Abstract

Transthyretin (TTR) is a tetrameric, amyloid-β (Aβ)-binding protein, which reduces Aβ toxicity. The TTR/Aβ interaction can be enhanced by a series of small molecules that stabilize its tetrameric form. Hence, TTR stabilizers might act as disease-modifying drugs in Alzheimer's disease. We monitored the therapeutic efficacy of two TTR stabilizers, iododiflunisal (IDIF), which acts as small-molecule chaperone of the TTR/Aβ interaction, and tolcapone, which does not behave as a small-molecule chaperone, in an animal model of Alzheimer's disease using positron emission tomography (PET). Female mice (AβPPswe/PS1A246E/TTR+/-) were divided into 3 groups (n = 7 per group): IDIF-treated, tolcapone-treated, and non-treated. The oral treatment (100 mg/Kg/day) was started at 5 months of age. Treatment efficacy assessment was based on changes in longitudinal deposition of Aβ in the hippocampus (HIP) and the cortex (CTX) and determined using PET-[18F]florbetaben. Immunohistochemical analysis was performed at age = 14 months. Standard uptake values relative to the cerebellum (SUVr) of [18F]florbetaben in CTX and HIP of non-treated animals progressively increased from age = 5 to 11 months and stabilized afterwards. In contrast, [18F]florbetaben uptake in HIP of IDIF-treated animals remained constant between ages = 5 and 11 months and significantly increased at 14 months. In the tolcapone-treated group, SUVr progressively increased with time, but at lower rate than in the non-treated group. No significant treatment effect was observed in CTX. Results from immunohistochemistry matched the in vivo data at age = 14 months. Our work provides encouraging preliminary results on the ability of small-molecule chaperones to ameliorate Aβ deposition in certain brain regions.

Highlights

  • IntroductionAlzheimer disease (AD) is the most common cause of dementia

  • Radiochemical purity as determined by radio-high-performance liquid chromatography (HPLC) was > 95% in all cases at the injection time, and no major peaks were identified in the UV chromatographic profiles, confirming the chemical purity

  • Some studies reported that mouse wild type TTR, which is more stable than human wt TTR, is less capable of preventing Aβ aggregation and oligomers toxicity [62,63,64], in vivo studies show accelerated development of the neuropathologic phenotype when the endogenous TTR gene is deleted, demonstrating that the mouse TTR has a relevant effect on the disease progression in Alzheimer disease (AD) mouse models [29, 60, 61]

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Summary

Introduction

Alzheimer disease (AD) is the most common cause of dementia. It is the fifth leading cause of death globally, with a total of 2.4 million deaths in 2016, and the second leading cause of death among those over the age of 70. These numbers are increasing and are estimated to reach 50 million dementia patients by 2050, worldwide [1]. AD is characterized by the accumulation of amyloid-beta (Aβ) aggregates [2], the occurrence of neurofibrillary tangles (NFTs) of hyperphosphorylated tau protein [3], and synaptic dysfunction [4]. AD progression is accompanied by neuroinflammation [5], structural cerebrovascular alterations and deficits in cerebral glucose uptake and cerebral blood flow responses [6]

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