Targeting Sur1-Trpm4 in sepsis-induced brain injury

摘要 脓毒症引起的脑损伤与精神状态的急性恶化有关，导致长期的脑损伤。 认知缺陷、功能性发病率增加和生活质量下降。存在有限 由于没有可用的靶向治疗，中心性败血症患者的临床管理 神经系统（CNS）疾病学仅限于治疗潜在感染， 休克的重症监护管理。因此，需要更好地理解病理生物学， 败血症导致的急性脑功能紊乱我们之前已经证明， 盲肠结扎和穿孔（CLP）小鼠的脑中， 在与轴突肿胀和/或轴突损伤一致的各向异性分数中， 活化，以及随后的细胞毒性水肿的发展，如通过显著降低 CLP后4天的表观扩散系数值。磺酰脲受体-1（Sur 1）是一种跨膜受体， ATP结合盒转运蛋白家族ABCC 8中的受体，其在CNS损伤后上调以形成 与Ca 2+敏感性瞬时受体电位melastatin-4（Trpm 4）的专性结合导致水肿。 我们的初步数据表明，在小鼠脓毒症脑中Sur 1的上调。在该提案的目标1中， 我们将在小鼠败血症模型中确定Sur 1-Trpm 4表达与水肿之间的时间相关性， 个脑袋在目标2中，我们将确定Sur 1-Trpm 4的抑制是否与小胶质细胞的减少有关。 激活和水肿，从而导致随后的改善结果在鼠CLP模型， 败血症FDA批准的Sur 1-Trpm 4抑制剂的可用性进一步提高了对这种方法的兴趣。

Abstract Sepsis-induced brain injury is associated with an acute deterioration of mental status resulting in long-term cognitive deficits, increased functional morbidity, and diminution in the quality of life. There are limited diagnostic adjuncts, and as no targeted therapy is available, clinical management of septic patients with central nervous system (CNS) symptomatology is limited to the treatment of the underlying infection and optimal critical care management of shock. Therefore, a better understanding of the pathobiology is needed to define acute brain derangements in sepsis. We have previously demonstrated that magnetic resonance imaging of the brain in mice subjected to cecal ligation and puncture (CLP) was notable for an early and marked decrease in fractional anisotropy consistent with axonal swelling and/or axonal injury that was associated with microglial activation, and the subsequent development of cytotoxic edema as evidenced by a significant decrease in apparent diffusion coefficient values four days after CLP. Sulfonylurea receptor -1(Sur1) is a transmembrane receptor in the ATP binding cassette transporter family ABCC8 that upregulates after CNS injury to form an obligate association with Ca2+ sensitive transient receptor potential melastatin-4 (Trpm4) resulting in edema. Our preliminary data demonstrate the upregulation of Sur1 in murine septic brains. In this proposal, in aim 1, we will determine the temporal correlation between Sur1-Trpm4 expression and edema in the murine septic brain. In aim 2, we will determine if inhibition of Sur1-Trpm4 is associated with a decrease in microglial activation and edema, thereby leading to a subsequent improvement in outcomes in a murine CLP model of sepsis. The availability of an FDA approved Sur1-Trpm4 inhibitor further raises interest in this approach.