Sepsis-associated encephalopathy (SAE) is a frequent complication of severe systemic infection resulting in delirium, premature death, and long-term cognitive impairment. We closely mimicked SAE in a murine peritoneal contamination and infection (PCI) model. We found long-lasting synaptic pathology in the hippocampus including defective long-term synaptic plasticity, reduction of mature neuronal dendritic spines, and severely affected excitatory neurotransmission. Genes related to synaptic signaling, including the gene for activity-regulated cytoskeleton-associated protein (Arc/Arg3.1) and members of the transcription-regulatory EGR gene family, were downregulated. At the protein level, ARC expression and mitogen-activated protein kinase signaling in the brain were affected. For targeted rescue we used adeno-associated virus-mediated overexpression of ARC in the hippocampus in vivo. This recovered defective synaptic plasticity and improved memory dysfunction. Using the enriched environment paradigm as a non-invasive rescue intervention, we found improvement of defective long-term potentiation, memory, and anxiety. The beneficial effects of an enriched environment were accompanied by an increase in brain-derived neurotrophic factor (BDNF) and ARC expression in the hippocampus, suggesting that activation of the BDNF-TrkB pathway leads to restoration of the PCI-induced reduction of ARC. Collectively, our findings identify synaptic pathomechanisms underlying SAE and provide a conceptual approach to target SAE-induced synaptic dysfunction with potential therapeutic applications to patients with SAE.
Targeted rescue of synaptic plasticity improves cognitive decline in sepsis-associated encephalopathy.
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作者:Grünewald Benedikt, Wickel Jonathan, Hahn Nina, Rahmati Vahid, Rupp Hanna, Chung Ha-Yeun, Haselmann Holger, Strauss Anja S, Schmidl Lars, Hempel Nina, Grünewald Lena, Urbach Anja, Bauer Michael, Toyka Klaus V, Blaess Markus, Claus Ralf A, König Rainer, Geis Christian
期刊: | Molecular Therapy | 影响因子: | 12.000 |
时间: | 2024 | 起止号: | 2024 Jul 3; 32(7):2113-2129 |
doi: | 10.1016/j.ymthe.2024.05.001 |
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