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Dhakar MB, Sheikh Z, Kumari P, Lawson EC, Jeanneret V, Desai D, Ruiz AR, Haider HA. Epileptiform Abnormalities in Acute Ischemic Stroke: Impact on Clinical Management and Outcomes. J Clin Neurophysiol 2022; 39:446-452. [PMID: 33298681 PMCID: PMC8371977 DOI: 10.1097/wnp.0000000000000801] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Studies examining seizures (Szs) and epileptiform abnormalities (EAs) using continuous EEG in acute ischemic stroke (AIS) are limited. Therefore, we aimed to describe the prevalence of Sz and EA in AIS, its impact on anti-Sz drug management, and association with discharge outcomes. METHODS The study included 132 patients with AIS who underwent continuous EEG monitoring >6 hours. Continuous EEG was reviewed for background, Sz and EA (lateralized periodic discharges [LPD], generalized periodic discharges, lateralized rhythmic delta activity, and sporadic epileptiform discharges). Relevant clinical, demographic, and imaging factors were abstracted to identify risk factors for Sz and EA. Outcomes included all-cause mortality, functional outcome at discharge (good outcome as modified Rankin scale of 0-2 and poor outcome as modified Rankin scale of 3-6) and changes to anti-Sz drugs (escalation or de-escalation). RESULTS The frequency of Sz was 7.6%, and EA was 37.9%. Patients with Sz or EA were more likely to have cortical involvement (84.6% vs. 67.5% P = 0.028). Among the EAs, the presence of LPD was associated with an increased risk of Sz (25.9% in LPD vs. 2.9% without LPD, P = 0.001). Overall, 21.2% patients had anti-Sz drug changes because of continuous EEG findings, 16.7% escalation and 4.5% de-escalation. The presence of EA or Sz was not associated with in-hospital mortality or discharge functional outcomes. CONCLUSIONS Despite the high incidence of EA, the rate of Sz in AIS is relatively lower and is associated with the presence of LPDs. These continuous EEG findings resulted in anti-Sz drug changes in one-fifth of the cohort. Epileptiform abnormality and Sz did not affect mortality or discharge functional outcomes.
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Affiliation(s)
- Monica B. Dhakar
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Zubeda Sheikh
- Department of Neurology, West Virginia University School of Medicine, Morgantown, West Virginia, U.S.A
| | - Polly Kumari
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Eric C. Lawson
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Valerie Jeanneret
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Dhaval Desai
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Andres Rodriguez Ruiz
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
| | - Hiba A. Haider
- Epilepsy Section, Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, U.S.A
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Jeanneret V, Neill S, Greene JG, Groover O, Kase CS. Clinical Reasoning: A 55-Year-Old Woman With Recurrent Episodes of Aphasia and Vision Changes. Neurology 2021; 98:330-335. [PMID: 34906981 DOI: 10.1212/wnl.0000000000013219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
A 55-year-old woman presented with recurrent episodes of headache, vision changes and language disturbances. Brain MRI showed multifocal white matter lesions, microhemorrhages, and enlarged perivascular spaces. After an extensive and unrevealing workup, she underwent a biopsy of brain and meninges that revealed thick and hyalinized leptomeningeal and cortical vessel walls that were strongly positive for ß-amyloid by immunohistochemical staining, suggestive of cerebral amyloid angiopathy (CAA). CAA can present as a spectrum of inflammatory responses to the deposition of amyloid-ß in the vessel walls. Her clinical presentation, radiological and histopathological findings supported a diagnosis of probable CAA-related inflammation (CAA-ri). Although an uncommon entity, it is important to recognize it because most patients respond to immunosuppressive therapy.
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Affiliation(s)
- Valerie Jeanneret
- Emory University School of Medicine, Department of Neurology, Atlanta, Georgia
| | - Stewart Neill
- Emory University School of Medicine, Pathology Department, Atlanta, Georgia
| | - James G Greene
- Emory University School of Medicine, Department of Neurology, Atlanta, Georgia
| | - Olivia Groover
- Emory University School of Medicine, Department of Neurology, Atlanta, Georgia
| | - Carlos S Kase
- Emory University School of Medicine, Department of Neurology, Atlanta, Georgia
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3
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Jeanneret V, Peterson RB, Kase CS. Clinical Reasoning: A 62-year-old man with history of catheter ablation presenting with recurrent strokes. Neurology 2020; 95:e3065-e3069. [PMID: 32764099 DOI: 10.1212/wnl.0000000000010606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Valerie Jeanneret
- From the Departments of Neurology (V.J., C.S.K.) and Radiology and Imaging Sciences (R.B.P.), Emory University School of Medicine, Atlanta, GA.
| | - Ryan B Peterson
- From the Departments of Neurology (V.J., C.S.K.) and Radiology and Imaging Sciences (R.B.P.), Emory University School of Medicine, Atlanta, GA
| | - Carlos S Kase
- From the Departments of Neurology (V.J., C.S.K.) and Radiology and Imaging Sciences (R.B.P.), Emory University School of Medicine, Atlanta, GA
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Affiliation(s)
- Marcela Abufhele
- Departamento Pediatría, Clínica Alemana de Santiago, Santiago, Chile
| | - Valerie Jeanneret
- Departamento Pediatría, Clínica Alemana de Santiago, Santiago, Chile
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5
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Affiliation(s)
- Valerie Jeanneret
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Paul A. Beach
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
| | - Carlos S. Kase
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia
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6
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Diaz A, Jeanneret V, Merino P, McCann P, Yepes M. Tissue-type plasminogen activator regulates p35-mediated Cdk5 activation in the postsynaptic terminal. J Cell Sci 2019; 132:jcs224196. [PMID: 30709918 PMCID: PMC6432712 DOI: 10.1242/jcs.224196] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 01/19/2019] [Indexed: 11/20/2022] Open
Abstract
Neuronal depolarization induces the synaptic release of tissue-type plasminogen activator (tPA). Cyclin-dependent kinase-5 (Cdk5) is a member of the family of cyclin-dependent kinases that regulates cell migration and synaptic function in postmitotic neurons. Cdk5 is activated by its binding to p35 (also known as Cdk5r1), a membrane-anchored protein that is rapidly degraded by the proteasome. Here, we show that tPA prevents the degradation of p35 in the synapse by a plasminogen-dependent mechanism that requires open synaptic N-methyl-D-aspartate (NMDA) receptors. We show that tPA treatment increases the abundance of p35 and its binding to Cdk5 in the postsynaptic density (PSD). Furthermore, our data indicate that tPA-induced p35-mediated Cdk5 activation does not induce cell death, but instead prevents NMDA-induced ubiquitylation of postsynaptic density protein-95 (PSD-95; also known as Dlg4) and the removal of GluR1 (also known as Gria1)-containing α-amino-3-hydroxy-5-methyl-4-isoxazoleproprionic acid (AMPA) receptors from the PSD. These results show that the interaction between tPA and synaptic NMDA receptors regulates the expression of AMPA receptor subunits in the PSD via p35-mediated Cdk5 activation. This is a novel role for tPA as a regulator of Cdk5 activation in cerebral cortical neurons.
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Affiliation(s)
- Ariel Diaz
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA 30329, USA
| | - Valerie Jeanneret
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Paola Merino
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA 30329, USA
| | - Patrick McCann
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA 30329, USA
| | - Manuel Yepes
- Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA 30329, USA
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
- Department of Neurology, Veterans Affairs Medical Center, Atlanta, GA 30033, USA
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7
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Jeanneret V, Ospina JP, Diaz A, Manrique LG, Merino P, Gutierrez L, Torre E, Wu F, Cheng L, Yepes M. Tissue-type plasminogen activator protects the postsynaptic density in the ischemic brain. J Cereb Blood Flow Metab 2018; 38:1896-1910. [PMID: 29547062 PMCID: PMC6259311 DOI: 10.1177/0271678x18764495] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Cerebral ischemia causes the presynaptic release of tissue-type plasminogen activator (tPA). The postsynaptic density (PSD) is a postsynaptic structure that provides a matrix where signaling transduction of excitatory synapses takes place. The postsynaptic density protein-95 (PSD-95) is the most abundant scaffolding protein in the postsynaptic density (PSD), where it modulates the postsynaptic response to the presynaptic release of glutamate by regulating the anchoring of glutamate receptors to the PSD. We found that tPA induces the local translation of PSD-95 mRNA and the subsequent recruitment of PSD-95 protein to the PSD, via plasminogen-independent activation of TrkB receptors. Our data show that PSD-95 is removed from the PSD during the early stages of cerebral ischemia, and that this effect is abrogated by either the release of neuronal tPA, or intravenous administration of recombinant tPA (rtPA). We report that the effect of tPA on PSD-95 is associated with inhibition of the phosphorylation and recruitment of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors to the PSD, known to amplify the effect of the excitotoxic injury, and that this is followed by TrkB-mediated protection of dendritic spines from the harmful effects of the hypoxic insult. These data reveal that tPA is a synaptic protector in the ischemic brain.
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Affiliation(s)
- Valerie Jeanneret
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA
| | - Juan P Ospina
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA
| | - Ariel Diaz
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Luis G Manrique
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Paola Merino
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Laura Gutierrez
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA
| | - Enrique Torre
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Fang Wu
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Lihong Cheng
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA
| | - Manuel Yepes
- 1 Department of Neurology & Center for Neurodegenerative Disease, School of Medicine, Emory University, Atlanta, GA, USA.,2 Division of Neuropharmacology and Neurologic Diseases, Yerkes National Primate Research Center, Atlanta, GA, USA.,3 Department of Neurology, Veterans Affairs Medical Center, Atlanta, GA, USA
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8
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Abstract
Membrane depolarization induces the release of the serine proteinase tissue-type plasminogen activator (tPA) from the presynaptic terminal of cerebral cortical neurons. Once in the synaptic cleft this tPA promotes the exocytosis and subsequent endocytic retrieval of glutamate-containing synaptic vesicles, and regulates the postsynaptic response to the presynaptic release of glutamate. Indeed, tPA has a bidirectional effect on the composition of the postsynaptic density (PSD) that does not require plasmin generation or the presynaptic release of glutamate, but varies according to the baseline level of neuronal activity. Hence, in inactive neurons tPA induces phosphorylation and accumulation in the PSD of the Ca2+/calmodulin-dependent protein kinase IIα (pCaMKIIα), followed by pCaMKIIα-induced phosphorylation and synaptic recruitment of GluR1-containing α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. In contrast, in active neurons with increased levels of pCaMKIIα in the PSD tPA induces pCaMKIIα and pGluR1 dephosphorylation and their subsequent removal from the PSD. These effects require active synaptic N-methyl-D-aspartate (NMDA) receptors and cyclin-dependent kinase 5 (Cdk5)-induced phosphorylation of the protein phosphatase 1 (PP1) at T320. These data indicate that tPA is a homeostatic regulator of the postsynaptic response of cerebral cortical neurons to the presynaptic release of glutamate via bidirectional regulation of the pCaMKIIα /PP1 switch in the PSD.
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Affiliation(s)
- Valerie Jeanneret
- Department of Neurology & Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA
| | - Manuel Yepes
- Department of Neurology & Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, GA, USA.,Department of Neurology, Veterans Affairs Medical Center, Atlanta, GA, USA.,Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, GA, USA
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9
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Merino P, Diaz A, Jeanneret V, Wu F, Torre E, Cheng L, Yepes M. Urokinase-type Plasminogen Activator (uPA) Binding to the uPA Receptor (uPAR) Promotes Axonal Regeneration in the Central Nervous System. J Biol Chem 2016; 292:2741-2753. [PMID: 27986809 DOI: 10.1074/jbc.m116.761650] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 12/15/2016] [Indexed: 11/06/2022] Open
Abstract
Axonal injury is a common cause of neurological dysfunction. Unfortunately, in contrast to axons from the peripheral nervous system, the limited capacity of regeneration of central nervous system (CNS) axons is a major obstacle for functional recovery in patients suffering neurological diseases that involve the subcortical white matter. Urokinase-type plasminogen activator (uPA) is a serine proteinase that upon binding to the urokinase-type plasminogen activator receptor (uPAR) catalyzes the conversion of plasminogen into plasmin on the cell surface. uPAR expression increases after an injury, and signaling through uPAR promotes tissue remodeling. However, it is yet unknown whether uPA binding to uPAR has an effect on axonal recovery in the CNS. Here, we used in vitro and in vivo models of CNS axonal injury to test the hypothesis that uPA binding to uPAR promotes axonal regeneration in the CNS. We found that newly formed growth cones from axons re-emerging from an axonal injury express uPAR and that binding of uPA to this uPAR promotes axonal recovery by a mechanism that does not require the generation of plasmin. Our data indicate that the binding of recombinant uPA or endogenous uPA to uPAR induces membrane recruitment and activation of β1 integrin via the low density lipoprotein receptor-related protein-1 (LRP1), which leads to activation of the Rho family small GTPase Rac1 and Rac1-induced axonal regeneration. Our results show that the uPA/uPAR/LRP1 system is a potential target for the development of therapeutic strategies to promote axonal recovery following a CNS injury.
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Affiliation(s)
- Paola Merino
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322.,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and
| | - Ariel Diaz
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322.,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and
| | - Valerie Jeanneret
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322.,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and
| | - Fang Wu
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322.,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and
| | - Enrique Torre
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322.,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and
| | - Lihong Cheng
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322.,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and
| | - Manuel Yepes
- From the Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine, Atlanta, Georgia 30322, .,the Division of Neurosciences, Yerkes National Primate Research Center, Atlanta, Georgia 30329, and.,the Department of Neurology, Veterans Affairs Medical Center, Atlanta, Georgia 30033
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Jeanneret V, Wu F, Merino P, Torre E, Diaz A, Cheng L, Yepes M. Tissue-type Plasminogen Activator (tPA) Modulates the Postsynaptic Response of Cerebral Cortical Neurons to the Presynaptic Release of Glutamate. Front Mol Neurosci 2016; 9:121. [PMID: 27881952 PMCID: PMC5101231 DOI: 10.3389/fnmol.2016.00121] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 10/31/2016] [Indexed: 01/31/2023] Open
Abstract
Tissue-type plasminogen activator (tPA) is a serine proteinase released by the presynaptic terminal of cerebral cortical neurons following membrane depolarization (Echeverry et al., 2010). Recent studies indicate that the release of tPA triggers the synaptic vesicle cycle and promotes the exocytosis (Wu et al., 2015) and endocytic retrieval (Yepes et al., 2016) of glutamate-containing synaptic vesicles. Here we used electron microscopy, proteomics, quantitative phosphoproteomics, biochemical analyses with extracts of the postsynaptic density (PSD), and an animal model of cerebral ischemia with mice overexpressing neuronal tPA to study whether the presynaptic release of tPA also has an effect on the postsynaptic terminal. We found that tPA has a bidirectional effect on the composition of the PSD of cerebral cortical neurons that is independent of the generation of plasmin and the presynaptic release of glutamate, but depends on the baseline level of neuronal activity and the extracellular concentrations of calcium (Ca2+). Accordingly, in neurons that are either inactive or incubated with low Ca2+ concentrations tPA induces phosphorylation and accumulation in the PSD of the Ca2+/calmodulin-dependent protein kinase IIα (pCaMKIIα), followed by pCaMKIIα-mediated phosphorylation and synaptic recruitment of GluR1-containing α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors. In contrast, in neurons with previously increased baseline levels of pCaMKIIα in the PSD due to neuronal depolarization in vivo or incubation with high concentrations of either Ca2+ or glutamate in vitro, tPA induces pCaMKIIα and pGluR1 dephosphorylation and their subsequent removal from the PSD. We found that these effects of tPA are mediated by synaptic N-methyl-D-aspartate (NMDA) receptors and cyclin-dependent kinase 5 (Cdk5)-induced phosphorylation of the protein phosphatase 1 (PP1) at T320. Our data indicate that by regulating the pCaMKIIα/PP1 balance in the PSD tPA acts as a homeostatic regulator of the postsynaptic response of cerebral cortical neurons to the presynaptic release of glutamate.
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Affiliation(s)
- Valerie Jeanneret
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine Atlanta, GA, USA
| | - Fang Wu
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine Atlanta, GA, USA
| | - Paola Merino
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine Atlanta, GA, USA
| | - Enrique Torre
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine Atlanta, GA, USA
| | - Ariel Diaz
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine Atlanta, GA, USA
| | - Lihong Cheng
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of Medicine Atlanta, GA, USA
| | - Manuel Yepes
- Department of Neurology and Center for Neurodegenerative Disease, Emory University School of MedicineAtlanta, GA, USA; Department of Neurology, Veterans Affairs Medical CenterAtlanta, GA, USA
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Jeanneret V, Yepes M. The Plasminogen Activation System Promotes Dendritic Spine Recovery and Improvement in Neurological Function After an Ischemic Stroke. Transl Stroke Res 2016. [PMID: 26846991 DOI: 10.1007/s12975-016-0454-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Advances in neurocritical care and interventional neuroradiology have led to a significant decrease in acute ischemic stroke (AIS) mortality. In contrast, due to the lack of an effective therapeutic strategy to promote neuronal recovery among AIS survivors, cerebral ischemia is still a leading cause of disability in the world. Ischemic stroke has a harmful impact on synaptic structure and function, and plasticity-mediated synaptic recovery is associated with neurological improvement following an AIS. Dendritic spines (DSs) are specialized dendritic protrusions that receive most of the excitatory input in the brain. The deleterious effect of cerebral ischemia on DSs morphology and function has been associated with impaired synaptic transmission and neurological deterioration. However, these changes are reversible if cerebral blood flow is restored on time, and this recovery has been associated with neurological improvement following an AIS. Tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA) are two serine proteases that, besides catalyzing the conversion of plasminogen into plasmin in the intravascular and pericellular environment, respectively, are also efficient inductors of synaptic plasticity. Accordingly, recent evidence indicates that both, tPA and uPA, protect DSs from the metabolic stress associated with the ischemic injury, and promote their morphological and functional recovery during the recovery phase from an AIS. Here, we will review data indicating that plasticity-induced changes in DSs and the associated post-synaptic density play a pivotal role in the recovery process from AIS, making special emphasis on the role of tPA and uPA in this process.
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Affiliation(s)
- Valerie Jeanneret
- Department of Neurology & Center for Neurodegenerative Disease, Emory University School of Medicine, Whitehead Biomedical Research Building, 615 Michael Street, Suite 505J, Atlanta, GA, 30322, USA
| | - Manuel Yepes
- Department of Neurology & Center for Neurodegenerative Disease, Emory University School of Medicine, Whitehead Biomedical Research Building, 615 Michael Street, Suite 505J, Atlanta, GA, 30322, USA. .,Department of Neurology, Veterans Affairs Medical Center, Atlanta, GA, USA.
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12
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Jeanneret V, Yepes M. The Plasminogen Activation System Promotes Dendritic Spine Recovery and Improvement in Neurological Function After an Ischemic Stroke. Transl Stroke Res 2016:10.1007/s12975-016-0454-x. [PMID: 26846991 PMCID: PMC4974155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 01/21/2016] [Accepted: 01/26/2016] [Indexed: 02/28/2024]
Abstract
Advances in neurocritical care and interventional neuroradiology have led to a significant decrease in acute ischemic stroke (AIS) mortality. In contrast, due to the lack of an effective therapeutic strategy to promote neuronal recovery among AIS survivors, cerebral ischemia is still a leading cause of disability in the world. Ischemic stroke has a harmful impact on synaptic structure and function, and plasticity-mediated synaptic recovery is associated with neurological improvement following an AIS. Dendritic spines (DSs) are specialized dendritic protrusions that receive most of the excitatory input in the brain. The deleterious effect of cerebral ischemia on DSs morphology and function has been associated with impaired synaptic transmission and neurological deterioration. However, these changes are reversible if cerebral blood flow is restored on time, and this recovery has been associated with neurological improvement following an AIS. Tissue-type plasminogen activator (tPA) and urokinase-type plasminogen activator (uPA) are two serine proteases that, besides catalyzing the conversion of plasminogen into plasmin in the intravascular and pericellular environment, respectively, are also efficient inductors of synaptic plasticity. Accordingly, recent evidence indicates that both, tPA and uPA, protect DSs from the metabolic stress associated with the ischemic injury, and promote their morphological and functional recovery during the recovery phase from an AIS. Here, we will review data indicating that plasticity-induced changes in DSs and the associated post-synaptic density play a pivotal role in the recovery process from AIS, making special emphasis on the role of tPA and uPA in this process.
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Affiliation(s)
- Valerie Jeanneret
- Department of Neurology & Center for Neurodegenerative Disease, Emory University School of Medicine, Whitehead Biomedical Research Building, 615 Michael Street, Suite 505J, Atlanta, GA, 30322, USA
| | - Manuel Yepes
- Department of Neurology & Center for Neurodegenerative Disease, Emory University School of Medicine, Whitehead Biomedical Research Building, 615 Michael Street, Suite 505J, Atlanta, GA, 30322, USA.
- Department of Neurology, Veterans Affairs Medical Center, Atlanta, GA, USA.
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Toro J, Díaz C, Reyes S, Jeanneret V, Burbano LE. Superficial siderosis related to a thoracic disc herniation with associated dural injury. CNS Neurosci Ther 2014; 20:469-72. [PMID: 24645836 DOI: 10.1111/cns.12253] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 02/19/2014] [Accepted: 02/19/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Jaime Toro
- Department of Neurology, Hospital Universitario Fundación Santa Fe de Bogotá, Bogotá, Colombia; School of Medicine, Universidad El Bosque, Bogotá, Colombia; School of Medicine, Universidad de Los Andes, Bogotá, Colombia
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Jeanneret V, Vogel P, Renaut P, Millet J, Theveniaux J, Barberousse V. Carbaxylosides of 4-ethyl-2-oxo-2H-benzopyran-7-yl as non-hydrolyzable, orally active venous antithrombotic agents. Bioorg Med Chem Lett 1998; 8:1687-8. [PMID: 9873415 DOI: 10.1016/s0960-894x(98)00283-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A (-)-conduritol F derivative was condensed with 4-ethyl-7-hydroxy-2H-1-benzopyran-2-one and converted into (+)-4-ethyl-7-[(1'R,2'S,3'S,4'R)-2',3',4'- trihydroxycyclohexyloxy]-2H-1-benzopyran-2-one ((+)-2). Enantiomer (-)-2 was obtained from a (+)-conduritol F derivative. The carbaxyloside (-)-2 with the L-xylose configuration was more active than (+)-2 in the Wessler's model.
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Affiliation(s)
- V Jeanneret
- Institut de chimie organique de l'Université de Lausanne, BCH, Lausanne-Dorigny, Switzerland
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