Vascular mural cells protect the adult brain from haemorrhage but do not control the blood-brain barrier in developing zebrafish

Reviewer #1 (Public review):

Summary:

The study investigates the role of vascular mural cells, specifically pericytes and vascular smooth muscle cells (vSMCs), in maintaining blood-brain barrier (BBB) integrity and regulating vascular patterning. Analyzing zebrafish pdgfrb mutants that lack brain pericytes and vSMCs, they show that mural cell deficiency does not impair BBB establishment or maintenance during larval and early juvenile stages. However, mural cells seem to be crucial for preventing vascular aneurysms and hemorrhage in adulthood as focal leakage, basement membrane disruption, and increased caveolae formation are observed in adult zebrafish at aneurysm hotspots. The authors challenge the paradigm that mural cells are essential for BBB regulation in early development while highlighting their importance for long-term vascular stability.

Strengths:

Previous studies have established that the zebrafish BBB shares molecular and morphological homology with e.g. the mammalian BBB and therefore represents a suitable model. By examining mural cell roles across different life stages - from larval to adult zebrafish - the study provides an unprecedented comprehensive developmental analysis of brain vascular development and of how mural cells influence BBB integrity and vascular stability over time. The use of live imaging, whole-brain clearing, and electron microscopy offers high-resolution insights into cerebrovascular patterning, aneurysm development, and structural changes in endothelial cells and basement membranes. By analyzing "leakage hotspots" and their association with structural endothelial defects in adults the presented findings add novel insights into how mural cell loss may lead to vascular instability.

Weaknesses:

The study uses quantitative tracer assays with multiple molecular weight dyes to evaluate blood-brain barrier (BBB) permeability. The study normalizes the intensity of tracer signals (e.g., 10 kDa, 70 kDa dextrans) in the brain parenchyma to the vascular signal of a 2000 kDa dextran tracer (assumed to remain within vessels). Intensity normalization is used to control for variations in tracer injection efficiency or vascular density. This method doesn't directly assess the absolute amount of tracer present in the parenchyma, potentially underestimating leakage severity. As the lack of BBB impairment is a "negative" finding, more rigorous controls or other methods might be needed to corroborate it.

Reviewer #2 (Public review):

Summary:

The authors generated a zebrafish mutant of the pdgfrb gene. The presented analyses and data confirm previous studies demonstrating that Pdgfrb signaling is necessary for mural cell development in zebrafish. In addition, the data support previously published studies in zebrafish showing that mural cell deficiency leads to hemorrhages later in life. The authors presented quantified data on vessel density and branching, assessed tracer extravasation, and investigated the vasculature of adult mice using electron microscopy.

Strengths:

The strength of this article is that it provides independent confirmation of the important role of Pdgfrb signaling for the development of mural cells in the zebrafish brain. In addition, it confirms previous literature on zebrafish that provides evidence that, in the absence of pericytes/VSMC, hemorrhages appear (Wang et al, 2014, PMID: 24306108 and Ando et al 2021, PMID: 3431092). The study by Ando et al, 2021 did not report experiments assessing BBB leakage in pdgfrb mutants but in the review article by Ando et al (PMID: 34685412) it is stated that "indicating that endothelial cells can produce basic barrier integrity without pericytes in zebrafish".

Weaknesses:

(1) The authors should avoid using violin plots, which show distribution. Instead, they should replace all violin plots in the figures with graphs showing individual data points and standard deviation. For Figure 2f specifically, the standard deviation in the analyzed cohort should be shown.

(2) The authors have not shown the reduced PDGFRB protein or the effect of mutation on mRNA level in their zebrafish mutant.

(3) Statistical data analysis: Did the authors perform analyses to investigate whether the data has a normal distribution (e.g., Figures 1d, e)?

(4) Analysis of tracer extravasation. The use of 2000 kDa dextran intensity as an internal reference is problematic because the authors have not provided data demonstrating that the 2000 kDa dextran signal remains consistent across the entire vasculature. The authors have not provided data demonstrating that the 2000 kDa dextran signal in vessels exhibits acceptable variance across the vasculature to serve as a reliable internal reference. The variability of this signal within a single animal remains unknown. The presented data do not address this aspect.

Additionally, it's intriguing that the signal intensity in the parenchyma of the tested tracers presents a substantial range, varying by 20-30% in the analysed cohort (Figure 1g, Extended Figure 1e). Such large variability raises the question of its origin. Could it be a consequence of the normalization to 2000 kDa dextran intensity which differs between different fish? Or is it due to the differences in the parenchymal signal intensity while the baseline 2000 kDa intensity is stable? Or is the situation mixed?

An alternative and potentially more effective approach would be to cross the pdgfrb mutant line with a line where endothelial cells are genetically labeled to define vessels (e.g. the line kdrl used in acquiring data presented in Figure 2a). Non-injected controls could then be used as a baseline to assess tracer extravasation into the parenchyma.

How is the data presented in Figure 3e generated? How was the dextran intensity calculated? It looks like the authors have used the kdrl line to define vessels. Was the 2000 kDa still used as in previous figures? If not, please describe this in the Materials and Methods section.

(5) The authors state that both controls and mutants show extravasation of 1 kDa NHS-ester into the parenchyma. However, the presented images do not illustrate this; it is not obvious from these images (Extended Data Figure 1c). Additionally, the presented quantification data (Extended Data Figure 1e) do not show that, at 7 dpf, the vasculature is permeable to this tracer. Note that the range of signal intensity of the 1 kDa NHS-ester is similar to the 70 kDa dextran (Figure 1g and Extended Figure 1e). Would one expect an increase in the ratio in case of extravasation, considering that the 2000 kDa dextran has the same intensity in all experiments? Please explain.

(6) The study would be strengthened by a more detailed temporal analysis of the phenotype. When do the aneurysms appear? Is there an additional loss of VSMC?

(7) The authors intended to analyze the BBB at later stages (line 128), but there is not a significant time difference between 2 months (Figure 2) and 3 months (Figure 3) considering that zebrafish live on average 3 years. Therefore, the selection of only two time-points, 2 and 3 months, to analyze BBB changes does not provide a comprehensive overview of temporal changes throughout the zebrafish's lifespan. How long do the pdgfb mutants live?

(8) Why is there a difference in tracer permeability between 2 and 3 months (Figures 2 and 3)? Are hemorrhages not detected in 2-month-old zebrafish?

(9) Figure 3: The capillary bed should be presented in magnified images as it is not clearly visible. Figure 3e shows that in the pdgfb mutant the dextran intensity is higher also in regions 6-10. How do the authors explain this?

(10) In general, the manuscript would benefit from a more detailed description of the performed experiments. How long did the tracer circulate in the experiments presented in Figures 2, 3, and 4?

(11) How do the authors explain the poor signal of the 70 kDa dextran from the vasculature of 5-month-old zebrafish presented in Extended Data Figure 3?

(12) The study would benefit from a clear separation of the phenotypes caused by the loss of VSMC. The title eludes that also capillaries present hemorrhages which is not the case. How do vascular mural cells differ from mural cells? Are there any other mural cells?

(13) I have a few comments about how the authors have interpreted the literature and why, in my opinion, they should revise their strong statements (e.g., the last sentence in the abstract).

Scientists have their own insights and interpretations of data. However, when citing published data, it should be clearly indicated whether the statement is a direct quote from the original publication or an interpretation. In the current manuscript, the authors have not correctly cited the data presented in the two published papers (references 5 and 6). These papers do not propose a model where pericytes suppress "adsorptive transcytosis" (lines 73-76). While increased transcytosis is observed in pericyte-deficient mice, the specific type of vesicular transport that is increased or induced remains unknown.

Similarly, lines 151-152 refer to references 5 and 6 and use the term "adsorptive transcytosis," but the authors of both papers did not use this term. Attributing this term to the original authors is inaccurate. Additionally, lines 152-153 do not accurately represent the findings of references 5 and 6. These papers do not state that there is an induction of "caveolae" in endothelial cells in pericyte-deficient mice. In the absence of pericytes, many vesicles can be observed in endothelial cells, but these vesicles are relatively large. It is more likely that there is some form of uncontrolled transcytosis, perhaps micropinocytosis. Please refer to the original papers accurately.

Also, the authors have missed the fact that in mice, the extent of pericyte loss correlates with the extent of BBB leakage. To a certain extent, the remaining pericytes, can compensate for the loss by making longer processes and so ensure the full longitudinal coverage of the endothelium. This was shown in the initial work of Armulik et al (reference 5) and later in other studies.

The bold assertion on lines 183 -187 that a lack of specific BBB phenotype in pdgfrb zebrafish mutant invalidates mouse model findings is unfounded. Despite the notion that zebrafish endothelium possesses a BBB, I present a few examples highlighting the differences in brain vascular development and why the authors' expectation of a straightforward extrapolation of mouse BBB phenotypes to zebrafish is untenable.

In mice Pdgfrb knockout is lethal, but in zebrafish, this is not the case. In marked contrast to mice, however, zebrafish pdgfrb null mutants reach adulthood despite extensive cerebral vascular anomalies and hemorrhage. Following the authors' argumentation about the unlikely divergence of zebrafish and mice evolution, does it mean that the described mouse phenotype warrants a revisit and that the Pdgfrb knockout in mice perhaps is not lethal? Another example where the role of a gene product is not one-to-one, which relates to pericyte development, is Notch3. Notch3-null mice do not show significant changes in pericyte numbers or distribution, suggesting a less prominent role in pericyte development compared to zebrafish.

Although many aspects of development are conserved between species, there are significant differences during brain vascular development between zebrafish and mice. These differences could reveal why the BBB is not impaired in zebrafish pdgfrb mutants. There is a difference in the temporal aspect when various cellular players emerge. The timing of microglia colonization in the brain differs. In mice, microglia colonization starts before the first vessel sprouts enter the brain, while in zebrafish, microglia enter after. Additionally, microglia in zebrafish and mice have a different ontogeny. In mice, astrocytes specialize postnatally and form astrocyte endfeet postnatally. In zebrafish, radial glia/astrocytes form at 48 hpf, and as early as 3 dpf, gfap+ cells have a close relationship with blood vessels. Thus, these radial glia/astrocyte-like cells could play an important role in BBB induction in zebrafish. It's worth noting that in Drosophila, the blood-brain barrier is located in glial cells. While speculative, these cells might still play a role in zebrafish, while the role of pericytes does not seem to be crucial. Pericytes enter the brain and contact with developing vasculature (endothelium) relatively late in zebrafish (60 hpf). In mice, the situation is different, as there is no such lag between endothelium and pericyte entry into the brain. I suggest that the authors approach the observed data with curiosity and ask: Why are these differences present? Are all aspects of the BBB induced by neural tissue in zebrafish? What is the contribution of microglia and astrocytes?"

Another interesting aspect to consider is the endothelial-pericyte ratio and longitudinal coverage of pericytes in the zebrafish brain, and how this relates to what is observed in mice. How similar is the zebrafish vasculature to the mouse vasculature when it comes to the average length of pericytes in the zebrafish brain? Does the longitudinal coverage of pericytes in the zebrafish brain reach nearly 100%, as it does in mice?

Based on the preceding arguments, it is recommended that the authors present a balanced discussion that provides insightful discussion and situates their work within a broader framework.

Reviewer #3 (Public review):

This manuscript examines the role of pdgfrb-positive pericytes in the establishment and maintenance of the blood-brain barrier (BBB) in the zebrafish. Previous studies in PDGFB- or PDGFRB-deficient mice have suggested that loss of pericytes results in disruption of the BBB. The authors show that zebrafish pdgfrb mutant larvae have an intact BBB and that pdgfrb mutant adult fish show large vessel defects and hemorrhage but do not exhibit substantial leakage from brain capillaries, suggesting loss of pericytes is not sufficient to "open" the BBB. The authors use beautiful and compelling images and rigorous quantification to back up most of their conclusions. The imaging of the adult brain is particularly nice. The authors rigorously document the lack of BBB leakage in pdgfrbuq30bh mutant larvae and large vessel phenotypes (eg, enlargement and rupture) in pdgfrbuq30bh mutant adults. A few points would help the authors to further strengthen their findings contradicting the current dogma from rodent models.

Major point:

The authors document pericyte loss using a single TgBAC(pdgfrb:egfp)ncv22 transgenic line driven by the promoter of the same gene mutated in their pdgfrbuq30bh mutants. Given their findings on the consequences of pericyte loss directly contradict current dogma from rodent studies, it would be useful to further validate the absence of brain pericytes in these mutants using one of several other transgenic lines marking pericytes currently available in the zebrafish. This could be done using pdgfrb crispants, which the authors show nicely phenocopy the germline mutants, at least in larvae. This would help nail down the absence of any currently identifiable pericyte population or sub-population in the loss of pdgfrb animals and substantially strengthen the authors' conclusions.

Other issues:

The authors should provide more information about the pdgfrbuq30bh mutant and how it was generated (including a diagram in a supplemental figure would be useful).

It would be helpful to show some data on whether mutants show morphological phenotypes or developmental delay at 7 and 14 dpf, to provide some context to better assess the reduced branching and vessel length vascular phenotypes (see Figures 1c-e).

If available, it would be helpful to have a positive control for the tracer leakage experiments - a genetic manipulation that does cause disruption of the BBB and leakage at 2 hours post-tracer injection (see Figures 1f and g).

Quantification of the findings in Figure 4c,d would be useful, as would the use of germline fish for these experiments if these are now available. If this is not possible, it would be helpful to document that the crispants used in these experiments lack pdgfrb:egfp pericytes at adult stages (this is only shown for 5 dpf larvae, in Extended Data Figure 4b).

Adult mutants clearly show less dye leakage in the more superficial capillary regions than WT siblings, but dextran intensity is a bit higher, although this could well be diffusion from more central brain regions where overt hemorrhage is occurring. Along similar lines though, the authors' TEM data in Extended Data Figure 4d hints that there may be more caveolae in mutant brain capillaries, although the N number was lower here than for the measurements from TEM of larger central vessels (Figure 4g). It would be useful to carry out additional measurements to increase the N number in Figure 4d to see whether the difference between wild-type sibling and mutant capillary caveolae numbers remains as not significant.

It might be helpful to include some orienting labels and/or additional descriptions in the figure legends to help readers who are not used to looking at zebrafish brain vessels have an easier time figuring out what they are looking at and where it is in the brain.

Author response:

We thank all the reviewers for their detailed comments. In response, we will address the comments with further analysis, experiments and an expanded discussion.

In terms of each specific reviewer's comments:

Reviewer 1 was positive overall but had several suggestions and requested further rigorously controls. These are highly constructive technical concerns and will be addressed through additional experimentation and methods for quantification.

Reviewer 2 summarised the strengths of the study as being largely confirmatory. They have perhaps not fully appreciated that this is the first published functional assessment of cerebral vascular permeability in a pericyte deficient zebrafish model.

The reviewer has made a number of very helpful suggestions to improve technical aspects of the analysis. Many align with the suggestions of Reviewer 1. Additional experiments that include more rigorous controls and further methods to quantify vessel permeability will address these concerns in revision.

We also note that the reviewer calls for a more nuanced and careful discussion section. We take the reviewers point and do appreciate their concerns. We were limited by wordcount in the initial submission in short report format, but in response will expand and provide a more thorough discussion.

Reviewer 3 was positive overall but has suggested additional controls and experiments to further strengthen the findings and support our conclusions. Some align with the suggestions of Reviewers 1 and 2. We agree and aim to address them through additional work in revision.