Complement-dependent P-selectin expression and injury following ischemic stroke

J Immunol. 2006 Nov 15;177(10):7266-74. doi: 10.4049/jimmunol.177.10.7266.

Abstract

The mechanisms that contribute to inflammatory damage following ischemic stroke are poorly characterized, but studies indicate a role for both complement and P-selectin. In this study, we show that compared with wild-type mice, C3-deficient mice showed significant improvement in survival, neurological deficit, and infarct size at 24 h after middle cerebral artery occlusion and reperfusion. Furthermore, P-selectin protein expression was undetectable in the cerebral microvasculature of C3-deficient mice following reperfusion, and there was reduced neutrophil influx, reduced microthrombus formation, and increased blood flow postreperfusion in C3-deficient mice. We further investigated the use of a novel complement inhibitory protein in a therapeutic paradigm. Complement receptor 2 (CR2)-Crry inhibits complement activation at the C3 stage and targets to sites of complement activation. Treatment of normal mice with CR2-Crry at 30 min postreperfusion resulted in a similar level of protection to that seen in C3-deficient mice in all of the above-measured parameters. The data demonstrate an important role for complement in cerebrovascular thrombosis, inflammation, and injury following ischemic stroke. P-selectin expression in the cerebrovasculature, which is also implicated in cerebral ischemia and reperfusion injury, was shown to be distal to and dependent on complement activation. Data also show that a CR2-targeted approach of complement inhibition provides appropriate bioavailability in cerebral injury to enable complement inhibition at a dose that does not significantly affect systemic levels of serum complement activity, a potential benefit for stroke patients where immunosuppression would be undesirable due to significantly increased susceptibility to lung infection.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Apoptosis / genetics
  • Apoptosis / immunology
  • Brain Ischemia / etiology
  • Brain Ischemia / genetics
  • Brain Ischemia / metabolism*
  • Brain Ischemia / therapy
  • Cerebrovascular Circulation / immunology
  • Complement C3 / antagonists & inhibitors*
  • Complement C3 / deficiency
  • Complement C3 / genetics
  • Complement C3 / physiology*
  • Complement Inactivator Proteins / administration & dosage
  • Complement Inactivator Proteins / physiology
  • Complement Inactivator Proteins / therapeutic use
  • Infarction, Middle Cerebral Artery / genetics
  • Infarction, Middle Cerebral Artery / metabolism
  • Infarction, Middle Cerebral Artery / pathology
  • Infarction, Middle Cerebral Artery / therapy
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Neutrophil Infiltration / genetics
  • Neutrophil Infiltration / immunology
  • P-Selectin / biosynthesis*
  • P-Selectin / physiology
  • Receptors, Complement / administration & dosage
  • Receptors, Complement / metabolism
  • Receptors, Complement / physiology
  • Receptors, Complement 3b
  • Receptors, Complement 3d / administration & dosage
  • Receptors, Complement 3d / physiology
  • Receptors, Complement 3d / therapeutic use
  • Reperfusion Injury / etiology
  • Reperfusion Injury / genetics
  • Reperfusion Injury / metabolism
  • Reperfusion Injury / therapy
  • Survival Analysis

Substances

  • Complement C3
  • Complement Inactivator Proteins
  • Cr1l protein, mouse
  • P-Selectin
  • Receptors, Complement
  • Receptors, Complement 3b
  • Receptors, Complement 3d