Abstract

BackgroundAlzheimer’s disease (AD) is the most common form of dementia. AD has a multifactorial disease etiology and is currently untreatable. Multiple genes and molecular mechanisms have been implicated in AD, including ß-amyloid deposition in the brain, neurofibrillary tangle accumulation of hyper-phosphorylated Tau, synaptic failure, oxidative stress and inflammation. Relatively little is known about the role of the blood-brain barriers, especially the blood-cerebrospinal fluid barrier (BCSFB), in AD. The BCSFB is involved in cerebrospinal fluid (CSF) production, maintenance of brain homeostasis and neurodegenerative disorders.ResultsUsing an Agilent platform with common reference design, we performed a large scale gene expression analysis and functional annotation of the Choroid Plexus Epithelium (CPE), which forms the BCSFB. We obtained 2 groups of freshly frozen Choroid Plexus (CP) of 7 human donor brains each, with and without AD: Braak stages (0–1) and (5–6). We cut CP cryo-sections and isolated RNA from cresyl-violet stained, laser dissected CPE cells. Gene expression results were analysed with T-tests (R) and the knowledge-database Ingenuity.We found statistically significantly altered gene expression data sets, biological functions, canonical pathways, molecular networks and functionalities in AD-affected CPE. We observed specific cellular changes due to increased oxidative stress, such as the unfolded protein response, E1F2 and NRF2 signalling and the protein ubiquitin pathway. Most likely, the AD-affected BCSFB barrier becomes more permeable due to downregulation of CLDN5. Finally, our data also predicted down regulation of the glutathione mediated detoxification pathway and the urea cycle in the AD CPE, which suggest that the CPE sink action may be impaired. Remarkably, the expression of a number of genes known to be involved in AD, such as APP, PSEN1, PSEN2, TTR and CLU is moderate to high and remains stable in both healthy and affected CPE. Literature labelling of our new functional molecular networks confirmed multiple previous (molecular) observations in the AD literature and revealed many new ones.ConclusionsWe conclude that CPE failure in AD exists. Combining our data with those of the literature, we propose the following chronological and overlapping chain of events: increased Aß burden on CPE; increased oxidative stress in CPE; despite continuous high expression of TTR: decreased capability of CPE to process amyloid; (pro-) inflammatory and growth factor signalling by CPE; intracellular ubiquitin involvement, remodelling of CPE tight junctions and, finally, cellular atrophy. Our data corroborates the hypothesis that increased BCSFB permeability, especially loss of selective CLDN5-mediated paracellular transport, altered CSF production and CPE sink action, as well as loss of CPE mediated macrophage recruitment contribute to the pathogenesis of AD.Electronic supplementary materialThe online version of this article (doi:10.1186/s12864-015-2159-z) contains supplementary material, which is available to authorized users.

Highlights

  • Alzheimer’s disease (AD) is the most common form of dementia

  • Gene expression upregulated in AD-affected Choroid Plexus Epithelium (CPE) In total, we found 343 upregulated genes in (Br5–6) ADaffected CPE ((BH P > 0.05; fold change (FC) > 2.0; Additional file 6: Table S3)

  • The unfolded protein response in AD-affected CPE cells The most important canonical pathways upregulated in AD (Br5–6) CPE, compared to (Br0–1) CPE, indicate that CPE cells suffer from increased cellular stress: we found upregulation of the intracellular unfolded protein response, the endoplasmic reticulum stress pathway, and the protein ubiquitin pathway

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Summary

Introduction

Alzheimer’s disease (AD) is the most common form of dementia. AD has a multifactorial disease etiology and is currently untreatable. The most recent large scale DNA analyses implicated, apart from the APOE locus, 19 loci containing common, small-effect, susceptibility variants in over 100 AD candidate disease genes, such as CR1, CLU, PICALM, BIN1, EPHA1, MS4A, CD33, CD2AP and ABCA7 [5,6,7,8]. Pathobiological pathways such as insulin signalling, synaptic or mitochondrial failure, oxidative stress, inflammation, vascular effects and cholesterol metabolism have been implicated in AD [1]. Extracellular overproduction of Aß, insufficient Aß-processing or too little Aß clearance from the brain leads (initially) to higher levels these peptides in the CSF, extracellular plaques and neuronal dysfunction or death [1]

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