Myeloid dickkopf-1 fuels neurovascular and neuroimmune alterations in ischemic stroke

Abstract Neurovascular impairments and neuroimmune deregulation contribute to injury progression after ischemic stroke. Dickkopf-1 (DKK1) elevated levels correlates with poor stroke outcomes. DKK1 antagonizes the canonical Wnt pathway that plays a critical role in regulating neurovascular and neuroimmune functions. Herein, we report that DKK1 expression in the normal adult brain is absent, but is de novo expressed at the lesion site after experimental ischemic stroke. Using genetic tools to conditionally induce DKK1 expression in a tissue-specific manner, we reveal that its early induction aggravates neurological deficits and injury severity after stroke, associated with altered neuronal and vascular functions. DKK1 post-stroke induction hinders lesion containment by disorganizing the astroglial scar, leading to a chronic neuroinflammation and increased anxiety-like behaviors. Using chimeric mice, we unravel thatDKK1 is released by bone marrow-derived cells (BMDCs) expressing myeloid markers that infiltrate the lesion site. DKK1 restricted induction in BMDCs is sufficient to mediate astroglial scar disorganization. Notably, neutralization of DKK1 limits injury progression and improves neurological recovery after stroke. Our findings indicate that BMDCs-derived DKK1 promotes injury progression after stroke and suggest that neutralizing its biological activity represent a promising therapeutic avenue for ischemic stroke.