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<front>
<journal-meta>
<journal-id journal-id-type="publisher-id">Front. Aging Neurosci.</journal-id>
<journal-title>Frontiers in Aging Neuroscience</journal-title>
<abbrev-journal-title abbrev-type="pubmed">Front. Aging Neurosci.</abbrev-journal-title>
<issn pub-type="epub">1663-4365</issn>
<publisher>
<publisher-name>Frontiers Media S.A.</publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id pub-id-type="doi">10.3389/fnagi.2021.729652</article-id>
<article-categories>
<subj-group subj-group-type="heading">
<subject>Aging Neuroscience</subject>
<subj-group>
<subject>Original Research</subject>
</subj-group>
</subj-group>
</article-categories>
<title-group>
<article-title>Glibenclamide Attenuates Neuroinflammation and Promotes Neurological Recovery After Intracerebral Hemorrhage in Aged Rats</article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name><surname>Jiang</surname> <given-names>Bing</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn002"><sup>&#x2020;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1428920/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Zhang</surname> <given-names>Ying</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<xref ref-type="author-notes" rid="fn002"><sup>&#x2020;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1428918/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Wang</surname> <given-names>Yan</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1429024/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Li</surname> <given-names>Zheng</given-names></name>
<xref ref-type="aff" rid="aff1"><sup>1</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1429016/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Chen</surname> <given-names>Qianwei</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1429306/overview"/>
</contrib>
<contrib contrib-type="author">
<name><surname>Tang</surname> <given-names>Jun</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/1429323/overview"/>
</contrib>
<contrib contrib-type="author" corresp="yes">
<name><surname>Zhu</surname> <given-names>Gang</given-names></name>
<xref ref-type="aff" rid="aff2"><sup>2</sup></xref>
<xref ref-type="corresp" rid="c001"><sup>&#x002A;</sup></xref>
<uri xlink:href="http://loop.frontiersin.org/people/404237/overview"/>
</contrib>
</contrib-group>
<aff id="aff1"><sup>1</sup><institution>Department of Neurology, Chengdu Fifth People&#x2019;s Hospital</institution>, <addr-line>Chengdu</addr-line>, <country>China</country></aff>
<aff id="aff2"><sup>2</sup><institution>Department of Neurosurgery, Southwest Hospital, Army Medical University</institution>, <addr-line>Chongqing</addr-line>, <country>China</country></aff>
<author-notes>
<fn fn-type="edited-by"><p>Edited by: Donghui Zhu, Stony Brook University, United States</p></fn>
<fn fn-type="edited-by"><p>Reviewed by: Yihao Tao, Chongqing Medical University, China; Gang Chen, First Affiliated Hospital of Soochow University, China</p></fn>
<corresp id="c001">&#x002A;Correspondence: Gang Zhu, <email>gangzhu6666@sina.com</email></corresp>
<fn fn-type="other" id="fn002"><p><sup>&#x2020;</sup>These authors have contributed equally to this work</p></fn>
</author-notes>
<pub-date pub-type="epub">
<day>26</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="ecorrected">
<day>17</day>
<month>03</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="collection">
<year>2021</year>
</pub-date>
<volume>13</volume>
<elocation-id>729652</elocation-id>
<history>
<date date-type="received">
<day>23</day>
<month>06</month>
<year>2021</year>
</date>
<date date-type="accepted">
<day>21</day>
<month>07</month>
<year>2021</year>
</date>
</history>
<permissions>
<copyright-statement>Copyright &#x00A9; 2021 Jiang, Zhang, Wang, Li, Chen, Tang and Zhu.</copyright-statement>
<copyright-year>2021</copyright-year>
<copyright-holder>Jiang, Zhang, Wang, Li, Chen, Tang and Zhu</copyright-holder>
<license xlink:href="http://creativecommons.org/licenses/by/4.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.</p></license>
</permissions>
<abstract>
<p>Intracerebral hemorrhage (ICH) is a common disease in the elderly population. Inflammation following ICH plays a detrimental role in secondary brain injury, which is associated with a poor prognosis of patients with ICH, and no efficient pharmacological preventions are available. Here, we investigated the effects of glibenclamide (GLC) on neuroinflammation in an autoblood-induced aged rat (18 months old) model of ICH. Rats were randomized into the sham, vehicle, and GLC groups. First, we investigated the expression level of sulfonylurea receptor 1 (Sur1) surrounding the hematoma after ICH. Then, neurological scores were calculated, and water maze tests, brain water content analysis, western blotting, and immunofluorescence assays were implemented to detect the neuroprotective effect of GLC. The expression of the Sur1-Trpm4 channel was significantly increased in the perihematomal tissue following ICH in aged rats. The GLC administration effectively reduced brain edema and improved neurofunction deficits following ICH. In addition, GLC increased the expression of brain-derived neurotrophic factors and decreased the expression of proinflammatory factors [tumor necrosis factor (TNF)-&#x03B1;,interleukin (IL)-1, and IL-6]. Moreover, GLC markedly reduced Ikappa-B (I&#x03BA;B) kinase (IKK) expression in microglia and nuclear factor (NF)-&#x03BA;B-P65 levels in perihematomal tissue. GLC ameliorated ICH-induced neuroinflammation and improved neurological outcomes in aged rats. In part, GLC may exert these effects by regulating the NF-&#x03BA;B signaling pathway through the Sur1-Trpm4 channel.</p>
</abstract>
<kwd-group>
<kwd>intracerebral hemorrhage</kwd>
<kwd>glibenclamide</kwd>
<kwd>SUR1</kwd>
<kwd>neuroinflammation</kwd>
<kwd>aged rats</kwd>
</kwd-group>
<counts>
<fig-count count="6"/>
<table-count count="1"/>
<equation-count count="0"/>
<ref-count count="49"/>
<page-count count="10"/>
<word-count count="0"/>
</counts>
</article-meta>
</front>
<body>
<sec id="S1">
<title>Introduction</title>
<p>Intracerebral hemorrhage (ICH) is a subtype of stroke that leads to high rates of disability and death in humans (<xref ref-type="bibr" rid="B45">Xi et al., 2006</xref>). ICH is a common disease among the elderly population, and age is an essential factor that affects the prognosis of humans and animals after a stroke (<xref ref-type="bibr" rid="B7">Davis et al., 1995</xref>; <xref ref-type="bibr" rid="B10">Gong et al., 2004</xref>). Inflammatory responses play an important role in the pathogenesis after ICH (<xref ref-type="bibr" rid="B1">Aronowski and Hall, 2005</xref>; <xref ref-type="bibr" rid="B15">Hussain et al., 2009</xref>). Previous research has shown that nuclear factor (NF)-&#x03BA;B plays a crucial role in secondary brain injury after ICH (<xref ref-type="bibr" rid="B28">Pozniak et al., 2014</xref>; <xref ref-type="bibr" rid="B48">Zhang et al., 2019</xref>). Therefore, it is necessary to research new therapies that target inflammatory responses to improve the prognosis of patients with clinical ICH.</p>
<p>Glibenclamide (GLC) is an oral hypoglycemic medicine that works by inhibiting sulfonylurea receptor 1 (Sur1) (<xref ref-type="bibr" rid="B22">Kurland et al., 2013</xref>). Sur1 forms two distinct ion channels: the Sur1-Trpm4 channel and Sur1-Kir6.2 channel (<xref ref-type="bibr" rid="B5">Chen et al., 2003</xref>). Many reports have shown that GLC protects against central nervous system (CNS) diseases, such as cerebral metastases, subarachnoid hemorrhage (SAH), traumatic brain injury, ischemic stroke, and status epilepticus (<xref ref-type="bibr" rid="B34">Simard et al., 2009</xref>; <xref ref-type="bibr" rid="B38">Thompson et al., 2013</xref>; <xref ref-type="bibr" rid="B25">Lin et al., 2017</xref>; <xref ref-type="bibr" rid="B17">Jha et al., 2020</xref>; <xref ref-type="bibr" rid="B44">Woo et al., 2020</xref>). For the first time, our previous research showed that the expression increased in the Sur1-Trpm4 channel in the perihematomal tissue following ICH in adult rats. GLC treatment improved neurological outcomes and protected the blood&#x2013;brain barrier integrity following ICH, and these effects involved the expression of MMPs (<xref ref-type="bibr" rid="B18">Jiang et al., 2016</xref>). Previous research demonstrated that GLC treatment reduced tumor necrosis factor (TNF)-&#x03B1;, interleukin (IL)-6, and NF-&#x03BA;B following experimental cardiac arrest (<xref ref-type="bibr" rid="B27">Nakayama et al., 2018</xref>). However, no literature reported whether CLC participates in neuroinflammation following ICH in aged rats.</p>
<p>Thus, we hypothesize that GLC treatment alleviates secondary brain injury and improves neurofunction deficits after ICH in aged rats by suppressing neuroinflammation by inhibiting the Sur1-Trpm4 channel. An ICH model of an aged rat was used to verify this hypothesis.</p>
</sec>
<sec id="S2" sec-type="materials|methods">
<title>Materials and Methods</title>
<sec id="S2.SS1">
<title>Ethics Statement</title>
<p>All the procedures in this study complied with the Guide for the Care and Use of Laboratory Animals. All the experiments were designed to minimize pain and animal numbers, and the study protocol was approved by the Animal Care and Use Committee at Army Medical University. The animals were housed under a 12-h light and 12-h dark cycle and were given free access to food and water.</p>
</sec>
<sec id="S2.SS2">
<title>Animals and Surgical Procedures</title>
<p>A total of 150 male Sprague-Dawley (SD) rats, weighing 450&#x2013;550 g, were provided by the Army Medical University (Chongqing, China). Rats were randomly divided into three groups: the sham-operated group, ICH + vehicle group, and ICH + GLC group. To mimic the clinical condition of ICH, a model was established <italic>via</italic> injection of autogenous blood, as previously reported (<xref ref-type="bibr" rid="B18">Jiang et al., 2016</xref>). Briefly, the animals were anesthetized by intraperitoneal injection of pentobarbital (40 mg/kg). The body temperature of the animals was maintained at 37&#x00B0;C. The animals were positioned in a stereotaxic frame, a cranial burr hole (1 mm diameter) was drilled, and 100 &#x03BC;l autogenous arterial blood (obtained from the right femoral artery) was microinfused using a pump at a constant rate of 10 &#x03BC;l/min into the right caudate nucleus (coordinates: 3.5 mm lateral, 5.5 mm ventral, and 0.2 mm anterior to the bregma) through a 29-G needle. The sham-operated rats were only subjected to needle insertion. All rats survived the ICH induction and no mortality happened.</p>
</sec>
<sec id="S2.SS3">
<title>Glibenclamide Treatment</title>
<p>Glibenclamide (Tocris Bioscience, Ellisville, MO, United States) was administered as previously reported (<xref ref-type="bibr" rid="B18">Jiang et al., 2016</xref>). Briefly, dimethyl sulfoxide (DMSO) (50 mg/ml) was used to prepare stock solutions of GLC. The injection solution (200 ng/&#x03BC;l or 1 &#x03BC;g/ml) was made by dilution in 0.9% NaCl, and clarifying the solution using a few microliters of 0.1 N NaOH (final pH &#x223C; 8.5). At the end of the surgery, GLC was administered in a single loading dose (10 &#x03BC;g/kg intraperitoneal injection) plus continuous subcutaneous infusion (200 ng/h) <italic>via</italic> a mini-osmotic subcutaneous pump (Alzet, 2001, 1.0 &#x03BC;l/h; Alzet Corp., Cupertino, CA, United States). The vehicle group was treated with vehicle control solutions in the same manner.</p>
</sec>
<sec id="S2.SS4">
<title>Measurement of Brain Water Content</title>
<p>The brain water content was examined 72 h following ICH, as previously reported (<xref ref-type="bibr" rid="B23">Li et al., 2015</xref>). Briefly, the rats (<italic>n</italic> = 10/group) were euthanized and decapitated, the brains were quickly removed, and a 4-mm thick section of the coronal brain tissue surrounding the needle entry site was harvested. The brain tissue was divided into four parts: the contralateral cortex, contralateral basal ganglia, ipsilateral cortex, and ipsilateral basal ganglia. The cerebellum served as the internal control. The brain tissue weights were determined immediately after removal and after drying for more than 24 h at 100&#x00B0;C on an electronic analytical balance. The brain water content (%) was calculated using the following formula: (wet weight&#x2212;dry weight)/wet weight &#x00D7; 100%.</p>
</sec>
<sec id="S2.SS5">
<title>Tissue Fixation and Immunofluorescence</title>
<p>Immunofluorescent labeling was conducted 24 or 72 h following ICH as previously described (<xref ref-type="bibr" rid="B37">Tang et al., 2015</xref>). About 18-&#x03BC;m thick brain tissue sections were prepared and stored at &#x2212;20&#x00B0;C. The specimens were incubated with primary antibodies overnight at 4&#x00B0;C, and then with the appropriate secondary antibodies for 2 h at 37&#x00B0;C. Co-localization was examined by fluorescence microscopy (LSM780; Zeiss, Oberkochen, Germany).</p>
</sec>
<sec id="S2.SS6">
<title>Western Blot Analysis</title>
<p>Western blot analysis was conducted 24 h following ICH as previously described (<xref ref-type="bibr" rid="B29">Qi et al., 2019</xref>). The perihematomal brain tissues (4-mm-thick) were sampled. The relative densities of the bands were analyzed using ImageJ software (National Institutes of Health, Bethesda, MD, United States).</p>
</sec>
<sec id="S2.SS7">
<title>Real-Time PCR</title>
<p>PCR was performed to analyze Sur1 gene expression as previously reported (<xref ref-type="bibr" rid="B18">Jiang et al., 2016</xref>). Rats (<italic>n</italic> = 6/group) were sacrificed by decapitation 6, 12, and 24 h following ICH. The brain tissues were dissected (2 mm posterior and 2 mm anterior to the needle entry site) and immediately flash-frozen with liquid nitrogen. The primers for SUR1 were as follows: forward, 5&#x2032;-CACAAGAAGCCCATCGACCT-3&#x2032;; reverse, 5&#x2032;-ATCGAAGGCCAAGCAGAGTC-3&#x2032; (<xref ref-type="table" rid="T1">Table 1</xref>). A positive standard curve was obtained using a serially diluted complementary DNA sample mixture. Gene expression was normalized by glyceraldehyde 3-phosphate dehydrogenase (GAPDH) expression and quantified with standard samples. The data are expressed as a normalized messenger RNA expression (fold mRNA increase).</p>
<table-wrap position="float" id="T1">
<label>TABLE 1</label>
<caption><p>Primers used for real-time RT-PCR.</p></caption>
<table cellspacing="5" cellpadding="5" frame="hsides" rules="groups">
<thead>
<tr>
<td valign="top" align="left"><bold>Gene</bold></td>
<td valign="top" align="center"><bold>GenBank accession no.</bold></td>
<td valign="top" align="center"><bold>Primer sequences</bold></td>
</tr>
</thead>
<tbody>
<tr>
<td valign="top" align="left">SUR1</td>
<td valign="top" align="center"><ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="NM_013039.2">NM_013039.2</ext-link></td>
<td valign="top" align="center">F: CACAAGAAGCCCATCGACCT</td>
</tr>
<tr>
<td/>
<td/>
<td valign="top" align="center">R: ATCGAAGGCCAAGCAGAGTC</td>
</tr>
<tr>
<td valign="top" align="left">GAPDH</td>
<td valign="top" align="center"><ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="NM_017008.4">NM_017008.4</ext-link></td>
<td valign="top" align="center">F: TGAGGAGTCCCCATCCCAAC</td>
</tr>
<tr>
<td/>
<td/>
<td valign="top" align="center">R: GATGGTATTCGAGAGAAGGGAGG</td>
</tr>
<tr>
<td valign="top" align="left">&#x03B2;-actin</td>
<td valign="top" align="center"><ext-link ext-link-type="DDBJ/EMBL/GenBank" xlink:href="NM_031144.3">NM_031144.3</ext-link></td>
<td valign="top" align="center">F: GCAGGAGTACGATGAGTCCG</td>
</tr>
<tr>
<td/>
<td/>
<td valign="top" align="center">R: ACGCAGCTCAGTAACAGTCC</td>
</tr>
</tbody>
</table>
<table-wrap-foot>
<attrib><italic>F, forward primer; R, reverse primer.</italic></attrib>
</table-wrap-foot>
</table-wrap>
</sec>
<sec id="S2.SS8">
<title>Corner Turn Test and Forelimb Placing Test</title>
<p>We used the corner turn test and forelimb placement test to assess the neurological function of the experimental rats 7 days following ICH as previously described (<xref ref-type="bibr" rid="B14">Hua et al., 2002</xref>; <xref ref-type="bibr" rid="B21">Krafft et al., 2014</xref>; <xref ref-type="bibr" rid="B36">Tan et al., 2017</xref>).</p>
<p>The corner turn test was conducted by two blinded observers. The experimental rats were allowed to proceed to a corner with an angle of 30&#x00B0;. We recorded the direction in which rats turned, and the process was repeated 10 times (60 s between trials); the percentage of right turns was calculated.</p>
<p>The forelimb placement test was conducted by two blinded observers. The rats were held by the torso, and all four limbs were allowed to hang freely in space. A trial was scored if a rat placed its forelimb on the edge of the countertop in response to vibrissae stimulation. Each forelimb was tested 10 times, and the percentage of successful scores was determined.</p>
</sec>
<sec id="S2.SS9">
<title>Morris Water Maze Test</title>
<p>The Morris water maze test was performed to measure the learning and spatial memory of rats as previously described (<xref ref-type="bibr" rid="B6">Dai et al., 2017</xref>). Twenty-three days following ICH, rats (<italic>n</italic> = 10, per group) were placed in a pool (200 cm in diameter, 50 cm in depth) in which they searched to find a platform (5 cm in diameter, top surface 1.5 cm below the surface of the water) within 120 s. The rats that failed the mission would be picked up and placed on the platform for 15 s to familiar with the situation. The rats were subjected to five consecutive days of trials. The latency time was recorded to assess spatial learning ability. The probe trial was performed on the sixth day by removing the platform, and each rat was allowed to swim freely (120 s). The number of times the target area (previous location of the platform) was crossed, the percent distance and percent time in the target quadrant were analyzed.</p>
</sec>
<sec id="S2.SS10">
<title>Statistical Analysis</title>
<p>The results of this study are expressed as the mean &#x00B1; SD. Statistical analysis of the data was conducted using one-way analysis ANOVA, followed by Student&#x2013;Newman&#x2013;Keuls (SNK). Statistical significance was set as a <italic>p</italic>-value &#x003C; 0.05.</p>
</sec>
</sec>
<sec id="S3">
<title>Results</title>
<sec id="S3.SS1">
<title>Sur1 Is Upregulated After ICH in Aged Rats</title>
<p>The protein expression of Sur1 was significantly upregulated surrounding the hematoma after ICH in aged rats (<italic>p</italic> &#x003C; 0.0001, <xref ref-type="fig" rid="F1">Figures 1A,D</xref>), but no significant difference was observed between the rats in the GLC treatment group and the vehicle group (<italic>p</italic> &#x003E; 0.05, <xref ref-type="fig" rid="F1">Figures 1A,D</xref>). No difference was observed in KIR6.2 expression among the sham group, GLC treatment group, and vehicle group (<italic>p</italic> &#x003E; 0.05, <xref ref-type="fig" rid="F1">Figure 1C</xref>). The Sur1 mRNA expression was examined at 6, 12, and 24 h after ICH. Compared with the sham-treated rats, aged rats with ICH exhibited a remarkable increase in Sur1 mRNA (<italic>p</italic> &#x003C; 0.05, <italic>p</italic> &#x003C; 0.01, <xref ref-type="fig" rid="F1">Figure 1B</xref>).</p>
<fig id="F1" position="float">
<label>FIGURE 1</label>
<caption><p>Sulfonylurea receptor 1 (Sur1), but not Kir6.2, is upregulated in the aged rat model of intracerebral hemorrhage (ICH). <bold>(A,C,D)</bold> Western blot analysis and quantification of the mean density of the Sur1 (180 kDa) and Kir6.2 (45 kDa) bands surrounding the hematoma 24 h after ICH (six rats/group). The results of the mean band densities are presented as the mean &#x00B1; SD, <sup>&#x0026;&#x0026;&#x0026;&#x0026;</sup><italic>p</italic> &#x003C; 0.0001. <bold>(B)</bold> Relative normalized expression levels of Sur1 mRNA surrounding the hematoma at 6, 12, and 24 h after ICH, Sur1 mRNA expression increased and peaked at 12 h (six rats/group). The results are presented as the mean &#x00B1; SD, <sup>&#x0026;</sup><italic>p</italic> &#x003C; 0.05, <sup>&#x0026;&#x0026;</sup><italic>p</italic> &#x003C; 0.01.</p></caption>
<graphic xlink:href="fnagi-13-729652-g001.tif"/>
</fig>
</sec>
<sec id="S3.SS2">
<title>Glibenclamide Administration Improved Neurological Deficits</title>
<p>The corner turn score and forelimb placing score were used to measure the neurological function of the rats on day 7 after ICH. In these tests, the GLC-treated group had a lower corner turn score (<italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F2">Figure 2A</xref>) and higher forelimb placing score (<italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F2">Figure 2B</xref>) than the vehicle group.</p>
<fig id="F2" position="float">
<label>FIGURE 2</label>
<caption><p><bold>(A)</bold> Results of the corner turn test on day 3 after intracerebral hemorrhage (ICH). <bold>(B)</bold> Results of the forelimb placement test on day 3 after ICH thrombolytic therapy. The results are presented as the mean &#x00B1; SD. <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05, <sup>##</sup><italic>p</italic> &#x003C; 0.01, <sup>###</sup><italic>p</italic> &#x003C; 0.001. <bold>(C)</bold> Glibenclamide (GLC) significantly reduced ICH-induced brain edema in the ipsilateral basal ganglia (Ipsi-BG) and ipsilateral cortex (Ipsi-CX) 72 h after injury. The cerebellum (Cerebel) served as the internal control. The values are expressed as the mean &#x00B1; SD, <italic>n</italic> = 10. Ipsi-BG: vehicle vs. sham <sup>###</sup><italic>p</italic> &#x003C; 0.001, vs. GLC <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05; Ipsi-CX: vehicle vs. sham <sup>##</sup><italic>p</italic> &#x003C; 0.01, vs. GLC <italic>p</italic> &#x003E; 0.05.</p></caption>
<graphic xlink:href="fnagi-13-729652-g002.tif"/>
</fig>
</sec>
<sec id="S3.SS3">
<title>Treatment With GLC Decreased Brain Water Content</title>
<p>The brain water content of the rats in the vehicle group was significantly increased 72 h after ICH, especially in the ipsilateral basal ganglia (Ipsi-BG: sham vs. vehicle, <italic>p</italic> &#x003C; 0.001, <xref ref-type="fig" rid="F2">Figure 2C</xref>). The GLC treatment remarkably decreased the brain water content in the ipsilateral basal ganglia (Ipsi-BG: vehicle vs. GLC, <italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F2">Figure 2C</xref>).</p>
</sec>
<sec id="S3.SS4">
<title>Glibenclamide Treatment Ameliorated the Performance of the Experimental Rats in the Morris Water Maze Test</title>
<p>The rats exhibited disadvantageous spatial learning and memory deficits following ICH. The latency of the rats in the GLC group was significantly shorter than that of the rats in the vehicle group beginning on the fourth of five consecutive days of acquisition training (<italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F3">Figure 3A</xref>). The GLC-treated rats spent more time (<italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F3">Figure 3D</xref>) and traveled a greater distance (<italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F3">Figure 3C</xref>) in the target quadrat compared with the vehicle-treated rats. In addition, the rats in the vehicle group crossed the platform fewer times (<italic>p</italic> &#x003C; 0.001 and <italic>p</italic> &#x003C; 0.05, respectively, vs. sham and GLC, <xref ref-type="fig" rid="F3">Figure 3B</xref>). The results demonstrated that GLC improved spatial learning and memory deficits following ICH.</p>
<fig id="F3" position="float">
<label>FIGURE 3</label>
<caption><p>Spatial learning and memory deficits were examined 4 weeks after intracerebral hemorrhage (ICH). The values are expressed as the mean &#x00B1; SD, <italic>n</italic> = 10. <bold>(A)</bold> Escape latency in training trials: vehicle vs. sham <sup>#</sup><italic>p</italic> &#x003C; 0.05, vs. glibenclamide (GLC) <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05. <bold>(B)</bold> Times that the platform was crossed in the probe trials: vehicle vs. sham <sup>###</sup><italic>p</italic> &#x003C; 0.001, vs. GLC <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05. <bold>(C)</bold> Percent distance in the target quadrant in the probe trials: vehicle vs. sham <sup>#</sup><italic>p</italic> &#x003C; 0.05, vs. GLC <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05. <bold>(D)</bold> Percent time in the target quadrant in the probe trials: sham <sup>#</sup><italic>p</italic> &#x003C; 0.05, vs. GLC <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05.</p></caption>
<graphic xlink:href="fnagi-13-729652-g003.tif"/>
</fig>
</sec>
<sec id="S3.SS5">
<title>Treatment With GLC Increased Brain-Derived Neurotropic Factor 72 h After ICH</title>
<p>Immunofluorescence staining suggested a significant increase in brain-derived neurotrophic factor (BDNF) co-localized with neurons in the GLC group compared with that in the vehicle group (<xref ref-type="fig" rid="F4">Figure 4A</xref>). Studied regions were marked with &#x201C;squares&#x201D; (<xref ref-type="fig" rid="F4">Figure 4B</xref>). Western blotting examination revealed that the GLC treatment significantly increased the protein expression of BDNF 72 h following ICH (<italic>p</italic> &#x003C; 0.01, <xref ref-type="fig" rid="F4">Figures 4C,D</xref>).</p>
<fig id="F4" position="float">
<label>FIGURE 4</label>
<caption><p>Glibenclamide treatment significantly increased the expression of brain-derived neurotrophic factor (BDNF). <bold>(A)</bold> BDNF upregulation was observed in neuron cells surrounding the hematoma (six rats/group). Bar = 20 &#x03BC;m. <bold>(B)</bold> Studied regions were marked with &#x201C;&#x25A1;&#x201D;. <bold>(C,D)</bold> The results of the mean band densities are presented as the mean &#x00B1; SD, <sup>&#x2217;&#x2217;</sup><italic>p</italic> &#x003C; 0.01.</p></caption>
<graphic xlink:href="fnagi-13-729652-g004.tif"/>
</fig>
</sec>
<sec id="S3.SS6">
<title>Treatment With GLC Decreased the Expression of NF-&#x03BA;B</title>
<p>We used western blotting and immunofluorescence staining to measure the expression of components of the NF-&#x03BA;B signaling pathway. Immunofluorescence staining demonstrated a remarkable decrease in Ikappa-B kinase (IKK&#x03B2;) in the GLC group compared with the vehicle group (<xref ref-type="fig" rid="F5">Figure 5A</xref>). The protein expression of NF-&#x03BA;B-p65 was significantly increased 24 h after ICH (sham vs. vehicle, <italic>p</italic> &#x003C; 0.001, <xref ref-type="fig" rid="F5">Figures 5B,C</xref>). The GLC treatment significantly decreased the protein expression of NF-&#x03BA;B p65 24 h after ICH (vehicle vs. GLC, <italic>p</italic> &#x003C; 0.01, <xref ref-type="fig" rid="F5">Figures 5B,C</xref>).</p>
<fig id="F5" position="float">
<label>FIGURE 5</label>
<caption><p>The regulatory effect of glibenclamide (GLC) on the NF-&#x03BA;B signaling pathway after intracerebral hemorrhage (ICH). <bold>(A)</bold> GLC reduced microglial secretion of Ikappa-B kinase (IKK&#x03B2;) (<italic>n</italic> = 6). Bar = 20 &#x03BC;m. <bold>(B,C)</bold> Western blot analysis and quantification of the mean density of the nuclear factor (NF)-&#x03BA;B-p65 (65 kDa) band surrounding the hematoma 24 h after ICH (six rats/group), vehicle vs. sham <sup>###</sup><italic>p</italic> &#x003C; 0.001, vs. GLC <sup>&#x2217;&#x2217;</sup><italic>p</italic> &#x003C; 0.01. Amplified regions were marked with &#x201C;squares&#x201D;. Iba-1 co-localized with Ikk&#x03B2; were marked with &#x201C;arrows&#x201D;.</p></caption>
<graphic xlink:href="fnagi-13-729652-g005.tif"/>
</fig>
</sec>
<sec id="S3.SS7">
<title>Glibenclamide Reduces ICH-Induced Neuroinflammation</title>
<p>The expression of inflammatory factors was examined using western blotting analysis. The results revealed that TNF-&#x03B1;, IL-1, and IL-6 expression was significantly increased 24 h after ICH (<xref ref-type="fig" rid="F6">Figure 6</xref>). GLC significantly decreased the expression of TNF-&#x03B1; (<italic>p</italic> &#x003C; 0.01, <xref ref-type="fig" rid="F6">Figure 6A,B</xref>). GLC significantly reduced the expression of IL-1 (<italic>p</italic> &#x003C; 0.05, <xref ref-type="fig" rid="F6">Figure 6A,C</xref>). GLC decreased the expression of IL-6, but no significant difference was observed (<italic>p</italic> &#x003E; 0.05, <xref ref-type="fig" rid="F6">Figures 6A,D</xref>).</p>
<fig id="F6" position="float">
<label>FIGURE 6</label>
<caption><p>Effect of glibenclamide (GLC) on neuroinflammation protein expression following intracerebral hemorrhage (ICH). The band intensity quantification is presented as the mean &#x00B1; SD, <bold>(A,B)</bold> tumor necrosis factor (TNF)-&#x03B1;: vehicle vs. sham <sup>##</sup><italic>p</italic> &#x003C; 0.01, vs. GLC <sup>&#x2217;&#x2217;</sup><italic>p</italic> &#x003C; 0.01; <bold>(A,C)</bold> IL-1: vehicle vs. sham <sup>###</sup><italic>p</italic> &#x003C; 0.001, vs. GLC <sup>&#x2217;</sup><italic>p</italic> &#x003C; 0.05; <bold>(A,D)</bold> IL-6: vehicle vs. sham <sup>##</sup><italic>p</italic> &#x003C; 0.01, vs. GLC <italic>p</italic> &#x003E; 0.05.</p></caption>
<graphic xlink:href="fnagi-13-729652-g006.tif"/>
</fig>
</sec>
</sec>
<sec id="S4">
<title>Discussion</title>
<p>Intracerebral hemorrhage is currently one of the most common diseases, particularly in the elderly population. With an aged rat model, we mimicked the pathophysiological processes observed in spontaneous ICH in elderly patients in the clinic. We detected an upregulation of Sur1 expression in an ICH model of an aged rat. Moreover, we suggested that the inhibition of Sur1 by GLC ameliorated neuroinflammation and improved neurological deficits.</p>
<p>Sulfonylurea receptor 1 forms two distinct ion channels: the Sur1-Trpm4 channel and Sur1-Kir6.2 channel (<xref ref-type="bibr" rid="B39">Tosun et al., 2013</xref>). Under normal conditions, Sur1 is constitutively expressed in some neurons of the CNS and exclusively forms Sur1-Kir6.2 channels (<xref ref-type="bibr" rid="B35">Simard et al., 2014</xref>). Previous study demonstrated, the expression increased in the Sur1-Trpm4 channel following ICH, which was not observed in uninjured brain tissues (<xref ref-type="bibr" rid="B43">Woo et al., 2013</xref>). We showed that the level of Sur1 was significantly increased 6 h following ICH in aged rats, and the increase continued until 12 h but decreased at 24 h. Interestingly, we found that the increased level and peak timepoint are somewhat inconsistent with the results of our previous study showing that Sur1 mRNA significantly increased 12 h after ICH in adult rats, and the increase was maintained until 24 h but decreased at 48 h. Several factors may explain this difference. One possible reason is related to the different measures of thrombin. <xref ref-type="bibr" rid="B16">Ibbotson et al. (1992)</xref> proved that coagulation rates in plasma are accelerated with age, suggesting that hematoma can produce much more thrombin in aged rats. Thrombin can induce the expression of matrix metalloproteinase (MMP)-9, and MMPs are involved in the expression of Sur1 (<xref ref-type="bibr" rid="B3">Caffes et al., 2015</xref>). The second possible explanation for our findings is related to Sur1 expression in the different microglial responses in adult and aged animals (<xref ref-type="bibr" rid="B4">Camacho et al., 2015</xref>). Microglia play an important role in inflammation after CNS injury, and inflammation may be a factor in the upregulation of Sur1 (<xref ref-type="bibr" rid="B34">Simard et al., 2009</xref>). <xref ref-type="bibr" rid="B42">Wasserman et al. (2008)</xref> reported a difference in microglial activation and macrophage distribution between young and aged rats following ICH. Therefore, it is possible that the timing of Sur1 upregulation after ICH might be different between young rats and aged rats. In this report, we demonstrate that the expression of Sur1 is upregulated in aged rats after ICH.</p>
<p>The present study shows that the Sur1-Trpm4 channel is implicated in ICH-induced inflammation. GLC administration significantly reduces the expression of the NF-&#x03BA;B, IL-1, TNF-&#x03B1;, and IL-6. Similarly, many studies have shown that GLC inhibits inflammation in animal models of SAH (<xref ref-type="bibr" rid="B34">Simard et al., 2009</xref>), experimental cardiac arrest (<xref ref-type="bibr" rid="B27">Nakayama et al., 2018</xref>), and cerebral ischemic injury (<xref ref-type="bibr" rid="B3">Caffes et al., 2015</xref>). Our previous study determined that inhibition of Sur1 alleviated ICH-induced metalloproteinase (MMPs) expression. Many previous studies showed that MMPs play an important role in neuroinflammation (<xref ref-type="bibr" rid="B40">Vandooren et al., 2014</xref>; <xref ref-type="bibr" rid="B12">Hannocks et al., 2017</xref>; <xref ref-type="bibr" rid="B26">Mi et al., 2021</xref>). The increased activity of MMPs can affect the secretion of many types of inflammatory cytokines and the activation of inflammatory cells (<xref ref-type="bibr" rid="B9">Florczak-Rzepka et al., 2012</xref>).</p>
<p>This study found that treatment with GLC induced the expression of BDNF. Previous studies determined that BDNF stimulates neural progenitor cells to differentiate into mature neurons, and it exerts a neurotrophic effect at sites of injury (<xref ref-type="bibr" rid="B32">Shimotake et al., 2010</xref>; <xref ref-type="bibr" rid="B8">Deng et al., 2019</xref>). Previous studies have shown that neuroinflammation reduces the expression of BDNF and negatively affects many stages of neurogenesis (<xref ref-type="bibr" rid="B13">Hashimoto, 2015</xref>; <xref ref-type="bibr" rid="B47">Zhang et al., 2018</xref>; <xref ref-type="bibr" rid="B49">Zhong et al., 2020</xref>). <xref ref-type="bibr" rid="B2">Bi et al. (2016)</xref> proved that neuroinflammation attenuates the expression of BDNF by activating the NF-&#x03BA;B pathway. Therefore, a significant increase in BDNF may be involved in the activation of the NF-&#x03BA;B pathway.</p>
<p>Many factors are related to neurological deficits following ICH, including primary brain injury, edema, inflammation, and age (<xref ref-type="bibr" rid="B19">Keep et al., 2012</xref>; <xref ref-type="bibr" rid="B11">Guo et al., 2021</xref>). In this study, GLC improved neurological deficits, consistent with previous studies (<xref ref-type="bibr" rid="B24">Liew et al., 2012</xref>; <xref ref-type="bibr" rid="B46">Xu et al., 2015</xref>). <xref ref-type="bibr" rid="B33">Simard et al. (2006)</xref> proved that continuous subcutaneous infusion of GLC (75 ng/h) reached the peri-infarct regions of rats with cerebral ischemia, resulting in potential neuroprotection. Several recent clinical trials have shown that GLC is associated with improvements in midline shift, level of alertness, neurofunction deficits, and survival after large hemispheric infarction (<xref ref-type="bibr" rid="B20">Kimberly et al., 2018</xref>; <xref ref-type="bibr" rid="B31">Sheth et al., 2018</xref>; <xref ref-type="bibr" rid="B41">Vorasayan et al., 2019</xref>). <xref ref-type="bibr" rid="B30">Robert et al. (2020)</xref> concluded that inhibiting the ion channel Sur1-Trpm4 could be a valuable adjuvant to prevent and even reverse fluid accumulation in the brain parenchyma. Several clinical trials about the safety and efficacy of GLC in CNS diseases are ongoing, such as SE-GRACE and GASH. Within a few years, all these research findings make it possible to use GLC in clinical stroke treatment.</p>
</sec>
<sec id="S5">
<title>Conclusion</title>
<p>In summary, in the current study, we found that the expression of the Sur1-Trpm4 channel was significantly increased in perihematomal tissue following ICH in aged rats. We demonstrated that GLC ameliorated ICH-induced neuroinflammation and improved neurological outcomes, and GLC may exert these effects in part by regulating the NF-&#x03BA;B signaling pathway through the Sur1-Trpm4 channel. Our findings may contribute to the further elucidation of the mechanism of action of CLC and assist in developing a novel therapeutic strategy for treating clinical stroke.</p>
</sec>
<sec id="S6">
<title>Data Availability Statement</title>
<p>The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.</p>
</sec>
<sec id="S7">
<title>Ethics Statement</title>
<p>The animal study was reviewed and approved by the Animal Care and Use Committee at Army Medical University.</p>
</sec>
<sec id="S8">
<title>Author Contributions</title>
<p>BJ and YZ wrote the manuscript, analyzed the data, and designed and performed the experiments. YW, ZL, JT, and QC assisted with the experiments, prepared the figures, and performed the behavioral tests. GZ contributed to the conception of the review and gave final approval of the version to be published. All authors contributed to the article and approved the submitted version.</p>
</sec>
<sec sec-type="COI-statement" id="conf1">
<title>Conflict of Interest</title>
<p>The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.</p>
</sec>
<sec sec-type="correction-note" id="S10">
<title>Correction Note</title>
<p>A correction has been made to this article. Details can be found at: <ext-link ext-link-type="uri" xlink:href="https://doi.org/10.3389/fnagi.2026.1809579">10.3389/fnagi.2026.1809579</ext-link>.</p>
</sec>
<sec sec-type="disclaimer" id="s9">
<title>Publisher&#x2019;s Note</title>
<p>All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.</p>
</sec>
</body>
<back>
<fn-group>
<fn fn-type="financial-disclosure">
<p><bold>Funding.</bold> This work was supported by the National Natural Science Foundation of China (Grant Numbers: 81571130, 81571116, and 81601356), Special Subject for Hypertension of Sichuan Province (2018SHD5-7) and Clinical Trial of Symptomatic Hypoperfusion in Sichuan Province (Q18002).</p>
</fn>
</fn-group>
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