Peptidylglycine α-amidating monooxygenase restores brain microvascular blood flow and improves recovery following ischemic stroke

IntroductionReduced or absent capillary blood flow (termed no-reflow) even after arterial recanalization is associated with poorer neurological outcomes following ischemic stroke. The aim of the current study was to test whether acute administration of peptidylglycine -amidating monooxygenase (PAM) can increase capillary blood flow and improve brain recovery after ischemic stroke. MethodsA 60-minute ischemic stroke was induced using middle cerebral artery occlusion (MCAO) in rats. A modified, long-acting PAM enzyme was administered 30 minutes after induction of ischemia and rats were recovered for either 24 hours or 7 days. In all animals, real-time cerebral blood flow was assessed before, during and after MCAO using trasncranial contrast enhanced ultrasound (tCEU). For rats in the 7-day protocol, a modified neuroscore test was used to assess neurological deficit following MCAO. At the end of each experiment, a transcardiac perfusion was used to generate a fluorescent vascular cast and histology was used to examine capillary diameters and determine infarct volume. ResultsFollowing MCAO and arterial recanalization, untreated rats had reduced cerebral blood flow across brain regions affected by ischemia, indicative of no-reflow. PAM administration led to enhanced cerebral blood flow in affected regions, and this was associated with increased capillary diameters 24 hours after ischemic stroke. Although there was no difference in infarct volume at 24 hours, by day 7, infarct volume was markedly reduced in the PAM group and these animals exhibited improved neurological function compared to the untreated group. ConclusionAdministration of PAM improves capillary blood flow after ischemic stroke leading to enhanced neurological and brain recovery. This work highlights PAM as a novel theraputic approach to improve brain blood flow and recovery after ischemic stroke. GRAPHICAL ABSTRACT O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=110 SRC="FIGDIR/small/732201v1_ufig1.gif" ALT="Figure 1"> View larger version (36K): org.highwire.dtl.DTLVardef@1637bdeorg.highwire.dtl.DTLVardef@59548aorg.highwire.dtl.DTLVardef@bd365borg.highwire.dtl.DTLVardef@3baf84_HPS_FORMAT_FIGEXP M_FIG C_FIG