Tumor necrosis factor (TNF)-α is produced in brain in response to acute cerebral ischemia, and promotes neuronal apoptosis. Biologic TNF inhibitors (TNFIs), such as the etanercept, cannot be developed as new stroke treatments because these large molecule drugs do not cross the blood-brain barrier (BBB). A BBB-penetrating biologic TNFI was engineered by fusion of the type II human TNF receptor (TNFR) to each heavy chain of a genetically engineered chimeric monoclonal antibody (MAb) against the mouse transferrin receptor (TfR), designated as cTfRMAb-TNFR fusion protein. The cTfRMAb domain of the fusion protein acts as a molecular Trojan horse to deliver the fused TNFR across the BBB. Etanercept or the cTfRMAb-TNFR fusion protein (1 mg/kg) was administered intravenously in adult mice subjected to 1-hour reversible middle cerebral artery occlusion up to 90 minutes after the occlusion. Neuroprotection was assessed at 24 hours or 7 days after occlusion. The cTfRMAb-TNFR fusion protein treatment caused a significant 45%, 48%, 42%, and 54% reduction in hemispheric, cortical, and subcortical stroke volumes, and neural deficit, respectively. Intravenous etanercept had no therapeutic effect. Biologic TNFIs can be reengineered for BBB penetration, and the IgG-TNFR fusion protein is therapeutic after delayed intravenous administration in experimental stroke.

译文

肿瘤坏死因子 (TNF)-α 在大脑中产生,以响应急性脑缺血,并促进神经元凋亡。生物肿瘤坏死因子抑制剂 (TNFIs),如依那西普,不能作为新的中风治疗方法开发,因为这些大分子药物不会穿过血脑屏障 (BBB)。通过将II型人TNF受体 (TNFR) 融合到针对小鼠转铁蛋白受体 (TfR) 的基因工程嵌合单克隆抗体 (MAb) 的每个重链上,工程化了BBB穿透性生物TNFI,称为cTfRMAb-TNFR融合蛋白。融合蛋白的cTfRMAb结构域充当分子特洛伊木马,将融合的TNFR传递穿过BBB。依那西普或cTfRMAb-TNFR融合蛋白 (1  mg/kg) 在成年小鼠中静脉注射,该成年小鼠在闭塞后长达90  分钟的可逆性大脑中动脉闭塞1小时。在闭塞后24小时或7天评估神经保护作用。cTfRMAb-TNFR融合蛋白处理分别导致半球,皮质和皮质下中风体积以及神经缺陷的显着45%,48%,42% 和54% 减少。静脉注射依那西普无疗效。可以对生物TNFIs进行重组以进行BBB渗透,并且在实验性中风中延迟静脉内给药后,IgG-TNFR融合蛋白可以治疗。

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