Apolipoprotein D, a Novel Ligand for CD36, Is Essential for Blood–Brain Barrier Integrity

C Chang-Xiong Gong (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) P Pei-Xia Shi (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) Y Yan-Jie Huang (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) Y Yue Dai L Lin-Lin Hu (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) X Xiao-Feng Cheng (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) S Shuang Zhang M Meng-ting He (Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University) J Jian-Hua Wang (Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, China (M.-T.H., J.-H.W., M.-Q.D.).) Z Zhao-You Meng (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) Y Yi-Liang Fang (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) B Bin-Qiao Wang (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) Y Yuan Zhao C Cheng-Kang He (Medical Care Center, Shigatse Branch of Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-K.H.).) G Guo-Qiang Yang (Department of Neurology, Huaihai Hospital, Xuzhou medical University, Xuzhou, China (G.-Q.Y.).) W Wen-Jie Zi (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) Z Zhong-Ming Qiu (Department of Neurology, the 903rd Hospital of The Chinese People’s Liberation Army. Hangzhou, China (Z.-M.Q.).) F Feng-Li Li (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) S Sen Lin (State Key Laboratory of Chemistry for NBC Hazards Protection, College of Chemistry) H Hui Lu C Chen-Hao Zhao (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) C Chi Zhang Z Zhen-Yu Liu (Department of Urology, General Hospital of central Theater Command of Chinese People’s Liberation Army, Wuhan, Hubei, China (Z.-Y.L.).) M Meng-Qiu Dong Q Qin Ouyang (College of Pharmacy, Third Military Medical University, Shapingba, Chongqing 400038, China) H Hong-Ting Zheng (Department of Endocrinology, Xinqiao Hospital, the Army Medical University, Chongqing, China (H.-T.Z.).) J Jian-Qin Niu (Department of Histology and Embryology, the Army Medical University, Chongqing, China (J.-Q.N., F.M.).) F Feng Mei B Bao-Liang Sun (Department of Neurology, the Second Affiliated Hospital, Key Laboratory of Cerebral Microcirculation in Universities of Shandong, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China (B.-L.S.).) J Jin Zhou (Department of Oncology Sichuan Cancer Hospital Chengdu China) Q Qi Xie F Fang-Fei Li (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).) Q Qing-Wu Yang (Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).)

Abstract

BACKGROUND: The disruption of the blood–brain barrier (BBB) is a central pathogenic event in many central nervous system disorders. However, the mechanisms regulating BBB function remain incompletely understood, and effective treatments are lacking. Brain mural cells differ significantly from their peripheral counterparts, a distinction likely critical for maintaining BBB integrity. METHODS: We combined proteomic profiling of human brain vs peripheral mural cells with multiple ischemic stroke models (global apolipoprotein D [ApoD] knockout, mural cell–specific ApoD knockout, and adeno-associated virus–mediated ApoD overexpression) to evaluate the role of ApoD in BBB integrity. Mechanistic studies (co-immunoprecipitation, binding assays, including surface plasmon resonance, bio-layer interferometry, cross-linking mass spectrometry, and CD36 loss-of-function approaches, both in vitro and in vivo) were performed to determine how ApoD interacts with CD36 and inhibits its signaling. Finally, we assessed the effect of ApoD glycosylation on CD36 binding and tested therapeutic delivery of hypoglycosylated ApoD in stroke. RESULTS: Our study has shown an increased expression of ApoD in mural cells after ischemic stroke. We found that mural cell–derived ApoD functions as an inhibitory ligand of endothelial CD36, suppressing pathological endothelial proliferation, preserving BBB integrity, and promoting neurological recovery. Additionally, overexpression of ApoD in mural cells improved BBB integrity and enhanced functional recovery in ApoD -null mice. Mechanistically, ApoD competes with long-chain fatty acids for CD36 binding and directly attenuates downstream CD36 signaling. Furthermore, we reveal that peripheral hyperglycosylated ApoD (hyperglyco-ApoD) showed minimal effect on BBB integrity maintenance, whereas hypoglycosylation of ApoD enhances its binding affinity to CD36, amplifying its therapeutic efficacy. Exogenous administration of hypoglyco-ApoD via vein injection profoundly inhibited BBB disruption and improved neural function, especially in aging stroke. CONCLUSIONS: Our work identifies a previously unrecognized paracrine mechanism in which mural cell–derived ApoD directly engages endothelial CD36 to restrain pathological endothelial proliferation, thereby preserving BBB integrity and promoting neurological recovery after stroke. These findings further suggest that hypoglycosylated ApoD, with its higher CD36-binding affinity, merits investigation as a potential strategy to enhance BBB repair in central nervous system disorders.

Article Details

Journal Circulation
Volume / Issue Vol. 153, Issue 14
Published April 07, 2026
Pages 1038-1059
ISSN 0009-7322
Publisher Lippincott Williams & Wilkins

Journal Info

Circulation

Lippincott Williams & Wilkins

ISSN: 0009-7322 Health Sciences

Authors (33)

C

Chang-Xiong Gong

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

P

Pei-Xia Shi

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

Y

Yan-Jie Huang

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

Y

Yue Dai

L

Lin-Lin Hu

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

X

Xiao-Feng Cheng

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

S

Shuang Zhang

M

Meng-ting He

Inflammation and Immune Mediated Diseases Laboratory of Anhui Province, The Key Laboratory of Anti-inflammatory of Immune Medicines, Ministry of Education, Anhui Institute of Innovative Drugs, School of Pharmacy, Anhui Medical University

J

Jian-Hua Wang

Tsinghua Institute of Multidisciplinary Biomedical Research, Tsinghua University, Beijing, China (M.-T.H., J.-H.W., M.-Q.D.).

Z

Zhao-You Meng

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

Y

Yi-Liang Fang

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

B

Bin-Qiao Wang

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

Y

Yuan Zhao

C

Cheng-Kang He

Medical Care Center, Shigatse Branch of Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-K.H.).

G

Guo-Qiang Yang

Department of Neurology, Huaihai Hospital, Xuzhou medical University, Xuzhou, China (G.-Q.Y.).

W

Wen-Jie Zi

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

Z

Zhong-Ming Qiu

Department of Neurology, the 903rd Hospital of The Chinese People’s Liberation Army. Hangzhou, China (Z.-M.Q.).

F

Feng-Li Li

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

S

Sen Lin

State Key Laboratory of Chemistry for NBC Hazards Protection, College of Chemistry

H

Hui Lu

C

Chen-Hao Zhao

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

C

Chi Zhang

Z

Zhen-Yu Liu

Department of Urology, General Hospital of central Theater Command of Chinese People’s Liberation Army, Wuhan, Hubei, China (Z.-Y.L.).

M

Meng-Qiu Dong

Q

Qin Ouyang

College of Pharmacy, Third Military Medical University, Shapingba, Chongqing 400038, China

H

Hong-Ting Zheng

Department of Endocrinology, Xinqiao Hospital, the Army Medical University, Chongqing, China (H.-T.Z.).

J

Jian-Qin Niu

Department of Histology and Embryology, the Army Medical University, Chongqing, China (J.-Q.N., F.M.).

F

Feng Mei

B

Bao-Liang Sun

Department of Neurology, the Second Affiliated Hospital, Key Laboratory of Cerebral Microcirculation in Universities of Shandong, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong, China (B.-L.S.).

J

Jin Zhou

Department of Oncology Sichuan Cancer Hospital Chengdu China

Q

Qi Xie

F

Fang-Fei Li

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).

Q

Qing-Wu Yang

Department of Neurology, Xinqiao Hospital, the Army Medical University, Chongqing, China (C.-X.G., P.-X.S., Y.-J.H., L.-L.H., X.-F.C., S.Z., M.-T.H., Z.-Y.M., Y.-L.F., B.-Q.W., Y.Z., W.-J.Z., F.-L.L., S.L., H.L., C.-H.Z., Q.X., F.-F.L., Q.-W.Y.).