Volume 69, Issue 1 pp. 119-129
Original Article

Fingolimod provides long-term protection in rodent models of cerebral ischemia

Ying Wei MD

Ying Wei MD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Muge Yemisci MD, PhD

Muge Yemisci MD, PhD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Hyung-Hwan Kim PhD

Hyung-Hwan Kim PhD

Department of Vascular Medicine Research, Brigham & Women's Hospital, Cambridge, MA

International Research Center of Bioscience & Biotechnology, Jungwon University, Goesan, Korea

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Lai Ming Yung PhD

Lai Ming Yung PhD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Hwa Kyoung Shin PhD

Hwa Kyoung Shin PhD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Seo-Kyoung Hwang MS

Seo-Kyoung Hwang MS

Department of Vascular Medicine Research, Brigham & Women's Hospital, Cambridge, MA

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Shuzhen Guo PhD

Shuzhen Guo PhD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Tao Qin

Tao Qin

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Nafiseh Alsharif

Nafiseh Alsharif

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Volker Brinkmann PhD

Volker Brinkmann PhD

Novartis Institutes for Biomedical Research, Autoimmunity, Transplantation and Inflammation, Basel, Switzerland

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James K Liao MD

James K Liao MD

Department of Vascular Medicine Research, Brigham & Women's Hospital, Cambridge, MA

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Eng H Lo PhD

Eng H Lo PhD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

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Christian Waeber PhD

Corresponding Author

Christian Waeber PhD

Department of Radiology, Massachusetts General Hospital, Charlestown, MA

Massachusetts General Hospital, CNY149 Room 6403, 149 13th Street, Charlestown, MA 02129Search for more papers by this author
First published: 12 November 2010
Citations: 234

Abstract

Objective:

The sphingosine-1-phosphate (S1P) receptor agonist fingolimod (FTY720), that has shown efficacy in advanced multiple sclerosis clinical trials, decreases reperfusion injury in heart, liver, and kidney. We therefore tested the therapeutic effects of fingolimod in several rodent models of focal cerebral ischemia. To assess the translational significance of these findings, we asked whether fingolimod improved long-term behavioral outcomes, whether delayed treatment was still effective, and whether neuroprotection can be obtained in a second species.

Methods:

We used rodent models of middle cerebral artery occlusion and cell-culture models of neurotoxicity and inflammation to examine the therapeutic potential and mechanisms of neuroprotection by fingolimod.

Results:

In a transient mouse model, fingolimod reduced infarct size, neurological deficit, edema, and the number of dying cells in the core and periinfarct area. Neuroprotection was accompanied by decreased inflammation, as fingolimod-treated mice had fewer activated neutrophils, microglia/macrophages, and intercellular adhesion molecule-1 (ICAM-1)-positive blood vessels. Fingolimod-treated mice showed a smaller infarct and performed better in behavioral tests up to 15 days after ischemia. Reduced infarct was observed in a permanent model even when mice were treated 4 hours after ischemic onset. Fingolimod also decreased infarct size in a rat model of focal ischemia. Fingolimod did not protect primary neurons against glutamate excitotoxicity or hydrogen peroxide, but decreased ICAM-1 expression in brain endothelial cells stimulated by tumor necrosis factor alpha.

Interpretation:

These findings suggest that anti-inflammatory mechanisms, and possibly vasculoprotection, rather than direct effects on neurons, underlie the beneficial effects of fingolimod after stroke. S1P receptors are a highly promising target in stroke treatment. ANN NEUROL, 2010

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