Intranasal epidermal growth factor treatment rescues neonatal brain injury

Nature. 2014 Feb 13;506(7487):230-4. doi: 10.1038/nature12880. Epub 2013 Dec 25.

Abstract

There are no clinically relevant treatments available that improve function in the growing population of very preterm infants (less than 32 weeks' gestation) with neonatal brain injury. Diffuse white matter injury (DWMI) is a common finding in these children and results in chronic neurodevelopmental impairments. As shown recently, failure in oligodendrocyte progenitor cell maturation contributes to DWMI. We demonstrated previously that the epidermal growth factor receptor (EGFR) has an important role in oligodendrocyte development. Here we examine whether enhanced EGFR signalling stimulates the endogenous response of EGFR-expressing progenitor cells during a critical period after brain injury, and promotes cellular and behavioural recovery in the developing brain. Using an established mouse model of very preterm brain injury, we demonstrate that selective overexpression of human EGFR in oligodendrocyte lineage cells or the administration of intranasal heparin-binding EGF immediately after injury decreases oligodendroglia death, enhances generation of new oligodendrocytes from progenitor cells and promotes functional recovery. Furthermore, these interventions diminish ultrastructural abnormalities and alleviate behavioural deficits on white-matter-specific paradigms. Inhibition of EGFR signalling with a molecularly targeted agent used for cancer therapy demonstrates that EGFR activation is an important contributor to oligodendrocyte regeneration and functional recovery after DWMI. Thus, our study provides direct evidence that targeting EGFR in oligodendrocyte progenitor cells at a specific time after injury is clinically feasible and potentially applicable to the treatment of premature children with white matter injury.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal
  • Animals
  • Animals, Newborn
  • Brain Injuries / congenital*
  • Brain Injuries / drug therapy*
  • Brain Injuries / pathology
  • Brain Injuries / prevention & control
  • Cell Differentiation / drug effects
  • Cell Division / drug effects
  • Cell Lineage / drug effects
  • Cell Survival / drug effects
  • Demyelinating Diseases / congenital
  • Demyelinating Diseases / metabolism
  • Demyelinating Diseases / pathology
  • Demyelinating Diseases / prevention & control
  • Disease Models, Animal
  • Epidermal Growth Factor / administration & dosage
  • Epidermal Growth Factor / pharmacology*
  • Epidermal Growth Factor / therapeutic use*
  • ErbB Receptors / genetics
  • ErbB Receptors / metabolism
  • Humans
  • Hypoxia / genetics
  • Hypoxia / metabolism
  • Hypoxia / pathology
  • Hypoxia / physiopathology
  • Infant, Premature, Diseases / drug therapy
  • Infant, Premature, Diseases / metabolism
  • Infant, Premature, Diseases / pathology
  • Male
  • Mice
  • Molecular Targeted Therapy
  • Oligodendroglia / cytology
  • Oligodendroglia / drug effects*
  • Oligodendroglia / metabolism
  • Oligodendroglia / pathology
  • Regeneration / drug effects
  • Signal Transduction / drug effects
  • Stem Cells / cytology
  • Stem Cells / drug effects
  • Stem Cells / metabolism
  • Time Factors

Substances

  • Epidermal Growth Factor
  • ErbB Receptors