ABSTRACT
Oxidative stress critically contributes to the pathogenesis of a variety of neurodegenerative diseases such as multiple sclerosis. Astrocytes are the main regulators of oxidative homeostasis in the brain and dysregulation of these cells likely contributes to the accumulation of oxidative damage. The nuclear factor erythroid 2-related factor 2 (Nrf2) is the main transcriptional regulator of the anti-oxidant stress defense. In this study, we elucidate the effects of astrocytic Nrf2-activation on brain-intrinsic inflammation and lesion development. Cells deficient for the Nrf2 repressor kelch-like ECH-associated protein 1 (Keap1) are characterized by hyperactivation of Nrf2-signaling. Therefore, wild type mice and mice with a GFAP-specific Keap1-deletion were fed with 0.25% cuprizone for 1 or 3 weeks. Cuprizone intoxication induced pronounced oligodendrocyte loss, demyelination and reactive gliosis in wild type animals. In contrast, astrocyte-specific Nrf2-activation was sufficient to prevent oligodendrocyte loss and demyelination, to ameliorate brain intrinsic inflammation and to counteract axonal damage. Our results highlight the potential of the Nrf2/ARE system for the treatment of neuroinflammation in general and of multiple sclerosis in particular. © GLIA 2016;64:2219-2230.
Subject(s)
Astrocytes/metabolism , Demyelinating Diseases/etiology , Gene Expression Regulation/physiology , Multiple Sclerosis/complications , Multiple Sclerosis/pathology , NF-E2-Related Factor 2/metabolism , Animals , Astrocytes/drug effects , Brain/diagnostic imaging , Brain/metabolism , Brain/pathology , Chemokine CXCL10/genetics , Chemokine CXCL10/metabolism , Cuprizone/toxicity , Disease Models, Animal , Gene Expression Regulation/drug effects , Gene Expression Regulation/genetics , Glial Fibrillary Acidic Protein/genetics , Glial Fibrillary Acidic Protein/metabolism , Glutamate-Cysteine Ligase/genetics , Glutamate-Cysteine Ligase/metabolism , Heme Oxygenase-1/genetics , Heme Oxygenase-1/metabolism , Kelch-Like ECH-Associated Protein 1/genetics , Kelch-Like ECH-Associated Protein 1/metabolism , Membrane Proteins/genetics , Membrane Proteins/metabolism , Mice , Mice, Inbred C57BL , Mice, Transgenic , Monoamine Oxidase Inhibitors/toxicity , Multiple Sclerosis/chemically induced , NF-E2-Related Factor 2/genetics , Oxidative Stress/drug effects , Oxidative Stress/genetics , Thioredoxin Reductase 1/genetics , Thioredoxin Reductase 1/metabolismABSTRACT
Space-occupying subarachnoid bleeding after atraumatic puncture of the spinal canal for spinal anesthesia in a patient with no coagulation disorders or anticoagulant therapy is described. The hematoma was caused by puncturing a previously undiagnosed small spinal ependymoma. A thorough and specific preoperative evaluation is of importance to minimize the risks associated with spinal anesthesia.
