In this experiment, the process of neuronal death caused by transient global ischemia was analyzed, focusing on the prolonged changes in glial cells and multiple cytokine expression (IL-1α, IL-1β, IL-2, IL-4, IL-6, IL-10, GM-CSF, IFN-γ and TNF-α). The reduction curve of neuronal cells in CA1 after 4VO (Figure
3) was S shaped. The process of neuronal cell degeneration was divided into four phases: lag, exponential, deceleration and stationary phases. We found that the changes of glial cell morphology and cytokine expression differed among these four phases of neuronal reduction.
Glial cell activation after 4VO
In this 4VO experiment, activated microglial cells and astrocytes were observed in the entire hippocampus in the lag phase. After neuronal reduction was observed, both microglial cells and astrocytes gradually became more hypertrophic in CA1 than CA2-3. These results suggest that transient global ischemia activates microglial cells and astrocytes in an area wider than CA1 of the hippocampus in the lag phase but after the exponential phase, the activation of both glial cells was gradually restricted mainly to CA1. Glial cells in CA1 also increased in the deceleration phase.
Iba1+ clusters around Py on day3 consisted of activated microglial cells in the prophase or metaphase of the mitosis (see additional file
1). Fujita et al. [
30] prior reported that microglial cells actively proliferated in the initial stage of brain injury supports our findings. The existence of Iba1+ clusters on day3 indicates that the activated microglial cells, which may have migrated around Py or had already existed there, actively proliferated and Iba1+ clusters were created.
In order to shed more light on the relationship between neuronal death and NeuN+ cell loss, we studied DNA fragmentation using terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining. The result from this staining showed that neuronal DNA damage had already started on day2 (see additional file
2). There was a time lag between when neuronal death was detected by TUNEL and the occurrence of NeuN+ cell loss.
Our results, combined with those from previous reports [
29], suggest that glial cell activation is mainly a result of transient global ischemia in the lag phase. Neuronal cell death gradually evoked glial cell activation in the exponential phase and then dead cells stimulated the proliferation of glial cells.
Cytokine expression after 4VO
In previous experiments using the rat model, an increase in IL-1β and IL-6 mRNA levels after recirculation within hours after transient global ischemia was reported [
6,
8,
31,
32]. In our experiment, we did not observe an increase in inflammatory cytokine protein levels at 6 h, but our immuno-histochemical study showed that in the hippocampus, IL-1β immuno-intensity in astrocytes was higher in 4VO than in sham (see additional file
3). These results point to the possibility that IL-1β is related to neuronal damage induced by 4VO. On day1, an increase in IL-1α and IL-6 was detected by bead-based immunoassay. The beads assay and immuno-histochemical study delivered different results, maybe due to the fact that cytokine in the soluble form was reduced during brain fixation and immunostaining process. A previous report using gerbil model showed that TNF-α protein level increased at 1 h, decreased to the control level and increased again on day1 [
7]. It was further reported that IL-1β and IL-6 protein levels increased after 6 h and 3 h respectively, decreased and then increased again on day1. The disparity between Saito et al's results [
7] and those of this study may be due to the difference in the animal model or breeder that was used as well as the fact that we used a bead-based assay while Saito et al. employed an enzyme immunoassay. An increase of IL-1β and TNF-α in the early phase after re-circulation is thought to trigger a signal transduction towards neuronal cell death in CA1. In our rat model, IL-1β, IL-6 and TNF-α protein levels may have increased earlier than 6 h after re-circulation and then decreased to the sham level at 6 h.
The protein levels of IL-1α, IL-1β, IL-2, IL-4, IL-6, GM-CSF, IFN-γ and TNF-α were up-regulated on day7 in both 4VO and sham, but protein levels in other cytokines except IL-1β and IL-2 were not significantly different between 4VO and sham. On the same day, all glial cells in CA1 were strongly activated in 4VO but in sham there was only a slight morphological change of glial cells. We observed also that more microglial cells in 4VO on day7 was more activated than on day5. Additionally, our immuno-histochemical study of IL-1β distribution in the hippocampus showed that IL-1β staining intensity in activated astrocytes in 4VO was stronger than sham on day7 (see additional file
3). In 4VO, activated astrocytes and microglial cells in the hippocampus might be involved in the increase in cytokine levels on day 7. In sham, these results suggest that sham operation (heat-cauterization of alar foramen) may affect cytokine protein levels in the hippocampus without any pronounced activation of microglial cells and astrocytes. These results may also indicate that in addition to cytokines produced in glial cells, peripheral-born cytokines and/or brain-born cytokines produced outside of the hippocampus can contribute to the increase in cytokine protein levels on day7 and cytokine producing cells might be different between 4VO and sham. On day7, only IL-1β was significantly higher in 4VO than in sham and IL-2 in sham was significantly higher than in 4VO. The change in cytokine protein levels after day10 was different in 4VO and sham. In 4VO, IL-1α, IL-1β, IL-4, IL-6, GM-CSF, IFN-γ and TNF-α protein levels were higher or significantly higher than in sham and these cytokines maintained a high protein level during the deceleration phase. In sham, on the other hand, most cytokines were up-regulated on day7 and then decreased on day10. It is possible that day7 may be an important point in 4VO and sham when the continuation or end of inflammation is decided. IL-2 is a neuro-regulatory cytokine in the brain [
33] and IL-1β has both neurotrophic and neurotoxic functions. IL-1β in 4VO and IL-2 in sham on day7 may be involved in regulating other cytokine expression after day7.
In the exponential and deceleration phases the protein levels of IL-1α, IL-1β, IL-4, IL-6 and IFN-γ were significantly higher in 4VO than in sham, thereby making it difficult to ascertain how these cytokines contribute to the process of neuronal loss. IL-1α, IL-1β, IL-6 and TNF-α have both neurotoxic and neurotrophic functions. The role of each cytokine in the progression of neuronal cell death or repair might be revealed through cytokine interaction. It could be that the interaction among cytokines with protein levels that were significantly higher than sham in the lag and exponential phases might lead to the progression of neuronal cell death. In the deceleration and early stationary phases after day7, glial cells in CA1 of the hippocampus remained activated in 4VO but were not activated in sham. In the deceleration and early stationary phases after day7, the interaction among cytokines with protein levels that were significantly higher in 4VO than in sham, may have led to the end of neuronal death, and the cleaning of dead cell debris mainly with the help of activated microglial cells/macrophages. However, more studies are required to fully understand this relationship. In addition to understanding the profile of multiple cytokines after re-circulation, we believe that knowing when neuronal death is triggered may also be important for developing a wider therapeutic window.
Significantly higher protein level in GM-CSF was observed only in the deceleration phase in 4VO, compared with sham. GM-CSF counteracts apoptosis, is neurotrophic and stimulates the differentiation of granulocyte/macrophage [
34]. GM-CSF administration suppresses delayed neuronal cell death after focal ischemia [
35]. An increase in GM-CSF only in the deceleration phase suggests that GM-CSF may help to protect neuronal cells from apoptosis and repair the injury induced by transient global ischemia.
No significant difference between 4VO and sham in IL-10, an anti-inflammatory cytokine, was observed after transient global ischemia in our experiment but it is reported that IL-10 administration suppresses neuronal cell reduction caused by ischemia [
36].
Suppressing the function of IL-1α, IL-1β and TNF-α [
12‐
16], anti-inflammatory cytokines such as IL-10, and delayed neuronal cell death suppressors such as GM-CSF, are effective for suppressing delayed neuronal cell death after transient global ischemia. Detailed information of the function of each cytokine in the lag, exponential and deceleration phases might be helpful in developing methods for mitigating ischemic insult.
More information about the relationship between neuronal death and cytokine profile can lead to the development of new cytokine therapy based on the changes in cytokine profile and the progression time of neuronal death after transient global ischemia.