2,5-Hexanedione induced apoptosis in rat spinal cord neurons and VSC4.1 cells via the proNGF/p75NTR and JNK pathways

Abstract Increasing evidence suggests that n-hexane induces nerve injury via neuronal apoptosis induced by its active metabolite 2,5-hexanedione (HD). However, the underlying mechanism remains unknown. Studies have confirmed that pro-nerve growth factor (proNGF), a precursor of mature nerve growth factor (mNGF), might activate apoptotic signaling by binding to p75 neurotrophin receptor (p75NTR) in neurons. Therefore, we studied the mechanism of the proNGF/p75NTR pathway in HD-induced neuronal apoptosis. Sprague–Dawley (SD) rats were injected with 400 mg/kg HD once a day for 5 weeks, and VSC4.1 cells were treated with 10, 20, and 40 mM HD in vitro. Results showed that HD effectively induced neuronal apoptosis. Moreover, it up-regulated proNGF and p75NTR levels, activated c-Jun N-terminal kinase (JNK) and c-Jun, and disrupted the balance between B-cell lymphoma-2 (Bcl-2) and Bcl-2-associated X protein (Bax). Our findings revealed that the proNGF/p75NTR signaling pathway was involved in HD-induced neuronal apoptosis; it can serve as a theoretical basis for further exploration of the neurotoxic mechanisms of HD.


Introduction
N-hexane, an organic solvent, is required for industrial production. Since the first incident of n-hexane poisoning in the 1960s [1], numerous poisoning accidents in various regions have been reported [2,3], particularly in China [4,5]. The clinical manifestations of prolonged exposure to n-hexane include central and peripheral neuropathy, which manifests as progressive numbness of the distal limbs, limb atrophy, and even paralysis [6]. This significantly affects patient quality of life. The neuropathic effects of n-hexane are due to its metabolite, 2,5-hexadione (HD). Some studies have reported that subacute administration of HD results in a neurotoxic syndrome known as induced central-peripheral distal axonopathy [7,8]. This neuropathy was found to be related to the y-spacing of the carbonyl groups. HD can cross the blood-brain barrier and/or directly induce lesions in the myelin sheaths of the peripheral nerves. Therefore, its potential to induce hexacarbon neuropathy is worth public attention.
Neuronal death is a critical element in the pathogeneses of various neurodegenerative diseases. Numerous studies have demonstrated that neuronal apoptosis is a well-established contributor to neurological dysfunction induced by chemicals and toxins [9,10]. HD is known to mediate neurotoxicity by inducing neuronal apoptosis. One study found that HD played a role in reducing neuron count and aggravating cellular structural damage in the cerebral cortices of HD-poisoned rats [11]. In addition, apoptosis was also observed in rat dorsal-root ganglion cells after HD exposure in vitro [12]. In our previous studies, we confirmed that HD induced apoptosis of spinal cord neurons in rats and stimulated various types of neural cells such as VSC4.1 and PC12 to undergo significant apoptosis in vitro [13,14]. Based on these data, we speculated that neuropathic damage caused by HD might be inextricably linked to apoptosis of nerve cells, especially neurons. However, the specific molecular mechanism underlying neuronal apoptosis induced by HD requires further investigation.
Mature nerve growth factor (mNGF), which is biosynthesized from its precursor (pro-nerve growth factor; proNGF), is required in all neuronal cells for proper function and survival [15]. Unlike mNGF, proNGF binds to p75 neurotrophin receptor (p75NTR) as a mediator of cell damage [16]. Under pathological conditions, proNGF and p75NTR levels are up-regulated, which activates apoptosis via the binding of proNGF to p75NTR [17,18]. Inhibition of proNGF or p75NTR level decreases apoptosis [19]. This evidence suggests that activation of proNGF/p75NTR might play a crucial role in promoting neuronal apoptosis. In our previous study, we found that HD down-regulated mNGF levels in HD-exposed rats [13]. Therefore, we speculated that HD disrupts the balance of proNGF and mNGF levels and that proNGF accumulation might be involved in HD-induced neuronal apoptosis.
In the current study, we investigated whether HD induced neuronal apoptosis by activating the proNGF/p75NTR pathway. Our results could help further determine the pathological mechanisms of HD in neuronal damage. . Acclimatization was done in the animal room at 22 • C and 50% humidity in a 12-h light-dark cycle for 2 weeks. The rats were housed in polycarbonate boxes with sufficient drinking water and food. Rats were randomly divided into a control group and an HD group (n=20 per group). We selected dose and frequency of HD exposure based on the literature [13] and our previous research [20]. Rats in the HD group were injected intraperitoneally (i.p.) with 400 mg/kg HD 5×/week for 5 weeks [13,21]. Those in the control group were injected i.p. with a corresponding volume of saline. After 5 weeks, rats in each group were killed by cervical decapitation, after which we severed the ribs on both sides of the thoracic and lumbar spine and blew the lumbar spinal cord out of the spinal canal using a syringe filled with phosphate-buffered saline (PBS) for subsequent experiments [22]. All of the experimental operations were approved by the Animal Ethics Committee of DMU and strictly complied with its applicable requirements.

Electron microscopy
The lumbar spinal anterior-horn tissues were cut into small (approximately 2 mm 3 ) pieces, and quickly placed in 2% glutaraldehyde at 4 • C for 24 h. They were then rinsed in phosphate buffer, fixed with 1% acetic acid for 3 h, dehydrated via alcohol gradient, osmicated (post-fixed in osmium tetroxide), embedded in fresh araldite resin, and sliced with an ultramicrotome. Finally, we counterstained the tissues with uranyl acetate and lead nitrate. Morphological and pathological changes in neuronal cells were observed under a H/7500 transmission electron microscope (TEM; Hitachi, Tokyo, Japan).

Co-staining, terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick-end labeling assay, and immunofluorescence
We blocked 8-μm frozen sections of rat spinal cords with 10% goat serum for 1 h and then incubated them with an anti-microtubule-associated protein 2 (anti-MAP-2) antibody (1:200; Cell Signaling Technology [CST], Danvers, MA, U.S.A.) overnight at 4 • C. Then, sections were washed three times with PBS before addition of a conjugating secondary antibody (1:300; Invitrogen, Carlsbad, CA, U.S.A.) for 1 h at room temperature (RT) in the dark. Next, we performed a terminal deoxynucleotidyl transferase deoxyuridine triphosphate (dUTP) nick-end labeling (TUNEL) assay (KeyGEN BioTECH, Nanjing, China) per manufacturer's instructions. Pictures were taken under a confocal microscope (Olympus, Nikon, Japan) using Alexa-488 (green) and Alexa-594 (red); immunofluorescence (IF) images were captured using a Nikon Eclipse 80i (×200 magnification; Nikon, Tokyo, Japan). We randomly selected ten areas and recorded MAP-2 + /TUNEL + cell counts in order to calculate the neuronal apoptosis index (AI):

TUNEL assay
We performed TUNEL staining to assess apoptosis in the spinal anterior horns of rats and in VSC4.1 cells. The cord of the lumbar spine had been removed from rats in each group (n=3) to create 8-μm frozen sections. We fixed sections and VSC4.1 cells in 4% paraformaldehyde and stained them using a TUNEL assay kit (KeyGEN BioTECH) per manufacturer's instructions. Nuclei were counterstained with 4 ,6-diamidino-2-phenylindole (DAPI; C1006; Beyotime, Shanghai, China) and observed under a fluorescence microscope (Olympus, Nikon, Japan). Green-labeled nuclei represented TUNEL + cells. We observed four or five sections from each animal at the anterior horn of the spinal cord and selected ten fields randomly. Using Image-Pro Plus software (v6.

Transfection of siRNA
We seeded VSC4.1 cells at a density of 1 × 10 5 cells per well in 24-well plastic culture plates in DMEM-HG medium and cultured them at 37 • C for 24 h. Then, 50 nM p75NTR siRNA (encoding sequence GGTGCCAAGGAGACAT-GTT) and negative-control (NC) siRNA were transfected into the cells using riboFECT CP Reagent (RiboBio) per manufacturer's instructions. Transfection efficiency was approximately 80%. After 48 h of incubation at 37 • C, we treated the cells with 40 mM HD and performed Western blotting (WB) and TUNEL staining as described above.

Western blot analysis
Spinal cords of rats and VSC4.1 cells were homogenized/lysed in lysis buffer (Beyotime, Shanghai, China), and proteins were separated by sodium dodecyl sulfate/polyacrylamide gel electrophoresis (SDS/PAGE) and transferred on to polyvinylidene difluoride (PVDF) membranes (0.45 μm; Merck Millipore, Darmstadt, Germany). After blocking them with 5% skimmed milk, we incubated the membranes with the appropriate primary antibodies at 4 • C overnight. Antibodies used were against proNGF (

Statistical analysis
All of the data analysis results are expressed as mean + − standard error of the mean (SEM). Student's t test (control vs. HD) and one-way analysis of variance (ANOVA; multiple groups) were used for statistical analysis of each group, followed by the least-significant-difference (LSD) test or Dunnett's multiple-comparison tests. We performed these analyses using SPSS version 17.0 (IBM Corp., Armonk, NY, USA). P<0.05 was considered to be significant.

Effect of HD on neuronal apoptosis in rat spinal cords
To determine whether HD was associated with motor impairment, we examined gait scores in rats with or without HD exposure ( Figure 1A). We found that HD-intoxicated rats displayed impairment of motor function as shown by a gradual increase in gait score (mean gait score = 3.83 + − 0.32). Next, we detected the ultrastructures of rat spinal anterior-horn neurons, which innervate limb movement [24], under the TEM. Results showed that the cell nuclear membrane of neurons in the control group appeared smooth, with no wrinkles, and had normal morphology and uniform chromatin in the nuclei. In contrast, the morphology of spinal cords in the HD group showed neuronal-cell nucleolar enrichment, chromatin edge set, non-uniformity, and irregularly wave-shaped nuclear membranes, indicating that HD might have induced typical apoptotic changes in rat spinal cord neurons ( Figure 1B).
To determine whether HD exposure induced apoptosis in rat spinal cords, we measured apoptosis via TUNEL assay. Apoptotic cells in the spinal anterior horn that were stained green were identified as TUNEL + . The AI of spinal cords from HD-exposed rats was significantly increased (P<0.05) compared with the control group ( Figure 1C). To further verify the proportion of neuronal cells undergoing apoptosis, we performed a TUNEL assay and IF staining with MAP-2 antibody on spinal cord tissue. MAP-2, a landmark protein in the cytoplasm of neurons [25], appeared in red. As shown in Figure 1D, the AI of spinal anterior-horn neurons was 1.26 + − 0.87% in the control group and 36.56 + − 8.75% in the HD group. These results showed that the HD group had significantly more apoptotic neurons than the control group (P<0.05). Additionally, the activity of Caspase-3, a recognized standard for apoptosis detection, significantly increased in HD-exposed rats compared with normal rats ( Figure 1E). All of these results demonstrated that HD induced neuronal apoptosis in the anterior horns of rat spinal cords.

Effect of HD on apoptosis in VSC4.1 cells
We used VSC4.1, a line of spinal anterior-horn motor neuron cells corresponding to the anterior-horn neurons of the spinal cord in vivo, to study the effects of HD on neuronal apoptosis in vitro [26]. We assessed morphological changes in VSC4.1 cells treated with 0-80 mM concentrations of HD ( Figure 2A) and measured cell viability via MTT assay to detect the cytotoxic effects of HD on these cells. VSC4.1 cell viability gradually decreased as concentration of HD increased ( Figure 2B). These results showed that HD treatment led to a significant decrease (P<0.05) in VSC4.1 cell viability in a dose-dependent manner. Therefore, we selected representative concentrations (10, 20, and 40 mM) of HD for subsequent experiments.
the 0 mM HD group, AI gradually increased in the 10, 20, and 40 mM HD groups (P<0.05). We also studied the effect of HD on apoptosis in VSC4.1 cells using AV/PI co-staining and flow cytometry (FCM). Early-stage apoptotic cells were defined as AV + /PI − and late-stage apoptotic ones were defined as AV + /PI + . As shown in Figure 2D,E, total proportions of apoptosis (sum of early-and late-apoptosis rates) of VSC4.1 cells in the three HD groups (10, 20, and 40 mM HD) were 8.11 + − 0.32%, 15.2 + − 2.88%, and 34.9 + − 4.06%, respectively. These values were significantly higher than those of the control group (2.22 + − 0.13%). In addition, HD also increased Caspase-3 activity in VSC4.1 cells ( Figure 2F). All of these results demonstrated that HD induced apoptosis in VSC4.1 cells in vitro.

Effect of HD on expression levels of proNGF and p75NTR in spinal cord tissues and in VSC4.1 cells
Overexpression of proNGF causes neurological disorders, including apoptosis [27], via binding to p75NTR [28]. We explored whether HD triggered apoptosis via proNGF overexpression and activation of p75NTR. Compared with the control group, proNGF and p75NTR levels significantly increased (P<0.05) in the spinal cords of HD-poisoned rats ( Figure 3A,B). In addition, proNGF and p75NTR levels in VSC4.1 cells increased in a dose-dependent manner with increasing concentrations of HD in vitro ( Figure 3C,D). Taken together, these results indicated that HD activated proNGF and p75NTR in rat spinal cords and in VSC4.1 cells.

Effect of HD on JNK, c-Jun, Bax, and Bcl-2 in rat spinal nerve tissues and in VSC4.1 cells
JNK is a member of the mitogen-activated protein kinase (MAPK) family and plays a dual role by regulating cell proliferation and apoptosis [29]. To determine whether HD triggered apoptosis by regulating the JNK/c-Jun pathway, we examined expression levels of JNK, p-JNK, c-Jun, and p-c-Jun via WB. Results showed that HD promoted the phosphorylation of JNK and c-Jun in rat spinal nerve tissues ( Figure 4A,B) and VSC4.1 cells (Figure 4C,D) by activating the JNK/c-Jun pathway. Moreover, detection of JNK downstream proteins Bcl-2 and Bax showed that HD increased the expression level of Bax ( Figure 4E) but decreased that of Bcl-2 ( Figure 4F) in rat spinal nerve tissues. Moreover, we found similar results in cultured VSC4.1 cells: HD effectively up-regulated Bax levels while down-regulating Bcl-2 levels ( Figure 4G,H). These results indicated that in neurons, HD activated the JNK/c-Jun pathway, subsequently up-regulating Bax protein levels and down-regulating Bcl-2 protein levels.

HD induced apoptosis of VSC4.1 cells by activating the proNGF/p75NTR pathway
Overexpression of proNGF and activation of p75NTR can mediate apoptosis by increasing the activity of JNK kinase and its downstream proteins, which are essential to the p75NTR-mediated apoptosis signaling pathway [30]. To verify whether HD induced neuronal apoptosis via activation of proNGF and p75NTR, we transfected VSC4.1 cells with p75NTR siRNA. After blocking p75NTR expression with p75NTR siRNA, we found that JNK and c-Jun phosphorylation in HD-exposed cells was significantly reduced (Figure 5A,B). In addition, HD-induced apoptosis in VSC4.1 cells was reduced by approximately 23% in HD-exposed cells transfected with p75NTR siRNA compared with other HD-exposed cells ( Figure 5C). In addition, Caspase-3 activity was attenuated in HD-exposed cells transfected with p75NTR siRNA ( Figure 5D). Taken together, these data revealed that HD activated the JNK/c-Jun pathway by activating p75NTR protein and also induced neuronal apoptosis in VSC4.1 cells by activating the proNGF/p75NTR pathway.

HD induced apoptosis of VSC4.1 cells by activating the JNK apoptotic pathway
To verify whether activation of JNK was involved in HD-induced apoptosis, we blocked phosphorylation of JNK in HD-exposed VSC4.1 cells using SP600125, a JNK phosphorylation inhibitor. First, we found that blocking JNK phosphorylation down-regulated Bax levels and up-regulated Bcl-2 levels ( Figure 6A,B). This suggested that the effect of HD on key apoptotic proteins (Bax and Bcl-2) was mediated via activation of the JNK pathway. Second, we found that the AI of HD-exposed VSC4.1 cells after SP600125 intervention was notably reduced by approximately 36% compared with the HD exposure group ( Figure 6C). Similarly, we found that SP600125 treatment blocked the effect of HD on Caspase-3 activity ( Figure 6D). These data indicated that HD induced apoptosis in VSC4.1 cells via the JNK apoptotic pathway.
Effect of HD on the imbalance of proNGF and mNGF expression via tPA or MMP-7 in spinal nerve tissues and VSC4.1 cells mNGF, the mature form of proNGF, exerts its biological effects mainly by binding to the cell surface of TrkA [31]. To further confirm that HD promoted accumulation of proNGF, we detected levels of mNGF and TrkA. Results showed that mNGF levels and TrkA phosphorylation were reduced in the spinal cord tissues of HD-exposed rats ( Figure  7A,B) and in cultured VSC4.1 cells (Figure 7C,D). Based on the above results and the proNGF results, we speculated that HD increased accumulation of proNGF due to its failure to convert into mNGF. To further verify this hypothesis, we performed linear-regression analysis between the spinal cord tissues of control rats and those of HD-exposed rats. As shown in Figure 7E, compared with that of the control group, the regression line of the HD group was relatively siRNA. (C) Apoptosis in VSC4.1 cells after transfection with p75NTR siRNA was determined by TUNEL assay (green represents apoptotic cells) and DAPI (blue represents cell nuclei) staining (×200 magnification). White arrows indicate apoptotic cells. Scale bar, 100 μm. The AI (%) of VSC4.1 cells was calculated via TUNEL assay according to the data from (C). (D) Caspase-3 activity was detected using a commercial Caspase-3 activity detection kit. NC, siRNA, HD, and HD + siRNA respectively represent the negativecontrol group, p75NTR siRNA group, HD group, and HD + p75NTR siRNA group. Quantified data are shown as mean + − SEM (n=3 biological replicates). Statistical analysis was performed using one-way ANOVA, the LSD test, or Dunnett's multiple-comparison test. **P<0.01, ***P<0.001. Asterisks indicate statistically significant differences between groups in square brackets.
flat; this indicated that HD exposure might have inhibited the conversion of proNGF into mNGF, leading to proNGF accumulation.
Recently, key enzymes such as plasmin and MMPs have been confirmed to be involved in the conversion of proNGF into mNGF [19]. Two key molecules, tPA and MMP-7, might be crucial enzymes in this process. Therefore, we further explored the effects of these enzymes on HD-induced disruption of the conversion of mNGF into proNGF. Results showed that tPA levels were decreased in the HD group of VSC4.1 cells in a dose-dependent manner compared with the control group, while there was no significant effect on MMP-7 levels ( Figure 7F-I). These data suggested that the imbalance in mNGF and proNGF levels might have been due to HD's attenuation of tPA but not MMP-7 expression.

Discussion
The current study confirmed that HD had a pro-apoptotic effect on rat spinal cord neurons and on VSC4.1 cells by activating the proNGF/p75NTR and JNK/c-Jun pathways in the spinal cords of rats and in VSC4.1 cells. However, inhibition of p75NTR or JNK phosphorylation ameliorated HD-induced neuronal apoptosis (Figure 8).
Hexacarbon neuropathy is a major characteristic of HD toxicity. Its hallmark is the presence of large axonal swellings containing filaments that are ultrastructurally and immunocytochemically indistinguishable from normal 10-nm neurofilaments [32]. Axonal degeneration seems to begin by an increase in the number of axonal 10-nm neurofilaments, which accumulate distally in swellings on the proximal sides of the nodes of Ranvier. Paranodal swelling occurs concomitantly with shrinkage and myelin corrugation of the adjacent, more-distally located internode. The enlarged nodal and paranodal axons displace the paranodal myelin sheaths, leaving denuded axonal swellings in the vicinity of the nodes [33]. Schwann cells appear at the denuded regions, axonal swelling attenuates, and remyelination of the denuded axon then occurs. Schwann cell abnormalities include increased cytoplasm, focal enlargements containing cytoplasmic filaments that lack side arms, vesicular complexes, lamellated bodies, osmiophilic droplets, and filament-filled inner loops of Schwann cells [34,35].
In the HD-induced nerve injury response, excessive apoptosis of tissues and cells is prominent. Apoptosis is an indispensable physiological process that maintains the stability of the neuronal internal environment and adjusts the adaptability of the external environment in the nervous system [36]. Aberration of this process initiates a wide range of neurodegenerative diseases, including HD-induced neuropathy [37]. Our previous studies showed that rat spinal cords showed obvious apoptosis and increased Caspase-3 activity in the presence of HD [13,31]. The results of this study were consistent with those of our previous studies, indicating that HD administration induced apoptosis of rat spinal neurons and of VSC4.1 cells.
ProNGF has been shown to exert biological activity and to activate cell death signals [38]. Increasing evidence has confirmed it to be involved in diverse neurodegenerative conditions, including Alzheimer's disease (AD), Down syndrome, and retinal neurodegenerative diseases [39,40]. Moreover, accumulation of proNGF has been shown to induce apoptosis of nerve cells under pathological conditions that include seizures and spinal cord injury. In this study, we found that HD up-regulated proNGF levels in the spinal cord tissues of rats and in cultured VSC4.1 cells, indicating that it might stimulate accumulation of proNGF. Moreover, one study reported that proNGF acts as a mediator of cell death and apoptosis by activating p75NTR [17]. Therefore, we also measured p75NTR levels and found that HD also up-regulated them in the spinal cord tissues of rats and in VSC4.1 cells. Inhibition of p75NTR abolished apoptosis and Caspase-3 activity in VSC4.1 cells. This indicated that activation of the proNGF/p75NTR pathway was involved in HD-induced apoptotic toxicity. The JNK pathway is a downstream regulator of p75NTR-induced apoptosis in nerve cells [41]. Studies have also proven that activation of the proNGF/p75NTR pathway in cerebral cortical neurons is closely related to JNK activation and regulates JNK pathway-induced apoptosis to modulate levels of the c-Jun kinase-dependent proteins Bax and Bcl-2 [42,43]. In this study, we found that HD promoted JNK phosphorylation and changed the levels of the JNK downstream apoptosis-related proteins Bax and Bcl-2 in spinal cord tissues and VSC4.1 cells, consistent with previous reports [44]. In addition, inhibition of JNK activation significantly reduced HD-induced apoptosis and reversed activation of Bax and Bcl-2 in vitro. Taken together, these results suggested that the JNK signaling pathway was involved in HD-induced neuronal apoptosis.
In the present study, we confirmed that accumulation of proNGF played a key role in HD-induced neuronal apoptosis. As is well known, under normal physiological conditions proNGF is a ubiquitous form of mNGF that transforms to mNGF according to a definitive pattern to ensure balance in the nervous system. Generally, mNGF promotes cell survival, proliferation, and neurite outgrowth [45]; all neuronal cells require it for proper function and survival. Unlike mNGF, proNGF helps induce cell death and remove damaged cells to maintain the homeostasis of the cell environment [13]. However, under pathological conditions, the conversion of proNGF into mNGF is blocked, and proNGF accumulates in large amounts, competing with mNGF and decreasing mNGF-mediated neurotrophic signaling rather than actively inducing neuronal death [46]. Our study found that proNGF and p75NTR levels were increased, but mNGF and TrkA levels decreased in the spinal cords of HD-exposed rats and in VSC4.1 cells. These results suggested that HD exposure might inhibit the conversion of mNGF into proNGF, leading to accumulation of proNGF.
Recent studies have reported that the metabolic transformation of proNGF to mNGF is enacted by key enzymes such as plasmin and MMPs [19]. The plasminogen cascade is a fundamental component of proNGF's transformation to mNGF by plasmin cleavage [47]. Moreover, studies have shown that the function of plasmin mainly depends on the activity of tPA [48]. In addition, proNGF is also traditionally cleaved intracellularly by furin and then extracellularly by MMPs, especially MMP-7 [49]. In this study, we found that inhibition of tPA levels by HD was obvious, but MMP-7 level was not significantly different. Therefore, we speculated that HD might reduce the production of mNGF, causing a large accumulation of proNGF by inhibiting the activity of tPA, not of MMP-7 ( Figure 8).

Conclusion
In summary, the current study confirmed that HD triggered pathological apoptotic responses in rat spinal cord neurons and VSC4.1 cells by binding proNGF to p75NTR and activating downstream JNK signaling pathways. However, in the future, more work needs to be done for exploring the effect and mechanism of the activation of proNGF/p75NTR and JNK pathways on inhibiting HD-induced neuronal apoptosis in vivo, as well as on whether inhibiting proNGF/p75NTR and JNK pathways might be used as the therapeutic targets to treat the HD-induced neuronal apoptosis in humans. Additionally, we found that the pro-apoptotic response might be related to the down-regulation of tPA by HD, shifting the balance between proNGF and mNGF such that the former cannot be metabolized in this study. Our study will broaden understanding of the theoretical mechanism of HD in promoting neuronal apoptosis and inducing neural damage. However, the mechanism by which HD reduced tPA and affected proNGF metabolic conversion needs to be further clarified via in vitro and in vivo studies.

Data Availability
All of the data presented in the current study are available from the corresponding author upon reasonable request.