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Brief Reviews |
From the Department of Molecular and Experimental Medicine (G.J.d.Z.), The Scripps Research Institute, La Jolla, Calif; Department of Molecular and Experimental Medicine (R.M.), The Scripps Research Institute, La Jolla, Calif.
Correspondence to Gregory J. del Zoppo, Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, MEM 132, La Jolla, CA 92037. E-mail grgdlzop{at}scripps.edu
| Abstract |
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In the central nervous system matrix adhesion receptors are uniquely expressed by the cells comprising the microvascular compartment, and by neurons and their supporting glial cells. This review examines current information about cell adhesion receptor expression within the cerebral microvasculature and surrounding tissue, and their potential roles during the vascular responses to local injury.
Key Words: bloodbrain barrier cerebral microvasculature dystroglycan integrins matrix adhesion receptors
| Introduction |
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Pial and cortical penetrating arteries consist of an endothelial cell layer, the basal lamina (derived from the extracellular matrix [ECM]), a myointima with smooth muscle cells encased in the matrix, and an adventitia.5 Arising from the leptomeninges, the adventitia of the cortical penetrating arteries is an extension of the subarachnoid space which forms the Virchow-Robbins space until it disappears into the glia limitans, the abluminal boundary formed by the astrocyte end-feet in small-caliber microvessels.57 In the cortical gray matter, the microvasculature consists of hierarchical arrays descending from pial penetrating arteries.810 In contrast, in the gray matter of the corpus striatum neurons are arranged in a more-or-less consistent and orderly fashion in relation to their adjacent microvessel supply.11 These arrangements derive from laminin-directed migration of both neurons and microvessel elements during development of the central nervous system (CNS).1214
Capillaries comprise
60% of the cerebral microvasculature, and are an integral part of the neuropil. Within cerebral capillaries the matrix-containing basal lamina separates the specialized endothelium from astrocyte foot processes.5,15 Astrocytes participate in both the capillary ultrastructure and in communication with nearby neurons. Communication among astrocytes follows from their syncytial arrangement and occurs via Ca2+ channels.16 Neuronal stimulation can initiate microvascular and endothelial cell responses via these glial elements.17 Nedergaard has shown that neuronal function can also be modulated by astrocyte activation,18,19 and that astrocytes can signal.20
In addition to these cellular components of cerebral capillaries, recent evidence suggests the importance of pericytes and microglia to maturation of endothelial cell contacts and to the responses of the neurovascular unit to ischemia.21,22 Pericytes are found in the basal lamina matrix on the luminal aspect of astrocyte end-feet.
| Endothelial Transport Properties |
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| Specialization of the Microvasculature |
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| The Cerebral Microvascular Permeability Barrier |
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| Matrix Adhesion Receptors |
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Integrins
Integrins are cell surface transmembrane, noncovalently-linked
ß heterodimers that recognize specific matrix ligands.43 Functionally, integrins can regulate cell behavior by: (1) forming a transmembrane link between the matrix and the cell cytoskeleton; (2) transducing extracellular stimuli to intracellular signals; and (3) generating increased receptor specificity by cellular activation.44,45 Integrins are central to many developmental, physiological, and pathological processes of the CNS and other tissues. In the adult CNS, integrin subunits are distributed in the microvasculature in distinct expression patterns.32
Dystroglycan
Dystroglycan is a single
ß heterodimeric transmembrane receptor, distinct from integrins, that forms a physical link between the intracellular cytoskeleton and the ECM. The
subunit is formed by proteolytic cleavage of a single precursor, and interacts noncovalently with the 43-kDa transmembrane ß subunit to form the active receptor.46,47
-dystroglycan, the 120- to 190-kDa glycosylated extracellular subunit, binds to the ECM proteins laminin (the laminin-
2 chain), perlecan (heparin sulfate proteoglycan [HSPG]), and agrin.48,49 The intracellular carboxy-terminus of ß-dystroglycan binds to the cytoskeletal proteins dystrophin and utrophin.50,51 Expression of
ß-dystroglycan in the cerebral microvasculature is associated with both endothelial cells and astrocytes.49,52,53 The dystroglycan complex shares laminin as the primary matrix ligand with a number of integrin receptors, including
1ß1,
3ß1,
6ß1, and
6ß4, which are also expressed in the CNS microvasculature.5457
| Roles of Integrin Receptors in the CNS as Defined by Integrin Null Mice |
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4,
5,
8, or ß1 expression results in embryonic lethality in murine knockout constructs (Table 1),5861 it has not been established whether their functions are required for maintaining bloodbrain barrier integrity. Deletions of the integrin subunits
3,
6,
v, ß4, or ß8 are lethal in the perinatal period in mice.6266 Significantly, deletions of the integrin subunits
6,
v, and ß8 demonstrate a clear CNS phenotype.64,66,67
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6 Integrin
The premature death of
6 integrin null mice is caused by defective attachment of the epidermis to the matrix of the underlying basement membrane (reminiscent of the disorders junctional epidermolysis bullosa and bullous pemphigoid in humans).63 Mice lacking the integrin
6 subunit also show defective neuronal migration in the CNS. Neurons migrate beyond their normal position resulting in disordered layering of the cerebral cortex and neuronal ectopia on the outer surface of the cortex.67 A similar phenotype is generated by deletion within the laminin
1 chain gene and the gene of the ECM protein reelin,68,69 demonstrating that laminin
6ß1 signaling is required for the establishment of neuronal patterning during cerebral development. The impact on cerebrovascular development has not been investigated.
v or ß8 Integrins
Within the CNS, the endothelium or microvascular structures associated with the endothelium depend on integrin
vß8 in a way that blood vessels outside the CNS do not.70 Mice which lack the
v or ß8 integrin subunits suffer cerebral hemorrhage, and do not survive past the perinatal period.64,66 Cerebral vessels in
v or ß8 null constructs dilate at an early developmental stage resulting in a leaky vasculature. This defect has been attributed to failure of proper adhesive interactions among the neuroepithelial cells, astrocytes, and endothelial cells during cerebrovascular development. Conditional knockout preparations which specifically remove
v integrins from either endothelial cells or astrocytes have demonstrated that integrin
vß8 expressed by astrocytes is important for the adhesive interaction to take place.71,72 Recent work has suggested that astrocyte
vß8 integrin may activate transforming growth factor-ß and thereby stabilize the endothelium, such that in the absence of this integrin, the microvasculature is more prone to hemorrhage.73
ß1 Integrins
The role of ß1 integrins in neurons and glia has been evaluated using cre-lox technology. Such cell-selective knockouts produce a phenotype similar to deletions of the
6 integrin,
-laminin, and reelin genes.63,68,69 Integrin ß1/ neurons adhere to and migrate along radial glia normally, but result in a disordered neuronal layering of the cerebral cortex.74 Furthermore, glial end-feet fail to make proper connections to the meningeal basement membrane, disordering the marginal zone of the developing cerebral cortex and resulting in aberrant cortical organization. Hence, while ß1 integrins are not required for neuronal adhesion, survival, or migration, they participate in glial-matrix interactions at the meninges, and are required for the proper establishment of the marginal zone in the developing cerebral cortex.
To date, the consequences of conditional knockout of the integrin ß1 subunit on the cerebral vasculature are not known. The loss of ß1 integrin expression on both endothelial cells and astrocytes after focal cerebral ischemia accompanies structural alterations in the microvasculature.75 This suggests essential roles for ß1 integrins within the microvasculature.
| Regulation of Integrin Expression and Function During CNS Development |
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6ß1 and loss of the active conformation of the ß1 integrins still expressed on the cell surface of retinal ganglion cells.77,78 Another form of developmental integrin regulation is exemplified by oligodendroglial cells which change the ß-subunit partners of
v integrins from
vß1 to
vß5 during terminal differentiation.79
Cerebral blood vessel maturation is associated with marked up-regulation of ß1 integrin expression during CNS development,80 which coincides with a switch in endothelial cell ß1 integrin expression. In the postnatal angiogenic period cerebral endothelial cells express the fibronectin receptors
4ß1 and
5ß1, but after cessation of angiogenesis, switch to the laminin receptors
1ß1 and
6ß1. This "integrin switch" coincides with a concomitant change in the endothelial cellmatrix ligands from fibronectin to laminin. Taken together, this suggests an instructive role for ß1 integrins during angiogenesis in the CNS.
| Adhesion Receptor Expression in the Adult Brain |
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Endothelial Cells
ß1 Integrins
Haring et al characterized microvascular integrin subunit expression in the normal primate striatum and cortex gray matter,32 in part confirming other reports of vascular integrin expression in human brain (Table 2).8183 Integrin subunits
1 and
6 are distributed throughout the normal cerebral microvasculature in a pattern identical to subunit ß1,81 suggesting the common expression of integrins
1ß1 and
6ß1 throughout the cerebrovascular tree in all mammalian species.82 Their expression parallels that of the ß1-matrix ligands laminin, collagen IV, and fibronectin. The integrin
3 subunit is expressed on a subset of capillaries less frequently than
1 or
6. The reasons for this differential expression are not known.32 McGeer et al and Paulus et al confirmed that integrin
2 appears on the cerebral microvasculature, and Haring et al noted its expression by non-capillary microvessels exclusively in a pattern quite similar to subunits
4,
5 and ß3.81,82 The expression of several known typical
-subunit partners for the integrin ß1 on select capillary/microvessel subclasses might be explained by endothelial cell specialization along the microvascular axis.
Integrin
vß3
Integrin subunits
v and ß3 are roughly equally expressed on a very small proportion of resting non-capillary microvessels in comparison to the distribution of basal lamina matrix proteins.32,84 Integrin
vß3 expression is significantly upregulated after the onset of focal ischemia.85
Glial Cells
ß1 Integrins
The observation of ß1 integrin expression on astrocytes is consistent in post-mortem human brain and rat brain.82,83 Both subunits
1 and ß1 are found on astrocyte fibers surrounding select microvessels in the adult primate.32,86 In addition, murine primary astrocytes in culture express integrins
1ß1,
3ß1,
5ß1, and
6ß1.79,87,88 Function-blocking studies show that these integrins are functionally active adhesion receptors for laminin (
1ß1,
3ß1, and
6ß1) and fibronectin (
5ß1).88,89 Astrocytes in culture also express integrins
vß5 and
vß8 which, on a vitronectin substrate, promote astrocyte adhesion and migration, respectively.89
Integrin
6ß4
Integrin
6ß4 is expressed on the astrocyte end-feet in a small proportion of normal capillaries and noncapillary microvessels (Table 2).32,86 The reasons for this restricted expression are so far unknown. A matrix ligand for integrin
6ß4, laminin-5 is codistributed in the cerebral microvascular basal lamina with the major matrix constituents laminin-1, collagen type IV, and cellular fibronectin.86 Hemidesmosomes, which anchor epithelial cells to the cuticular basement membrane, contain the integrin
6ß4,90,91 and have been found in astrocyte end-feet at the vascular basal lamina interface of larger microvessels.92 In short, integrin
6ß4 could play active roles in the attachment of astrocyte end-feet to the basal lamina of select microvessels for maintaining their close apposition to the endothelium.
Other Integrin Receptors
4 and
5 Integrins
While
4 and
5 integrins are expressed during angiogenesis, they are developmentally downregulated after angiogenesis80 and are expressed by only a small proportion of noncapillary cerebral microvessels in the primate.84 But, subunit
5, and not
4, has been identified on adult human cerebral microvessels in one report.82
| Vascular Matrix-Adhesion Receptor Expression During Focal Cerebral Ischemia |
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The changes seen in microvascular integrin expression accompany rapid local alterations in their matrix ligands within the basal lamina. Laminin-1, collagen type IV, and cellular fibronectin decrease to &60% of the baseline in the ischemic core by 24 hours following middle cerebral artery occlusion (MCAO).15 Within 2 hours there is significantly greater loss of the HSPG perlecan than laminin within the basal lamina, indicating the greater sensitivity of this integrin ß1-ligand to focal ischemia.94 These events correlate with the simultaneous generation of the matrix proteases pro-matrix metalloproteinase (MMP)-2 (pro-MMP-2), pro-MMP-9, and their activators urokinase, membrane-type 1 (MT1)-MMP, and MT3-MMP on microvessels (and neurons) within the regions of injury.9597 Cysteine protease activity, marked by the appearance of cathepsin L, corresponds to the loss of HSPG.94 Importantly, loss of the major basal lamina proteins are directly associated with extravasation of erythrocytes and hemorrhagic transformation.98
Endothelial Cells
ß1 Integrins
While the endothelium remains intact, glial end-feet are displaced from the basal lamina. By 2 hours after MCAO, endothelial cell ß1-integrin expression by the endothelium is lost in 69±7% of microvessels within the ischemic core (Figure 2).75 This loss is sustained and does not recover despite restitution of flow.75 The mechanisms by which ischemia diminishes microvessel ß1 expression are not yet known. However, within the ischemic core, downregulation of microvessel-associated integrin ß1 gene appears heterogeneous: confluent regions of increased ß1 transcription on microvessels surround subregions with depressed ß1 expression early after MCAO.75 The upregulation of ß1 in the boundary between the ischemic core and the intermediately affected peripheral zone, and around subregions lacking expression, is consistent with the notion that the "ischemic penumbra" is initially interspersed among relatively unaffected tissue within the core.75 In time all ß1 gene expression ceases as the injured subregions merge.
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Within the ischemic core, the subunits
1,
3, and
6 are significantly depressed in parallel with the ß1 subunit (Table 2, Figure 3),32 suggesting that all endothelial cell ß1-integrin complexes are affected by ischemia. Endothelial cell
1ß1 expression continues on microvessels which retain laminin within the intact basal lamina; the loss of this integrin generally precedes that of laminin.75 But, there is no evidence of endothelial cell detachment early after MCAO. The relationships of these changes to local flow conditions are not yet known.
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Integrin
vß3
Capillary bud formation appears by 7 days after MCAO.99,100 However, it is not yet known what roles integrin
vß3 plays in cerebral angiogenesis. Tissue culture studies have shown that integrin
vß3 is expressed by cerebral endothelial cells,101 but not astrocytes.89 While
vß3 is not normally expressed by resting endothelial cells in vivo, it is induced during angiogenesis or in cell culture, and plays an important role in mediating brain capillary endothelial cell adhesion to fibronectin, thus promoting endothelial cell survival and proliferation.101 Focal ischemia stimulates the consistent and significant early expression of the integrin
vß3 on activated noncapillary cerebral microvessels, whereas integrin
vß5 expression is not affected (Table 2, Figure 3).84,85 However, the molecular and vascular consequences of coordinated vascular endothelial growth factor (VEGF) and integrin
vß3 expression on activated microvessels, a highly significant relationship, seen by 2 hours after MCAO have not yet been defined.84 Several model systems have demonstrated local increases in hypoxia inducible factor (HIF)-1
or the cytokines interleukin (IL)-1ß and tumor necrosis factor-
, both promoters of VEGF gene expression, in the regions of ischemic injury.102104 Subunit
v transcription is upregulated along with VEGF in affected microvessels within the ischemic core.84 Also, a highly significant relationship between microvessel
vß3 expression and fibrin deposition (one of its ligands) within the microvasculature has been observed.84 The significant relationship among microvascular proliferating cell nuclear antigen, VEGF, and integrin
vß3 expression is independent of time, reflecting the heterogeneity of the evolving injury in the striatum.84
Glial Cells
Integrin
6ß4
After the onset of focal ischemia, integrin
6ß4 is rapidly lost from the astrocyte end-feet of select microvessels.86 This corresponds to the separation of astrocytes from the vascular matrix early after MCAO, and to the cell swelling and loss in cytoplasmic density, which accompanies astrocyte separation (Figure 2). These changes in ultrastructure and integrin
6ß4 expression also imply fundamental alterations in the end-foot apparatus.
| Multiple Sclerosis and Experimental Autoimmune Encephalomyelitis |
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6ß1 expression on microvascular endothelial cells is altered in MS (Table 2).105 During the active phase of MS, the expressions of the integrin ß1 and
6 subunits are decreased, but return to normal during the inactive recovery phase (Table 2). This indicates that loss of endothelial adhesion receptors coincides with increased barrier permeability during the active phase of MS, and implies that adhesion receptor function is necessary for maintenance of the bloodbrain barrier.
In experimental autoimmune encephalomyelitis (EAE), an animal model of MS, the expressions of the integrin ß4 and
v subunits on astrocytes are increased.106 This effect can be reproduced in vitro when primary astrocytes are treated with the pro-inflammatory cytokine tumor necrosis factor-
. This implies that cytokine expression could drive matrix receptor expression on microvascular cells (ie, astrocytes). In addition, a recent study described loss of dystroglycan from astrocyte end-feet during EAE.107
| Targeting IntegrinMatrix Interactions as Potential Treatments |
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Leukocytes enter the neuropil during the cellular inflammatory phases of MS and ischemic stroke.108111 In murine EAE,
4 integrins and to a lesser extent the ß2 integrins on leukocytes mediate their adhesion to the endothelium and transmigration.112,113 Based on promising data from animal studies, clinical trials have established that infusion of a humanized monoclonal antibody against the
4 integrin subunit into patients with the relapsingremitting form of MS significantly reduces both the relapse frequency and the number of new demyelinated lesions.108,109 However, total blockade of leukocyte entry into the CNS might not be a desirable outcome for the patient.114,115 More effective might be titration of the excessive leukocyte response while leaving some endogenous protection intact.116
Blockade of leukocyte ß2-integrins early during MCAO significantly decreases focal "no-reflow" in primates.110,111 Furthermore, blockade of the platelet-fibrin(ogen) receptor
IIbß3 increases microvessel patency and decreases injury volume after MCAO in a separate experimental system.117 A significant dose-dependent increase in debilitating hemorrhage within the ischemic regions can occur with these agents.117,118 In keeping with the observation that specific integrin
IIbß3 blockade can produce hemorrhage within the ischemic territory in animal models, a prospective phase III trial of the pan-ß3 inhibitor of platelet
IIbß3 in ischemic stroke patients has been terminated because of safety concerns.119 This suggests that despite salutary effects of integrin blockade at the vascular interface a more complete understanding of the mechanisms whereby adhesive events regulate bloodbrain barrier integrity and leukocyte trafficking across the microvessel permeability barrier is required.
| Adhesion Receptors and the Permeability Barrier |
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Three lines of evidence suggest that matrix adhesion receptors may play an important role in maintaining the permeability barrier of the brain. First, select integrins and dystroglycan are expressed at high levels specifically at the bloodbrain barrier. Second, alterations in the expression of these receptors coincide with breakdown of the permeability barrier, leading to glial activation and neuronal injury. Third, studies of transgenic mice show that the absence of specific integrins leads to breakdown of the cerebral vasculature, supporting the notion that ECM receptors could participate in the maintenance of cerebrovascular integrity.
Based on those observations, we propose that the microvessel permeability barrier in the brain consists of both "horizontal" and "vertical" components. The tight junctions that form between adjacent endothelial cells have been viewed as the basis for the endothelial permeability barrier in mammalian brain. The tight junctions and the interendothelial adherens complexes together constitute the "horizontal" component. We wish to extend this model to include a vertical component, consisting of the matrix adhesion complexes formed between adhesion receptors on both endothelial cells and astrocytes, which anchor the cells to the intervening basal lamina of extracellular matrix. "Vertical" adhesion of the astrocyte foot processes by matrix receptors maintains the close proximity of the astrocyte portion of the microvascular compartment to the endothelium, and hence their contribution to endothelial cell barrier integrity. This proximity is necessary for the competence of the microvascular barrier and its unique resistance properties in the CNS. One important implication of this concept is that by altering vertical adhesion at the barrier interface new avenues of therapeutic potential could be devised.
| Acknowledgments |
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Sources of Funding
The preparation of this manuscript was supported in part by RO1 NS026945, RO1 NS038710, and RO1 NS053716 of the National Institutes of Health.
Disclosures
None.
| Footnotes |
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| References |
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