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Vessel maturation schedule determines vulnerability to neuronal injuries of prematurity

J Clin Invest. 2015 Mar 2;125(3):1319-28. doi: 10.1172/JCI79401. Epub 2015 Feb 17.

Abstract

Premature birth is a major risk factor for multiple brain pathologies, notably periventricular leukomalacia (PVL), which is distinguished by bilateral necrosis of neural tissue around the ventricles and a sequela of neurological disturbances. The 2 hallmarks of brain pathologies of prematurity are a restricted gestational window of vulnerability and confinement of injury to a specific cerebral region. Here, we examined the proposition that both of these features are determined by the state of blood vessel immaturity. We developed a murine genetic model that allows for inducible and reversible VEGF blockade during brain development. Using this system, we determined that cerebral vessels mature in a centrifugal, wave-like fashion that results in sequential acquisition of a functional blood-brain barrier and exit from a VEGF-dependent phase, with periventricular vessels being the last to mature. This developmental program permitted selective ablation of periventricular vessels via episodic VEGF blockade within a specific, vulnerable gestational window. Enforced collapse of ganglionic eminence vessels and resultant periventricular neural apoptosis resulted in a PVL-like phenotype that recapitulates the primary periventricular lesion, ventricular enlargement, and the secondary cortical deficit in out-migrating GABAergic inhibitory interneurons. These findings provide an animal model that reproduces the temporal and spatial specificities of PVL and indicate that damage to VEGF-dependent, immature periventricular vessels contributes to PVL development.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis
  • Blood-Brain Barrier
  • Cell Hypoxia
  • Cerebral Ventricles / blood supply
  • Cerebral Ventricles / pathology
  • Disease Models, Animal
  • Female
  • Humans
  • Interneurons / physiology
  • Leukomalacia, Periventricular / physiopathology*
  • Male
  • Mice, Inbred C57BL
  • Mice, Inbred ICR
  • Mice, Transgenic
  • Neovascularization, Physiologic*
  • Neurons / physiology
  • Pregnancy
  • Premature Birth / physiopathology
  • Transcription, Genetic
  • Vascular Endothelial Growth Factor Receptor-1 / biosynthesis
  • Vascular Endothelial Growth Factor Receptor-1 / genetics

Substances

  • Vascular Endothelial Growth Factor Receptor-1