Evidence mapPaperPMID 41530786Full record

ArticleJournal of neuroinflammation2026

PKM2 preconditioning protects endothelial cells from pyroptosis and BBB disruption via NRF2/TRX/TXNIP signaling in neonatal hypoxic-ischemic brain injury.

Yingying Hu, Guosheng Yu, Liying Lu, Yan Nan, Xinyi Wang, Yani Feng, Jianghu Zhu, Xingyun Wang, Zhenlang Lin

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Article in Journal of neuroinflammation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Yingying HuDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Guosheng YuDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Liying LuDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Yan NanDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Xinyi WangDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Yani FengDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Jianghu ZhuDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China.
Xingyun WangHongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. wxy@shsmu.edu.cn.
Zhenlang LinDepartment of Neonatology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xueyuan West Road, Wenzhou, Zhejiang, 325027, China. zhenlanglin@wmu.edu.cn.

Funding

Key Research and Development Program of Zhejiang Province 2025C02081National Natural Science Foundation of China 82271747
6 · The paper itself

Abstract

backgroundNeonatal hypoxic-ischemic brain damage (HIBD) is a leading cause of neurological deficits and death in neonates. In HIBD, the death of endothelial cells and disruption of the blood-brain barrier (BBB) are closely related to the severity of brain damage and long-term clinical outcomes. There is increasing evidence that a glycolytic enzyme, pyruvate kinase M2 (PKM2), is essential for managing metabolic processes in endothelial cells, but its role (and underlying molecular mechanism) in hypoxic-ischemic (HI)-associated endothelial cell metabolism, cell survival, and BBB function remains unknown.

methodsWe established an in vivo HI-induced brain injury rat model and an in vitro model in which human cerebral microvascular endothelial cells (hCMECs) underwent oxygen-glucose deprivation (OGD). Infarct volume was measured and neurobehavioral tests were conducted to assess brain damage, and Evans blue extravasation and FITC-dextran were used to evaluate the BBB. RNA sequencing, qRT-PCR, western blotting, and immunofluorescence labeling were conducted to identify the molecular mechanisms underlying HIBD.

resultsPKM2 expression was upregulated in the brains of HIBD rats and in OGD-treated hCMECs. The inhibition of PKM2 greatly upregulated the expression of pyroptosis-associated proteins, including NLRP3, cleaved caspase-1, GSDMD, IL-1β, and IL-18. In contrast, the activation of PKM2 preserved junctional proteins and maintained the integrity of the BBB, which together improved functional recovery in HIBD rats. Mechanistically, preconditioning of PKM2 contributed to lactate-mediated cellular defense mechanisms, including the activation of nuclear factor erythroid 2-related factor 2 (NRF2) and thioredoxin (TRX), and to the downregulation of thioredoxin-interacting protein (TXNIP) via a modest increase in reactive oxygen species.

conclusionsOur analyses provide compelling evidence that PKM2 preconditioning attenuates endothelial cell pyroptosis and BBB disruption in neonatal HIBD by causing oxidative stress resistance and activating the NRF2/TRX/TXNIP pathway. Therefore, PKM2 represents a promising pharmacological target for treating HIBD.

Indexed as

Blood-Brain BarrierEndothelial CellsHypoxia-Ischemia, BrainPyroptosisPyruvate KinaseAnimalsAnimals, NewbornCarrier ProteinsCell Cycle ProteinsCells, CulturedHumansMaleNF-E2-Related Factor 2RatsRats, Sprague-DawleySignal TransductionCarrier ProteinsCell Cycle ProteinsNF-E2-Related Factor 2Pkm protein, ratPyruvate KinaseTXNIP protein, ratBlood–brain barrierHypoxic-ischemic brain damageNeonatePyroptosisPyruvate kinase M2

Identifiers

PMID41530786
PMCPMC12888557

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.