Journal
JOURNAL OF THE AMERICAN HEART ASSOCIATION
Volume 8, Issue 2, Pages -Publisher
WILEY
DOI: 10.1161/JAHA.118.010838
Keywords
amyloid; brain; ischemia/reperfusion injury/neuroprotection; proprotein convertase subtilisin/kexin type 9
Categories
Funding
- Thailand Research Fund [RTA6080003, RSA6080056, TRG6080005]
- Royal Golden Jubilee Program [PHD/0111/2559, PHD/144/2558]
- NSTDA Research Chair grant from the National Science and Technology Development Agency Thailand
- Chiang Mai University Center of Excellence Award
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Background-Cardiac ischemic/reperfusion (I/R) injury leads to brain damage. A new antihyperlipidemic drug is aimed at inhibiting PCSK9 (proprotein convertase subtilisin/kexin type 9), a molecule first identified in a neuronal apoptosis paradigm. Thus, the PCSK9 inhibitor (PCSK9i) may play a role in neuronal recovery following cardiac I/R insults. We hypothesize that PCSK9i attenuates brain damage caused by cardiac I/R via diminishing microglial/astrocytic hyperactivation, beta-amyloid aggregation, and loss of dendritic spine. Methods and Results-Adult male rats were divided into 7 groups: (1) control (n=4); (2) PCSK9i without cardiac I/R (n=4); (3) sham (n=4); and cardiac I/R (n=40). Cardiac I/R rats were divided into 4 subgroups (n=10/subgroup): (1) vehicle; (2) PCSK9i (10 jtg/kg, IV) before ischemia; (3) PCSK9i during ischemia; and (4) PCSK9i at the onset of reperfusion. At the end of cardiac I/R protocol, brains were removed to determine microglial and astrocytic activities, p-amyloid aggravation, and dendritic spine density. The cardiac I/R led to the activation of the brain's innate immunity resulting in increasing lbar microglia, GFAP1 astrocytes, and CD11b(+)/CD45(+low) cell numbers. However, CD11b(+)/CD45(+high) cell numbers were decreased following cardiac I/R. In addition, cardiac I/R led to reduced dendritic spine density, and increased beta-amyloid aggregation. Only the administration of PCSK9i before ischemia effectively attenuated these deleterious effects on the brain following cardiac I/R. PCSK9i administration under the physiologic condition did not affect the aforementioned parameters. Conclusions-Cardiac I/R injury activated microglial activity in the brain, leading to brain damage. Only the pretreatment with PCSK9i prevented dendritic spine loss via reduction of microglial activation and A beta aggregation.
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