Activation of Cholinergic Anti-Inflammatory Pathway Ameliorates Cerebral and Cardiac Dysfunction After Intracerebral Hemorrhage Through Autophagy

Background: Intracerebral hemorrhage (ICH) is the devastating subtype of stroke with cardiovascular complications, resulting in high rates of mortality and morbidity with the release of inflammatory factors. Previous studies have demonstrated that activation of alpha 7nAChR can reduce immune and inflammation-related diseases by triggering the cholinergic anti-inflammatory pathway (CAIP). alpha 7nAChR mediates protection from nervous system inflammation through AMPK-mTOR-p70S6K-associated autophagy. Therefore, the purpose of this study is to explore whether the activation of alpha 7nAChR improves cerebral and cardiac dysfunction after ICH through autophagy. Methods; Male C57BL/6 mice were randomly divided into five groups (1): Control + saline (2), ICH+ saline (3), ICH + PNU-282987 (4), ICH+ PNU-282987 + MLA (5), ICH + PNU-282987 + 3-MA. The neurological function was evaluated at multiple time points. Brain water content was measured at 3 days after ICH to assess the severity of brain edema. PCR, immunofluorescence staining, and Western Blot were performed at 7 days after ICH to detect inflammation and autophagy. Picro-Sirius Red staining was measured at 30 days after ICH to evaluate myocardial fibrosis, echocardiography was performed at 3 and 30 days to measure cardiac function. Results: Our results indicated that the PNU-282987 reduced inflammatory factors (MCP-1, IL-1 beta, MMP-9, TNF-alpha, HMGB1, TLR2), promoted the polarization of macrophage/microglia into anti-inflammatory subtypes(CD206), repaired blood-brain barrier injury (ZO-1, Claudin-5, Occludin), alleviated acute brain edema and then recovered neurological dysfunction. Echocardiography and PSR indicated that activation of alpha 7nAChR ameliorated cardiac dysfunction. Western Blot showed that activation of alpha 7nAChR increased autophagy protein (LC3, Beclin) and decreased P62. It demonstrated that the activation of alpha 7nAChR promotes autophagy and then recovers brain and heart function after ICH. Conclusions: In conclusion, PNU-282987 promoted the cerebral and cardiac functional outcomes after ICH in mice through activated alpha 7nAChR, which may be attributable to promoting autophagy and then reducing inflammatory reactions after ICH.