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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 9

Postnatal Prox1 induction compromises BBB integrity.

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Postnatal Prox1 induction compromises BBB integrity.
(A) Diagram depicti...
(A) Diagram depicting EC-specific Prox1 induction at P7 and vascular permeability assay at P10. Created in BioRender (Gonzalez S, 2025, https://BioRender.com/kdo2upo). (B) Gross appearance of P10 Prox1iEC-OE mutant and control brains with 3 kDa dextran tracer (red). (C) Quantification of dextran leakage outside of the brain vasculature in control (n = 5 individual brains, showing the average of 4 different fields of view) and mutant brains (n = 7 individual brains, showing the average of 4 different fields of view). Mean ± SEM, unpaired t test. ***P < 0.0005. (D and E) A sagittal view of whole-mount imaging of Prox1iEC-OE (E) and control (D) brains stained with EMCN (cyan) and dextran (red). Boxed regions in D and E are shown as magnified images for controls and Prox1iEC-OE mutants, respectively. (F) Section immunostaining of P10 Prox1iEC-OE mutant and their control littermate cerebrum stained with dextran (red) and EMCN (green). Scale bars: 1,000 μm (D and E), 300 μm (D and E, 3 right images), and 200 μm (F).

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