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Activity-based therapy is routinely integrated in rehabilitation programs to facilitate functional recovery after spinal cord injury (SCI). Among its beneficial effects is a reduction of hyperreflexia and spasticity, which affects ∼75% of the SCI population. Unlike current anti-spastic pharmacological treatments, rehabilitation attenuates spastic symptoms without causing an active depression in spinal excitability, thus avoiding further interference with motor recovery. Understanding how activity-based therapies contribute to decrease spasticity is critical to identifying new pharmacological targets and to optimize rehabilitation programs. It was recently demonstrated that a decrease in the expression of KCC2, a neuronal Cl– extruder, contributes to the development spasticity in SCI rats. Although exercise can decrease spinal hyperexcitability and increase KCC2 expression on lumbar motoneurons after SCI, a causal effect remains to be established. Activity-dependent processes include an increase in brain-derived neurotrophic factor (BDNF) expression. Interestingly, BDNF is a regulator of KCC2 but also a potent modulator of spinal excitability. Therefore, we hypothesized that after SCI, the activity-dependent increase in KCC2 expression: 1) functionally contributes to reduce hyperreflexia, and 2) is regulated by BDNF. SCI rats chronically received VU0240551 (KCC2 blocker) or TrkB-IgG (BDNF scavenger) during the daily rehabilitation sessions and the frequency-dependent depression of the H-reflex, a monitor of hyperreflexia, was recorded 4 weeks post-injury. Our results suggest that the activity-dependent increase in KCC2 functionally contributes to H-reflex recovery and critically depends on BDNF activity. This study provides a new perspective in understanding how exercise impacts hyperreflexia by identifying the biological basis of the recovery of function.

α-synuclein dysregulation is a critical aspect of Parkinson's disease pathology. Recent studies have observed that α-synuclein aggregates are cytotoxic to cells in culture and that this toxicity can be spread between cells. However, the molecular mechanisms governing this cytotoxicity and spread are poorly characterized. Recent studies of viruses and bacteria, which achieve their cytoplasmic entry by rupturing intracellular vesicles, have utilized the redistribution of galectin proteins as a tool to measure vesicle rupture by these organisms. Using this approach, we demonstrate that α-synuclein aggregates can induce the rupture of lysosomes following their endocytosis in neuronal cell lines. This rupture can be induced by the addition of α-synuclein aggregates directly into cells as well as by cell-to-cell transfer of α-synuclein. We also observe that lysosomal rupture by α-synuclein induces a cathepsin B dependent increase in reactive oxygen species (ROS) in target cells. Finally, we observe that α-synuclein aggregates can induce inflammasome activation in THP-1 cells. Lysosomal rupture is known to induce mitochondrial dysfunction and inflammation, both of which are well established aspects of Parkinson's disease, thus connecting these aspects of Parkinson's disease to the propagation of α-synuclein pathology in cells.

alpha -synuclein dysregulation is a critical aspect of Parkinson's disease pathology. Recent studies have observed that alpha -synuclein aggregates are cytotoxic to cells in culture and that this toxicity can be spread between cells. However, the molecular mechanisms governing this cytotoxicity and spread are poorly characterized. Recent studies of viruses and bacteria, which achieve their cytoplasmic entry by rupturing intracellular vesicles, have utilized the redistribution of galectin proteins as a tool to measure vesicle rupture by these organisms. Using this approach, we demonstrate that alpha -synuclein aggregates can induce the rupture of lysosomes following their endocytosis in neuronal cell lines. This rupture can be induced by the addition of alpha -synuclein aggregates directly into cells as well as by cell-to-cell transfer of alpha -synuclein. We also observe that lysosomal rupture by alpha -synuclein induces a cathepsin B dependent increase in reactive oxygen species (ROS) in target cells. Finally, we observe that alpha -synuclein aggregates can induce inflammasome activation in THP-1 cells. Lysosomal rupture is known to induce mitochondrial dysfunction and inflammation, both of which are well established aspects of Parkinson's disease, thus connecting these aspects of Parkinson's disease to the propagation of alpha -synuclein pathology in cells.

Activity-based therapies are routinely integrated in rehabilitation programs to induce repetitive activation of the neuromuscular system and facilitate functional recovery after spinal cord injury (SCI). Among the beneficial effects of physical therapy is a reduction of hyperreflexia and spasticity in SCI individuals, but the precise mechanism by which exercise regulates spinal networks and facilitate recovery remains elusive. Spasticity is a debilitating condition that affects ~ 75% of the SCI population and interferes with residual motor function. Current pharmacological treatments not only have serious side effects but also actively depress spinal excitability and interferes with motor recovery. Understanding how activity-based therapies contribute to decrease spasticity will help identify critical pharmacological targets and optimize rehabilitation programs. KCC2, a neuron-specific Cl- extruder, is critical to the maintenance of [Cl-]i and its downregulation after SCI leads to a shift in chloride homeostasis that contributes to develop spasticity. We have shown in earlier studies that not only exercise promotes reflex modulation but also restores KCC2 expression in motoneurons. KCC2 is dynamically modulated by several signaling pathways, the most prevalent being BDNF-TrkB. Interestingly, activity-dependent processes triggered by exercise include an increase in the expression of BDNF in the lumbar spinal cord. However, whether the increase in KCC2 contributes to functional recovery and rely on BDNF activity have not been established. Our objective was to determine 1) whether the activity-dependent upregulation of KCC2 contributes to decrease spasticity after SCI; 2) if BDNF regulates KCC2 expression in an activity-dependent manner. Using a model of complete SCI, we investigated this possible causal effect by intrathecally delivering VU0240551, a specific KCC2 blocker, or TrkB-IgG, a BDNF scavenger. Drugs were specifically delivered during the daily rehabilitation sessions to transiently prevent KCC2/BDNF activity. We provide evidence that the beneficial effect of exercise on functional recovery relies on a BDNF-dependent increase in KCC2 expression on motoneurons and the restoration of endogenous inhibition to a mature state. We identify, for the first time, that the increase in KCC2 activity with activity-based therapies functionally contributes to H-reflex recovery and critically depends on BDNF activity. This provides a new perspective on our understanding of how exercise impact hyperreflexia by identifying the biological basis of recovery of function. Acting directly on chloride homeostasis through BDNF to restore endogenous inhibition rather than actively depress excitability can diminish the reduction in motor output associated with the current pharmacological management of SCI and improve the outcome of rehabilitation programs.