Jiang Junliang, Zou Yue, Xie Chuantong, Yang Miaoxian, Tong Qiuping, Yuan Mimi, Pei Xu, Deng Shuixiang, Tian Mi, Xiao Lei, Gong Ye
Department of Critical Care Medicine and Neurosurgery of Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Institutes of Brain Science, Fudan University, Shanghai, China; Department of Orthopedics & Traumatology, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Yunnan Eye Institute & Key Laboratory of Yunnan Province, Yunnan Eye Disease Clinical Medical Center, Affiliated Hospital of Yunnan University, Yunnan University, Kunming, China.
Brain Behav Immun. 2023 Nov;114:195-213. doi: 10.1016/j.bbi.2023.08.023. Epub 2023 Aug 28.
Sepsis-associated encephalopathy (SAE) is a diffuse brain dysfunction, characterized by cognitive and memory impairments closely linked to hippocampal dysfunction. Though it is well-known that SAE is a diffuse brain dysfunction with microglial activation, the pathological mechanisms of SAE are not well established and effective clinical interventions are lacking. Oxytocin (OXT) is reported to have anti-inflammatory and neuroprotective roles. However, the effects of OXT on SAE and the underlying mechanisms are not clear.
SAE was induced in adult C57BL/6J male mice by cecal ligation and perforation (CLP) surgery. Exogenous OXT was intranasally applied after surgery. Clinical score, survivor rate, cognitive and memory behaviors, and hippocampal neuronal and non-neuronal functions were evaluated. Cultured microglia challenged with lipopolysaccharide (LPS) were used to investigate the effects of OXT on microglial functions, including inflammatory cytokines release and phagocytosis. The possible intracellular signal pathways involved in the OXT-induced neuroprotection were explored with RNA sequencing.
Hippocampal OXT level decreases, while the expression of OXT receptor (OXTR) increases around 24 h after CLP surgery. Intranasal OXT application at a proper dose increases mouse survival rate, alleviates cognitive and memory dysfunction, and restores hippocampal synaptic function and neuronal activity via OXTR in the SAE model. Intraperitoneal or local administration of the OXTR antagonist L-368,899 in hippocampal CA1 region inhibited the protective effects of OXT. Moreover, during the early stages of sepsis, hippocampal microglia are activated, while OXT application reduces microglial phagocytosis and the release of inflammatory cytokines, thereby exerting a neuroprotective effect. OXT may improve the SAE outcomes via the OXTR-ERK-STAT3 signaling pathway.
Our study uncovers the dysfunction of the OXT signal in SAE and shows that intranasal OXT application at a proper dose can alleviate SAE outcomes by reducing microglial overactivation, suggests that OXT may be a promising therapeutic approach in managing SAE patients.
脓毒症相关性脑病(SAE)是一种弥漫性脑功能障碍,其特征为认知和记忆障碍,与海马功能障碍密切相关。尽管众所周知SAE是一种伴有小胶质细胞激活的弥漫性脑功能障碍,但其病理机制尚未完全明确,且缺乏有效的临床干预措施。据报道,催产素(OXT)具有抗炎和神经保护作用。然而,OXT对SAE的影响及其潜在机制尚不清楚。
通过盲肠结扎和穿孔(CLP)手术在成年C57BL/6J雄性小鼠中诱导SAE。术后经鼻给予外源性OXT。评估临床评分、存活率、认知和记忆行为以及海马神经元和非神经元功能。用脂多糖(LPS)刺激培养的小胶质细胞,以研究OXT对小胶质细胞功能的影响,包括炎性细胞因子释放和吞噬作用。通过RNA测序探索OXT诱导神经保护作用可能涉及的细胞内信号通路。
CLP手术后约24小时,海马OXT水平降低,而催产素受体(OXTR)表达增加。在SAE模型中,以适当剂量经鼻应用OXT可提高小鼠存活率,减轻认知和记忆功能障碍,并通过OXTR恢复海马突触功能和神经元活性。在海马CA1区腹腔注射或局部给予OXTR拮抗剂L-368,899可抑制OXT的保护作用。此外,在脓毒症早期,海马小胶质细胞被激活,而应用OXT可减少小胶质细胞吞噬作用和炎性细胞因子释放,从而发挥神经保护作用。OXT可能通过OXTR-ERK-STAT3信号通路改善SAE结局。
我们的研究揭示了SAE中OXT信号的功能障碍,并表明以适当剂量经鼻应用OXT可通过减少小胶质细胞过度激活来减轻SAE结局,提示OXT可能是治疗SAE患者的一种有前景的治疗方法。