Modulation of the Blood-Brain Barrier During Hypertension Development

Abstract

Hypertension is involved in the exacerbation of stroke. Increased blood-brain barrier (BBB) permeability and cerebral edema formation are potentially lethal complications of cerebral infarction. It is unclear how BBB tight junction (TJ), ion transporter, and protein kinase C (PKC) signaling pathway proteins critical for maintaining brain homeostasis contribute to cerebral infarction during hypertension development. The hypothesis of this study is that hypertension leads to molecular changes in the BBB which predispose the brain to increased cerebral infarct damage following ischemic stroke. Studies were undertaken to investigate the effect of hypertension development on (1) physiological parameters of the spontaneously hypertensive rat (SHR) and on the expression levels of BBB TJ, ion transporter, and PKC proteins potentially involved in ischemia-induced infarct damage; (2) ischemia-induced infarct volume following permanent middle cerebral artery occlusion (MCAO); and (3) the effect of inhibition of Na+/H+ exchanger isoform 1 (NHE-1) on ischemia-induced infarct volume following permanent MCAO in hypertensive SHR (15 weeks). Early hypertension development was determined in SHR and compared to normotensive, age-matched Wistar-Kyoto (WKY) rats at 5 (pre-hypertension), 10 (early stage hypertension), and 15 (later stage hypertension) weeks of age. Characterization of BBB TJ and ion transporter proteins known to contribute to edema and fluid volume changes in the brain show differential protein expression patterns during hypertension development. Western blot analysis of TJ zonula occludens-2 (ZO-2) showed decreased expression while ion transporter, NHE-1 was markedly increased in hypertensive SHR (15 weeks) compared to age-matched controls. Hypertensive SHR (10 and 15 weeks) showed greatly increased necrotic volume with impaired neurological deficits and edema formation. Increased NHE-1 expression in hypertensive SHR (15 week) suggests a potential role for this ion transporter in the promotion of ischemic brain injury. Selective inhibition of NHE-1 using 5-(N,N-Dimethyl)amiloride (DMA) showed significant attenuation in ischemia-induced infarct volume in hypertensive SHR following MCAO. These data suggest a novel role for NHE-1 at the BBB/neurovascular unit in the regulation of ischemia-induced infarct volume in hypertensive SHR suggesting that modulation of NHE-1 may be a factor important in the potentiation of MCAO infarct size and a novel therapeutic target in the prevention of ischemic stroke.