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Endothelial PROX1 induces blood-brain barrier disruption in the central nervous system
Sara González-Hernández, Ryo Sato, Yuya Sato, Chang Liu, Wenling Li, Zulfeqhar A. Syed, Chengyu Liu, Sadhana Jackson, Yoshiaki Kubota, Yoh-suke Mukouyama
Sara González-Hernández, Ryo Sato, Yuya Sato, Chang Liu, Wenling Li, Zulfeqhar A. Syed, Chengyu Liu, Sadhana Jackson, Yoshiaki Kubota, Yoh-suke Mukouyama
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Research Article Neuroscience Vascular biology

Endothelial PROX1 induces blood-brain barrier disruption in the central nervous system

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Abstract

The central nervous system (CNS) parenchyma has conventionally been believed to lack lymphatic vasculature, likely owing to a non-permissive microenvironment that hinders the formation and growth of lymphatic endothelial cells (LECs). Recent findings of ectopic expression of LEC markers including prospero homeobox 1 (PROX1), a master regulator of lymphatic differentiation, and the vascular permeability marker plasmalemma vesicle–associated protein (PLVAP) in certain glioblastomas (GBM) and brain arteriovenous malformations have prompted investigation into their roles in cerebrovascular malformations, tumor environments, and blood-brain barrier (BBB) abnormalities. To explore the relationship between ectopic LEC properties and BBB disruption, we used endothelial cell–specific Prox1 overexpression mutants. When induced during embryonic stages of BBB formation, endothelial Prox1 expression induces hybrid blood-lymphatic phenotypes in the developing CNS vasculature. This effect is not observed when Prox1 is overexpressed during postnatal BBB maturation. Ectopic Prox1 expression leads to significant vascular malformations and enhanced vascular leakage, resulting in BBB disruption when induced during both embryonic and postnatal stages. Mechanistically, PROX1 downregulates critical BBB-associated genes, including β-catenin and claudin-5, which are essential for BBB development and maintenance. These findings suggest that PROX1 compromises BBB integrity by negatively regulating BBB-associated gene expression and Wnt/β-catenin signaling.

Authors

Sara González-Hernández, Ryo Sato, Yuya Sato, Chang Liu, Wenling Li, Zulfeqhar A. Syed, Chengyu Liu, Sadhana Jackson, Yoshiaki Kubota, Yoh-suke Mukouyama

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Figure 5

Endothelial Prox1 does not induce conventional lymphatic vessels in developing CNS vasculature.

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Endothelial Prox1 does not induce conventional lymphatic vessels in deve...
(A and B) Section immunostaining of trunk (A) and brain (B) from E16.5 Prox1iEC-OE and control embryos stained for PECAM1 (cyan) and LYVE1 (red). Arrows indicate PECAM1+LYVE1+ lymphatic vessels; yellow arrowheads mark PECAM1–LYVE1+ macrophages. Prox1iEC-OE mutants exhibited enhanced lymphatic differentiation to form PECAM1+LYVE1+ lymphatic vasculature in the trunk in comparison with their control littermates. In contrast, both Prox1iEC-OE mutants and their control littermates did not exhibit conventional PECAM1+LYVE1+ lymphatic vasculature in the brain. Scale bars: 200 μm (A), 50 μm (B). Created in BioRender (Gonzalez S, 2025, https://BioRender.com/kdo2upo).

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