Role of SPAK-NKCC1 Signaling Cascade in the Choroid Plexus Blood-CSF Barrier Damage After Stroke

What will your doctors and hospital do to get this testing(Pharmacological blockade of the SPAK-NKCC1 pathway protected the ChP barrier integrity) done in humans? If nothing you don't have a functioning stroke hospital.

Role of SPAK-NKCC1 Signaling Cascade in theChoroid Plexus Blood-CSF Barrier Damage After Stroke

Jun Wang, Ruijia Liu, Md Nabiul Hasan, Sydney Fischer, Matt Como, Victoria M Fiesler, Gulnaz Begum, Yang Chen, Mohammad Iqbal H. Bhuiyan, Shuying Dong, Eric Li, Kristopher T Kahle, Jinwei Zhang, Xianming Deng, Arohan R Subramanya, Yan Yin, Dandan Sun

DOI:

10.21203/rs.3.rs-1189368/v1

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Background: 

The mechanisms underlying dysfunction of choroid plexus (ChP) blood-cerebrospinal fluid (CSF) barrier and lymphocyte invasion in neuroinflammatory responses to stroke are not well understood. In this study, we investigated whether stroke damaged the blood-CSF barrier integrity due to dysregulation of major ChP ion transport system Na+-K+-Cl- cotransporter (NKCC1) and regulatory Ste20-related proline-alanine-rich kinase (SPAK). 

Methods: 

Sham or ischemic stroke was induced in C57Bl/6J mice. Changes of the SPAK-NKCC1 complex and tight junction proteins (TJs) in the ChP were quantified by immunofluorescence staining and immunoblotting. Immune cell infiltration in the ChP was assessed by flow cytometry and immunostaining. Cultured ChP epithelium cells (CPECs) and cortical neurons were used to evaluate H2O2-mediated oxidative stress in stimulating the SPAK-NKCC1 complex and cellular damage. In vivo or in vitro pharmacological blockade of the ChP SPAK-NKCC1 cascade with SPAK inhibitor ZT-1a or NKCC1 inhibitor bumetanide were examined. 

Results: 

Ischemic stroke stimulated activation of the CPECs apical membrane SPAK-NKCC1 complex, NF-κB, and MMP9, which was associated with loss of the blood-CSF barrier integrity and increased immune cell infiltration into the ChP. Oxidative stress directly activated SPAK-NKCC1 pathway and resulted in apoptosis, neurodegeneration, and NKCC1-mediated ion influx. Pharmacological blockade of the SPAK-NKCC1 pathway protected the ChP barrier integrity, attenuated ChP immune cell infiltration or neuronal death. 

Conclusion: 

Stroke-induced pathological stimulation of the SPAK-NKCC1 cascade caused CPECs damage and disruption of TJs at the blood-CSF barrier. The ChP SPAK-NKCC1 complex emerged as a therapeutic target for attenuating ChP dysfunction and lymphocyte invasion after stroke.

KEYWORDS

bumetanide, choroid plexus, H2O2, Na+-K+-Cl- cotransporter, SPAK, ZT-1a