Meningeal neutrophil infiltration drives inflammation-exacerbated pediatric stroke through IL-36γ signaling

Abstract

Infection and systemic inflammation have been identified as major risk factors for pediatric stroke; however, the immune mechanisms underlying these clinical observations remain poorly understood. Here, we utilized an LPS-sensitized photothrombotic stroke model (LPS/PT) to investigate the contribution of immune cell infiltration to pediatric stroke pathogenesis and identified a previously unrecognized route of neutrophil entry into the injured brain. Compared with photothrombotic stroke alone (PT), LPS/PT mice exhibited markedly increased neutrophil infiltration accompanied by a hyperactivated phenotype. Depletion of neutrophils, but not monocytes, significantly reduced infarct size in LPS/PT animals, indicating a central role for neutrophils in inflammation-exacerbated pediatric stroke. Notably, we observed that neutrophils first accumulated within the leptomeningeal space before entering the brain parenchyma during the early phase of stroke, suggesting that the meninges may serve as an initial staging site for neutrophil recruitment. Using KikGR photoconvertible reporter mice combined with two-photon imaging, we further demonstrated that neutrophils infiltrate the ischemic brain through a compromised meningeal barrier following stroke. Transcriptomic analysis of infiltrating neutrophils revealed distinct gene expression signatures between meningeal neutrophils and circulating blood-derived neutrophils. Among these, IL-36{gamma} was highly enriched in meninges-associated neutrophils during pediatric stroke. Consistently, single-cell RNA sequencing of meningeal immune cells confirmed elevated IL-36{gamma} expression within the neutrophil cluster in LPS/PT animals. Importantly, intracisternal administration of IL-36 receptor antagonist (IL-36Ra) or anti-ICAM-1 antibody significantly reduced infarct volume in this pediatric stroke model. Together, our findings identify the meningeal barrier as a critical gateway for neutrophil infiltration and reveal IL-36{gamma} as a key inflammatory mediator regulating neuroinflammation in pediatric stroke, highlighting a potential therapeutic target for limiting immune-mediated brain injury.