Familial Alzheimer's Disease Subjects Research Articles

Apolipoprotein E ε4 Mediates Myelin Breakdown by Targeting Oligodendrocytes in Sporadic Alzheimer Disease.

White matter degradation in the frontal lobe is one of the earliest detectable changes in aging and Alzheimer disease. The ε4 allele of apolipoprotein E (APOE4) is strongly associated with such myelin pathology but the underlying cellular mechanisms remain obscure. We hypothesized that, as a lipid transporter, APOE4 directly triggers pathology in the cholesterol-rich myelin sheath independent of AD pathology. To test this, we performed immunohistochemistry on brain tissues from healthy controls, sporadic, and familial Alzheimer disease subjects. While myelin basic protein expression was largely unchanged, in frontal cortex the number of oligodendrocytes (OLs) was significantly reduced in APOE4 brains independent of their Braak stage or NIA-RI criteria. This high vulnerability of OLs was confirmed in humanized APOE3 or APOE4 transgenic mice. A gradual decline of OL numbers was found in the aging brain without associated neuronal loss. Importantly, the application of lipidated human APOE4, but not APOE3, proteins significantly reduced the formation of myelinating OL in primary cell culture derived from Apoe-knockout mice, especially in cholesterol-depleted conditions. Our findings suggest that the disruption of myelination in APOE4 carriers may represent a direct OL pathology, rather than an indirect consequence of amyloid plaque formation or neuronal loss.

Evidence of beta amyloid independent small vessel disease in familial Alzheimer's disease.

We studied small vessel disease (SVD) pathology in Familial Alzheimer's disease (FAD) subjects carrying the presenilin 1 (PSEN1) p.Glu280Ala mutation in comparison to those with sporadic Alzheimer's disease (SAD) as a positive control for Alzheimer's pathology and Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) bearing different NOTCH3 mutations, as positive controls for SVD pathology. Upon magnetic resonance imaging (MRI) in life, some FAD showed mild white matter hyperintensities and no further radiologic evidence of SVD. In post-mortem studies, total SVD pathology in cortical areas and basal ganglia was similar in PSEN1 FAD and CADASIL subjects, except for the feature of arteriosclerosis which was higher in CADASIL subjects than in PSEN1 FAD subjects. Further only a few SAD subjects showed a similar degree of SVD pathology as observed in CADASIL. Furthermore, we found significantly enlarged perivascular spaces in vessels devoid of cerebral amyloid angiopathy in FAD compared with SAD and CADASIL subjects. As expected, there was greater fibrinogen-positive perivascular reactivity in CADASIL but similar reactivity in PSEN1 FAD and SAD groups. Fibrinogen immunoreactivity correlated with onset age in the PSEN1 FAD cases, suggesting increased vascular permeability may contribute to cognitive decline. Additionally, we found reduced perivascular expression of PDGFRβ AQP4 in microvessels with enlarged PVS in PSEN1 FAD cases. We demonstrate that there is Aβ-independent SVD pathology in PSEN1 FAD, that was marginally lower than that in CADASIL subjects although not evident by MRI. These observations suggest presence of covert SVD even in PSEN1, contributing to disease progression. As is the case in SAD, these consequences may be preventable by early recognition and actively controlling vascular disease risk, even in familial forms of dementia.

Calcilytic NPS 2143 Reduces Amyloid Secretion and Increases sAβPPα Release from PSEN1 Mutant iPSC-Derived Neurons.

Despite numerous efforts and studies over the last three decades, Alzheimer’s disease (AD) remains a disorder not fully understood and incurable so far. Development of induced pluripotent stem cell (iPSC) technology to obtain terminally differentiated neurons from adult somatic cells revolutionized the study of AD, providing a powerful tool for modelling the disease and for screening candidate drugs. Indeed, iPSC reprogramming allowed generation of neurons from both sporadic and familial AD patients with the promise to recapitulate the early pathological mechanisms in vitro and to identify novel targets. Interestingly, NPS 2143, a negative allosteric modulator of the calcium sensing receptor, has been indicated as a possible therapeutic for AD. In the present study, we assessed the potential of our iPSC-based familial AD cellular model as a platform for drug testing. We found that iPSC-derived neurons respond to treatment with γ-secretase inhibitor, modifying the physiological amyloid-β protein precursor (AβPP) processing and amyloid-β (Aβ) secretion. Moreover, we demonstrated the expression of calcium sensing receptor (CaSR) protein in human neurons derived from healthy and familial AD subjects. Finally, we showed that calcilytic NPS 2143 induced a changing of Aβ and sAβPPα secreted into conditioned media and modulation of CaSR and PSEN1 expression at the plasma membrane of AD neurons. Overall, our findings suggest that NPS 2143 affects important AD processes in a relevant in vitro system of familial AD.

The need for better AD animal models.

The need for better AD animal models.

IC-PL2: Amyloid imaging: Developments, challenges, future direction

The first in vivo positron emission tomography (PET) imaging studies of amyloid-beta (Aβ) in human subjects were reported by the UCLA group in 2002 using a fluorine-18 labeled membrane dye derivative, [F-18]FDDNP, that bound preferentially to both Aβ plaques and neurofibrillary tangles (NFT) in the brains of Alzheimer's disease (AD) patients relative to elderly control subjects. Groups from Pittsburgh and Toronto followed in 2004 with literature reports of PET imaging studies in AD and control subjects using Aβ-selective carbon-11 labeled thioflavin-T ([C-11]PIB) and stilbene ([C-11]SB-11) derivatives, respectively. Researchers have sought to employ these PET agents in cross-sectional and longitudinal studies of Aβ deposition in a variety of non-invasive imaging studies in amyloid-based diseases. In addition, investigators have sought to expand the choice of Aβ-specific radioligands to include other F-18 and C-11 labeled compounds for PET imaging applications, as well as I-123 labeled agents for single photon emission computed tomography (SPECT) imaging studies. Over the past 4 years, literature reports of Aβ imaging in human subjects using PET have exploded, with more than 70 publications in a variety of subject populations. The vast majority of these studies have utilized [C-11]PIB, but the relatively short half-life of carbon-11 (20 min) has limited its distribution to about 40 specialized PET radiochemistry facilities throughout the world. The development of a more convenient, longer-lived (110 min) F-18 labeled radioligand with in vivo properties comparable to those of [C-11]PIB has been an active area of research over the past several years with some recent encouraging results. In contrast, efforts to develop a SPECT Aβ imaging agent have been largely unsuccessful. PET Aβ imaging studies have provided some important insights into the pathophysiology of amyloid deposition, particularly in mild cognitive impairment (MCI), healthy elderly controls, and familial AD subjects. Aβ PET methodology is proving valuable in helping to assess the amyloid cascade hypothesis, as a diagnostic agent for brain amyloid deposition, and as a potential surrogate marker of therapeutic efficacy in anti-Aβ drug trials.

Genetic study of Sardinian patients with Alzheimer's disease

We describe the genetic analysis of an Alzheimer's disease (AD) sample derived from a genetically isolated population. Genetic assessment included the analysis of genes involved in AD, such as the genes for amyloid precursor protein (APP), presenilin 1 (PSEN1) and presenilin 2 (PSEN2). We also assessed genes for some proteins that constitute the γ-secretase complex: nicastrin (NCSTN), presenilin enhancer-2 (PEN2), in addition to the AD risk factor apolipoprotein E (APOE). Using polymerase chain reaction and single strand conformational polymorphism method, screens for APP, PSEN1 and PSEN2 genes revealed one mutation in PSEN1. Furthermore, we found an intronic +17G > C polymorphism in PEN2 which, in homozygous form, was greater in early onset Alzheimer's disease (EOAD) compared to controls, and one haplotype in the NCSTN gene which was linked to EOAD and familial AD (FAD). Finally, the genotyping of APOE confirmed that the ɛ4 allele could be a risk factor for the onset of AD, in particular for FAD subjects. In conclusion, these results show the existence of Sardinian genetic peculiarities, essential in studies regarding genetically inherited and multifactorial disorders, as AD.

P4-285 Insulin degrading enzyme immunostaining is decreased in the hippocampus of familial Alzheimer's disease subjects with presenilin 1 mutations

P4-285 Insulin degrading enzyme immunostaining is decreased in the hippocampus of familial Alzheimer's disease subjects with presenilin 1 mutations

The Human Amyloid-β Precursor Protein770 Mutation V717F Generates Peptides Longer Than Amyloid-β-(40-42) and Flocculent Amyloid Aggregates

One of the familial forms of Alzheimer's disease (AD) encodes the amyloid-beta precursor protein (AbetaPP) substitution mutation V717F. This mutation is relevant to AD research, since it has been utilized to generate transgenic mice models to study AD pathology and therapeutic interventions. Amyloid beta (Abeta) peptides were obtained from the cerebral tissue of three familial AD subjects carrying the AbetaPP V717F mutation. A combination of ultracentrifugation, size-exclusion, and reverse-phase high performance liquid chromatography, tryptic and cyanogen bromide hydrolysis, amino acid analysis, and matrix-assisted laser desorption ionization and surface-enhanced laser desorption ionization mass spectrometry was used to characterize the familial AD mutant Abeta peptides. The AbetaPP V717F mutation, located 4-6 residues beyond the wild-type AbetaPP gamma-secretase cleavage site, yielded longer Abeta peptides with C termini between residues 43 and 54. In the cerebral cortex these peptides aggregated into thin water- and SDS-insoluble amyloid bundles that condensed into flocculent spherical plaques. In the leptomeningeal arteries the amyloid was deposited in moderate amounts and was primarily composed of the shorter and more soluble Abeta species ending at residues 40, 42, and 44. The single V717F mutation in AbetaPP results in distinctive and drastic changes in the length and tertiary structure of Abeta peptides, which appear to be responsible for the earlier clinical manifestations of dementia and death of these patients.

Enhancer function and novel DNA binding protein activity in the near upstream betaAPP gene promoter.

The role of betaAPP gene transcription and promoter regulation in modifying amyloid beta-peptide (Abeta) levels is not well understood. Increased production of Abeta or changes in Abeta42/Abeta40 ratio by fibroblasts occurs in the presence of mutant presenilin or betaAPP alleles in familial Alzheimer's disease subjects. Both betaAPP mRNA and Abeta levels are increased in trisomy 21. The APP gene promoter is in a class of housekeeping genes and contains two putative consensus sites for the binding of transcription factor AP1. Electrophoretic mobility shift (EMSA) and DNase protection assays using human fibroblast and HeLa nuclear extract identified specific protein binding with novel Sp1-like properties to both a near-upstream and a downstream domain of the betaAPP promoter. The upstream binding activity was localized to a putative AP1 consensus site and its immediate 5'-adjacent GC-rich element. However, c-Jun antibody and competition experiments had no effect on binding to this domain. A series of 5'-deleted betaAPP promoter-reporter gene transfections in HeLa and fibroblast cells showed that the domain-containing region, n.t. -383 to -348, exerts a 2.9-fold activating influence on basal pbetaAPP-reporter transcription. When subcloned to test enhancer function, the 5'-GC element/'AP1 site' tandem construct conferred four-fold greater activity than either element alone and two-fold greater than the more 3'-situated HSE consensus sequence. Phorbol ester treatment had no effect in these reporter assays. This element shares homology and binding properties with a domain immediately 5' to the downstream E-box/USF element. An interaction model involving both domains and looping of interjacent DNA is proposed. We conclude that this newly described binding protein-enhancer complex is required for full betaAPP promoter activation.

PET study in subjects from two Italian FAD families with APP717 Val to Ileu mutation

Cerebral glucose metabolism was investigated with 2‐[18F]‐fluoro‐2‐deoxy‐D‐glucose ([18F]FDG) and positron emission tomography (PET) in seven members belonging to two Italian families with familial Alzheimer's disease (FAD) and APP717 Val to Ileu mutation. The aim of the study was to identify the pattern of cerebral hypometabolism in the affected patients and the possible occurrence of brain metabolic changes in the APP mutated subjects. The two patients with FAD, when compared with normal age matched controls, showed a severe bilateral hypometabolism in parietal and temporal regions, as well as in the prefrontal areas, which were more affected on the left side. Subcortical thalamic structures were also involved in one patient. In a comparison with a group of patients with sporadic AD, the most affected cerebral areas in the FAD patients were the prefrontal regions and the thalamus, bilaterally. One of the four mutated subjects, with an age close to the family age of disease onset, in a comparison with normals, showed metabolic reductions in the right thalamus, in the left dorsolateral frontal cortex and, bilaterally, in the frontal orbital regions. This regional brain hypometabolism was present in a preclinical phase, 1 year before the onset of dementia. In the three younger subjects carrying the mutation, a metabolic reduction was detected in the thalamus, bilaterally. These results demonstrate that a pattern of cerebral hypometabolism involving cortical and subcortical structures is present in FAD patients with APP717 Val to Ileu mutation. Cerebral hypometabolism may occur in pre‐symptomatic and young asymptomatic APP717 mutated FAD subjects and it can be detected by a highly sensitive procedure such as PET.

Presenilin Proteins Undergo Heterogeneous Endoproteolysis between Thr 291and Ala 299and Occur as Stable N- and C-Terminal Fragments in Normal and Alzheimer Brain Tissue

Humans inheriting missense mutations in the presenilin(PS)1 and -2 genes undergo progressive cerebral deposition of the amyloid β-protein at an early age and develop a clinically and pathologically severe form of familial Alzheimer's disease (FAD). Because PS1 mutations cause the most aggressive known form of AD, it is important to elucidate the structure and function of this multitransmembrane protein in the brain. Using a panel of region-specific PS antibodies, we characterized the presenilin polypeptides in mammalian tissues, including brains of normal, AD, and PS1-linked FAD subjects, and in transfected and nontransfected cell lines. Very little full-length PS1 or -2 was detected in brain and untransfected cells; instead the protein occurred as a heterogeneous array of stable N- and C-terminal proteolytic fragments that differed subtly among cell types and mammalian tissues. Sequencing of the major C-terminal fragment from PS1-transfected human 293 cells showed that the principal endoproteolytic cleavage occurs at and near Met 298in the proximal portion of the large hydrophilic loop. Full-length PS1 in these cells is quickly turned over ( T 1/2 ≈ 60 min), in part to the two major fragments. The sizes and amounts of the PS fragments were not significantly altered in four FAD brains with the Cys410Tyr PS1 missense mutation. Our results indicate that presenilins are rapidly processed to N- and C-terminal fragments in both neural and nonneural cells and that interference with this processing is not an obligatory feature of FAD-causing mutations.

Trypsin inhibitor activities of fibroblasts increase with age of donor and are unaltered in familial Alzheimer's disease

Increasing evidence suggests that proteases and their inhibitors play an important role in the etiology of ß-amyloidogenesis and Alzheimer's disease (AD). It is not clear, however, which proteases and protease inhibitors are responsible for the amyloidogenic proteolysis. Candidates include α-1-antichymotrypsin, inter-α-trypsin inhibitor, and forms of ß-amyloid precursor protein (ßPP) bearing Kunitz protease inhibitor domains. As one approach to this question, we have determined the trypsin inhibitor activity of fibroblast-like cells from 10 familial AD subjects and 20 controls. The activity was quantitated by measuring remaining trypsin activity of reaction mixtures containing trypsin and cell lysates using a fluorogenic substrate and two physiologically distinct populations of fibroblasts: proliferating cells (grown in the presence of 16% serum) and quiescent cells (maintained in 0.1% serum). The remaining trypsin activities of crude protein extracts from proliferating and quiescent AD cultures were not significantly different from those of controls. Perhaps of more general interest to the biology of aging, however, was our finding that protease inhibitor activity increased with the age of the donor ( p = 0.005).