Tissue plasminogen activator in central nervous system physiology and pathology
Jerry P. Melchor and Sidney Strickland
Summary
Although
conventionally associated with fibrin clot degradation, recent work has
uncovered new functions for the tissue plasminogen activator
(tPA)/plasminogen cascade in central nervous system physiology and
pathology. This extracellular proteolytic cascade has been shown to have
roles in learning and memory, stress, neuronal degeneration, addiction
and Alzheimer’s disease. The current review considers the different ways
tPA functions in the brain.
PA:
plasminogen activator,
tPA: tissue-type plasminogen activator,
uPA:
urokinase-type plasminogen activator,
PAI-1: plasminogen activator
inhibitor-1,
LRP: low-density lipoprotein receptor-related protein, (tPA clearing receptor)
CNS:
central nervous system,
CPEB: cytoplasmic polyadenylation element
binding,
LTP: long-term potentiation,
LTD: long-term depression,
mRNA:
messenger ribonucleic acid,
BDNF: brain-derived neurotrophic factor,
NMDA: N-methyl-D-aspartate,
RAP: receptor-associated protein,
ECM:
extracellular matrix,
BBB: blood brain barrier,
MMP: matrix
metalloproteinase,
EtOH: ethanol,
ERK: extracellular signal-regulated
kinase,
GAP: growth-associated protein,
CRF: corticotropin-releasing
factor,
MCAO: middle cerebral artery occlusion,
Aβ: beta-amyloid
Sitaatti artikkelista:
Johdannosta (Introduction)
The plasminogen activator (PA)/plasminogen proteolytic cascade is known to be important for thrombolysis (1, 2). There are two mammalian PAs: tissue-type (tPA) and urokinase-type (uPA) (3).
PAs are serine proteases that cleave a specific peptide bond within the zymogen plasminogen to generate the active protease, plasmin, which is capable of degrading numerous substrates
In the vasculature, plasmin efficiently breaks down fibrin clots, aiding in hemostasis and vascular patency. This protease cascade is tightly regulated by the actions of serine protease inhibitors (serpins), of which plasminogen activator inhibitor-1 (PAI-1) and neuroserpin are the major cognate serpins for tPA, while plasmin is inhibited by α2 -antiplasmin (2).
Furthermore, tPA activity can be attenuated by rapid clearance through low-density lipoprotein receptor-related protein (LRP)-mediated endocytosis and augmented by binding annexin-II or to fibrin within a clot (4, 5).
Plasminogen, PAI-1, and neuroserpin are also present in the brain indicating that the components of the tPA/plasminogen cascade are present in the CNS (9, 13–15).
In neurons, the expression of tPA can be under translational control; tPA expression is regulated by the binding of the cytoplasmic polyadenylation element binding (CPEB) protein which leads to the extension of tPA mRNA polyadenylation and a subsequent increase in tPA protein synthesis (16). This regulation of tPA expression allows for a rapid increase in activity in response to specific stimuli (as seen in synaptic plasticity), and the presence of cognate serpins of tPA in the CNS allows for swift and specific inactivation. The localization to axon terminals and the highly regulated axonal release of tPA is consistent with a proteolytic-dependent role for tPA in the CNS in which PA cascade activation alters the extracellular matrix (ECM) and modifies synapses, such as during seizure, kindling, and long-term potentiation (LTP) (6, 17).
While tPA also has been visualized in dendrites, the release of this protein from these structures has yet to be demonstrated (16).
Another action of the tPA/plasminogen system that contributes to LTP generation is cleavage of the pre-cursor form of brain-derived neurotrophic factor (proBDNF) to its mature form (mBDNF) (24). The application of mBDNF, derived from tPA/plasmin cleavage, to hippocampal slices can rescue impaired L-LTP in both tPA-deficient and plasminogen-deficient mice. This work reveals an interaction between the tPA/plasminogen axis and BDNF and suggests a potential impact of this interaction on LTP. These observations suggest further studies to define plasmin/proBDNF binding and identify putative mBDNF receptors for LTP propagation.
The function of tPA in plasticity in vivo
has been scrutinized in mice either deficient for or over-expressing
this protease since Qian and co-workers showed that tPA mRNA was
up-regulated in the rat hippocampus after seizure, kindling, and LTP (6).
Although several studies do not indicate a role for tPA in traditional
hippocampal-based behavioral tests, mice overexpressing tPA in the CNS
show enhanced LTP in hippocampal slices and exhibit improved
hippocampal-dependent spatial memory formation as measured by Morris water maze and homing hole board tests (32). In these studies, overexpression of tPA led to increased synaptic activity in vivo, which is similar to published in vitro
results. Thus, despite a lack of a learning phenotype in tPA-deficient
mice in several learning paradigms, behavioral results from
tPA-overexpressing mice indicate a role for this protease in memory (23, 33).
In
addition to its roles in the hippocampus, amygdala, and cerebellum, the
tPA/plasminogen system is also involved in the recovery of function in
the visual cortex after reverse occlusion. The development of the visual
pathway is dependent on activity and leads to ocular dominance, a
condition in which certain cortical neurons become selectively connected
to one specific eye. Ocular dominance progression can be enhanced by addition of norepinephrine, which leads to increased tPA mRNA (35).
Preventing visual stimulation of an eye leads to monocular deprivation,
a state of diminished cortical response in the closed eye. Reverse
occlusion is the rescue of visual function in the previously deprived
eye by opening this eye and closing the formerly open eye, and this
process occurs by the formation of connections from the lateral
geniculate nucleus of the thalamus to the visual cortex.
Muller and Griesinger have shown the tPA/plasminogen proteolytic cascade is necessary for reverse occlusion, since inhibition of either protease prevents proper formation of thalamocortical connections for visual rescue (36). Other research has extended this finding, indicating that tPA/plasminogen activity allows for reorganization of connections in the visual cortex, again highlighting this proteolytic cascade’s contribution in synaptic plasticity (37). More specifically, two recent reports show that during monocular deprivation, tPA/plasminogen activity helps in structural remodeling by pruning dendritic spines and reorganizing the ECM (38, 39).
Further investigation identified laminin, a component of the ECM, as a substrate of plasmin proteolysis, and laminin cleavage combined with glutamate excitotoxicity results in neuronal degeneration due to anoikis (43–46). Plasmin-cleaved laminin fragments or anti-laminin antibodies infused into the hippocampus of either wild-type or plasminogen-deficient mice disrupts the ECM, sensitizing these mice to kainate excitotoxicity (46). The disruption of the ECM by laminin fragments indicates that the ECM is an active structure, whose components can be replaced or competed against by excess exogenous laminin. The dynamic nature of the ECM would also permit the remodeling necessary during synaptic plasticity, and it has been reported that cleavage of laminin by plasmin can hinder LTP in rat hippocampal neurons (47).
Johdannosta (Introduction)
The plasminogen activator (PA)/plasminogen proteolytic cascade is known to be important for thrombolysis (1, 2). There are two mammalian PAs: tissue-type (tPA) and urokinase-type (uPA) (3).
PAs are serine proteases that cleave a specific peptide bond within the zymogen plasminogen to generate the active protease, plasmin, which is capable of degrading numerous substrates
In the vasculature, plasmin efficiently breaks down fibrin clots, aiding in hemostasis and vascular patency. This protease cascade is tightly regulated by the actions of serine protease inhibitors (serpins), of which plasminogen activator inhibitor-1 (PAI-1) and neuroserpin are the major cognate serpins for tPA, while plasmin is inhibited by α2 -antiplasmin (2).
Furthermore, tPA activity can be attenuated by rapid clearance through low-density lipoprotein receptor-related protein (LRP)-mediated endocytosis and augmented by binding annexin-II or to fibrin within a clot (4, 5).
Infusion
of PAs, such as recombinant tPA and its derivatives, is used for lysis
of fibrin clots to help restore blood flow following myocardial
infarction or thrombotic stroke (2).
Although tPA can be used for the treatment of stroke, there is a narrow
time-frame and limited patient population for which thrombolytics are
appropriate, since delayed delivery of tPA can lead to neuronal damage
or cerebral hemorrhage, worsening the outcome for the patient.
The
function of tPA, however, is not limited to the initiation of
thrombolysis. Recent research has shown that the tPA/plasminogen system
has other roles within the central nervous system (CNS). Although the
presence of uPA has been confirmed in the brain, its role has not been
fully investigated. Therefore, this review will focus on the various
functions of tPA in brain physiology and pathology.
tPA/plasminogen system in CNS physiology
tPA expression and regulation
tPA is highly expressed in the adult mouse brain in regions involved in learning and memory (hippocampus), fear and anxiety (amygdala), motor learning (cerebellum), and autonomic and endocrine functions (hypothalamus) (6–13). Both neurons and microglial cells express tPA.Plasminogen, PAI-1, and neuroserpin are also present in the brain indicating that the components of the tPA/plasminogen cascade are present in the CNS (9, 13–15).
In neurons, the expression of tPA can be under translational control; tPA expression is regulated by the binding of the cytoplasmic polyadenylation element binding (CPEB) protein which leads to the extension of tPA mRNA polyadenylation and a subsequent increase in tPA protein synthesis (16). This regulation of tPA expression allows for a rapid increase in activity in response to specific stimuli (as seen in synaptic plasticity), and the presence of cognate serpins of tPA in the CNS allows for swift and specific inactivation. The localization to axon terminals and the highly regulated axonal release of tPA is consistent with a proteolytic-dependent role for tPA in the CNS in which PA cascade activation alters the extracellular matrix (ECM) and modifies synapses, such as during seizure, kindling, and long-term potentiation (LTP) (6, 17).
While tPA also has been visualized in dendrites, the release of this protein from these structures has yet to be demonstrated (16).
There
is an additional level of complexity to tPA expression in neuronal
cells. In neurons, tPA is not constitutively secreted but contained in
vesicles. tPA can be released from secretory vesicles after membrane
depolarization or stimulation (18–21). This mechanism of regulated tPA secretion allows for rapid localized increase in tPA activity at the synapse.
The role of tPA in synaptic plasticity
Another action of the tPA/plasminogen system that contributes to LTP generation is cleavage of the pre-cursor form of brain-derived neurotrophic factor (proBDNF) to its mature form (mBDNF) (24). The application of mBDNF, derived from tPA/plasmin cleavage, to hippocampal slices can rescue impaired L-LTP in both tPA-deficient and plasminogen-deficient mice. This work reveals an interaction between the tPA/plasminogen axis and BDNF and suggests a potential impact of this interaction on LTP. These observations suggest further studies to define plasmin/proBDNF binding and identify putative mBDNF receptors for LTP propagation.
One of the molecules with which tPA
purportedly interacts to enhance LTP is the NR1 subunit of the
N-methyl-D-aspartate (NMDA) receptor. Using a neuronal cell culture
model, Nicole et al. reported that tPA cleaves NR1, enhancing
NMDA-mediated intracellular calcium levels and neuronal degeneration (25).
In this model, tPA cleaves at amino acid Arg260 of the NR1 subunit
leading to NMDA signaling enhancement; mutation of Arg260 to Ala260
abrogates tPA-induced NMDA activity augmentation (26). However, the direct cleavage of NR1 by tPA has not been observed in other studies (27, 28). An interaction between tPA and NR2B-containing NMDA receptors has been reported during ethanol withdrawal-induced seizures (29).
Therefore, although tPA can interact with either NR1 or NR2B, the
specific outcome of these interactions as they pertain to LTP have yet
to be delineated.
An additional tPA receptor affecting
synaptic plasticity is LRP (LDL-receptor related protein) An antagonist of LRP, receptor-associated
protein (RAP), hinders tPA-induced L-LTP and prevents rescue of synaptic
potentiation by addition of tPA in tPA-deficient mice (17).
Additionally, the binding of tPA to LRP can lead to the up-regulation
of matrix metalloproteinase-9 (MMP-9), a protease which can degrade the
ECM contributing to either synaptic plasticity or neuronal degeneration (30).
Interaction between LRP and tPA also contributes to blood-brain barrier (BBB) breakdown (31).
tPA-induced opening of the BBB is evident in both plasminogen-deficient
and MMP-9-deficient mice as measured by Evans blue dye extravasation,
implying that neither plasminogen nor MMP-9 is necessary for tPA to
produce its effect on vascular permeability.
However, the tPA-clearing
receptor LRP is involved since both RAP and anti-LRP antibodies can
block this specific tPA activity. The exact mechanism by which tPA
alters the BBB is still not clear and is subject to further
investigation.
tPA has also been studied in the amygdala, a brain region that regulates reponse to fear and anxiety (10, 12).
Acute restraint stress studies in mice indicate that one function of
this protease is in amygdala-dependent learning in fear response. tPA is
induced in the medial and central amygdala after acute restraint
stress, where it promotes stress-induced post-synaptic (phosphorylation
of ERK1/2) and axonal (amplified GAP-43 expression) neuronal changes (10).
tPA-deficient mice display impaired response to stress and abnormal
circulating levels of corticosterone during the recovery period after
stress. They also do not exhibit stress-induced anxiety as measured by
the elevated-plus maze test. These results indicate that tPA contributes
to proper control of hormonal stress response and has a significant
role in emotional learning.
Further research into the role of tPA in
stress has revealed that this protease is elevated after the infusion of
corticotrophin-releasing factor (CRF), an important hormone for
triggering the stress response, into the lateral ventricle (34).
The activation of tPA by CRF in the central and medial amygdala leads
to an increase of c-fos immunoreactivity, a measure of neuronal
activation. However, the function of tPA seems to be independent of
plasmin production during stress-induced anxiety, since
plasminogen-deficient mice, unlike tPA-deficient mice, do not show lower
levels of anxiety in the elevated plus-maze after restraint stress or
abnormal c-fos expression after CRF infusion into the ventricle. As the
function of tPA in stress and the amygdala have been uncovered, the next
challenge is to identify new therapies for anxiety-related disorders in
the context of the tPA/plasminogen axis.
Another area of
the brain in which tPA has been shown to have a role is the cerebellum,
which is responsible for motor learning. Seeds and colleagues reported
the up-regulation of tPA mRNA in rats after learning a complicated motor
task (traversing a runway by grabbing horizontal irregular pegs) (7).
Additionally, even though there were no apparent consequences, the rate
of cerebellar granule cell migration seems hindered in tPA-deficient
mice, since more granule cells are present in the molecular layer of the
cerebellum in these mice as compared to age-matched controls (8).
Consistent with the importance of proteolytic action, wild-type mice
infused with tPA inhibitors PAI-1 or tPA-STOP have deficits in
cerebellar motor learning (11).
Muller and Griesinger have shown the tPA/plasminogen proteolytic cascade is necessary for reverse occlusion, since inhibition of either protease prevents proper formation of thalamocortical connections for visual rescue (36). Other research has extended this finding, indicating that tPA/plasminogen activity allows for reorganization of connections in the visual cortex, again highlighting this proteolytic cascade’s contribution in synaptic plasticity (37). More specifically, two recent reports show that during monocular deprivation, tPA/plasminogen activity helps in structural remodeling by pruning dendritic spines and reorganizing the ECM (38, 39).
Addiction
can be considered a form of adaptive synaptic plasticity. In models of
morphine and ethanol addiction, tPA expression is elevated in the
nucleus accumbens and limbic system, respectively. The rewarding effects
of morphine can be measured by the conditioned place-preference test,
which associates the rewarding or aversive effect of a drug to placement
into a specific compartment. Both the rewarding effect of morphine and
morphine- related dopamine release are diminished in tPA-deficient and
plasminogen-deficient mice when compared to wild-type mice (40).
Although the effector substrate of plasmin in morphine addiction is not
yet identified, the role of plasmin in this pathway is evident.
In
addition to morphine addiction, ethanol consumption and withdrawal also
elevate tPA activity. Ethanol inhibits NMDA receptor activity, and NMDA
receptor numbers increase as an adaptive response. The rapid removal of
ethanol relieves this inhibition on the expanded population of NMDA
receptors, and when tPA acts on this large number of NR2B-containing
NMDA receptors, it can result in hyperexcitation and seizures. However,
in this instance, the primary effect of tPA does not appear to be
plasminogen activation but rather interaction with the NR2B subunit of
the NMDA receptor in a non-proteolytic manner (29).
Additionally, tPA-deficient mice also have reduced ethanol withdrawal
seizures (see below). This is an example of the progression of a
physiological role for tPA (synaptic plasticity in addiction) resulting
in a pathological consequence (seizure induction upon ethanol
withdrawal).
tPA function in CNS pathology
The role of tPA in neurotoxicity
While the understanding of physiological functions of tPA in the CNS has expanded, so has understanding of its roles in pathological situations. The participation of the tPA/plasminogen axis has been defined in neuronal degeneration due to excitotoxicity. Injection of kainate, an excitotoxic glutamate analog, into the CA1 region of the hippocampus of wild-type mice leads to neuronal damage, and this damage is reduced in either tPA-deficient or plasminogen-deficient mice (41–43). Neurodegeneration is prevented in wild-type mice co-injected with both kainate and α2 -antiplasmin, supporting the role of plasmin in this neuronal injury paradigm.Further investigation identified laminin, a component of the ECM, as a substrate of plasmin proteolysis, and laminin cleavage combined with glutamate excitotoxicity results in neuronal degeneration due to anoikis (43–46). Plasmin-cleaved laminin fragments or anti-laminin antibodies infused into the hippocampus of either wild-type or plasminogen-deficient mice disrupts the ECM, sensitizing these mice to kainate excitotoxicity (46). The disruption of the ECM by laminin fragments indicates that the ECM is an active structure, whose components can be replaced or competed against by excess exogenous laminin. The dynamic nature of the ECM would also permit the remodeling necessary during synaptic plasticity, and it has been reported that cleavage of laminin by plasmin can hinder LTP in rat hippocampal neurons (47).
While
the tPA/plasminogen axis contributes to excitotoxic neuronal
degeneration, tPA is also involved in other CNS pathologies. The role of
tPA has been studied in Alzheimer’s disease (AD), stroke, infarct
formation, and seizure spreading. tPA expression is elevated during
seizures, a state of synchronous, pathological hyperactivity in the CNS.
Comparable to observations in the hippocampus, delivery of kainate into
the rat amygdala results in damage to hippocampal neurons (48).
The neurodegeneration observed in the hippocampus after kainate
injection into the amygdala is tPA-dependent, since neuronal damage can
be attenuated by neuroserpin delivery into the brain (48).
Additionally, seizure spreading is plasminogen-independent, since
seizure inception in plasminogen-deficient mice was similar to wild-type
mice, and seizure onset is also delayed by neuroserpin. The
tPA/plasminogen system also contributes to handling-induced seizures
after ethanol withdrawal in mice, and these seizures are attenuated in
tPA-deficient mice (29).
The
role of tPA in infarct formation has also been described. tPA-deficient
mice have reduced infarct volume and neuronal damage as compared to
control mice subjected to middle cerebral artery occlusion (MCAO) (49, 50).
The infusion of recombinant tPA or delivery of tPA-expressing
adenovirus into tPA-deficient mice also led to increased infarct size
after MCAO, indicating a role for tPA in this process. The observation
that thrombolytics can increase the infarct size after MCAO is
independent of plasminogen activation since plasminogen-deficient mice
displayed larger infarcts post-MCAO. In accordance with the contribution
of tPA to infarct formation, PAI-1-deficient mice have increased
infarct size while neuroserpin-injected mice have diminished infarcts
after MCAO. Therefore, regulating tPA activity might be beneficial in
controlling infarct injury after stroke (50–52).
tPA in Alzheimer’s disease
Serpins in CNS pathology
There
is a significant elevation in PAI-1 and neuroserpin expression during
pathological insult to the brain. The increase of PAI-1 in the brain is
seen in neurological disorders such as AD and dementia, after kainate
injection into the CA1 region of the hippocampus, and after restraint
stress. Escalation of PAI-1 expression normally corresponds to a
depression of tPA activity, and it is thought to be a regulatory
response to increased tPA, since excessive tPA activity can contribute
to CNS pathology, such as by worsening neuronal damage. However, PAI-1
could interact with tPA, not as a serpin but as a binding partner to
mediate its effect on receptors including the NMDA receptors. Clearly,
tPA can function either as a protease or modulator of cell signaling,
and PAI-1 can influence both of these activities. The elevation of
neuroserpin, the other major tPA inhibitor in the CNS, has also been
implicated in regulation of seizure spreading, control of BBB integrity,
and emotional learning (15, 62, 63).
Conclusions
The
function of the tPA/plasminogen proteolytic cascade has been
conventionally assigned to fibrinolysis. However, existing research,
especially using mice deficient in specific components of the
fibrinolytic system, has extended the role of tPA and plasminogen from
thrombolytic enzymes to encompass functions in both CNS physiology and
pathology (Table I).
Identification of novel substrates for either tPA or plasmin in the CNS
would extend understanding of the influence of this proteolytic
cascade. New lessons learned about the function of the tPA/plasminogen
system can be utilized to identify novel therapies for slowing the
pathogenesis of disorders such as AD or attenuating the severity of
ethanol withdrawal-induced seizures. Further clarification of the
contributions of this proteolytic cascade to LTP (such as the
identification of the interaction domains between tPA and NR2B or
proBDNF and plasmin) might help ease cognitive decline. The potential
applications of new functions of the tPA/plasminogen proteolytic cascade
highlight the importance and complexity of this system.
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