Cook Douglas J, Nguyen Cynthia, Chun Hyun N, L Llorente Irene, Chiu Abraham S, Machnicki Michal, Zarembinski Thomas I, Carmichael S Thomas
1 Department of Surgery, Division of Neurosurgery, Kingston General Hospital, Kingston, Canada.
2 Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, USA.
J Cereb Blood Flow Metab. 2017 Mar;37(3):1030-1045. doi: 10.1177/0271678X16649964. Epub 2016 Jul 20.
Stroke is the leading cause of adult disability. Systemic delivery of candidate neural repair therapies is limited by the blood-brain barrier and off-target effects. We tested a bioengineering approach for local depot release of BDNF from the infarct cavity for neural repair in chronic periods after stroke. The brain release levels of a hyaluronic acid hydrogel + BDNF were tested in several stroke models in mouse (strains C57Bl/6, DBA) and non-human primate ( Macaca fascicularis) and tracked with MRI. The behavioral recovery effects of hydrogel + BDNF and the effects on tissue repair outcomes were determined. Hydrogel-delivered BDNF diffuses from the stroke cavity into peri-infarct tissue over 3 weeks in two mouse stroke models, compared with 1 week for direct BDNF injection. Hydrogel delivery of BDNF promotes recovery of motor function. Mapping of motor system connections indicates that hydrogel-BDNF induces axonal sprouting within existing cortical and cortico-striatal systems. Pharmacogenetic studies show that hydrogel-BDNF induces the initial migration of immature neurons into the peri-infarct cortex and their long-term survival. In chronic stroke in the non-human primate, hydrogel-released BDNF can be detected up to 2 cm from the infarct, a distance relevant to human functional recovery in stroke. The hydrogel can be tracked by MRI in mouse and primate.
中风是成人残疾的主要原因。候选神经修复疗法的全身给药受到血脑屏障和脱靶效应的限制。我们测试了一种生物工程方法,用于从梗死腔局部缓释脑源性神经营养因子(BDNF),以促进中风后慢性期的神经修复。在小鼠(C57Bl/6、DBA品系)和非人灵长类动物(食蟹猴)的多个中风模型中,测试了透明质酸水凝胶+BDNF的脑内释放水平,并通过磁共振成像(MRI)进行跟踪。确定了水凝胶+BDNF的行为恢复效果以及对组织修复结果的影响。在两种小鼠中风模型中,水凝胶递送的BDNF在3周内从中风腔扩散到梗死周围组织,而直接注射BDNF则为1周。水凝胶递送BDNF可促进运动功能恢复。运动系统连接图谱表明,水凝胶-BDNF可诱导现有皮质和皮质-纹状体系统内的轴突发芽。药物遗传学研究表明,水凝胶-BDNF可诱导未成熟神经元向梗死周围皮质的初始迁移及其长期存活。在非人灵长类动物的慢性中风中,在距梗死灶2厘米处仍可检测到水凝胶释放的BDNF,这一距离与人类中风后的功能恢复相关。该水凝胶可通过MRI在小鼠和灵长类动物中进行跟踪。