human endogenous retrovirus) or a breach in blood-brain barrier associated with viral presence in both peripheral blood and CSF. Evidence of breach in blood-brain barrier was seen in 86.5% of patients as evidenced by abnormal CSF/serum albumin index and or MRI. EBV nuclear antigen (EBNA1 IgG) was seen in 89% of MS patients and 58% controls (P = <0.001). However, HHV6 IgG was similar in both groups (85% versus 81%; P = 0.45). In affinity immunoblotting reaction intrathecal IgG synthesis against EBNA1 antigen was demonstrable in 26% (16/62) of patients and none against HHV6. A subset of patients showed significant elevation in mean copy number of plasma EBV DNA during relapse and there was a trend for the same among patients harboring HHV-6B. No evidence of isolated intrathecal viral presence or multiplication was seen. The results of our study suggest that viruses studied namely EBV and HHV6 have a role in triggering relapses through a peripheral mechanism, rather than a direct role through intrathecal multiplication.

Gender-Dependent Effects of Thimerosal on Human Progenitor Neurons: A Potential Link to Regressive Autism

Regressive Autism [RA] is a subtype of autism spectrum disorder (ASD) that manifests as the loss of previously acquired developmental milestones and skills. Early life dysregulation of neurodevelopment due to exposure to toxic metals has been associated with ASD, but the underlying biological mechanisms by which metals influence neurodevelopment remain unclear. We explored the potential role of thimerosal or ethylmercury on neurite formation and oxytocin receptor (OXTR) modulation in four human-developing neuronal cell lines of male and female origin (N = 2 each). We exposed the cell lines to three levels of thimerosal that closely represented the concentrations an infant (equivalent to 1 L of blood volume), an adolescent (~5 L), and an adult (~10 L) might receive from multiple doses of vaccine containing 100 µg/mL of thimerosal. We found that exposure to vaccine-equivalent concentrations of thimerosal induced significantly greater neurite dysregulation, including central chromatolysis, neurite abnormalities (i.e., axonal length, relative diameter, and pathways in neurons), and syncytia formation in undifferentiated and partially differentiated human developing neurons compared to controls. Exposure of male neurons to thimerosal significantly affected neurite formation and OXTR expression compared to the female neurons. In developed nations, most vaccines are thimerosal-free; nonetheless, some still incorporate ethylmercury as a preservative. In contrast, due to the lack of refrigeration in many developing nations, thimerosal is still used widely in most vaccines. Our study shows that ethylmercury induced profound neurite dysregulation and downregulated OXTR expression. The progenitor neurons from males were significantly more susceptible to thimerosal than those from females. However, internal factors in vaccine recipients may trigger dysfunction in the Blood-Brain Barrier (BBB), and screening potentially vulnerable individuals for conditions that may contribute to a BBB breach before vaccination might be beneficial.