Nrg1 Type Research Articles

A Novel Form of Neuregulin 1 Type III Caused by N-Terminal Processing.

Nrg1 (Neuregulin 1) type III, a susceptible gene of schizophrenia, exhibits a critical role in the central nervous system and is essential at each stage of Schwann's cell development. Nrg1 type III comprises double-pass transmembrane domains, with the N-terminal and C-terminal localizing inside the cells. The N-terminal transmembrane helix partially overlaps with the cysteine-rich domain (CRD). In this study, Nrg1 type III constructs with different tags were transformed into cultured cells to verify whether CRD destroyed the transmembrane helix formation. We took advantage of immunofluorescent and immunoprecipitation assays on whole cells and analyzed the N-terminal distribution. Astonishingly, we found that a novel form of Nrg1 type III, about 10% of Nrg1 type III, omitted the N-terminal transmembrane helix, with the N-terminal positioning outside the membrane. The results indicated that the novel single-pass transmembrane status was a minor form of Nrg1 type III caused by N-terminal processing, while the major form was a double-pass transmembrane status.

Unmyelinated sensory neurons use Neuregulin signals to promote myelination of interneurons in the CNS.

The signaling mechanisms neurons use to modulate myelination of circuits in the central nervous system (CNS) are only partly understood. Through analysis of isoform-specific neuregulin1 (nrg1) mutants in zebrafish, we demonstrate that nrg1 type II is an important regulator of myelination of two classes of spinal cord interneurons. Surprisingly, nrg1 type II expression is prominent in unmyelinated Rohon-Beard sensory neurons, whereas myelination of neighboring interneurons is reduced in nrg1 type II mutants. Cell-type-specific loss-of-function studies indicate that nrg1 type II is required in Rohon-Beard neurons to signal to other neurons, not oligodendrocytes, to modulate spinal cord myelination. Together, our data support a model in which unmyelinated neurons express Nrg1 type II proteins to regulate myelination of neighboring neurons, a mode of action that may coordinate the functions of unmyelinated and myelinated neurons in the CNS.

Imbalance of NRG1-ERBB2/3 signalling underlies altered myelination in Charcot-Marie-Tooth disease 4H.

Charcot-Marie-Tooth (CMT) disease is one of the most common inherited neurological disorders, affecting either axons from the motor and/or sensory neurons or Schwann cells of the peripheral nervous system (PNS) and caused by more than 100 genes. We previously identified mutations in FGD4 as responsible for CMT4H, an autosomal recessive demyelinating form of CMT disease. FGD4 encodes FRABIN, a GDP/GTP nucleotide exchange factor, particularly for the small GTPase Cdc42. Remarkably, nerves from patients with CMT4H display excessive redundant myelin figures called outfoldings that arise from focal hypermyelination, suggesting that FRABIN could play a role in the control of PNS myelination. To gain insights into the role of FGD4/FRABIN in Schwann cell myelination, we generated a knockout mouse model (Fgd4SC-/-), with conditional ablation of Fgd4 in Schwann cells. We show that the specific deletion of FRABIN in Schwann cells leads to aberrant myelination in vitro, in dorsal root ganglia neuron/Schwann cell co-cultures, as well as in vivo, in distal sciatic nerves from Fgd4SC-/- mice. We observed that those myelination defects are related to an upregulation of some interactors of the NRG1 type III/ERBB2/3 signalling pathway, which is known to ensure a proper level of myelination in the PNS. Based on a yeast two-hybrid screen, we identified SNX3 as a new partner of FRABIN, which is involved in the regulation of endocytic trafficking. Interestingly, we showed that the loss of FRABIN impairs endocytic trafficking, which may contribute to the defective NRG1 type III/ERBB2/3 signalling and myelination. Using RNA-Seq, in vitro, we identified new potential effectors of the deregulated pathways, such as ERBIN, RAB11FIP2 and MAF, thereby providing cues to understand how FRABIN contributes to proper ERBB2 trafficking or even myelin membrane addition through cholesterol synthesis. Finally, we showed that the re-establishment of proper levels of the NRG1 type III/ERBB2/3 pathway using niacin treatment reduces myelin outfoldings in nerves of CMT4H mice. Overall, our work reveals a new role of FRABIN in the regulation of NRG1 type III/ERBB2/3 NRG1signalling and myelination and opens future therapeutic strategies based on the modulation of the NRG1 type III/ERBB2/3 pathway to reduce CMT4H pathology and more generally other demyelinating types of CMT disease.

The impact of NRG1 expressions and methylation on multifactorial Hirschsprung disease

BackgroundHirschsprung disease (HSCR) is a complex genetic disorder characterized by the lack of ganglion cells in the intestines. A current study showed that the NRG1 rare variant frequency in Indonesian patients with HSCR is only 0.9%. Here, we investigated the impact of NRG1 expressions and methylation patterns on the pathogenesis of HSCR.MethodsThis cross-sectional study determined NRG1 type I (HRGα, HRGβ1, HRGβ2, HRGβ3, HRGγ, and NDF43 isoforms), type II and type III expressions in both ganglionic and aganglionic colons of 20 patients with HSCR and 10 control colons by real-time polymerase chain reaction (qPCR). For methylation studies, we treated the extracted gDNA from 16 HSCR patients’ and 17 control colons with sodium bisulfate and analyzed the methylation pattern of NRG1 exon 1 with methylation-specific PCR. The samples were collected and analyzed at our institution from December 2018 to December 2020.ResultsNRG1 types I, II and III expressions were upregulated (17.2-, 3.2-, and 7.2-fold, respectively) in the ganglionic colons compared with control colons (type I: 13.32 ± 1.65 vs. 17.42 ± 1.51, p < 0.01; type II: 13.73 ± 2.02 vs. 16.29 ± 2.19, p < 0.01; type III: 13.47 ± 3.01 vs. 16.32 ± 2.58, p = 0.03; respectively); while only type I (7.7-fold) and HRGβ1/HRGβ2 (3.3-fold) isoforms were significantly upregulated in the aganglionic colons compared to the controls (type I: 14.47 ± 1.66 vs. 17.42 ± 1.51, p < 0.01; HRGβ1/HRGβ2: 13.62 ± 3.42 vs 14.75 ± 1.26, p = 0.01). Moreover, the frequency of partially methylated NRG1 was higher in the ganglionic (81%) and aganglionic (75%) colons than in the controls (59%).ConclusionsOur study provides further insights into the aberrant NRG1 expression in the colons of patients with HSCR, both ganglionic and aganglionic bowel, which might contribute to the development of HSCR, particularly in Indonesia. Furthermore, these aberrant NRG1 expressions might be associated with its methylation pattern.

Overexpression of Neuregulin-1 Type III Has Impact on Visual Function in Mice.

Schizophrenia is associated with several brain deficits, including abnormalities in visual processes. Neuregulin-1 (Nrg1) is a family of trophic factors containing an epidermal growth factor (EGF)-like domain. It is thought to play a role in neural development and has been linked to neuropsychiatric disorders. Abnormal Nrg1 expression has been observed in schizophrenia in clinical studies. Moreover, in schizophrenia, there is more and more evidence found about pathological changes of the retina regarding structural, neurochemical and physiological parameters. However, mechanisms of these changes are not well known. To investigate this, we analysed the function of the visual system using electroretinography (ERG) and the measurement of visual evoked potentials (VEP) in transgenic mice overexpressing Nrg1 type III of three different ages (12 weeks, 24 weeks and 55 weeks). ERG amplitudes tended to be higher in transgenic mice than in control mice in 12-week old mice, whereas the amplitudes were almost similar in older mice. VEP amplitudes were larger in transgenic mice at all ages, with significant differences at 12 and 55 weeks (p values between 0.003 and 0.036). Latencies in ERG and VEP measurements did not differ considerably between control mice and transgenic mice at any age. Our data show for the first time that overexpression of Nrg1 type III changed visual function in transgenic mice. Overall, this investigation of visual function in transgenic mice may be helpful to understand corresponding changes that occur in schizophrenia, as they may find use as biomarkers for psychiatric disorders as well as a potential tool for diagnosis in psychiatry.

Effects of handling on the behavioural phenotype of the neuregulin 1 type III transgenic mouse model for schizophrenia

Handling of laboratory mice affects animal wellbeing and behavioural test outcomes. However, present research has focused on handling effects in common strains of laboratory mice despite the knowledge that environmental factors can modify established phenotypes of genetic mouse models. Thus, we examined the impact of handling on the face validity of a transgenic mouse model for the schizophrenia risk gene neuregulin 1 (i.e. Nrg1 type III overexpression). Nrg1 III tg and wild type-like (WT) control mice of both sexes underwent tail or tunnel handling before being assessed in the open field (OF), elevated plus maze (EPM), social preference/novelty, prepulse inhibition, and fear conditioning tests. Tunnel-handling reduced the startle response in all mice, increased OF locomotion and exploration in males and reduced anxiety in males (OF) and females (EPM) compared to tail-handling. Importantly, tunnel handling induced a more pronounced startle response to increasing startle stimuli in Nrg1 III tg females compared to respective controls, a phenomenon absent in tail-handled females. Finally, Nrg1 III tg males displayed reduced OF exploration and centre locomotion and Nrg1 III tg females displayed increased cue freezing over time compared to controls. In conclusion, handling methods have a significant impact on a variety of behavioural domains thus the impact of routine handling procedures need be considered when testing behavioural phenotypes. Handling did not change the main schizophrenia-relevant characteristics of Nrg1 III tg mice but affected the acoustic startle-response in a genotype- and sex-specific manner. Future research should evaluate the effect of handling on other genetic models.

Sex-specific sensitivity to methamphetamine-induced schizophrenia-relevant behaviours in neuregulin 1 type III overexpressing mice.

Gene-environment interactions contribute to schizophrenia aetiology. Neuregulin 1 is a well-established genetic risk factor for schizophrenia, and elevated expression of type III neuregulin 1 mRNA in the dorsolateral prefrontal cortex is observed in patients with a core risk haplotype. A mouse model of type III Nrg1 overexpression (Nrg1 III tg) possesses face and construct validity for schizophrenia; however, the sensitivity of these transgenic mice to environmental risk factors relevant to schizophrenia is unknown. To determine sensitivity of Nrg1 III tg mice to the psychostimulant methamphetamine (METH) in schizophrenia and addiction-relevant behavioural tests. We examined behavioural responses of adult male and female Nrg1 III tg mice METH (1-3 mg/kg) in schizophrenia-relevant paradigms (drug-induced locomotion, sensorimotor gating) and drug reward (conditioned place preference). Male Nrg1 III tg mice were less sensitive to METH-induced stereotypies, yet showed a greater negative impact of METH on prepulse inhibition compared with wild type-like males. In contrast, female Nrg1 III tg mice were less sensitive to METH-induced locomotion than wild type-like females, while sensorimotor gating was similarly impaired by METH between the genotypes. There were no genotype differences for METH reward, or anxiety-like and exploratory behaviours. These results indicate that overexpression of Nrg1 type III modulates schizophrenia-relevant behaviours, and may help to explain increased sensitivity to the psychoactive effects of METH in patients with schizophrenia.

Schwann cells selectively myelinate primary motor axons via neuregulin-ErbB signaling.

Spinal motor neurons project their axons out of the spinal cord via the motor exit point (MEP) and regulate their target muscle fibers for diverse behaviors. Several populations of glial cells including Schwann cells, MEP glia, and perineurial glia are tightly associated with spinal motor axons in nerve fascicles. Zebrafish have two types of spinal motor neurons, primary motor neurons (PMNs) and secondary motor neurons (SMNs). PMNs are implicated in the rapid response, whereas SMNs are implicated in normal and slow movements. However, the precise mechanisms mediating the distinct functions of PMNs and SMNs in zebrafish are unclear. In this study, we found that PMNs were myelinated by MEP glia and Schwann cells, whereas SMNs remained unmyelinated at the examined stages. Immunohistochemical analysis revealed that myelinated PMNs solely innervated fast muscle through a distributed neuromuscular junction (NMJ), whereas unmyelinated SMNs innervated both fast and slow muscle through distributed and myoseptal NMJs, respectively, indicating that myelinated PMNs could provide rapid responses for startle and escape movements, while unmyelinated SMNs regulated normal, slow movement. Further, we demonstrate that neuregulin 1 (Nrg1) type III-ErbB signaling provides a key instructive signal that determines the myelination of primary motor axons by MEP glia and Schwann cells. Perineurial glia ensheathed unmyelinated secondary motor axons and myelinated primary motor nerves. Ensheathment required interaction with both MEP glia and Schwann cells. Collectively, these data suggest that primary and secondary motor neurons contribute to the regulation of movement in zebrafish with distinct patterns of myelination.

Juxtacrine signalling via Notch and ErbB receptors in the switch to fate commitment of bone marrow-derived Schwann cells.

The phenotypic instability of adult tissue-derived Schwann cell-like cells (SCLCs) as revealed upon withdrawal of glia-inducing culture supplements limits their clinical utility for cell therapy and disease modelling. We previously overcame this limitation by co-culturing bone marrow-derived SCLCs with neurons purified from developing rat and subsequently human sensory neurons such that direct contact between cell types accomplished the cell-intrinsic switch to the Schwann cell fate. Here, our search for juxtacrine instructive signals found both Notch ligands and neuregulin-1 type III localized on the surface of DRG neurons via live cell immunocytochemistry. Bypassing ligand-induced release of the Notch intracellular domain (NICD) by transient transfection of SCLCs with the pAdlox/V5-His-NICD construct was shown to upregulate ErbB2/3. Interaction of ErbB2/3 with neuregulin-1 type III (NRG1 type III) as presented on neurons then mediated the switch to the Schwann cell fate as demonstrated by expression of S100β/p75/ Sox10/Krox20. In contrast, treatment of cocultures with γ-secretase inhibitor perturbed Notch signalling in SCLCs and consequently deterred both upregulation of ErbB2/3 and the transition to the Schwann cell fate. Taken together, juxtacrine signalling via Notch is key to the upregulation of ErbB receptors for neuregulin-driven commitment of SCLCs to the Schwann cell fate.

The Y172 Monoclonal Antibody Against p-c-Jun (Ser63) Is a Marker of the Postsynaptic Compartment of C-Type Cholinergic Afferent Synapses on Motoneurons.

C-bouton-type cholinergic afferents exert an important function in controlling motoneuron (MN) excitability. During the immunocytochemical analysis of the role of c-Jun in MNs with a monoclonal (clone Y172) antibody against phospho (p)-c-Jun (serine [Ser]63), unexpected labeling was identified in the cell body cytoplasm. As predicted for c-Jun in adult spinal cord, very few, if any MNs exhibited nuclear immunoreactivity with the Y172 antibody; conversely, virtually all MNs displayed strong Y172 immunostaining in cytoplasmic structures scattered throughout the soma and proximal dendrites. The majority of these cytoplasmic Y172-positive profiles was closely associated with VAChT-positive C-boutons, but not with other types of nerve afferents contacting MNs. Ultrastructural analysis revealed that cytoplasmic Y172 immunostaining was selectively located at the subsurface cistern (SSC) of C-boutons and also in the inner areas of the endoplasmic reticulum (ER). We also described changes in cytoplasmic Y172 immunoreactivity in injured and degenerating MNs. Moreover, we noticed that MNs from NRG1 type III-overexpressing transgenic mice, which show abnormally expanded SSCs, exhibited an increase in the density and size of peripherally located Y172-positive profiles. A similar immunocytochemical pattern to that of the Y172 antibody in MNs was found with a polyclonal antibody against p-c-Jun (Ser63) but not with another polyclonal antibody that recognizes c-Jun phosphorylated at a different site. No differential band patterns were found by western blotting with any of the antibodies against c-Jun or p-c-Jun used in our study. In cultured MNs, Y172-positive oval profiles were distributed in the cell body and proximal dendrites. The in vitro lentiviral-based knockdown of c-Jun resulted in a dramatic decrease in nuclear Y172 immunostaining in MNs without any reduction in the density of cytoplasmic Y172-positive profiles, suggesting that the synaptic antigen recognized by the antibody corresponds to a C-bouton-specific protein other than p-c-Jun. Our results lay the foundation for further studies aimed at identifying this protein and determining its role in this particular type of synapse.

Behavioural effects of high fat diet in adult Nrg1 type III transgenic mice

Some diets appear to have detrimental effects on schizophrenia symptoms. Neuregulin 1 (NRG1) is a risk gene for schizophrenia and a recently developed transgenic mouse model for Nrg1 type III demonstrates a schizophrenia-relevant phenotype. The current study evaluated the behavioural response of Nrg1 type III transgenic mice to a high fat diet (HFD) to determine the potential interactive impact of diets and genetic risk factors on disease symptoms.Male and female Nrg1 III and control littermates (N = 13–24) were exposed during adulthood to either HFD or standard chow diet (CHOW) for eight weeks before being tested in behavioural domains relevant to schizophrenia. Locomotion and exploration, anxiety, social behaviours (including social preference), sensorimotor gating (i.e. prepulse inhibition, PPI), associative learning, and anhedonia were assessed.HFD increased the body weight gain of mice, suppressed locomotion, exploration, and anxiety-related behaviours in a sex-dependent manner. HFD augmented the PPI response in male mice and decreased anhedonia in a sucrose preference test. Finally, HFD had a sex-dependent impact on fear-associated memory with HFD-induced cognitive impairments being most prominent in Nrg1 transgenic females.In conclusion, HFD and mutant Nrg1 III interactively impair particular cognitive domains in a sex-specific manner. Thus, our preclinical data suggest that genetic predisposition to the schizophrenia risk gene NRG1 may modulate detrimental behavioural effects of diets. This indicates the importance to research further the role of particular diets in the context of populations at risk to develop schizophrenia.

NRG1 type I dependent autoparacrine stimulation of Schwann cells in onion bulbs of peripheral neuropathies

In contrast to acute peripheral nerve injury, the molecular response of Schwann cells in chronic neuropathies remains poorly understood. Onion bulb structures are a pathological hallmark of demyelinating neuropathies, but the nature of these formations is unknown. Here, we show that Schwann cells induce the expression of Neuregulin-1 type I (NRG1-I), a paracrine growth factor, in various chronic demyelinating diseases. Genetic disruption of Schwann cell-derived NRG1 signalling in a mouse model of Charcot-Marie-Tooth Disease 1A (CMT1A), suppresses hypermyelination and the formation of onion bulbs. Transgenic overexpression of NRG1-I in Schwann cells on a wildtype background is sufficient to mediate an interaction between Schwann cells via an ErbB2 receptor-MEK/ERK signaling axis, which causes onion bulb formations and results in a peripheral neuropathy reminiscent of CMT1A. We suggest that diseased Schwann cells mount a regeneration program that is beneficial in acute nerve injury, but that overstimulation of Schwann cells in chronic neuropathies is detrimental.

Neuregulin in Health and Disease.

The neuregulins Neuregulins, a family of EGF-like signaling molecules, are involved in cell-cell crosstalk and play an important role in development, maintenance and repair of the nervous system, heart, breast and other organs. Independent studies described a ligand for the oncogene ErbB2 (neu, Her2) and factors that stimulated proliferation of Schwann cells, as well as synthesis of receptors for acetylcholine by muscle. These ligands and factors are essentially products of the same gene, referred to by Marchionni M. as neuregulin (NRG-1) [1]. Besides NRG-1 gene, there are other genes that encode related proteins, such as NRG-2 (Don-1, NTAK), NRG-3 and NRG-4. There are few studies that describe NRG-2, −3 and −4 and a complete analysis of their function remains a challenge. However, NRG-2 was recently reported as a component of stress granules (SG), microscopically visible aggregates of translationally stalled messenger ribonucleoprotein complexes that are formed in response to direct stress conditions [2]. Furthermore, it was shown that NRG-2, secreted from astrocytes, bound to ErbB3 on neurons and promoted neuronal survival [3]. NRG-3 was shown to be associated with schizophrenia (SZ) in a Chinese population [4], with bipolar disorder (BD) [5] and with the risk and age of onset of Alzheimer disease (AD) [6]. In addition, NRG-3 has a key function in promoting early mammary morphogenesis and is involved in breast cancer (BC) [7]. NRG-4 expression was decreased in human inflammatory bowel disease samples and mouse models of colitis, suggesting that activation of ErbB4 is altered [8]. An interesting study [9] showed that NRG-4 overexpression prevents high fat diet-induced weight gain and fatty liver and reduces obesity-induced chronic inflammation. Considering the increasing interest and research focused on NRG-1 in the past years, this review summarizes what is currently known about NRG-1 and its impact on health and disease as well as its current and potential use(s) as a CNS anti-inflammatory agent against inducers of brain inflammation and injury as well as in the treatment of various neurological disorders. Neuregulin-1: Structure, function and signaling pathways: NRG-1 gene encodes 21 exons located on human chromosome 8p22–21. Alternative splicing of more than 30 exons in different parts of the NRG-1 transcript generates more than 30 isoforms that can be grouped into six types (I-VI) [10–12] (Figure 1). They are synthesized as transmembrane precursors consisting of either an immunoglobulin-like (Ig) domain or cysteine-rich domain (CRD), an EGF-like domain, a transmembrane domain and a cytoplasmic tail [13]. NRG-1 types I and II are released from the cell surface after protease-mediated proteolytic cleavage and may function as paracrine signals [14]. NRG-1 type III remains tethered to the cell membrane after cleavage and acts as a juxtacrine signal [15]. Full-length type IV spans 1.8 kb and encodes a putative protein of 590 amino acids with a predicted molecular mass of approximately 66 kDa [15]. Further-more, there are two major classes of NRG-1 identified as α and β isoforms. NRG-1α and NRG-1β contain related, but structurally distinct EGF-like domains composed of a common amino terminal segment followed by α or β variant sequences [16]. NRG-1β isoforms predominate in the nervous system while α isoforms are common in mesenchymal cells and are critically important for breast development [14]. Type I NRGα and β isoforms are the predominant isoforms expressed in early embryogenesis, whereas type II and type III are undetectable until the mid-gestation stage [17]. Type I or Heregulin is an acetylcholine receptor activator, type II is a Glial Growth Factor, type III is a sensory and motor neuron-derived factor and type IV is involved in neuronal activity regulation. Functions of types V and VI are not well known and their investigation remains a challenge. Types I, II and III of NRG-1 express in human peripheral blood in addition to neurons, while types IV and V express specifically in the brain [18]. Open in a separate window Figure 1: Neuregulin (NRG) and ErbB receptor structures. NRG gene products share a structural characteristic for the extracellular epidermal growth factor (EGF) domain and it differentiates this subfamily from other members of the EGF family. All EGF family members are ligands of ErbB receptors, although with varying affinities, with ErbB3 and ErbB4 being specific NRG-binding receptors. NRG-1 isoforms have been classified in types I-VI on the basis of differences in the NH2-terminal distal region [19].

Altered hippocampal gene expression and structure in transgenic mice overexpressing neuregulin 1 (Nrg1) type I

Transgenic mice overexpressing the type I isoform of neuregulin 1 (Nrg1; NRG1) have alterations in hippocampal gamma oscillations and an age-emergent deficit in hippocampus-dependent spatial working memory. Here, we examined the molecular and morphological correlates of these findings. Microarrays showed over 100 hippocampal transcripts differentially expressed in Nrg1tg-type I mice, with enrichment of genes related to neuromodulation and, in older mice, of genes involved in inflammation and immunity. Nrg1tg-type I mice had an enlarged hippocampus with a widened dentate gyrus. The results show that Nrg1 type I impacts on hippocampal gene expression and structure in a multifaceted and partly age-related way, complementing the evidence implicating Nrg1 signaling in aspects of hippocampal function. The findings are also relevant to the possible role of NRG1 signaling in the pathophysiology of schizophrenia or other disorders affecting this brain region.

S47. ADD-ON SPIRONOLACTONE FOR THE TREATMENT OF SCHIZOPHRENIA (SPIRO TREAT)

BackgroundPatients with schizophrenia often display three main types of symptoms: positive symptoms (e.g. auditory hallucinations or delusions), negative symptoms (e.g. blunted affect, lack or decline in speech, social withdrawal) and cognitive symptoms (e.g. impairment of working memory and declarative memory). Treatment of positive symptoms with available antipsychotics is well established, while therapy options for cognitive and negative symptoms are lacking. Neurobiological studies identified an enhanced NRG1-ERBB4 signaling as a risk pathway in schizophrenia. Spironolactone was found to function as an inhibitor of the ERBB4 receptor. In Nrg1 type III transgenic mice, spironolactone treatment led to an improvement of schizophrenia-like symptoms (Wehr et al. 2017). This is the first study to investigate an add-on spironolactone treatment in schizophrenia patients for the treatment of cognitive deficits.MethodsThis is a multicenter, randomized, double-blind, parallel (3-groups), longitudinal pilot study including 3 x 27 (81) patients with a clinically stable schizophrenia. Patients are randomized in three groups: one group receives add-on spironolactone 100 mg for three weeks (intervention I), one group receives add-on spironolactone 200 mg for three weeks (intervention II) and one group receives add-on placebo for three weeks (control group). The primary endpoint is the modification of the working memory in dependence to the intervention as investigated with the n-back task (0-, 1- and 2-back). Secondary endpoints include: modification of other cognitive functions (e.g. declarative memory and attention), psychopathology (e.g. PANSS and CDSS), overall level of functioning via GAF and severity of disease via CGI, changes in the number of patients in remission using the Andreasen Criteria, modifications of the inhibitory cortical function in the context of the prepuls paradigm with TMS, evaluating possible dose-differences, spironolactone effects on mRNA levels in peripheral blood lymphocytes (PBMC measures). Statistical analysis of the primary endpoint will be based on the intention-to-treat (ITT) population including all randomised patients using a mixed model ANOVA.ResultsThe first patient was recruited in July 2015. Currently 45 patients are included in the trial. The overall tolerance of the medication was satisfactory with 48 reported AE (adverse events). In 3 cases, the causality of the medication was definite, in 4 cases probable and in 5 cases possible. The other cases were probably or definitely not related to the study medication. SAE (serious adverse events) were not reported. The current state of research will be discussed on the conference.DiscussionThis is the first study to describe the effects of an add-on treatment of spironolactone in patients with a clinically stable schizophrenia. Also, it is the first study with a direct target of a biochemically disturbed signaling pathway in schizophrenia patients with a possibly new treatment option in this severe disease.Funded by Stanley Foundation: (13T-004). EUDRACT: 2014-001968-35, WHO-Clinical-Trials: http://apps.who.int/trialsearch/Trial2.aspx?TrialID=EUCTR2014-001968-35-DEReference:1. Wehr, M.C., Hinrichs, W., Brzózka, M.M., Unterbarnscheidt, T., Herholt, A., Wintgens, J.P., Papiol, S., Soto-Bernardini, M.C., Kravchenko, M., Zhang, M., et al. (2017). Spironolactone is an antagonist of NRG1-ERBB4 signaling and schizophrenia-relevant endophenotypes in mice. EMBO Mol. Med.

Schizophrenia-relevant behaviours of female mice overexpressing neuregulin 1 type III

Elevated levels of the type III (III) isoforms of neuregulin 1 (NRG1) have been observed in the brains of schizophrenia patients that carry NRG1 HapICE risk alleles, which is thought to contribute to the aetiology of the disease. We generated transgenic mice with forebrain driven Nrg1 III overexpression (Nrg1 III tg) and previously found that male heterozygous Nrg1 type III tg mice exhibit several schizophrenia-relevant behaviours including social and cognitive deficits as well as impaired sensorimotor gating. A number of mouse models for other Nrg1 isoform types exhibit sex-specific phenotypes yet sex-specific effects of Nrg1 III overexpression had not been evaluated. Thus, in this study we tested female Nrg1 III transgenic mice using a comprehensive behavioural phenotyping battery relevant to positive, negative and cognitive symptoms of schizophrenia. Firstly, forebrain Nrg1 III mRNA overexpression was confirmed in female transgenic mice using by qPCR. In the open field test, female Nrg1 III mice exhibited a blunted response to an acute challenge with the N-methyl-d-aspartate (NMDA) receptor antagonist MK-801. Female Nrg1 III tg mice also exhibited moderately impaired short-term memory. Other behavioural domains including sensory abilities, motor functions, baseline locomotion, anxiety, sociability, social recognition memory, fear conditioning and prepulse inhibition were unperturbed in Nrg1 III tg females. Together these results illustrate that overexpressing forebrain Nrg1 III in female mice modifies the locomotive response to NMDA receptor antagonism without causing severe alterations to a number of other schizophrenia-related behavioural domains. The data suggest that behavioural effects of Nrg1 III overexpression may be sex-dependent.

Tissue Inhibitor of Metalloproteinase-3 Promotes Schwann Cell Myelination.

Tissue inhibitor of metalloproteinase-3 (TIMP-3) inhibits the activities of various metalloproteinases including matrix metalloproteinases and ADAM family proteins. In the peripheral nervous system, ADAM17, also known as TNF-α converting enzyme (TACE), cleaves the extracellular domain of Nrg1 type III, an axonal growth factor that is essential for Schwann cell myelination. The processing by ADAM17 attenuates Nrg1 signaling and inhibits Schwann cell myelination. TIMP-3 targets ADAM17, suggesting a possibility that TIMP-3 may elicit a promyelinating function in Schwann cells by relieving ADAM17-induced myelination block. To investigate this, we used a myelinating coculture system to determine the effect of TIMP-3 on Schwann cell myelination. Treatment with TIMP-3 enhanced myelin formation in cocultures, evident by an increase in the number of myelin segments and upregulated expression of Krox20 and myelin protein. The effect of TIMP-3 was accompanied by the inhibition of ADAM17 activity and an increase in Nrg1 type III signaling in cocultures. Accordingly, the N-terminus fragment of TIMP-3, which exhibits a selective inhibitory function toward ADAM17, elicited a similar myelination-promoting effect and increased Nrg1 type III activity. TIMP-3 also enhanced laminin production in cocultures, which is likely to aid Schwann cell myelination.

Spironolactone is an antagonist of NRG1‐ERBB4 signaling and schizophrenia‐relevant endophenotypes in mice

Enhanced NRG1‐ERBB4 signaling is a risk pathway in schizophrenia, and corresponding mouse models display several endophenotypes of the disease. Nonetheless, pathway‐directed treatment strategies with clinically applicable compounds have not been identified. Here, we applied a cell‐based assay using the split TEV technology to screen a library of clinically applicable compounds to identify modulators of NRG1‐ERBB4 signaling for repurposing. We recovered spironolactone, known as antagonist of corticosteroids, as an inhibitor of the ERBB4 receptor and tested it in pharmacological and biochemical assays to assess secondary compound actions. Transgenic mice overexpressing Nrg1 type III display cortical Erbb4 hyperphosphorylation, a condition observed in postmortem brains from schizophrenia patients. Spironolactone treatment reverted hyperphosphorylation of activated Erbb4 in these mice. In behavioral tests, spironolactone treatment of Nrg1 type III transgenic mice ameliorated schizophrenia‐relevant behavioral endophenotypes, such as reduced sensorimotor gating, hyperactivity, and impaired working memory. Moreover, spironolactone increases spontaneous inhibitory postsynaptic currents in cortical slices supporting an ERBB4‐mediated mode‐of‐action. Our findings suggest that spironolactone, a clinically safe drug, provides an opportunity for new treatment options for schizophrenia.

Microglia-derived neuregulin expression in psychiatric disorders

Several studies have revealed that neuregulins (NRGs) are involved in brain function and psychiatric disorders. While NRGs have been regarded as neuron- or astrocyte-derived molecules, our research has revealed that microglia also express NRGs, levels of which are markedly increased in activated microglia. Previous studies have indicated that microglia are activated in the brains of individuals with autism spectrum disorder (ASD). Therefore, we investigated microglial NRG mRNA expression in multiple lines of mice considered models of ASD. Intriguingly, microglial NRG expression significantly increased in BTBR and socially-isolated mice, while maternal immune activation (MIA) mice exhibited identical NRG expression to controls. Furthermore, we observed a positive correlation between NRG expression in microglia and peripheral blood mononuclear cells (PBMCs) in mice, suggesting that NRG expression in human PBMCs may mirror microglia-derived NRG expression in the human brain. To translate these findings for application in clinical psychiatry, we measured levels of NRG1 splice-variant expression in clinically available PBMCs of patients with ASD. Levels of NRG1 type III expression in PBMCs were positively correlated with impairments in social interaction in children with ASD (as assessed using the Autistic Diagnostic Interview-Revised test: ADI-R). These findings suggest that immune cell-derived NRGs may be implicated in the pathobiology of psychiatric disorders such as ASD.

Niacin-mediated Tace activation ameliorates CMT neuropathies with focal hypermyelination.

Charcot–Marie–Tooth (CMT) neuropathies are highly heterogeneous disorders caused by mutations in more than 70 genes, with no available treatment. Thus, it is difficult to envisage a single suitable treatment for all pathogenetic mechanisms. Axonal Neuregulin 1 (Nrg1) type III drives Schwann cell myelination and determines myelin thickness by ErbB2/B3‐PI3K–Akt signaling pathway activation. Nrg1 type III is inhibited by the α‐secretase Tace, which negatively regulates PNS myelination. We hypothesized that modulation of Nrg1 levels and/or secretase activity may constitute a unifying treatment strategy for CMT neuropathies with focal hypermyelination as it could restore normal levels of myelination. Here we show that in vivo delivery of Niaspan, a FDA‐approved drug known to enhance TACE activity, efficiently rescues myelination in the Mtmr2 −/− mouse, a model of CMT4B1 with myelin outfoldings, and in the Pmp22 +/− mouse, which reproduces HNPP (hereditary neuropathy with liability to pressure palsies) with tomacula. Importantly, we also found that Niaspan reduces hypermyelination of Vim (vimentin)−/− mice, characterized by increased Nrg1 type III and Akt activation, thus corroborating the hypothesis that Niaspan treatment downregulates Nrg1 type III signaling.