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Exogenous inter-α inhibitor proteins prevent cell death and improve ischemic stroke outcomes in mice
Louise D. McCullough, … , Yow-Pin Lim, Venugopal Reddy Venna
Louise D. McCullough, … , Yow-Pin Lim, Venugopal Reddy Venna
Published September 1, 2021
Citation Information: J Clin Invest. 2021;131(17):e144898. https://doi.org/10.1172/JCI144898.
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Research Article Inflammation Neuroscience

Exogenous inter-α inhibitor proteins prevent cell death and improve ischemic stroke outcomes in mice

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Abstract

Inter-α inhibitor proteins (IAIPs) are a family of endogenous plasma and extracellular matrix molecules. IAIPs suppress proinflammatory cytokines, limit excess complement activation, and bind extracellular histones to form IAIP-histone complexes, leading to neutralization of histone-associated cytotoxicity in models of sepsis. Many of these detrimental processes also play critical roles in the pathophysiology of ischemic stroke. In this study, we first assessed the clinical relevance of IAIPs in stroke and then tested the therapeutic efficacy of exogenous IAIPs in several experimental stroke models. IAIP levels were reduced in both ischemic stroke patients and in mice subjected to experimental ischemic stroke when compared with controls. Post-stroke administration of IAIP significantly improved stroke outcomes across multiple stroke models, even when given 6 hours after stroke onset. Importantly, the beneficial effects of delayed IAIP treatment were observed in both young and aged mice. Using targeted gene expression analysis, we identified a receptor for complement activation, C5aR1, that was highly suppressed in both the blood and brain of IAIP-treated animals. Subsequent experiments using C5aR1-knockout mice demonstrated that the beneficial effects of IAIPs are mediated in part by C5aR1. These results indicate that IAIP is a potential therapeutic candidate for the treatment of ischemic stroke.

Authors

Louise D. McCullough, Meaghan Roy-O’Reilly, Yun-Ju Lai, Anthony Patrizz, Yan Xu, Juneyoung Lee, Aleah Holmes, Daniel C. Kraushaar, Anjali Chauhan, Lauren H. Sansing, Barbara S. Stonestreet, Liang Zhu, Julia Kofler, Yow-Pin Lim, Venugopal Reddy Venna

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Figure 6

IAIP treatment confers significant protection in both a permanent occlusion model and a thromboembolic stroke model.

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IAIP treatment confers significant protection in both a permanent occlus...
(A) Young male mice were subjected to permanent MCAO followed by treatment with IAIP or vehicle. (B) Infarct quantification after permanent MCA occlusion showed neuroprotection in the cortex (*P = 0.0185), striatum (**P = 0.0054), and total hemisphere (*P = 0.0111) at 48 hours after stroke with IAIP compared with the vehicle group by 2-sample t tests adjusted for multiple testing. (C) NDS 24 hours after stroke with IAIP and vehicle treatment (P = 0.0706, Wilcoxon’s rank sum test). (D) IAIP-treated mice had a significantly longer latency to fall in the grip test 48 hours after stroke (*P = 0.0378, t test). (E) Young male mice subjected to embolic stroke followed by t-PA administration were randomly assigned to IAIP or vehicle treatment as shown in the timeline. (F) Mice that received IAIP in combination with t-PA had reduced infarct compared with mice treated with t-PA and vehicle after thromboembolic stroke (mean ± SEM; *P = 0.0290, 2-sample t test). (G) Mice treated with t-PA plus IAIP after thromboembolic stroke demonstrated a significantly improved NDS 24 hours after stroke (*P = 0.046, Wilcoxon’s rank sum test). (H) IAIP-treated mice had a longer latency to fall in the hang-wire test 48 hours after stroke (**P = 0.0015, t test). (I) Mice that received IAIP had significantly reduced hemoglobin levels in the ipsilateral hemisphere (*P = 0.0487, t test). (J) Representative immunohistochemistry images analyzed 48 hours after thromboembolic stroke showed that IAIP reduced BBB leakage, as seen by fibrinogen immunoreactivity (red), counterstained with lectin (blue). Scale bars: 75 μm. (K) Quantification of fibrinogen immunoreactivity in the ipsilateral hemisphere of mice treated with t-PA plus IAIP compared with vehicle-treated mice (mean ± SEM; *P = 0.0196, t test).

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