Blood-brain barrier dysfunction in aging induces hyperactivation of TGFβ signaling and chronic yet reversible neural dysfunction

• Published in: Science translational medicine 2019-12, Vol.11 (521)
• Main Authors: Senatorov, Jr, Vladimir V, Friedman, Aaron R, Milikovsky, Dan Z, Ofer, Jonathan, Saar-Ashkenazy, Rotem, Charbash, Adiel, Jahan, Naznin, Chin, Gregory, Mihaly, Eszter, Lin, Jessica M, Ramsay, Harrison J, Moghbel, Ariana, Preininger, Marcela K, Eddings, Chelsy R, Harrison, Helen V, Patel, Rishi, Shen, Yizhuo, Ghanim, Hana, Sheng, Huanjie, Veksler, Ronel, Sudmant, Peter H, Becker, Albert, Hart, Barry, Rogawski, Michael A, Dillin, Andrew, Friedman, Alon, Kaufer, Daniela
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Aging; Aging - pathology; Albumins - metabolism; Animals; Astrocytes; Astrocytes - drug effects; Astrocytes - metabolism; Blood-brain barrier; Blood-Brain Barrier - drug effects; Blood-Brain Barrier - pathology; Blood-Brain Barrier - physiopathology; Chronic Disease; Cognitive ability; Cognitive Dysfunction - pathology; Cognitive Dysfunction - physiopathology; Gene Knockdown Techniques; Hippocampus - drug effects; Hippocampus - pathology; Hippocampus - physiopathology; Humans; Life span; Mice, Transgenic; Middle Aged; Mimicry; Phenotypes; Protein Kinase Inhibitors - pharmacology; Receptor, Transforming Growth Factor-beta Type I - antagonists & inhibitors; Receptor, Transforming Growth Factor-beta Type I - metabolism; Seizures; Signal Transduction; Transforming Growth Factor beta - metabolism; Transforming growth factor-b; Young Adult
• ISSN: 1946-6234; 1946-6242; 1946-6242; 1946-3242
• DOI: 10.1126/scitranslmed.aaw8283

Aging involves a decline in neural function that contributes to cognitive impairment and disease. However, the mechanisms underlying the transition from a young-and-healthy to aged-and-dysfunctional brain are not well understood. Here, we report breakdown of the vascular blood-brain barrier (BBB) in aging humans and rodents, which begins as early as middle age and progresses to the end of the life span. Gain-of-function and loss-of-function manipulations show that this BBB dysfunction triggers hyperactivation of transforming growth factor-β (TGFβ) signaling in astrocytes, which is necessary and sufficient to cause neural dysfunction and age-related pathology in rodents. Specifically, infusion of the serum protein albumin into the young rodent brain (mimicking BBB leakiness) induced astrocytic TGFβ signaling and an aged brain phenotype including aberrant electrocorticographic activity, vulnerability to seizures, and cognitive impairment. Furthermore, conditional genetic knockdown of astrocytic TGFβ receptors or pharmacological inhibition of TGFβ signaling reversed these symptomatic outcomes in aged mice. Last, we found that this same signaling pathway is activated in aging human subjects with BBB dysfunction. Our study identifies dysfunction in the neurovascular unit as one of the earliest triggers of neurological aging and demonstrates that the aging brain may retain considerable latent capacity, which can be revitalized by therapeutic inhibition of TGFβ signaling.