Intraventricular hemorrhage (IVH) in premature infants predisposes to white matter injury and subsequent cerebral palsy. The most common white matter injury in premature infants is 'gliosis and hypomyelination with intact axons'. In our model of IVH in premature rabbits, there is an arrest of oligodendrocyte (OL) maturation at a pre-myelinating stage. However, the mechanism underlying the maturational arrest of pre-OL and subsequent hypomyelination is unclear. Myelination is a dynamic process that needs an appropriate microenvironment containing growth factors, extracellular matrix molecules and myelinating OL. Chrondroitin sulfate proteoglycans (CSPG)-- neuracan, phosphacan, brevican, decorin, NG2 &versican--are important components of the extracellular matrix (ECM) and are increased in adult and neonatal brain injuries. They are primarily produced by reactive astrocytes and are regulated by transforming growth factor-2 (TGF-2) and epidermal growth factor (EGF). CSPGs have key regulatory functions during migration, proliferation and differentiation of pre-OL. Specifically, degradation of CSPGs by either chondroitinase or protease facilitates migration of OL, loosens the physical barriers in ECM, enhances formation of OL process outgrowths to unsheathe axons and improves interaction of growth factors with OL. Despite this evidence, direct effect(s) of CSPGs on myelination have not been studied. We hypothesize that CSPGs are elevated in premature newborns with IVH and that suppression of CSPG formation will restore myelination of axons and maturation of pre- OL into myelinating OL. Our preliminary data show that expression of CSPGs and growth factors (TGF2 and EGF) are elevated in premature infants and rabbit pups with IVH;and treatment with decorin, a CSPG and natural antagonist of TGF-2, reduces their levels. Our approach is to use a rabbit model that induces IVH with intraperitoneal glycerol. This model results in pups with hemorrhage to exhibit inflammation, cell death and subsequently, lesser myelination and more enhanced gliosis (day 14) compared to controls without IVH. The following specific aims will be addressed:
Aim #1. Determine whether the expression of CSPGs (neuracan, phosphacan, brevican, decorin, NG2 &versican) and their regulating growth factors (TGF-2 and EGF) are higher in both premature rabbit pups and infants with IVH compared to controls without IVH.
Aim # 2. Determine whether suppression of CSPGs either by chondroitinase or decorin (via TGF-2 inhibition) facilitates maturation of pre-OL, myelination and neurological recovery in premature rabbit pups with IVH. Our study that links CSPGs with failure to myelinate coupled with our novel approaches to regulate CSPG expression may provide effective strategies for prevention of cerebral palsy in infants with IVH.

Public Health Relevance

In the United States, about 12,240 premature infants develop bleeding in and around the ventricle (cavity) of the brain each year, which enhances the risk of white matter injuries and consequent cerebral palsy (weakness in extremities), and cognitive deficits--writing and reading difficulties. In this proposal, we seek to determine the mechanism of brain injuries in these infants with hemorrhage that leads to impairment in walking, reading and writing. In addition, we will test therapeutic strategies that can minimize or prevent cerebral palsy in them. To address these issues, we will use prematurely delivered rabbit pups as an experimental animal and will also use autopsy materials from premature infants with and without brain hemorrhage.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21HD061778-01
Application #
7708744
Study Section
Developmental Brain Disorders Study Section (DBD)
Program Officer
Parisi, Melissa
Project Start
2009-09-01
Project End
2011-08-31
Budget Start
2009-09-01
Budget End
2010-08-31
Support Year
1
Fiscal Year
2009
Total Cost
$220,240
Indirect Cost
Name
New York Medical College
Department
Pediatrics
Type
Schools of Medicine
DUNS #
041907486
City
Valhalla
State
NY
Country
United States
Zip Code
10595
Dohare, Preeti; Zia, Muhammad T; Ahmed, Ehsan et al. (2016) AMPA-Kainate Receptor Inhibition Promotes Neurologic Recovery in Premature Rabbits with Intraventricular Hemorrhage. J Neurosci 36:3363-77
Vinukonda, Govindaiah; Zia, Muhammad T; Bhimavarapu, Bala B R et al. (2013) Intraventricular hemorrhage induces deposition of proteoglycans in premature rabbits, but their in vivo degradation with chondroitinase does not restore myelination, ventricle size and neurological recovery. Exp Neurol 247:630-44
Vinukonda, Govindaiah; Dummula, Krishna; Malik, Sabrina et al. (2010) Effect of prenatal glucocorticoids on cerebral vasculature of the developing brain. Stroke 41:1766-73
Chua, C O; Vinukonda, G; Hu, F et al. (2010) Effect of hyperoxic resuscitation on propensity of germinal matrix haemorrhage and cerebral injury. Neuropathol Appl Neurobiol 36:448-58