Journal
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES
Volume 23, Issue 6, Pages -Publisher
MDPI
DOI: 10.3390/ijms23062943
Keywords
germinal matrix hemorrhage; hydrocephalus; neuroinflammation; complement; microglia; pediatric
Funding
- Neurosurgery Research and Education Foundation (NREF) through the AANS/CNS Section on Pediatric Neurological Surgery & NREF Research Fellowship Grant
- Department of Veterans Affairs [IK6BX005235, 1BX004256, 1RX001141]
- National Institutes of Health (NIH) [T32AI132164]
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This study developed a mouse model of GMH and investigated the role of complement in PHH development. The results showed that CR2Crry treatment could slow down the progression of PHH, reduce lesion size, and improve central neuronal density and behavioral outcomes.
Germinal matrix hemorrhage (GMH) is a devastating disease of infancy that results in intraventricular hemorrhage, post-hemorrhagic hydrocephalus (PHH), periventricular leukomalacia, and neurocognitive deficits. There are no curative treatments and limited surgical options. We developed and characterized a mouse model of GMH based on the injection of collagenase into the subventricular zone of post-natal pups and utilized the model to investigate the role of complement in PHH development. The site-targeted complement inhibitor CR2Crry, which binds deposited C3 complement activation products, localized specifically in the brain following its systemic administration after GMH. Compared to vehicle, CR2Crry treatment reduced PHH and lesion size, which was accompanied by decreased perilesional complement deposition, decreased astrocytosis and microgliosis, and the preservation of dendritic and neuronal density. Complement inhibition also improved survival and weight gain, and it improved motor performance and cognitive outcomes measured in adolescence. The progression to PHH, neuronal loss, and associated behavioral deficits was linked to the microglial phagocytosis of complement opsonized neurons, which was reversed with CR2Crry treatment. Thus, complement plays an important role in the pathological sequelae of GMH, and complement inhibition represents a novel therapeutic approach to reduce the disease progression of a condition for which there is currently no treatment outside of surgical intervention.
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