Mayne, E. W. | bioRxiv Science

bioRxiv2025

Blockade of VCAM1 or VLA4 preserves cerebrovasculature and prevents cognitive decline late after stroke

Infarct-induced neurodegeneration occurs chronically after stroke, doubling the risk of dementia. Endothelial vascular cell adhesion molecule 1 (VCAM1) facilitates blood-brain barrier opening and immune cell diapedesis by binding very late antigen 4 (VLA4) on immune cells. We hypothesized that vascular dysfunction persists after stroke and contributes to chronic neuroinflammation and cognitive decline via signaling through the VLA4/VCAM1 axis. We used adult (3-5 month old) and middle-aged (10 month old) C57BL/6J male & female mice and a permanent middle cerebral artery occlusion stroke model. Sham surgery consisted of an identical procedure without occlusion of the artery. We quantified vascular integrity using blood vessel length, pericyte coverage of vasculature, tight junctions, and extravascular fibrinogen leakage by immunostaining. Cognitive testing was performed using both Barnes maze and novel object recognition prior to stroke, and 1 and 6 weeks after stroke, and replicated in both male and female mice. We utilized anti-VCAM1, anti-VLA4 or isotype control antibodies to block VCAM1 or VLA4 function, and then to confirm mechanisms we utilized single cell RNA sequencing on immune and endothelial cells, aptamer-based plasma proteomics, and additional immunostaining for vascular integrity. Mouse brains exhibited signs of persistent vascular dysfunction and loss of blood-brain barrier integrity at 8 weeks after stroke, compared to sham animals. We observed reduced ZO-1 tight junction and pericyte coverage of vasculature, and increased extravascular fibrinogen. Mice with stroke also developed a cognitive deficit in both Barnes maze and novel object by 6 weeks. Treatment with anti-VCAM1 or anti-VLA4 resulted in mice with stroke performing as well as sham mice treated with isotype control antibody on both the Barnes maze and novel object recognition tasks. Anti-VCAM1 and anti-VLA4 both increased expression of blood-brain barrier maintenance genes in brain endothelial cells, while only minimally altering immune cell gene expression. Immune cell infiltration was reduced by anti-VCAM1 but not anti-VLA4 in tissue sections. In contrast to this, both antibodies increased blood vessel length and pericyte vascular coverage. Finally, extravascular fibrinogen was reduced by both antibody treatments in multiple brain regions. Together, our findings establish the VLA4/VCAM1 axis as a promising target to preserve vascular integrity and prevent cognitive decline late after stroke. Our data is consistent with a model where blocking either VCAM1 or VLA4 chronically after stroke promotes new blood vessel growth and maturation and restores the blood-brain barrier to prevent infarct-induced neurodegeneration.

neuroscience↗

bioRxiv2025

Juvenile mice are susceptible to infarct-induced neurodegeneration that causes delayed cognitive decline in a new model of pediatric ischemic stroke

Over half of pediatric stroke survivors have permanent neurologic and cognitive deficits, and some children develop new or worsening cognitive impairment late after stroke. Their cognitive symptoms are associated with chronic alterations of brain structure in regions distant from the infarct, including in the uninjured hemisphere. However, the mechanisms that cause childrens late cognitive symptoms and disrupted brain growth outside the infarcted tissue remain unknown. We therefore developed and validated a mouse model of pediatric ischemic stroke that causes infarct-induced, delayed cognitive decline accompanied by chronic innate and adaptive neuroinflammation in the infarct and in uninjured subcortical regions that are connected to the infarct. MethodsMale and female C57BL/6J mice were randomized to stroke or sham surgery at p28 to model stroke in late childhood and compared to adult 6-month-old mice. We used permanent distal MCAO followed by 60 minutes of hypoxia, an established model for focal ischemia that generates a purely cortical stroke. Mice underwent behavioral testing at 1- and 7-weeks post stroke Barnes Maze protocol adapted for reversal learning. We performed immunostaining to quantify stroke size, atrophy, and innate and adaptive neuroinflammation at 3 days and 7 weeks after surgery. ResultsAt 7 weeks post-stroke, juvenile stroke mice performed significantly worse on reversal learning on Barnes Maze testing than sham mice (n = 7 stroke, 7 sham, p = 0.0265 2-way ANOVA with repeated measures). At 3 days after stroke, juvenile mice had greater innate immune cell activation at subcortical sites of secondary neurodegeneration; however, by 7 weeks after surgery, this relationship was reversed, and adults had greater chronic innate immune cell activation at these uninjured subcortical sites (corpus callosum, corticospinal tract, thalamus). Like adult mice, pediatric mice exhibited chronic innate and adaptive neuroimmunity in the infarct scar; the inflammation in the stroke scar did not differ by age. ConclusionsIn a model of pediatric ischemic stroke, juvenile mice develop a delayed cognitive deficit that is associated with chronic innate and adaptive neuroinflammation in uninjured subcortical structures that undergo secondary neurodegeneration. Our results suggest that infarct-induced neurodegeneration occurs after stroke in juvenile mice and that juvenile and adult mice have divergent trajectories in the innate immune response to stroke.

neuroscience↗