中国神经再生研究(英文版) ›› 2026, Vol. 21 ›› Issue (4): 1574-1585.doi: 10.4103/NRR.NRR-D-23-01953

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

重组组织型纤溶酶原激活剂直接保护脑出血后神经元:PI3K/AKT/mTOR通路激活的作用

  

  • 出版日期:2026-04-15 发布日期:2025-07-28
  • 基金资助:
    国家自然科学基金重点项目(92148206),国家自然科学基金面上项目(82071330),湖北省科技厅“尖刀”技术攻关工程项目(2023BAA005),湖北省卫生厅重点研发计划(2021BCA109),同济医院科研基金培育项目(2022B37)

Recombinant tissue plasminogen activator protects neurons after intracerebral hemorrhage through activating the PI3K/AKT/mTOR pathway

Jie Jing1, 2, #, Shiling Chen1, #, Xuan Wu1 , Jingfei Yang1 , Xia Liu1 , Jiahui Wang1 , Jingyi Wang1 , Yunjie Li1 , Ping Zhang1, *, Zhouping Tang1, *   

  1. 1 Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China;  2 Department of Neurology, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
  • Online:2026-04-15 Published:2025-07-28
  • Contact: Ping Zhang, MD, ppkitty0609@163.com; Zhouping Tang, PhD, ddjtzp@163.com.
  • Supported by:
    The study was supported by the National Natural Science Foundation of China, Nos. 92148206, 82071330 (both to ZT); a grant from the Major Program of Hubei Province, No. 2023BAA005 (to ZT); a grant from the Key Research and Discovery Program of Hubei Province, No. 2021BCA109 (to ZT); and the Research Foundation of Tongji Hospital, No. 2022B37 (to PZ).

摘要:

重组组织纤溶酶原激活剂是脑出血后微创手术中常用的血肿清除剂。然而,在MIS手术过程中,重组组织纤溶酶原激活剂可能直接接触脑组织,因此有必要讨论其安全性。实验首先建立了VII型胶原酶诱导的脑出血小鼠模型,发现原位重组组织型纤溶酶原激活剂给药不伴血肿抽吸即可改善脑出血小鼠的神经功能,减轻病理损伤,并降低血肿周围组织的凋亡和自噬水平。继而在血红素诱导的脑出血体外模型中,重组组织型纤溶酶原激活剂能抑制神经元的神经元凋亡、自噬和内质网应激。而后的转录组测序分析显示,重组组织型纤溶酶原激活剂还可上调神经元中PI3K/AKT/mTOR通路,而PI3K抑制剂LY294002可逆转重组组织型纤溶酶原激活剂抑制细胞凋亡、过度自噬和内质网应激的神经保护作用,且表皮生长因子受体抑制剂AG-1478可逆转重组组织型纤溶酶原激活剂对PI3K/AKT/mTOR通路的影响。上述结果表明,重组组织型纤溶酶原激活剂对脑出血后神经元有直接的神经保护作用,其可能通过激活PI3K/AKT/mTOR通路起作用。

https://orcid.org/0000-0003-0858-8884 (Ping Zhang); https://orcid.org/0000-0002-4153-8590 (Zhouping Tang)

关键词: 脑出血, 微创手术, 重组组织型纤溶酶原激活剂, 自噬, 细胞凋亡, 内质网应激, AKT, mTOR, PI3K, 表皮生长因子

Abstract: Recombinant tissue plasminogen activator is commonly used for hematoma evacuation in minimally invasive surgery following intracerebral hemorrhage. However, during minimally invasive surgery, recombinant tissue plasminogen activator may come into contact with brain tissue. Therefore, a thorough assessment of its safety is required. In this study, we established a mouse model of intracerebral hemorrhage induced by type VII collagenase. We observed that the administration of recombinant tissue plasminogen activator without hematoma aspiration significantly improved the neurological function of mice with intracerebral hemorrhage, reduced pathological damage, and lowered the levels of apoptosis and autophagy in the tissue surrounding the hematoma. In an in vitro model of intracerebral hemorrhage using primary cortical neurons induced by hemin, the administration of recombinant tissue plasminogen activator suppressed neuronal apoptosis, autophagy, and endoplasmic reticulum stress. Transcriptome sequencing analysis revealed that recombinant tissue plasminogen activator upregulated the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway in neurons. Moreover, the phosphoinositide 3-kinase inhibitor LY294002 abrogated the neuroprotective effects of recombinant tissue plasminogen activator in inhibiting excessive apoptosis, autophagy, and endoplasmic reticulum stress. Furthermore, to specify the domain of recombinant tissue plasminogen activator responsible for its neuroprotective effects, various inhibitors were used to target distinct domains. It has been revealed that the epidermal growth factor receptor inhibitor AG-1478 reversed the effect of recombinant tissue plasminogen activator on the phosphoinositide 3-kinase/RAC-alpha serine/threonineprotein kinase/mammalian target of rapamycin pathway. These findings suggest that recombinant tissue plasminogen activator exerts a direct neuroprotective effect on neurons following intracerebral hemorrhage, possibly through activation of the phosphoinositide 3-kinase/RAC-alpha serine/threonine-protein kinase/mammalian target of rapamycin pathway.

Key words: apoptosis, autophagy, endoplasmic reticulum stress, epidermal growth factor, intracerebral hemorrhage, mammalian target of rapamycin, minimally invasive surgery, phosphoinositide 3-kinase, RAC-alpha serine/threonine-protein kinase, recombinant tissue plasminogen activator