Gain-of-Function Mutations of TRPV4 Acting in Endothelial Cells Drive Blood-CNS Barrier Breakdown and Motor Neuron Degeneration in Mice

This article is written by Jeremy M. Sullivan et al. and published in the journal “Science Translational Medicine” on May 22, 2024, titled “Gain-of-function TRPV4 Mutations in Endothelial Cells Disrupt the Blood-Spinal Cord Barrier and Cause Motor Neuron Degeneration in Mice.”

Academic Background

The research background of this article revolves around a key issue in neurodegenerative diseases: whether the disruption of the blood-spinal cord barrier (BSCB) is sufficient to trigger neurodegenerative diseases. Disruption of the BSCB is a significant feature of various neurological disorders, including Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), multiple sclerosis, traumatic brain and spinal cord injuries, stroke, and neuropathic pain. However, it remains unclear whether BSCB impairment alone can cause these pathological changes. Furthermore, therapeutic strategies to limit excessive BSCB permeability are still very limited.

Source of the Paper

This paper is co-authored by researchers from several academic institutions, including Johns Hopkins University School of Medicine, University of Rhode Island, and Jackson Laboratory. It was published in the journal “Science Translational Medicine” on May 22, 2024.

Research Process

The study explored the impact of TRPV4 mutations on neurological diseases by generating and characterizing mouse models carrying these mutations. The research process mainly included the following steps:

1. Generation of Mouse Models

The research team chose two disease-related mutations of TRPV4, R269C and R232C, and introduced them into the TRPV4 gene of mice via gene knock-in. Both mutations, R269C and R232C, are known to cause distal spinal muscular atrophy (DSMA) and Charcot-Marie-Tooth disease (CMT2). The trpv4r269c/r269c and trpv4r232c/+ mice were generated using the Cre/loxP system and CRISPR-Cas9 gene editing technology.

2. Phenotypic Analysis

The mutant mice exhibited significant neurological behavioral defects, which became apparent as early as the third week after birth and were lethal at the time of weaning. Behavioral defects observed in mutant mice included paralysis of the forelimbs, kyphosis, and difficulties in maintaining head posture.

3. Histopathological Examination

Research found local death of motor neurons and proximal axonal degeneration in the anterior horn of the cervical spinal cord in TRPV4 mutant mice. Moreover, denervation of neuromuscular junctions was observed in the upper cervical spinal cord, but not in forelimb muscles. Electrophysiological examinations showed significantly weakened monosynaptic sensory-motor reflexes at the upper cervical spinal cord level in mutant mice.

4. Gene Knockout Experiments

To further confirm the role of TRPV4 mutations in specific cell types, the research team used 13 different Cre mouse strains to specifically knock out the TRPV4 mutant gene. Results showed that only the specific knockout of the mutant gene in endothelial cells significantly improved the survival rate of mice, restored their motor behavior, and prevented motor neuron loss and axonal degeneration.

5. Endothelial Cell Functional Analysis

Through in vitro and in vivo experiments, including calcium ion imaging, resistance measurements, and patch-clamp electrophysiological experiments, the research team discovered that the mutant TRPV4 channel exhibited significant gain-of-function effects in neurovascular endothelial cells (NVECs), leading to markedly elevated intracellular calcium ion levels, which in turn affected the integrity of the BSCB.

6. BSCB Functional Damage Detection

Further analysis using tracer and immunostaining methods revealed that the permeability of the BSCB significantly increased in the anterior horn region at the cervical spinal cord level in TRPV4 mutant mice. The highly localized barrier disruption was directly related to the overactivation of mutant TRPV4 channels in NVECs.

7. Pharmacological Intervention Experiments

Systemic treatment of mutant mice using the TRPV4-specific antagonist GSK219 significantly improved the survival rate and motor behavior of the mutant mice, restored BSCB functional integrity, and prevented motor neuron loss and axonal degeneration.

Research Conclusions

This article proposes a novel disease mechanism whereby TRPV4 mutations non-cell autonomously induce local collapse of the blood-spinal cord barrier via endothelial cells, leading to motor neuron degeneration. These findings emphasize the critical role of NVECs in neurodegenerative diseases and identify TRPV4 as an important regulator of BSCB permeability.

The most important conclusion is that pharmacological inhibition of TRPV4 activity can reverse disease phenotypes, providing a potential therapeutic strategy. This has significant treatment potential for patients carrying TRPV4 mutations and other neurological diseases involving BSCB integrity impairment.

Research Highlights

  1. Discovery of a New Disease Mechanism: For the first time, proposed a mechanism where TRPV4 mutations lead to NVECs functional gain, causing BSCB collapse and motor neuron degeneration.
  2. Establishment of a Treatment Strategy: Experimentally demonstrated that specific TRPV4 antagonists can significantly improve disease phenotypes, implying the feasibility of TRPV4 antagonists as a therapeutic approach.
  3. Region-specific BSCB Collapse: Localized BSCB collapse induced by mutant TRPV4 primarily occurs in the anterior horn of the spinal cord, crucial for understanding local neurodegenerative pathology.

Research Value

This research not only provides a new perspective for understanding the overall pathology of neurodegenerative diseases but also offers new directions for clinical treatment. The potential application prospects of TRPV4 antagonists, especially in the treatment of neurological diseases, deserve further in-depth research and clinical testing. This discovery is bound to significantly influence existing treatment strategies for neurodegenerative diseases.