Sex-specific acute cerebrovascular response to photothrombotic stroke in mice requires rho-kinase

With high energy consumption and low energy storage, the brain is highly reliant on continuous cerebral blood flow (CBF) that delivers substrates to maintain proper function, which is compromised after a stroke. The current study explores the overlapping roles played by two important modulators of cerebrovascular tone, rho-kinase (ROCK) and endogenous sex hormones, in the acute CBF responses to a photothrombotic (PT) model of ischemic stroke in ROCK2+/- mice and wild-type (WT) littermates. To remove endogenous hormones, male mice were gonadectomized and female mice were ovariectomized, whereas control ("intact") animals received a sham surgery prior to stroke induction. Intact WT males showed a delayed drop in CBF compared to intact WT females, where maximal CBF drop was observed 48 hours following stroke. Gonadectomy in males did not alter this response, however ovariectomy in females produced a "male-like" response. Intact ROCK2+/- males also showed such phenotypic response, which was not altered by gonadectomy. Alternatively, intact ROCK2+/- females showed a striking difference in CBF values compared to intact WT females, where they displayed higher CBF values immediately post-stroke and also showed a maximal CBF drop 48 hours post-stroke, which was not altered by ovariectomy. Overall, there is a marked sex difference in acute CBF responses to PT stroke, which appears to be mediated by endogenous female sex hormones and ROCK2. This study reveals important sex-differences and the involvement of ROCK2 in acute CBF responses to PT stroke in mice. Significance StatementThere are very few mechanistic investigations on disparities between sexes in post-stroke CBF outcome. Rho-kinase, an important regulator of vascular tone, has only been explored in males in terms of its modulation of CBF following stroke. Both rho-kinase and endogenous female sex hormones have a converging role on the regulation of endothelial nitric oxide synthase (eNOS), an important modulator of vascular tone. Rho-kinase is thought to elicit its neuroprotective effects against ischemic stroke through eNOS, however this has never been investigated in both sexes. Elucidating the cellular and molecular bases of sex differences in cerebrovascular pathophysiology is vital for understanding the origins of stroke outcomes, and for designing novel therapeutic strategies to promote functional recovery in both women and men.