Induction of COX-2 activity in cerebral ischemia results in increased neuronal injury and infarct size. Recent studies investigating neurotoxic mechanisms of COX-2 demonstrate both toxic and paradoxically protective effects of downstream prostaglandin receptor signaling pathways. We tested whether misoprostol, a PGE 2 receptor agonist that is utilized clinically as an anti-ulcer agent and signals through the protective PGE 2 EP2, EP3, and EP4 receptors, would reduce brain injury in the murine middle cerebral artery occlusion-reperfusion (MCAO-RP) model. Administration of misoprostol, at the time of MCAO or 2 h after MCAO, resulted in significant rescue of infarct volume at 24 and 72 h. Immunocytochemistry demonstrated dynamic regulation of the EP2 and EP4 receptors during reperfusion in neurons and endothelial cells of cerebral cortex and striatum, with limited expression of EP3 receptor. EP3−/− mice had no significant changes in infarct volume compared to control littermates. Moreover, administration of misoprostol to EP3+/+ and EP3−/− mice showed similar levels of infarct rescue, indicating that misoprostol protection was not mediated through the EP3 receptor. Taken together, these findings suggest a novel function for misoprostol as a protective agent in cerebral ischemia acting via the PGE 2 EP2 and/or EP4 receptors.
KeywordsStroke; Misoprostol; Prostaglandin; PGE 2 ; Cerebral ischemia A neurotoxic effect of cyclooxygenase-2 (COX-2) has been demonstrated in rodent models of focal cerebral ischemia [10,16,21,22]. The cyclooxygenases COX-1 and COX-2 catalyze the first committed step in the synthesis of prostaglandins and thromboxane, which are lipid signaling molecules that participate in a broad range of physiologic and pathologic processes, including synaptic plasticity, neuronal injury, and neuroinflammation (reviewed in [15] Misoprostol is a widely used anti-ulcer agent in patients who are at risk for non-steroidal antiinflammatory drug (NSAID)-mediated gastritis and ulcer disease [23] and repletes cytoprotective levels of PGE 2 necessary for maintaining integrity of the gastric mucosa. Misoprostol binds the PGE 2 EP2, EP3, and EP4 receptors (K i : 34, 7.9, and 23 nM for EP2, EP3, and EP4, respectively [8]) increases cAMP production, indicating activation of the EP2 and EP4 receptors, which are positively coupled to adenylate cyclase. Based on our recent data demonstrating a protective role of the EP2 receptor in cerebral ischemia [19,20], we tested whether misoprostol, an agonist at this receptor, would reduce infarct volume in the MCAO model of transient focal ischemia. Results of this study indicate that misoprostol exerts a pronounced protective effect in MCAO followed by reperfusion, and that it exerts this effect through the EP2 and/or EP4 receptors in vivo.This study was conducted in accordance with the National Institutes of Health guidelines for the use of experimental animals and protocols were approved by the Institutional Animal Care and Use Committee. For MCAO-RP studies, male mice age...