Abstract

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by the progressive deterioration of cognitive functions. Its neuropathological features include amyloid-β (Aβ) accumulation, the formation of neurofibrillary tangles, and the loss of neurons and synapses. Neuroinflammation is a well-established feature of AD pathogenesis, and a better understanding of its mechanisms could facilitate the development of new therapeutic approaches. Recent studies in transgenic mouse models of AD have shown that neutrophils adhere to blood vessels and migrate inside the parenchyma. Moreover, studies in human AD subjects have also shown that neutrophils adhere and spread inside brain vessels and invade the parenchyma, suggesting these cells play a role in AD pathogenesis. Indeed, neutrophil depletion and the therapeutic inhibition of neutrophil trafficking, achieved by blocking LFA-1 integrin in AD mouse models, significantly reduced memory loss and the neuropathological features of AD. We observed that neutrophils release neutrophil extracellular traps (NETs) inside blood vessels and in the parenchyma of AD mice, potentially harming the blood–brain barrier and neural cells. Furthermore, confocal microscopy confirmed the presence of NETs inside the cortical vessels and parenchyma of subjects with AD, providing more evidence that neutrophils and NETs play a role in AD-related tissue destruction. The discovery of NETs inside the AD brain suggests that these formations may exacerbate neuro-inflammatory processes, promoting vascular and parenchymal damage during AD. The inhibition of NET formation has achieved therapeutic benefits in several models of chronic inflammatory diseases, including autoimmune diseases affecting the brain. Therefore, the targeting of NETs may delay AD pathogenesis and offer a novel approach for the treatment of this increasingly prevalent disease.

Highlights

  • The formation of neutrophil extracellular traps (NETs) is a defense mechanism used by neutrophils to trap and efficiently limit the damage caused by a wide range of microbial targets [1]

  • NET production is associated with dramatic changes in cellular morphology, including the extrusion of decondensed chromatin into the extracellular space to form web-like structures decorated with histones and granular antimicrobial proteins, such as neutrophil elastase (NE), myeloperoxidase (MPO), proteinase 3, cathepsin G, lactoferrin, matrix metalloproteinase 9 (MMP-9), peptidoglycanrecognition proteins, pentraxin, and LL-37 [1,2,3,4]

  • We found that intraparenchymal MPO+ cells were mainly localized to within 50 μm of Aβ plaques, and their distribution was non-random, suggesting that Aβ may act as a chemoattractant by creating a favorable microenvironment for the accumulation of neutrophils inside the brain, promoting their pro-inflammatory activities [8]

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Summary

INTRODUCTION

The formation of neutrophil extracellular traps (NETs) is a defense mechanism used by neutrophils to trap and efficiently limit the damage caused by a wide range of microbial targets [1]. Compelling evidence indicates that AD-related inflammation develops in two different but interconnected compartments: the blood and the brain In this context, systemic inflammation can lead to “brain activation,” whereas cerebral inflammation may in turn influence the peripheral system through the release of danger signals and other inflammatory mediators [12, 18,19,20,21]. Previous studies have shown that tau may contribute to BBB deterioration in vitro, and BBB dysfunction correlates with the appearance of perivascular tau around major hippocampal blood vessels in vivo [22,23,24] Both tau and Aβ may, induce BBB dysfunction, contributing to brain inflammation and neurodegeneration. Our recent data reveal that neutrophils adhere to blood vessels and infiltrate inside the brain parenchyma in two transgenic animal models of AD, inducing cognitive deficit and neuropathological changes [8]. We discuss the involvement of NETs in AD as a novel mechanism for neutrophil-mediated neurotoxicity and neurodegeneration and suggest that the inhibition of NETs may offer a new pharmacological approach to slow down the progression of this disease

NEUTROPHILS IN AD
INTRAVASCULAR NETs IN AD
INTRAPARENCHYMAL NETosis IN AD
FUTURE DIRECTIONS
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