(Stroke. 1997;28:564-573.)
© 1997 American Heart Association, Inc.
Articles |
A Putative Role for Platelet-Derived Growth Factor in Angiogenesis and Neuroprotection After Ischemic Stroke in Humans
From the Department of Biological Sciences, Manchester Metropolitan University (J. Krupinski, R.I., M.S., P.K.); the Department of Clinical Neurosciences, Institute of Psychiatry and King's College School of Medicine and Dentistry, London (J. Krupinski); the Christie Hospital, Manchester (S.K.), UK; and the Department of Neuropathology, Jagiellonian University, Kracow, Poland (J. Krupinski, T.B., J. Kaluza).
Correspondence to Jerzy Krupinski, MD, PhD, Department of Clinical Neurosciences, Institute of Psychiatry and King's College School of Medicine and Dentistry, London SE5 8AF, UK.
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Abstract |
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Background and Purpose Growth factors control two important processes in infarcted tissue, ie, angiogenesis and gliosis. We recently reported that transforming growth factor-ß1 (TGF-ß1) might be involved in angiogenesis after ischemic stroke in humans; here we present data of an extensive study on platelet-derived growth factor (PDGF) and its receptors.
Methods We studied brain samples from patients who suffered
from ischemic stroke for the expression of mRNA encoding PDGF-A,
PDGF-B, and PDGF receptors (PDGF-R). Proteins were examined by Western
blotting and immunohistochemistry using the antibodies to PDGF-AB,
PDGF-BB, PDGF-R
, and PDGF-Rß.
Results At the mRNA level, PDGF-A and PDGF-B were expressed
mainly in neurons in penumbra. PDGF-R mRNA was strongly expressed in
some astrocytes but mainly in type III/IV neurons in infarct and
penumbra. The least expression was seen in the contralateral hemisphere
(P<.001). In contrast, both PDGF-AB and PDGF-BB
immunoreactive products were present in most cell types: PDGF-R and
PDGF-Rß mainly on neurons, and PDGF-Rß on some endothelial cells,
with less staining of all the isoforms in the contralateral hemisphere.
On Western blots, PDGF-AB and -BB were expressed more within white
matter than gray matter of infarct/penumbra, whereas both isoforms of
receptor were expressed mainly in gray matter compared with
contralateral hemisphere. There was no or very weak expression of the
receptor in white matter.
Conclusions PDGF proteins are highly expressed in white matter, suggesting that PDGF may exert its function in white matter participating either in regeneration of damaged axons or in glial scar formation. PDGF-BB and its receptor expressed on microvessel endothelial cells might be involved in angiogenesis after stroke. Thus, PDGF is likely to be angiogenic and neuroprotective in stroke.
Key Words: angiogenesis • cerebral ischemia • growth factors • neuroprotection
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Introduction |
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Under hypoxic conditions, both infiltrating macrophages and host cells produce angiogenic factors and cytokines that directly or indirectly control new capillary growth.1 Early events involve activation of early response genes, c-fos and c-jun, which further regulate gliosis and angiogenesis in infarcted tissue. Fos expression colocalizes with the expression of basic fibroblast growth factor, being highest at the infarct periphery.2 The areas in which neurons tend to survive longer are the same as those demonstrated to be highly angiogenic.3 4 5 6 Thus, angiogenic factors might be neuroprotective and crucial determinants of neuronal survival after stroke. Not much is known about the expression of other growth factors after ischemia. We recently reported that TGF-ß1 might be involved in angiogenesis after ischemic stroke in humans7 ; here we present data from an extensive study on PDGF and its receptors.
PDGF is produced by many cells, including neonatal rat smooth muscle cells, stimulated fibroblasts,8 cytotrophoblasts,9 transformed and neoplastic cells,10 activated monocytes/macrophages,11 and arterial endothelial cells.12 Some endothelial cells express PDGF-AA and PDGF-BB both in vivo and in vitro.13
PDGF can be either homodimeric (PDGF-AA, PDGF-BB) or heterodimeric (PDGF-AB). The mature portions of the A and B chains show approximately 60% conservation of amino acid sequences and complete conservation of the positions of eight cysteine residues. Different cells express different ratios of the A and B chains of PDGF.14
There are two distinct PDGF receptors: an -receptor (PDGF-R) and
a ß-receptor (PDGF-Rß).15 PDGF-R binds each of the
three forms of PDGF dimers with high affinity, whereas PDGF-Rß binds
only PDGF-BB with high affinity and PDGF-AB with lower affinity.
PDGF appears to be ubiquitous in neurons throughout the central nervous system, and it is suggested to play an important role in nerve regeneration, mediation of glial cell proliferation, and differentiation.16 17
Both PDGF-A and -B chains are expressed in mammalian neurons. They induce neuronal cell differentiation and increase levels of the midsize neurofilament protein. This suggests that PDGF isoforms are involved in neuronal cell migration, growth, and differentiation in human brain development.18
PDGF-A transcripts are first expressed in brain during late embryogenesis in most neurons, well before the differentiation of most glia.19 This strongly implies that neurons express PDGF-A to attract and maintain supporting glial elements within the central nervous system.20
The PDGF-B chain containing protein is localized in neurons throughout the central nervous system of adult nonhuman primates such as Macaca nemestrina.16 Positive immunohistochemical staining reactions were observed to be restricted to neuronal cytoplasmic perinuclear regions and principal or secondary dendrites. The intensity of reaction varied with the location of the neurons. In contrast, blood vessels stained faintly, and there was no staining in glial cells.
In persons undergoing intrastriatal embryonic mesencephalic implants, PDGF-B chain expression was increased in and around implants, mainly in astrocytes. This may have important implications for graft survival and function. Glial cells may utilize the elevated levels of PDGF-A and -B to proliferate, causing reactive gliosis. PDGF could lead to astrocyte and glial cell chemotaxis and proliferation.21 It is also possible that PDGF increases the survival of neurites and promotes their outgrowth.22 The latter is more likely because only PDGF-BB increases human astrocyte proliferation in vitro (J. Krupinski, M. Slevin, and P. Kumar, unpublished data, 1996). PDGF-AA and -BB treatment in an experimental rat model produces a significant increase in numbers of oligodendrocyte precursors, suggesting that PDGF may have an effect on recruitment into the oligodendrocyte precursor pool. PDGF subsequently increases the rate of oligodendrocyte precursor cell proliferation and the number of mature oligodendrocytes. Proteolipid protein and myelin basic protein mRNAs increase after addition of PDGF to cultured oligodendrocytes from rat cerebral white matter.23
Ischemia transiently increased mRNA expression of the PDGF-B chain but not the PDGF-A chain in injured neocortex.24 It was induced in neurons and later in macrophages and may have an important role in the healing process of injured brain. Takayama et al25 (1994) demonstrated that after experimental brain injury, shrunken neurons and numerous macrophages were present with enhanced PDGF-B chain–related immunoreactivity in the vicinity of the lesion. The distribution was closely related to neovascularization and astrogliosis.
Transcripts for PDGF-R and PDGF-Rß subunits are expressed in
neurons in nearly all regions of the brain.16 17 Brain
capillary endothelial cells express functional PDGF-Rß in normal
brain of the nonhuman primate Macaca nemestrina; the PDGF
released from injured neurons could contribute to a local angiogenic
response.16
Although most macrovascular endothelial cells do not express PDGF receptors,13 PDGF-Rß was demonstrated on endothelial cells of capillaries in rat brain22 and on proliferating capillaries in glioblastomas26 and wounds.27
In brain tumors, PDGF can be produced by the tumor cells themselves rather than as a result of angiogenesis after activation and derangement of the blood-brain barrier.28 PDGF-BB acts as a growth factor in meningiomas, initiating cell division via the ß-receptor.29
PDGF has been shown to mediate interactions among glial cells in vitro.16 30 More recent evidence has indicated that PDGF may also be involved in controlling communication between neurons and glial cells and among neurons. The presence of receptors for PDGF on neurons of the developing nervous system is an essential piece of evidence. Ganglion cells are labeled with antibodies to PDGF-R only during the period of active process outgrowth. These findings suggest that PDGF is used as a mediator of intercellular signaling during neuronal development.
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Materials and Methods |
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Materials
Human brains for in situ hybridization and Western blotting were obtained with permission from the ethics committee from the Department of Neuropathology, Jagiellonian University, Krakow, Poland (Table
). One normal human brain (from a patient who died
in a road accident, aged 54 years) was obtained courtesy of Dr H. Reid,
Department of Neuropathology, Manchester University (UK). Human fetal
brain aged 16 weeks was obtained from Professor D. Donnai, Department
of Medical Genetics, Manchester University (UK).
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Probe Preparation
Competent cells were transformed, and plasmid was extracted and
purified. The vector was cut by restriction endonucleases, and the
insert was recovered from an agarose gel. A mouse PDGF-R cDNA (1161 bp)
cloned in an ampicillin-resistant pUC9 plasmid vector,
pmPDGFrec-HincII, was a kind gift of the late Professor H.
Antoniades. PDGF-A and PDGF-B oligoprobes were purchased from R&D
Systems. The probes were random prime labeled to specific activities of
1x106 to 1x108 cpm/mg using
[35S]-dCTP. Duplicate slides were treated with RNase A
to estimate the contribution of nonspecific signal to the overall
labeling.
In Situ Hybridization
This was carried out as described previously for
TGF-ß1.7 Grains were counted using a Cambridge Seescan
Image Analysis System. At least 300 cells were counted per tissue
section, ie, approximately 50 cells of each type.
Protein Studies
Immunohistochemistry
Goat anti-human polyclonal antibody to PDGF-AB was
purchased from Collaborative Biomedical Products, and rabbit anti-human
polyclonal antibodies to PDGF-BB, PDGF-R, and PDGF-Rß were
purchased from Santa-Cruz. All antibodies were used at a dilution of
1:100 in PBS, pH 7.6. After dewaxing and rehydration, sections were
treated with 1% saponin in PBS, pH 7.6, for 30 minutes. Blocking of
endogenous peroxidase activity was carried out in 0.3%
H2O2 for 5 minutes followed by incubation in
1% BSA for 20 minutes. The secondary antibody was goat anti-chicken
peroxidase conjugated (DAKO) used at a dilution of 1:200 in PBS for 45
minutes. Peroxidase activity was visualized using diaminobenzidine
(0.006% in dH2O) for 10 minutes followed by dehydration,
clearing in xylene, and permanent mounting in DPX.
Western Blotting
Protein extraction, determination, and blotting on PVDF
membranes were carried out as described previously for
TGF-ß1.7 The protein concentration of each sample was
determined using an assay developed by Bradford31 to
ensure loading of equal amounts during Western blotting. Briefly,
proteins were transferred to PVDF membrane (Immobilin), prewetted in
methanol, and equilibrated in Towbin buffer containing 192 mmol/L
glycine, 25 mmol/L Tris-HCl, 1% SDS, and 20% methanol, pH 8.3,
using a Hoefer electroblotting apparatus (1 hour, 0.8
mA/cm2 gel). After blotting, membranes were blocked with
blocking buffer (7.5% Marvel in TBS-Tween, pH 7.4) for 1 to 24 hours;
membranes were then stained with primary antibody in blocking buffer at
a dilution of 1:100 for 1 to 24 hours. The same antibodies were used as
for immunohistochemistry. Membranes were subsequently rinsed in
blocking buffer (5 3-minute washes) and then stained with the
appropriate peroxidase-conjugated secondary antibody in blocking buffer
for 1 hour, after which they were rinsed in TBS-Tween, pH 7.4 (5
3-minute washes), and the proteins were visualized using an ECL kit
(Amersham).
Semiquantitative Protein Estimation on Blots
The relative amounts of different proteins were estimated
directly from x-ray film by densitometric scanning using an LKB 2202
ultrascan laser densitometer. In every case, stroke tissue proteins
were compared with those of contralateral hemisphere (used as
controls), and the percentage was calculated (relative to a control of
100%).
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Results |
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PDGF Protein Expression in Tissue Sections
PDGF-AB immunoreactive products were present in both penumbra and infarct. All cell types expressed PDGF-AB. There was stronger staining in infiltrating monocytes/macrophages and glial cells in the vicinity of proliferating blood vessels (Fig 1a
through
1c). PDGF-AB was also present in the control
contralateral hemisphere, but the staining was weaker (Fig 1c).
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Western Blotting of PDGF
PDGF-AB
There was remarkable consistency among three membranes obtained by
Western blotting, indicating that the percentage values were accurate
for each tissue studied.
In 6 of 9 patients, there was more PDGF-AB in infarct/penumbra tissue
than in contralateral hemispheres: approximately 263%, 410%, 528%,
35%, 75%, 82%, 108%, 185%, and 158% (Fig 2a). When
samples were taken from areas of penumbra alone in 2 patients, there
was no change in PDGF-AB expression compared with infarct (Fig 2b and 2c). The main differences between control and affected brain tissues
were in white matter: 255% and 186% in infarct and penumbra in
patient 32 and 585% and 1021% in infarct and penumbra in patient 49,
respectively.
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PDGF-BB
There was higher expression in infarct/penumbra than in
contralateral controls in all patients studied: approximately 1720%,
275%, 140%, 290%, 500%, 213%, 180%, and 323% (Fig 3a). In 2 patients, the penumbra was studied separately,
and it contained less PDGF-BB than control contralateral hemisphere
(67% and 63% in the first patient and 40% in the second) (Fig 3b and 3c). Gray matter and white matter samples taken from infarcts,
penumbras, and contralateral control areas were studied in the same 2
patients. The highest differences were in white matter between infarcts
and contralateral hemispheres: approximately 470% and 1830% in
patients 32 and 49, respectively. In patient 49, the white matter of
the penumbra showed an increase to 167% and 533%. However, in patient
32, the white matter of the penumbra showed a decrease to 40%.
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In Situ Hybridization for PDGF mRNA
PDGF-A mRNA
There was weak PDGF-A mRNA transcription overall. Only
neurons within penumbra contained a significant signal (more
than 5 grains per cell), which was higher than the control
contralateral hemisphere (P<.0001, Spearman's rank
correlation test). In infarcts, neurons expressed fewer grains than in
control. In areas of active gliosis within the penumbra, astrocytes
expressed more grains than in the other areas. PDGF-A mRNA was found in
only a few large blood vessels of infarct or penumbra (Fig 4a through
4c, Fig 5a).
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PDGF-B mRNA
Only type I/II neurons in penumbra had higher expression than in
normal contralateral hemisphere (P<.001, Spearman's rank
correlation test). In the border zones between infarct and penumbra,
astrocytes produced more grains than controls. Endothelial cells in
infarcts and penumbra had higher median grain numbers than controls,
but grains were found only in some blood vessels and then mostly in
single endothelial cells. If the latter were surrounded by
microglia/macrophages or lymphocytes, the number of grains was smaller
(Fig 4d
through 4f, Fig 5b).
PDGF-R Protein Expression in Tissue Sections
Most neurons, but only some gigantic astrocytes, were stained with
antibody to PDGF-R in stroke tissue (Fig 1d). In contralateral
normal hemisphere, there was a similar pattern of staining but in fewer
cells (Fig 1e). White matter was virtually negative in both infarcted
and contralateral hemisphere (Fig 1f).
There was more staining obtained with antibody to PDGF-Rß in
infarcted/penumbra tissue (Fig 1g). It was localized to some
endothelial cells, reactive astrocytes, and fewer neurons compared with
PDGF-R staining. In contralateral control hemispheres, staining was
only present in neurons (Fig 1h). Some blood vessels in the white
matter of infarcted hemispheres were positive but not in contralateral
hemispheres (Fig 1i).
Western Blotting of PDGF-R
PDGF-R
In all 3 patients studied (patients 49, 50, and 51), there was
more PDGF-R in stroke and penumbra compared with the contralateral
hemisphere. This increase in gray matter was to 115%, 182%, and 147%
in infarct and to 142%, 176%, and 145% in penumbra, respectively. In
the white matter of patients 49 and 50, there was a decrease in
PDGF-R to 85% and 70% in infarct and to 55% and 72% in penumbra,
respectively (Fig 6a and 6b). In patient 51, there was
an increase in white matter to 181% and 122% in infarct and penumbra,
respectively (Fig 6c). In normal human brain, PDGF-R was mainly
expressed in gray matter, with less expression in white matter. In
human fetal brain, expression was reserved to gray matter (Fig 6d).
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PDGF-Rß
In all patients studied (patients 49, 50, and 51), there was more
PDGF-Rß in infarct and penumbra compared with the contralateral
hemisphere. This increase was observed in gray matter to 120%, 298%,
and 151% in stroke and to 124%, 296%, and 183% in penumbra,
respectively (Fig 7a through 7c). In the white matter of
patients 49 and 50, there was a decrease in PDGF-Rß to 68% and 81%
in infarct, respectively. In the penumbra, patient 49 showed a decrease
to 96%, and patient 50 showed an increase to 178% (Fig 7a and 7b). In
patient 51, PDGF-Rß could not be detected in control white matter. In
normal human brain, PDGF-Rß was mainly expressed in gray matter, with
less expression in white matter. In human fetal brain, expression was
reserved to gray matter (Fig 7d). Thus, the pattern of expression of
PDGF-R and PDGF-Rß protein was the same.
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PDGF-R mRNA Expression
The highest expression was around types III and IV ischemic
neurons32 in infarcted areas. Proliferating endothelial
cells produced a lot of grains, both in penumbra and infarct.
Macrophages in the vicinity of blood vessels contained more grains than
macrophages elsewhere. Astrocytes, especially large astrocytes in the
penumbra, expressed more grains than macrophages. Generally, white
blood cells and oligodendrocytes did not express PDGF-R mRNA (Fig 4g
through 4i, Fig 5c).
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Discussion |
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This study demonstrated an increase in PDGF both at the mRNA and protein levels in stroke infarcts and penumbras compared with contralateral hemispheres. PDGF-A mRNA was expressed mainly in neurons and larger blood vessels in the areas of penumbra. PDGF-B mRNA was expressed in type I/II neurons32 of penumbra and some microvessel endothelial cells in stroke/penumbra. Astrocytes expressed both PDGF chains in some areas, mainly in white matter and in a limited number of cells. The highest differences shown by Western blotting were for PDGF-B chain, and they were attributable to an increase within infarcts rather than in penumbras. The most pronounced increase was in tissue extracts from white matter compared with gray matter.
The highest grain counts for PDGF-R mRNA were in type III/IV neurons
within ischemic infarcts. At the protein level, there was higher
expression of both PDGF-R and PDGF-Rß in infarcts and penumbras
than in contralateral normal-looking hemispheres. This was mainly
localized in neurons in gray matter. PDGF-Rß was also expressed in
some microvessels.
Our results demonstrated greater protein expression of PDGF in white matter as opposed to gray matter. Thus, PDGF released in brain may contribute to nerve regeneration and to glial cell proliferation that leads to gliosis and scarring. Both glial cells and neurons were found to synthesize PDGF.16 17 Glia secrete molecules important for neuronal function, and in turn glia may be directed toward and supported by the neuronal elements they serve.
It is also possible that neurons play a part in the general response to injury. For example, the signals responsible for astrocyte proliferation at the site of an injury are not known. The neuronal secretion of PDGF may be ideally suited to stimulate migration and division of additional glial cells in proximity to the neuron. It is important that neuronal expression of PDGF in the central nervous system is ubiquitous, which is consistent with its general function as a growth/differentiation factor for glia.16
The previously reported localization of PDGF-B chain in axons and probable terminals in the spinal cord, brain stem, hypothalamus, and pituitary suggests a possible neuroregulatory role for PDGF.16 In our study, PDGF-B chain was expressed more in white matter of stroke/penumbra than in contralateral hemisphere. A number of effects of PDGF, including induction of c-fos in neurons,22 stimulation of tyrosine phosphorylation,33 inhibition of gap-junctional communication,34 and increase in amino acid transport, are consistent with possible involvement in synaptic transmission.
Immunohistochemical studies demonstrated that activated/proliferating
endothelial cells expressed PDGF-AB. They were surrounded by glial
cells and cell infiltrates, which were also strongly stained. Other
authors have suggested that it is PDGF-BB that participates in
angiogenesis.35 36 PDGF-BB can elicit endothelial cell
proliferation and the formation of endothelial cords/tubes in vitro via
direct action on PDGF-Rß that are expressed on proliferating but not
quiescent endothelial cells.37 In our studies, PDGF-Rß
but not PDGF-R was expressed on some of the endothelial cells in
stroke infarcts and penumbras. Angiogenic endothelial cells did not
express the PDGF-B chain, whereas quiescent nonangiogenic endothelial
cells did express PDGF-B chain transcripts. This suggests that
angiogenic endothelial cells are not the source of PDGF-B chain. It is
possible that PDGF-BB plays a part in early recruitment of endothelial
cells before the action of other cytokines, such as TGF-ß and
interleukin-1 or -6. The latter may switch off PDGF-BB in proliferating
endothelial cells. PDGF may control in vivo angiogenesis via the action
of other cells.38 Any direct action of PDGF in
angiogenesis would require the expression of PDGF receptors on
neovascular endothelium. Raines et al13 (1990)
demonstrated that quiescent endothelial cells in vitro originating from
microvessels do not express PDGF receptors. However, PDGF-B receptors
were demonstrated on endothelial cells of capillaries in the rat
brain,22 in glioblastomas,26 and in
wounds.27 In our studies, ischemic endothelial
cells expressed mRNA for PDGF-R, but mainly in areas where they were
surrounded by either infiltrating cells or glia. This may confirm that
indeed endothelial cell expression of PDGF-R is secondary and is
induced by other cells. PDGF-Rß might be of particular interest as a
marker for a population of phenotypically different endothelial cells
undergoing angiogenesis, although angiogenic endothelial cells
themselves are not the source of PDGF-BB.
The higher abundance of PDGF-R protein in the gray matter suggests that this growth factor might be important in remodeling and neuronal plasticity after ischemia. Interestingly, it is mainly white matter that contains high amounts of PDGF-AB and PDGF-BB protein; thus, although mRNA is produced in neuronal cell bodies in gray matter, PDGF may exert its function in white matter, participating either in regeneration of damaged axons or in glial scar formation. If the latter process could be controlled, this might decrease scar size after ischemia and increase the possibility for formation of new contacts between partially damaged neurons.
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Selected Abbreviations and Acronyms |
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Received June 12, 1996; revision received October 4, 1996; accepted October 10, 1996.
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