¹Department of Neurosurgery, Stanford Stroke Center, Stanford University School of Medicine, Stanford, California, USA

Correspondence: Dr GK Steinberg, Department of Neurosurgery, Stanford Stroke Center, Stanford University School of Medicine, 300 Pasteur Drive, Room 281A, Stanford, CA 94305-5327, USA. E-mail: gsteinberg@stanford.edu

²These two authors contributed equally to this work.

Received 5 June 2008; Revised 22 September 2008; Accepted 4 October 2008; Published online 5 November 2008.

Abstract

Functional recovery after cerebral ischemia is mediated by the regeneration of vascular networks and the restoration of synaptic architecture. Netrins have been implicated in neuronal pathfinding and angiogenesis. In this study, we investigated the expression of Netrin-4 and its putative receptors, deleted in colorectal cancer (DCC), Unc5A, and Unc5B after distal middle cerebral artery occlusion in mice. Netrin-4 protein was also administered intracerebroventricularly to examine its effect on angiogenesis and behavioral recovery. Netrin-4 protein was highly upregulated in the ischemic core as soon as 1 day after cerebral ischemia, with subsequent downregulation after 1 week. Its expression was limited to the area of blood–brain barrier damage and was seen on both blood vessels and astrocytic foot processes. Although there was not a significant upregulation of the putative Netrin-4 receptor Unc5A and Unc5B, there was a significant increase in expression of the DCC receptor on neuronal processes in the peri-infarct cortex. Intracerebroventricular administration of Netrin-4 into the ischemic brain increased blood vessel density, endothelial proliferation, and improved behavioral recovery at 1 week after stroke, but did not have an effect on blood–brain barrier permeability or infarct size. These findings suggest that Netrin-4 may improve poststroke functional recovery by enhancing blood vessel proliferation.