%0 Journal Article
%T Targeted rescue of synaptic plasticity improves cognitive decline in sepsis-associated encephalopathy.
%A Grünewald B
%A Wickel J
%A Hahn N
%A Rahmati V
%A Rupp H
%A Chung HY
%A Haselmann H
%A Strauss AS
%A Schmidl L
%A Hempel N
%A Grünewald L
%A Urbach A
%A Bauer M
%A Toyka KV
%A Blaess M
%A Claus RA
%A König R
%A Geis C
%J Mol Ther
%V 0
%N 0
%D 2024 May 23
%M 38788710
%F 12.91
%R 10.1016/j.ymthe.2024.05.001
%X Sepsis-associated encephalopathy (SAE) is a frequent complication of severe systemic infection resulting in delirium, premature death, and long-term cognitive impairment. We closely mimicked SAE in a murine peritoneal contamination and infection (PCI) model. We found long-lasting synaptic pathology in the hippocampus including defective long-term synaptic plasticity, reduction of mature neuronal dendritic spines, and severely affected excitatory neurotransmission. Genes related to synaptic signaling, including the gene for activity-regulated cytoskeleton-associated protein (Arc/Arg3.1) and members of the transcription-regulatory EGR gene family, were downregulated. At the protein level, ARC expression and mitogen-activated protein kinase signaling in the brain were affected. For targeted rescue we used adeno-associated virus-mediated overexpression of ARC in the hippocampus in vivo. This recovered defective synaptic plasticity and improved memory dysfunction. Using the enriched environment paradigm as a non-invasive rescue intervention, we found improvement of defective long-term potentiation, memory, and anxiety. The beneficial effects of an enriched environment were accompanied by an increase in brain-derived neurotrophic factor (BDNF) and ARC expression in the hippocampus, suggesting that activation of the BDNF-TrkB pathway leads to restoration of the PCI-induced reduction of ARC. Collectively, our findings identify synaptic pathomechanisms underlying SAE and provide a conceptual approach to target SAE-induced synaptic dysfunction with potential therapeutic applications to patients with SAE.