Preclinical and emerging clinical data show that glibenclamide reduces space occupying
edema and brain swelling following cerebral ischemia. Glibenclamide is a potent inhibitor
of numerous sulfonylurea receptor (SUR)-regulated channels, including K ATP (SUR1-KIR6.2,
SUR2A-KIR6.2, SUR2B-KIR6.2, SUR2B-KIR6.1) and SUR1-TRPM4. Here, we used molecularly
specific oligodeoxynucleotides (ODNs) to investigate the role of various SUR-regulated
ion channel subunits in post-ischemic brain swelling. Focal cerebral ischemia was
induced in adult male rats by permanent middle cerebral artery occlusion (pMCAo).
We used this model to study the effects of antisense-ODNs (AS-ODNs) directed against
Abcc8 /SUR1, Trpm4 /TRPM4, Kcnj8 /KIR6.1 and Kcnj11 /KIR6.2 on hemispheric swelling,
with sense or scrambled ODNs used as controls. We used antibodybased Förster resonance
energy transfer (immuno-FRET) and co-immunoprecipitation to study the co-assembly
of SUR1-TRPM4 heteromers. In the combined control groups administered sense or scrambled
ODNs, pMCAo resulted in uniformly large infarct volumes (mean±SD: 57.4±8.8%; n=34)
at 24 hours after onset of ischemia, with no effect of AS-ODNs on infarct size. In
controls, hemispheric swelling was 23.9±4.1% (n=34), and swelling was linearly related
to infarct volume ( P <0.02). In the groups administered anti- Abcc8 /SUR1 or anti-
Trpm4 /TRPM4 AS-ODN, hemispheric swelling was significantly less, 11.6±3.9% and 12.8±5.8%
respectively ( P <0.0001), and the relationship between infarct volume and swelling
was reduced and not significant. AS-ODNs directed against Kcnj8 /KIR6.1 and Kcnj11
/KIR6.2 had no significant effect on hemispheric swelling (23.3±5.4% and 22.9±5.8%
respectively). Post-ischemic tissues showed co-assembly of SUR1-TRPM4 heteromers.
Post-ischemic hemispheric swelling can be decoupled from infarct volume. SUR1-TRPM4
channels, not K ATP , mediate post-ischemic brain swelling.