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Calcium-dependent blood-brain barrier breakdown by NOX5 limits postreperfusion benefit in stroke
Ana I. Casas, … , Christoph Kleinschnitz, Harald H.H.W. Schmidt
Ana I. Casas, … , Christoph Kleinschnitz, Harald H.H.W. Schmidt
Published March 18, 2019
Citation Information: J Clin Invest. 2019;129(4):1772-1778. https://doi.org/10.1172/JCI124283.
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Concise Communication Neuroscience Therapeutics

Calcium-dependent blood-brain barrier breakdown by NOX5 limits postreperfusion benefit in stroke

Abstract

Ischemic stroke is a predominant cause of disability worldwide, with thrombolytic or mechanical removal of the occlusion being the only therapeutic option. Reperfusion bears the risk of an acute deleterious calcium-dependent breakdown of the blood-brain barrier. Its mechanism, however, is unknown. Here, we identified type 5 NADPH oxidase (NOX5), a calcium-activated, ROS-forming enzyme, as the missing link. Using a humanized knockin (KI) mouse model and in vitro organotypic cultures, we found that reoxygenation or calcium overload increased brain ROS levels in a NOX5-dependent manner. In vivo, postischemic ROS formation, infarct volume, and functional outcomes were worsened in NOX5-KI mice. Of clinical and therapeutic relevance, in a human blood-barrier model, pharmacological NOX inhibition also prevented acute reoxygenation-induced leakage. Our data support further evaluation of poststroke recanalization in the presence of NOX inhibition for limiting stroke-induced damage.

Authors

Ana I. Casas, Pamela W.M. Kleikers, Eva Geuss, Friederike Langhauser, Thure Adler, Dirk H. Busch, Valerie Gailus-Durner, Martin Hrabê de Angelis, Javier Egea, Manuela G. Lopez, Christoph Kleinschnitz, Harald H.H.W. Schmidt

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