Abstract

Lewy body dementia is the second most common neurodegenerative dementia and is pathologically characterized by α-synuclein positive cytoplasmic inclusions, with varying amounts of amyloid-β (Aβ) and hyperphosphorylated tau (tau) aggregates in addition to synaptic loss. A dysfunctional ubiquitin proteasome system (UPS), the major proteolytic pathway responsible for the clearance of short lived proteins, may be a mediating factor of disease progression and of the development of α-synuclein aggregates. In the present study, protein expression of a key component of the UPS, the RPT6 subunit of the 19S regulatory complex was determined. Furthermore, the main proteolytic-like (chymotrypsin- and PGPH-) activities have also been analyzed. The middle frontal (Brodmann, BA9), inferior parietal (BA40), and anterior cingulate (BA24) gyrus’ cortex were selected as regions of interest from Parkinson’s disease dementia (PDD, n = 31), dementia with Lewy bodies (DLB, n = 44), Alzheimer’s disease (AD, n = 16), and control (n = 24) brains. Clinical and pathological data available included the MMSE score. DLB, PDD, and AD were characterized by significant reductions of RPT6 (one-way ANOVA, p < 0.001; Bonferroni post hoc test) in prefrontal cortex and parietal cortex compared with controls. Strong associations were observed between RPT6 levels in prefrontal, parietal cortex, and anterior cingulate gyrus and cognitive impairment (p = 0.001, p = 0.001, and p = 0.008, respectively). These findings highlight the involvement of the UPS in Lewy body dementia and indicate that targeting the UPS may have the potential to slow down or reduce the progression of cognitive impairment in DLB and PDD.

Highlights

  • Lewy body diseases (LBD) include dementia with Lewy bodies (DLB), Parkinson’s disease (PD), and PD dementia (PDD)

  • BA24 was selected since ␣-synuclein pathology in BA24 develops early in DLB and PDD [28], while BA40 was selected because it shows severe Alzheimer’s disease (AD) and comparatively low LBD pathology, respectively [29]

  • BA24 (E): Mean RPT6 values for the control (n = 24) and PDD (n = 33) groups were significantly higher than DLB (p < 0.05, n = 52) and AD (p < 0.05, n = 16) groups

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Summary

Introduction

Lewy body diseases (LBD) include dementia with Lewy bodies (DLB), Parkinson’s disease (PD), and PD dementia (PDD). DLB and PDD account for 10–20% of dementias [1]. Both conditions are characterized by progressive cognitive decline, visual hallucinations, fluctuating cognition, and parkinsonism. The neuropathological hallmark lesions include ␣-synuclein aggregates which present as intracytoplasmic Lewy bodies and Lewy neurites in axons and dendrites in cortical and limbic areas (DLB and PDD) as well as in the substantia nigra (PDD and PD). The neurochemical features of DLB and PDD include severe loss of cholinergic neurons within the nucleus basalis magnocellularis [4] and extensive cortical and thalamic cholinergic deficits [5,6,7]. Cholinesterase inhibitors [8, 9] and memantine [10] offer symptomatic benefit, but the development of therapies targeting the mechanisms of ␣-synuclein accumulation and aggregation in the cortex are at a preliminary stage

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