Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy

Ying Gao,1 Lu Li,1 Fang Zhao,1 Yi Cheng,1 Mu Jin,2 Fu-Shan Xue1,3 1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republi...

Full description

Saved in:
Bibliographic Details
Main Authors: Gao Y, Li L, Zhao F, Cheng Y, Jin M, Xue FS
Format: Article
Language:English
Published: Dove Medical Press 2025-01-01
Series:Drug Design, Development and Therapy
Subjects:
Online Access:https://www.dovepress.com/esketamine-at-a-clinical-dose-attenuates-cerebral-ischemiareperfusion--peer-reviewed-fulltext-article-DDDT
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832592090197917696
author Gao Y
Li L
Zhao F
Cheng Y
Jin M
Xue FS
author_facet Gao Y
Li L
Zhao F
Cheng Y
Jin M
Xue FS
author_sort Gao Y
collection DOAJ
description Ying Gao,1 Lu Li,1 Fang Zhao,1 Yi Cheng,1 Mu Jin,2 Fu-Shan Xue1,3 1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, Fuzhou, People’s Republic of ChinaCorrespondence: Mu Jin, Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 An-Zhen Road, Chao-Yang District, Beijing, 100029, People’s Republic of China, Tel +86-13366600987, Email jinmu0119@hotmail.com Fu-Shan Xue, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, People’s Republic of China, Tel +86-13911177655, Fax +86-591-88217841, Email xuefushan@aliyun.com; xuefushan@mail.ccmu.edu.cnPurpose: This study aimed to assess the protective effect of a clinical dose esketamine on cerebral ischemia/reperfusion (I/R) injury and to reveal the potential mechanisms associated with microglial polarization and autophagy.Methods: Experimental cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) in adult rats and simulated by oxygen-glucose deprivation (OGD) in BV-2 microglial cells. Neurological and sensorimotor function, cerebral infarct volume, histopathological changes, mitochondrial morphological changes, and apoptosis of ischemic brain tissues were assessed in the presence or absence of esketamine and the autophagy inducer rapamycin. The expression of biomarkers related to microglial M1 and M2 phenotypes in the ischemic brain tissues was determined by immunofluorescence staining and RT-qPCR, and the expression of proteins associated with autophagy and the AKT signaling pathway in the ischemic brain tissues was assayed by Western blotting.Results: Esketamine alone and esketamine combined with rapamycin alleviated neurological impairment, improved sensorimotor function, decreased cerebral infarct volume, and mitigated tissue injury in the MCAO rats. Importantly, esketamine promoted microglial phenotypic transition from M1 to M2 in both the MCAO rats and the OGD-treated BV-2 microglia, induced autophagy, and inactivated AKT signaling. Furthermore, the effects of esketamine were enhanced by addition of autophagy inducer rapamycin.Conclusion: Esketamine at a clinical dose attenuates cerebral I/R injury by inhibiting AKT signaling pathway to facilitate microglial M2 polarization and autophagy. Furthermore, esketamine combined autophagy inducer can provide an improved protection against cerebral I/R injury. Thus, this study provides new insights into the neuroprotective mechanisms of esketamine and the potential therapeutic strategies of cerebral I/R injury.Keywords: cerebral ischemia/reperfusion injury, esketamine, microglia polarization, autophagy, ischemic stroke
format Article
id doaj-art-cd0fa7eb76884fd1b48e598763a7ffd7
institution Kabale University
issn 1177-8881
language English
publishDate 2025-01-01
publisher Dove Medical Press
record_format Article
series Drug Design, Development and Therapy
spelling doaj-art-cd0fa7eb76884fd1b48e598763a7ffd72025-01-21T16:58:07ZengDove Medical PressDrug Design, Development and Therapy1177-88812025-01-01Volume 1936938799393Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and AutophagyGao YLi LZhao FCheng YJin MXue FSYing Gao,1 Lu Li,1 Fang Zhao,1 Yi Cheng,1 Mu Jin,2 Fu-Shan Xue1,3 1Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Anesthesiology, Shengli Clinical Medical College of Fujian Medical University, Fuzhou University Affiliated Provincial Hospital, Fujian Provincial Hospital, Fuzhou, People’s Republic of ChinaCorrespondence: Mu Jin, Department of Anesthesiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 An-Zhen Road, Chao-Yang District, Beijing, 100029, People’s Republic of China, Tel +86-13366600987, Email jinmu0119@hotmail.com Fu-Shan Xue, Department of Anesthesiology, Beijing Friendship Hospital, Capital Medical University, No. 95 Yong-An Road, Xi-Cheng District, Beijing, 100050, People’s Republic of China, Tel +86-13911177655, Fax +86-591-88217841, Email xuefushan@aliyun.com; xuefushan@mail.ccmu.edu.cnPurpose: This study aimed to assess the protective effect of a clinical dose esketamine on cerebral ischemia/reperfusion (I/R) injury and to reveal the potential mechanisms associated with microglial polarization and autophagy.Methods: Experimental cerebral ischemia was induced by middle cerebral artery occlusion (MCAO) in adult rats and simulated by oxygen-glucose deprivation (OGD) in BV-2 microglial cells. Neurological and sensorimotor function, cerebral infarct volume, histopathological changes, mitochondrial morphological changes, and apoptosis of ischemic brain tissues were assessed in the presence or absence of esketamine and the autophagy inducer rapamycin. The expression of biomarkers related to microglial M1 and M2 phenotypes in the ischemic brain tissues was determined by immunofluorescence staining and RT-qPCR, and the expression of proteins associated with autophagy and the AKT signaling pathway in the ischemic brain tissues was assayed by Western blotting.Results: Esketamine alone and esketamine combined with rapamycin alleviated neurological impairment, improved sensorimotor function, decreased cerebral infarct volume, and mitigated tissue injury in the MCAO rats. Importantly, esketamine promoted microglial phenotypic transition from M1 to M2 in both the MCAO rats and the OGD-treated BV-2 microglia, induced autophagy, and inactivated AKT signaling. Furthermore, the effects of esketamine were enhanced by addition of autophagy inducer rapamycin.Conclusion: Esketamine at a clinical dose attenuates cerebral I/R injury by inhibiting AKT signaling pathway to facilitate microglial M2 polarization and autophagy. Furthermore, esketamine combined autophagy inducer can provide an improved protection against cerebral I/R injury. Thus, this study provides new insights into the neuroprotective mechanisms of esketamine and the potential therapeutic strategies of cerebral I/R injury.Keywords: cerebral ischemia/reperfusion injury, esketamine, microglia polarization, autophagy, ischemic strokehttps://www.dovepress.com/esketamine-at-a-clinical-dose-attenuates-cerebral-ischemiareperfusion--peer-reviewed-fulltext-article-DDDTcerebral ischemia/reperfusion injuryesketaminemicroglia polarizationautophagyischemic stroke
spellingShingle Gao Y
Li L
Zhao F
Cheng Y
Jin M
Xue FS
Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy
Drug Design, Development and Therapy
cerebral ischemia/reperfusion injury
esketamine
microglia polarization
autophagy
ischemic stroke
title Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy
title_full Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy
title_fullStr Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy
title_full_unstemmed Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy
title_short Esketamine at a Clinical Dose Attenuates Cerebral Ischemia/Reperfusion Injury by Inhibiting AKT Signaling Pathway to Facilitate Microglia M2 Polarization and Autophagy
title_sort esketamine at a clinical dose attenuates cerebral ischemia reperfusion injury by inhibiting akt signaling pathway to facilitate microglia m2 polarization and autophagy
topic cerebral ischemia/reperfusion injury
esketamine
microglia polarization
autophagy
ischemic stroke
url https://www.dovepress.com/esketamine-at-a-clinical-dose-attenuates-cerebral-ischemiareperfusion--peer-reviewed-fulltext-article-DDDT
work_keys_str_mv AT gaoy esketamineataclinicaldoseattenuatescerebralischemiareperfusioninjurybyinhibitingaktsignalingpathwaytofacilitatemicrogliam2polarizationandautophagy
AT lil esketamineataclinicaldoseattenuatescerebralischemiareperfusioninjurybyinhibitingaktsignalingpathwaytofacilitatemicrogliam2polarizationandautophagy
AT zhaof esketamineataclinicaldoseattenuatescerebralischemiareperfusioninjurybyinhibitingaktsignalingpathwaytofacilitatemicrogliam2polarizationandautophagy
AT chengy esketamineataclinicaldoseattenuatescerebralischemiareperfusioninjurybyinhibitingaktsignalingpathwaytofacilitatemicrogliam2polarizationandautophagy
AT jinm esketamineataclinicaldoseattenuatescerebralischemiareperfusioninjurybyinhibitingaktsignalingpathwaytofacilitatemicrogliam2polarizationandautophagy
AT xuefs esketamineataclinicaldoseattenuatescerebralischemiareperfusioninjurybyinhibitingaktsignalingpathwaytofacilitatemicrogliam2polarizationandautophagy