Blood-brain barrier opening by intracarotid artery hyperosmolar mannitol induces sterile inflammatory and innate immune responses

Scott R. Burks, Cymon N. Kersch, Jaclyn A. Witko, Michael A. Pagel, Maggie Sundby, Leslie L. Muldoon, Edward A. Neuwelt, Joseph A. Frank

Research output: Contribution to journalArticlepeer-review

Abstract

Intracarotid arterial hyperosmolar mannitol (ICAHM) blood-brain barrier disruption (BBBD) is effective and safe for delivery of therapeutics for central nervous system malignancies. ICAHM osmotically alters endothelial cells and tight junction integrity to achieve BBBD. However, occurrence of neuroinflammation following hemispheric BBBD by ICAHM remains unknown. Temporal proteomic changes in rat brains following ICAHM included increased damage-associated molecular patterns, cytokines, chemokines, trophic factors, and cell adhesion molecules, indicative of a sterile inflammatory response (SIR). Proteomic changes occurred within 5 min of ICAHM infusion and returned to baseline by 96 h. Transcriptomic analyses following ICAHM BBBD further supported an SIR. Immunohistochemistry revealed activated astrocytes, microglia, and macrophages. Moreover, proinflammatory proteins were elevated in serum, and proteomic and histological findings from the contralateral hemisphere demonstrated a less pronounced SIR, suggesting neuroinflammation beyond regions of ICAHM infusion. Collectively, these results demonstrate ICAHM induces a transient SIR that could potentially be harnessed for neuroimmunomodulation.

Original languageEnglish (US)
Article number2021915118
JournalProceedings of the National Academy of Sciences of the United States of America
Volume118
Issue number18
DOIs
StatePublished - May 4 2021

Keywords

  • Blood-brain barrier
  • Hyperosmolar mannitol
  • Neuroinflammation
  • Sterile inflammation

ASJC Scopus subject areas

  • General

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