Stroke is a leading cause of death, dementia, and adult disability. The available therapies are insufficient to restrict brain damage; therefore, we need to understand the mechanisms underlying neuronal death in those regions surrounding the infarct. A primary pathological mechanism in ischemia is excitotoxicity, a form of neuronal death induced by overactivation of the N-methyl-D-aspartate (NMDA)-type of glutamate receptors (NMDARs), also associated with other acute disorders or neurodegenerative diseases.
1 Nonetheless, efforts to inhibit NMDARs have generally failed, mainly due to the critical role these receptors have in neuronal survival,
2, 3 synaptic plasticity, learning, and memory.
4 Pro-survival signaling initiated by synaptic NMDARs includes induction of antioxidant defenses,
5 activation of extracellular signal-regulated kinase,
6 and phosphorylation of the cAMP response element-binding protein (CREB), which results in the expression of brain-derived neurotrophic factor (BDNF)
7, 8 and its receptor, tropomyosin-related kinase B (TrkB).
9, 10 Pathological activation of NMDARs opposes these effects by coupling Ca
2+-influx to mitochondrial dysfunction and neuronal death pathways.
2, 11 Additionally, NMDAR overactivation also disrupts critical survival pathways by uncoupling synaptic NMDARs from cytoskeletal proteins and pro-survival signaling. Transcriptional downregulation of the NMDAR subunit, GluN1,
12 and calpain-processing of the GluN2 subunits
13, 14 and NMDAR-interacting proteins
13, 15 in excitotoxicity and ischemia have been demonstrated. Calpain is an effector of Ca
2+-overload central to ischemia acting as a modulatory protease that transforms substrate stability, location, or activity.
16Processes downstream of the NMDAR overactivation, which are aberrant in stroke, might constitute novel therapeutic targets for reduction of neuronal death. We hypothesized that neurotrophin receptors, which are associated with NMDARs,
17, 18 are modified by ischemia as other NMDAR-related proteins. Although neurotrophins have been proposed as therapeutic agents for stroke and excitotoxicity-associated diseases,
19 the effect of ischemia on neurotrophin signaling is largely unknown. These molecules are fundamental for the development of adult nervous system. Among them, BDNF has a major role through binding to its high-affinity tyrosine-kinase receptor, TrkB, and initation of signaling cascades that regulate gene expression, neuronal survival, neurotransmitter release, and synaptic transmission.
20 In addition to the full-length isoform (TrkB-FL) encoding the active receptor, alternative splicing yields receptors that lack the kinase domain, TrkB-T1, TrkB-T2, and TrkB-T-Shc,
21 suggested as involved in TrkB-FL modulation.
22 Particularly, TrkB-T1 opposes TrkB-FL function
23, 24 via competition for BDNF binding
21 or the formation of inactive heterodimers.
25 Additionally, TrkB-FL-independent signaling has been also suggested for TrkB-T1.
26We were interested in the identification of additional neuronal survival pathways downregulated in stroke and sought to characterize their contribution to excitotoxicity. Therefore, we analyzed TrkB expression in models of ischemia and excitotoxicity, and characterized mechanisms acting at the mRNA and protein levels yielding TrkB-FL downregulation and TrkB-T1 upregulation. We investigated the contribution of this imbalance to excitotoxicity and ischemia, and demonstrated a strong association with neurodegeneration. Analysis of human necropsies suggested that TrkB levels might be similarly altered by stroke. These results identified the TrkB isoforms as new therapeutic targets for neuroprotection against excitotoxicity.