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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 6

Endothelial Prox1 induces a hybrid blood-lymphatic phenotype in developing CNS vasculature.

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Endothelial Prox1 induces a hybrid blood-lymphatic phenotype in developi...
(A) Schematic illustrations indicating EC markers expressed in conventional lymphatic vessels, hybrid vessels in the Schlemm’s canal, and CNS vessels in controls and Prox1iEC-OE mutants. (B) Section immunostaining of E16.5 Prox1iEC-OE mutant and their control littermate brains with PLVAP (cyan), ITGα9 (cyan), and VEGFR3 (cyan), together with ERG (red), PECAM1 (red), and EMCN (red), respectively. The sections labeled with VEGFR3 (cyan) and EMCN (red) are additionally stained with PROX1 (gray in the magnified images). (C) Quantifications of the mean fluorescence intensity for PLVAP, ITGα9, and VEGFR3 in the brain vasculature using Imaris software (Oxford Instruments). Each dot corresponds to random fields of view from at least 3 different control and mutant embryos. Data shown as mean ± SEM. (D) Relative mRNA expression levels of Prox1 and Plvap together with BEC markers such as Cadh5, Cd34, Itga5, and Gata2 in FACS-isolated brain ECs from E16.5 Prox1iEC-OE mutant and their control littermate brains. Bar graphs show mean normalized expression ± SEM; n = 3–4 biological samples obtained from FACS-isolated brain ECs from individual experiments. Mean ± SEM, unpaired t test. *P < 0.05, **P < 0.001, ***P < 0.0005, ****P < 0.0001. Scale bars: 50 μm (top panels), 100 μm (middle and bottom panels), 10 μm (inset panels). Created in BioRender (Gonzalez S, 2025, https://BioRender.com/kdo2upo).

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