Effect of calcineurin/NFAT inhibitors on biomarkers and cognition in a canine model of Alzheimer disease

Abstract

AbstractBackgroundCalcineurin/NFAT signaling increases in Alzheimer disease (AD) and is associated with neurodegeneration, neuroinflammation, amyloid‐β (Aβ) production, and cognitive decline. Hence, calcineurin/NFAT inhibitors (e.g., tacrolimus and Q134R) are attractive potential therapeutics to improve/prevent AD‐associated cognitive impairments. In AD mouse models, both tacrolimus and Q134R improved cognition and ameliorated neuroinflammation and synapse dysfunction.We hypothesized that 1) chronic low‐dose administration of tacrolimus and Q134R will delay cognitive decline over time in middle‐aged beagles, a model of human brain aging and AD; and 2) canine plasma and CSF biomarkers will be improved with treatment.MethodsCognitive outcomes were evaluated in 37 middle‐aged beagles at baseline and during follow‐up (years 1‐3) by assessing spatial learning [landmark‐discrimination (1, 2 and 4cm)], visual discrimination learning, reversal learning (executive function), and spatial working memory (20‐, 70‐, and 110‐second delays). Dogs were ranked for cognition at baseline and randomized into treatment groups: Control (n = 12; placebo), Q134R (n = 12; 8mg/day), and tacrolimus (n = 13; 0.075mg/kg/day). Concentrations of Aβ40, Aβ42, and NfL in plasma and CSF were measured using the Quanterix SIMOA.ResultsAccuracy at all landmark‐discrimination distances declined significantly among controls 20% faster than tacrolimus, and 15% faster than Q134R dogs, at the most difficult distance of 4cm. Accuracy on spatial working memory task declined 21% faster/year among controls than tacrolimus (years 2&3); and 18% faster than Q134R dogs (year 1). Performance on visual discrimination and reversal tasks declined with age but there was no treatment effect.Biomarkers in plasma tended to increase over time with no significant differences between treatment groups. In CSF, relative decreases in Aβ40 and Aβ42 in tacrolimus (2.9 and 2, respectively) and Q134R (5.4 and 3.7, respectively) were less than in control dogs. Finally, relative increases of NfL in tacrolimus and Q134R were less than in control dogs (2.3 and 3.7, respectively).ConclusionBoth tacrolimus and Q134R showed beneficial preventative effects on age‐related decline in spatial functions and memory but not on associative learning nor executive function in a canine model of AD. Finally, only CSF biomarkers tended to improve relative to treatment and are suggestive of less Aβ deposition in brain and higher clearance.