Soluble Amyloid-beta Oligomers Research Articles

Japanese Subgroup Analyses from EMERGE and ENGAGE, Phase 3 Clinical Trials of Aducanumab in Patients with Early Alzheimer’s Disease

BackgroundGlobal prevalence and incidence of dementia continue to rise at a rapid rate. There is a need for new Alzheimer’s disease (AD) treatments globally. Aducanumab is a human monoclonal antibody that selectively targets aggregated soluble amyloid beta oligomers and insoluble amyloid beta fibrils. In June 2021, aducanumab was approved by the US Food and Drug Administration for the treatment of AD under the accelerated approval pathway.ObjectivesWe evaluated the efficacy, safety, biomarker and pharmacokinetics (PK) of aducanumab in Japanese subgroups in EMERGE and ENGAGE studies.DesignEMERGE and ENGAGE were two randomized, double-blind, placebo-controlled, global, phase 3 studies of aducanumab in patients with early AD (mild cognitive impairment due to AD or mild AD dementia).SettingThese studies involved 348 sites in 20 countries. PARTICIPANTS: Participants enrolled in Japan included 121 (7.4% of total 1638 in EMERGE) and 100 (6.1% of total 1647 in ENGAGE) patients (aged 50–85 years with confirmed amyloid pathology) who met clinical criteria for mild cognitive impairment due to AD or mild AD dementia.InterventionParticipants were randomly assigned 1:1:1 to receive aducanumab low dose (3 or 6 mg/kg target dose), high dose (6 or 10 mg/kg target dose) or placebo via IV infusion once every 4 weeks over 76 weeks.MeasurementsThe primary outcome measure was change from baseline to Week 78 on the Clinical Dementia Rating Sum of Boxes (CDR-SB), an integrated scale that assesses both function and cognition. Other measures included safety assessments; secondary and tertiary clinical outcomes that assessed cognition, function, and behavior; biomarker endpoints (amyloid PET and plasma p-tau181); serum PK profiles and immunogenicity.ResultsResults from the Japanese subgroup analyses were generally consistent with those of the overall study population across endpoints, while a lower mean body weight (kg) and a smaller proportion of ApoE ε4 carriers were observed in the Japanese subgroup population. A treatment effect was observed in favor of aducanumab on the primary and secondary efficacy endpoints at Week 78 in EMERGE, but not ENGAGE. The incidence and type of adverse events in the Japanese subgroups were generally comparable to those observed in the overall study population; amyloid related imaging abnormalities (ARIA) were common treatment-related adverse events that appeared to be related to the aducanumab dose. ARIA incidence was generally lower in the Japanese subgroup compared with the overall population. Consistent with the overall data set, a robust dose-dependent decrease in amyloid beta levels as assessed with amyloid-PET and plasma p-tau181 was observed. Serum PK profiles and immunogenicity of aducanumab in Japanese population were consistent with the non-Japanese population.ConclusionEfficacy, safety, biomarker, and PK profiles of aducanumab were consistent between the Japanese subgroup and the overall population. A positive treatment effect of aducanumab on efficacy endpoints was observed in EMERGE, but not in ENGAGE.

Targeting soluble amyloid-beta oligomers with a novel nanobody

The classical amyloid cascade hypothesis postulates that the aggregation of amyloid plaques and the accumulation of intracellular hyperphosphorylated Tau tangles, together, lead to profound neuronal death. However, emerging research has demonstrated that soluble amyloid-β oligomers (SAβOs) accumulate early, prior to amyloid plaque formation. SAβOs induce memory impairment and disrupt cognitive function independent of amyloid-β plaques, and even in the absence of plaque formation. This work describes the development and characterization of a novel anti-SAβO (E3) nanobody generated from an alpaca immunized with SAβO. In-vitro assays and in-vivo studies using 5XFAD mice indicate that the fluorescein (FAM)-labeled E3 nanobody recognizes both SAβOs and amyloid-β plaques. The E3 nanobody traverses across the blood–brain barrier and binds to amyloid species in the brain of 5XFAD mice. Imaging of mouse brains reveals that SAβO and amyloid-β plaques are not only different in size, shape, and morphology, but also have a distinct spatial distribution in the brain. SAβOs are associated with neurons, while amyloid plaques reside in the extracellular matrix. The results of this study demonstrate that the SAβO nanobody can serve as a diagnostic agent with potential theragnostic applications in Alzheimer’s disease.

Aβ oligomers peak in early stages of Alzheimer's disease preceding tau pathology.

Soluble amyloid beta (Aβ) oligomers have been suggested as initiating Aβ related neuropathologic change in Alzheimer's disease (AD) but their quantitative distribution and chronological sequence within the AD continuum remain unclear. A total of 526 participants in early clinical stages of AD and controls from a longitudinal cohort were neurobiologically classified for amyloid and tau pathology applying the AT(N) system. Aβ and tau oligomers in the quantified cerebrospinal fluid (CSF) were measured using surface-based fluorescence intensity distribution analysis (sFIDA) technology. Across groups, highest Aβ oligomer levels were found in A+ with subjective cognitive decline and mild cognitive impairment. Aβ oligomers were significantly higher in A+T- compared to A-T- and A+T+. APOEε4 allele carriers showed significantly higher Aβ oligomer levels. No differences in tau oligomers were detected. The accumulation of Aβ oligomers in the CSF peaks early within the AD continuum, preceding tau pathology. Disease-modifying treatments targeting Aβ oligomers might have the highest therapeutic effect in these disease stages. Using surface-based fluorescence intensity distribution analysis (sFIDA) technology, we quantified Aβ oligomers in cerebrospinal fluid (CSF) samples of the DZNE-Longitudinal Cognitive Impairment and Dementia (DELCODE) cohortAβ oligomers were significantly elevated in mild cognitive impairment (MCI)Amyloid-positive subjects in the subjective cognitive decline (SCD) group increased compared to the amyloid-negative control groupInterestingly, levels of Aβ oligomers decrease at advanced stages of the disease (A+T+), which might be explained by altered clearing mechanisms.

The brain‐immune ecosystem: Implications for immunotherapy in defeating neurodegenerative diseases

AbstractBackgroundSince Medawar and Burnet’s studies some 70 years ago, it was widely accepted that the CNS cannot tolerate any immune activity under any circumstances. Over the past two decades, my team initiated a change in this dogma, by demonstrating that the brain requires support from innate and adaptive immune cells for its maintenance and repair. Deep understanding of these relationships by our team and by others has led us to propose that the immune cells that are hosted within the brain’s borders, together with neurons and non‐neuronal cells, form an ecosystem that enhances the resilience of the brain and its robustness in withstanding continuous and diverse perturbations. Accordingly, any dysfunction in this brain‐immune communication might impact brain activity.MethodAs aging is the major risk factor in dementia, including Alzheimer’s disease, we propose that dysfunction of any aspect of the brain‐immune ecosystem could affect disease onset and severity, but could be amenable to immune intervention. This model led us to propose that defeating such diseases could be accomplished by harnessing the immune system, which is either exhausted or insufficientResultWe found that transiently blocking the inhibitory PD‐1/PD‐L1 immune checkpoint pathway, initiates an immune response in the periphery that leads to disease modification within the brain. This approach was found to be effective regardless of disease etiology, and is independent of microglial polymorphism. We found that the treatment improved cognitive performance and reduced multiple parameters that contribute to disease escalation, including neural loss, local inflammation, and phospho‐ and aggregated‐tau in tauopathy, and soluble oligomers of amyloid beta in amyloidosis. The effect was found to be dependent on bone marrow‐derived macrophages, and was also associated with homing of FoxP3 regulatory T cells. Brief intermittent treatment with an AD‐optimized antibody was found to provide long‐term effect.ConclusionTogether, these studies show that targeting the immune system provides new avenues for understanding and treating neurodegenerative diseases.

Baseline characteristics of INTERCEPT‐AD: A phase 1 trial with ACU193 targeting soluble amyloid beta oligomers for the treatment of early Alzheimer’s disease

AbstractBackgroundAlzheimer’s disease (AD) is a neurodegenerative disorder affecting approximately 40 million people worldwide. There are few treatments available that affect the underlying degenerative process, making AD one of the largest unmet medical needs. ACU193 is a humanized, IgG2 subclass monoclonal antibody that targets soluble amyloid beta oligomers (sAβOs). Evidence supports the view that sAβOs are one of the primary instigators of AD neurodegeneration. Thus, blocking the toxicity of sAβOs with ACU193 may be a promising approach for the treatment of AD.MethodINTERCEPT‐AD is a phase 1 randomized, placebo‐controlled, single‐ and multiple‐dose study investigating the safety, tolerability, and pharmacokinetics of intravenous ACU193 in mild cognitive impairment or mild dementia due to AD. The SAD portion includes four cohorts with 2 mg/kg, 10 mg/kg, 25 mg/kg, and 60 mg/kg ACU193 or placebo. The MAD portion includes three cohorts receiving three doses of ACU193 or placebo: 10 mg/kg once every four weeks (Q4W), 60 mg/kg Q4W and 25 mg/kg once every 2 weeks (Q2W). Key inclusion criteria are 55‐90 years of age, PET scan positive for brain amyloid, MMSE 18‐30 and CDR‐Global score 0.5 or 1.0. The INTERCEPT‐AD trial is fully enrolled.ResultAt 17 sites in the U.S., 260 participants were screened, 65 were randomized, and 62 received at least one dose of ACU193 or placebo, including 33 females (53%) and 29 males (47%). Negative PET (61%) was the most common reason for screen failure. Baseline age was 72.1 ± 7.8 years (mean ± SD), CDR Sum of Boxes score was 3.5 ± 1.8, ADAS‐Cog‐13 was 24.2 ± 9.0 and screening MMSE was 24.2 ± 3.6. ApoE e4 homozygotes accounted for 13% of the study population and ApoE e4 heterozygotes for 46.7%. Traditionally underrepresented ethnoracial populations comprised 23% of the study (5% Black/African American, 16% Hispanic/Latino, 2% Other). Additional baseline measures including demographics, clinical characteristics, AD medication, and imaging data will be presented.ConclusionWe describe key baseline demographic, clinical, and cognitive characteristics of participants in the INTERCEPT‐AD trial. Data generated from this trial will guide further development of ACU193 for the treatment of early AD.

Amyloid β-Oligomers Inhibit the Nuclear Ca2+ Signals and the Neuroprotective Gene Expression Induced by Gabazine in Hippocampal Neurons.

Hippocampal neuronal activity generates dendritic and somatic Ca2+ signals, which, depending on stimulus intensity, rapidly propagate to the nucleus and induce the expression of transcription factors and genes with crucial roles in cognitive functions. Soluble amyloid-beta oligomers (AβOs), the main synaptotoxins engaged in the pathogenesis of Alzheimer's disease, generate aberrant Ca2+ signals in primary hippocampal neurons, increase their oxidative tone and disrupt structural plasticity. Here, we explored the effects of sub-lethal AβOs concentrations on activity-generated nuclear Ca2+ signals and on the Ca2+-dependent expression of neuroprotective genes. To induce neuronal activity, neuron-enriched primary hippocampal cultures were treated with the GABAA receptor blocker gabazine (GBZ), and nuclear Ca2+ signals were measured in AβOs-treated or control neurons transfected with a genetically encoded nuclear Ca2+ sensor. Incubation (6 h) with AβOs significantly reduced the nuclear Ca2+ signals and the enhanced phosphorylation of cyclic AMP response element-binding protein (CREB) induced by GBZ. Likewise, incubation (6 h) with AβOs significantly reduced the GBZ-induced increases in the mRNA levels of neuronal Per-Arnt-Sim domain protein 4 (Npas4), brain-derived neurotrophic factor (BDNF), ryanodine receptor type-2 (RyR2), and the antioxidant enzyme NADPH-quinone oxidoreductase (Nqo1). Based on these findings we propose that AβOs, by inhibiting the generation of activity-induced nuclear Ca2+ signals, disrupt key neuroprotective gene expression pathways required for hippocampal-dependent learning and memory processes.

Hippocampal injections of soluble amyloid-beta oligomers alter electroencephalographic activity during wake and slow-wave sleep in rats

BackgroundSoluble amyloid-beta oligomers (Aβo) begin to accumulate in the human brain one to two decades before a clinical diagnosis of Alzheimer’s disease (AD). The literature supports that soluble Aβo are implicated in synapse and neuronal losses in the brain regions such as the hippocampus. This region importantly contributes to explicit memory, the first type of memory affected in AD. During AD preclinical and prodromal stages, people are also experiencing wake/sleep alterations such as insomnia (e.g., difficulty initiating sleep, decreased sleep duration), excessive daytime sleepiness, and sleep schedule modifications. In addition, changes in electroencephalographic (EEG) activity during wake and sleep have been reported in AD patients and animal models. However, the specific contribution of Aβo to wake/sleep alterations is poorly understood and was investigated in the present study.MethodsChronic hippocampal injections of soluble Aβo were conducted in male rats and combined with EEG recording to determine the progressive impact of Aβ pathology specifically on wake/sleep architecture and EEG activity. Bilateral injections were conducted for 6 consecutive days, and EEG acquisition was done before, during, and after Aβo injections. Immunohistochemistry was used to assess neuron numbers in the hippocampal dentate gyrus (DG).ResultsAβo injections did not affect the time spent in wakefulness, slow wave sleep (SWS), and paradoxical sleep but altered EEG activity during wake and SWS. More precisely, Aβo increased slow-wave activity (SWA; 0.5–5 Hz) and low-beta activity (16–20 Hz) during wake and decreased theta (5–9 Hz) and alpha (9–12 Hz) activities during SWS. Moreover, the theta activity/SWA ratio during wake and SWS was decreased by Aβo. These effects were significant only after 6 days of Aβo injections and were found with alterations in neuron counts in the DG.ConclusionsWe found multiple modifications of the wake and SWS EEG following Aβo delivery to the hippocampus. These findings expose a specific EEG signature of Aβ pathology and can serve the development of non-invasive and cost-effective markers for the early diagnosis of AD or other amyloid-related diseases.

Comparing the structure and stability of diverse amyloid beta oligomers using fluorescence correlation spectroscopy.

Soluble oligomers of amyloid beta (Aβ) play a central role in Alzheimer's Disease pathology, however the detailed mechanisms of Aβ oligomer toxicity remain under investigation. One challenge in measuring oligomer size or cytotoxicity is the variability between published protocols that describe distinct oligomers, and the likely scenario that there are multiple pathological oligomers rather than a single disease-causing complex. Given the heavy use of dilution and incubation in these protocols, a systematic review covering how different oligomeric concentrations and preparation protocols affect oligomeric size and aggregation propensity is essential for standardizing assays of amyloid toxicity. To begin addressing this gap, we have systematically characterized and compared two distinct amyloid beta oligomers derived from either a homogeneous detergent or from cell media using fluorescence correlation spectroscopy (FCS). We observe temporal changes in size and stability of these oligomers over a wide range of concentrations and attempt to codify their similarities and differences. Significant changes between oligomer populations are observed over hours, with more diluted complexes falling apart. These observations also demonstrate that protein oligomer behavior is highly specific to their environments, which must be accounted for in biological assays, especially in the presence of cell media. Accounting for such discrepancies will also enable high-throughput screening of compounds that inhibit Aβ oligomer cytotoxicity with high reproducibility, which is a crucial component of drug discovery in the context of neurodegeneration and aging.

Genetic removal of synaptic Zn2+ impairs cognition, alters neurotrophic signaling and induces neuronal hyperactivity.

Vesicular Zn2+ (zinc) is released at synapses and has been demonstrated to modulate neuronal responses. However, mechanisms through which dysregulation of zinc homeostasis may potentiate neuronal dysfunction and neurodegeneration are not well-understood. We previously reported that accumulation of soluble amyloid beta oligomers (AβO) at synapses correlates with synaptic loss and that AβO localization at synapses is regulated by synaptic activity and enhanced by the release of vesicular Zn2+ in the hippocampus, a brain region that deteriorates early in Alzheimer's disease (AD). Significantly, drugs regulating zinc homeostasis inhibit AβO accumulation and improve cognition in mouse models of AD. We used both sexes of a transgenic mouse model lacking synaptic Zn2+ (ZnT3KO) that develops AD-like cognitive impairment and neurodegeneration to study the effects of disruption of Zn2+ modulation of neurotransmission in cognition, protein expression and activation, and neuronal excitability. Here we report that the genetic removal of synaptic Zn2+ results in progressive impairment of hippocampal-dependent memory, reduces activity-dependent increase in Erk phosphorylation and BDNF mRNA, alters regulation of Erk activation by NMDAR subunits, increases neuronal spiking, and induces biochemical and morphological alterations consistent with increasing epileptiform activity and neurodegeneration as ZnT3KO mice age. Our study shows that disruption of synaptic Zn2+ triggers neurodegenerative processes and is a potential pathway through which AβO trigger altered expression of neurotrophic proteins, along with reduced hippocampal synaptic density and degenerating neurons, neuronal spiking activity, and cognitive impairment and supports efforts to develop therapeutics to preserve synaptic zinc homeostasis in the brain as potential treatments for AD.

Regulatory role of melatonin in Notch1 signaling pathway in cerebral cortex of Aβ1-42-induced Alzheimer's disease rat model.

Soluble Amyloid-beta (Aβ) oligomers are thought to play a key role in the pathogenesis of Alzheimer's disease (AD), which is the most common age-associated neurodegenerative diseases with obvious neuropathological changes and functional decline in both cortical and subcortical regions. Melatonin is ubiquitously distributed and multifunctioning indoleamine. Accumulating studies support that melatonin is potential therapeutic molecule for AD through modulating a broad variety of signaling pathways. In recent years, Notch1 signaling pathway is been known involved in dynamic changes in the cellular architecture and function of adult brain, as well as associated with the pathophysiology of AD and other neurodegenerative disorders. In this study, we performed real-time polymerase chain reaction, immunohistochemistry and western blotting analyses using the cerebral cortical tissues of Aβ1-42 oligomers-induced AD rats with or without melatonin treatment. Our results showed that soluble Aβ1-42 oligomers decreased the expression of the main components of Notch1 signaling pathway, Notch1, NICD and Hes1 in the cerebral cortex, and melatonin could restore the level of Notch1, NICD and Hes1. This observation suggests that targeting of Notch1 signaling might be a promising therapeutic approach for AD and other age-associated neurodegenerative diseases, and melatonin might serve as a potential therapeutic agent for AD and other age-associated neurodegenerative diseases.

Preparation and qualification of soluble amyloid beta oligomers for use in bioanalytic assays supporting Alzheimer’s disease therapeutics

AbstractBackgroundSoluble amyloid beta oligomers (sAβOs) accumulate early in Alzheimer’s disease (AD) and trigger AD‐related neuropathologies and impairments in memory. sAβO structures contributing to the neurotoxic effects remain ill‐defined due to their low concentration, instability, and heterogeneity, impeding the effective design and use of sAβO reference standards in bioanalytic assays for use in clinical trials. At present, no assays for sAβOs are available with proven robustness and clinical performance, due to absence of well‐characterized critical raw materials (antibodies, reference materials for preparation of sAβO calibrators) and quality control specimens.MethodWe have used amyloid‐derived diffusible ligands (ADDLs), a synthetic model preparation commonly used in the literature (Stine et al. 2003), as a sAβO standard integrated into different assays designs developed on the Mesoscale Discovery (MSD) technology. As proof‐of‐concept, we have utilized these ADDL assays to study the specificity and selectivity of antibodies targeted against sAβOs.ResultOptimization of ADDL coating, stabilization of coated materials, and long‐term plate stability indicated that ADDL‐coated plates provided a suitable platform to assess the performance of sAβO‐targeting antibodies.Prior to coating, ADDL preparations were tested for reproducible SDS‐stable size distribution and immunoreactivity using SDS‐PAGE with silver stain and Western immunoblotting. The native size distribution (SEC) and globular conformation (AFM) of ADDLs and their ability to bind neuronal synapses in culture (ICC) and subsequently elicit AD‐related pathologies has been well reported in the literature. ADDLs were coated onto 96‐well MSD plates and the ADDL‐coated plates were stored at 4 °C for long‐term use; plate stability was confirmed up to one year. Biotinylated and non‐biotinylated sAβO‐targeting antibodies with variable selectivity towards monomeric or oligomeric Aβ species were used for comparative binding analysis. Additional sAβO preparations, including low concentration ADDL preparations and commercially available sAβOs were used to further understand the selectivity and specificity of the panel of sAβO‐targeting antibodies.ConclusionQualified sAβO preparations (ADDLs) can be used as tools for coating plates to determine specificity and selectivity of sAβO‐targeting antibodies. Other expected uses are: (i) calibrator in immunoassays; or (ii) to screen for the presence of sAβO auto‐antibodies in biological fluids.

Deducing the affinity between apolipoprotein E and soluble amyloid-beta oligomers using fluorescence correlation spectroscopy

Human apolipoprotein E (apoE), which plays a central role in lipid and cholesterol metabolism, exists in three major isoforms: E2, E3, and E4. The E4 allele is a major genetic factor for late-onset Alzheimer's disease (AD), while the E2 allele is thought to be protective. ApoE was shown to be connected to the aggregation, degradation, and clearance of toxic soluble oligomers of disordered amyloid-beta (Aβ) peptides, which are central to AD pathogenesis. However, previously reported interactions between apoE and Aβ are ambiguous since they rarely account for the dynamic and transient nature of Aβ oligomers or the aggregation and lipidation of apoE.

Understanding the pathophysiology of alzheimer's disease

Background: Neurodegenerative diseases, particularly Alzheimer's disease (AD), pose a significant health challenge globally, with projections indicating nearly 152 million affected individuals by 2050. AD accounts for 60% to 80% of neurodegenerative cases, manifesting primarily as sporadic Alzheimer's disease (SAD) after age 65. Aim: This review aims to elucidate the pathophysiology of AD, focusing on the early identification of biomarkers for diagnosis and the exploration of potential therapeutic interventions. Methods: A comprehensive literature review was conducted, examining the biological mechanisms underpinning AD, particularly the role of amyloid plaques and neurofibrillary tangles, along with the impact of lipid nutrients and nanotechnology in treatment delivery. Results: Key findings indicate that soluble amyloid-beta oligomers are critical in AD pathogenesis, contributing to synaptic dysfunction and cognitive decline. Moreover, recent advancements in nanotechnology, particularly through nanoliposomes, show promise for enhancing drug delivery across the blood-brain barrier. Conclusion: Understanding the complex interplay of genetic, environmental, and pathological factors in AD can inform early diagnostic strategies and therapeutic approaches. The role of lifestyle and dietary interventions is crucial, and future research should focus on leveraging nanotechnology for effective treatment delivery.

Knockdown of astrocytic Grin2a aggravates β-amyloid-induced memory and cognitive deficits through regulating nerve growth factor.

Synapse degeneration correlates strongly with cognitive impairments in Alzheimer's disease (AD) patients. Soluble Amyloid‐beta (Aβ) oligomers are thought as the major trigger of synaptic malfunctions. Our earlier studies have demonstrated that Aβ oligomers interfere with synaptic function through N‐methyl‐D‐aspartate receptors (NMDARs). Our recent in vitro study found the neuroprotective role of astrocytic GluN2A in the promotion of synapse survival and identified nerve growth factor (NGF) derived from astrocytes, as a likely mediator of astrocytic GluN2A buffering against Aβ synaptotoxicity. Our present in vivo study focused on exploring the precise mechanism of astrocytic GluN2A influencing Aβ synaptotoxicity through regulating NGF. We generated an adeno‐associated virus (AAV) expressing an astrocytic promoter (GfaABC1D) shRNA targeted to Grin2a (the gene encoding GluN2A) to perform astrocyte‐specific Grin2a knockdown in the hippocampal dentate gyrus, after 3 weeks of virus vector expression, Aβ were bilaterally injected into the intracerebral ventricle. Our results showed that astrocyte‐specific knockdown of Grin2a and Aβ application both significantly impaired spatial memory and cognition, which associated with the reduced synaptic proteins PSD95, synaptophysin and compensatory increased NGF. The reduced astrocytic GluN2A can counteract Aβ‐induced compensatory protective increase of NGF through regulating pNF‐κB, Furin and VAMP3, which modulating the synthesis, mature and secretion of NGF respectively. Our present data reveal, for the first time, a novel mechanism of astrocytic GluN2A in exerting protective effects on synapses at the early stage of Aβ exposure, which may contribute to establish new targets for AD prevention and early therapy.

Single-Molecule Characterization of Heterogeneous Soluble Protein Oligomers

Soluble protein oligomers are the primary toxic species in a number of human diseases including Alzheimer's Disease, Parkinson's Disease, Type II Diabetes, cancer, and even certain viral infections. A complicating factor in establishing structure/dynamics/toxicity relationships for soluble oligomers is divergent experimental conditions, such as oligomer preparation protocols, which heavily influence experimental outcomes. Similarly, the low abundance and the structural and dynamic heterogeneity of oligomers are challenges to traditional (ensemble-averaged) biophysical/biochemical characterization. Single-molecule methods are powerful tools for probing this heterogeneity, since oligomers can be observed one at a time. We used single-molecule Förster resonance energy transfer (smFRET) to characterize the heterogeneous structures and dynamics of soluble amyloid-beta (aβ) oligomers prepared using several disparate protocols. The improved comparison between aβ oligomers generated under disparate experimental conditions will better enable correlations to be made between biophysical observables and possible pathways for mediating disease (e.g., direct membrane damage, redox activity, etc.). These correlations are a prerequisite to identifying molecular determinants of oligomer toxicity and therefore means of interfering therapeutically with their mechanisms.

Hyperactivity Induced by Soluble Amyloid-β Oligomers in the Early Stages of Alzheimer's Disease.

Soluble amyloid-beta oligomers (Aβo) start to accumulate in the human brain one to two decades before any clinical symptoms of Alzheimer's disease (AD) and are implicated in synapse loss, one of the best predictors of memory decline that characterize the illness. Cognitive impairment in AD was traditionally thought to result from a reduction in synaptic activity which ultimately induces neurodegeneration. More recent evidence indicates that in the early stages of AD synaptic failure is, at least partly, induced by neuronal hyperactivity rather than hypoactivity. Here, we review the growing body of evidence supporting the implication of soluble Aβo on the induction of neuronal hyperactivity in AD animal models, in vitro, and in humans. We then discuss the impact of Aβo-induced hyperactivity on memory performance, cell death, epileptiform activity, gamma oscillations, and slow wave activity. We provide an overview of the cellular and molecular mechanisms that are emerging to explain how Aβo induce neuronal hyperactivity. We conclude by providing an outlook on the impact of hyperactivity for the development of disease-modifying interventions at the onset of AD.

Systematic Quantification of Synapses in Primary Neuronal Culture.

SummaryMost neurological disorders display impaired synaptic connectivity. Hence, modulation of synapse formation may have therapeutic relevance. However, the high density and small size of synapses complicate their quantification. To improve synapse-oriented screens, we analyzed the labeling performance of synapse-targeting antibodies on neuronal cell cultures using segmentation-independent image analysis based on sliding window correlation. When assessing pairwise colocalization, a common readout for mature synapses, overlap was incomplete and confounded by spurious signals. To circumvent this, we implemented a proximity ligation-based approach that only leads to a signal when two markers are sufficiently close. We applied this approach to different marker combinations and demonstrate its utility for detecting synapse density changes in healthy and compromised cultures. Thus, segmentation-independent analysis and exploitation of resident protein proximity increases the sensitivity of synapse quantifications in neuronal cultures and represents a valuable extension to the analytical toolset for in vitro synapse screens.

Esculetin as a Bifunctional Antioxidant Prevents and Counteracts the Oxidative Stress and Neuronal Death Induced by Amyloid Protein in SH-SY5Y Cells.

Oxidative stress (OS) appears to be an important determinant during the different stages of progression of Alzheimer’s Disease (AD). In particular, impaired antioxidant defense mechanisms, such as the decrease of glutathione (GSH) and nuclear factor erythroid 2 (NF-E2)-related factor 2 (Nrf2), a master regulator of antioxidant genes, including those for GSH, are associated with OS in the human AD brain. Among the neuropathological hallmarks of AD, the soluble oligomers of amyloid beta (Aβ) peptides seem to promote neuronal death through mitochondrial dysfunction and OS. In this regard, bifunctional antioxidants can exert a dual neuroprotective role by scavenging reactive oxygen species (ROS) directly and concomitant induction of antioxidant genes. In this study, among natural coumarins (esculetin, scopoletin, fraxetin and daphnetin), we demonstrated the ability of esculetin (ESC) to prevent and counteract ROS formation in neuronal SH-SY5Y cells, suggesting its profile as a bifunctional antioxidant. In particular, ESC increased the resistance of the SH-SY5Y cells against OS through the activation of Nrf2 and increase of GSH. In similar experimental conditions, ESC could also protect the SH-SY5Y cells from the OS and neuronal death evoked by oligomers of Aβ1–42 peptides. Further, the use of the inhibitors PD98059 and LY294002 also showed that Erk1/2 and Akt signaling pathways were involved in the neuroprotection mediated by ESC. These results encourage further research in AD models to explore the efficacy and safety profile of ESC as a novel neuroprotective agent.

Label-free distribution of anti-amyloid D-AIP in Drosophila melanogaster: prevention of Aβ42-induced toxicity without side effects in transgenic flies.

Soluble oligomers of the 42-amino acid amyloid beta (Aβ42) peptide are highly toxic and suspected as the causative agent of synaptic dysfunction and neuronal loss in Alzheimer's disease (AD). Previously, we have shown that a small, D-amino acid Aβ42-oligomer interacting peptide (D-AIP) can neutralize human Aβ42-mediated toxicity using in vitro and cell-based assays. In the present longitudinal study using a transgenic Drosophila melanogaster model, advanced live confocal imaging and mass spectrometry imaging (MALDI-MSI) showed that the eight amino acid D-AIP can attenuate Aβ42-induced toxicity in vivo. By separating male and female flies into distinct groups, the resultant distribution of ingested D-AIP was different between the sexes. The Aβ42-induced 'rough eye' phenotype could be rescued in the female transgenics, likely because of the co-localization of D-AIP with human Aβ42 in the female fly heads. Interestingly, the phenotype could not be rescued in the male transgenics, likely because of the co-localization of D-AIP with a confounding male-specific sex peptide (Acp70A candidate in MSI spectra) in the gut of the male flies. As a novel, more cost-effective strategy to prevent toxic amyloid formation during the early stages of AD (i.e. neutralization of toxic low-order Aβ42 oligomers without creating larger aggregates in the process), our longitudinal study establishes that D-AIP is a stable and highly effective neutralizer of toxic Aβ42 peptides in vivo. Cover Image for this issue: doi: 10.1111/jnc.14512.

The anaesthetic xenon partially restores an amyloid beta-induced impairment in murine hippocampal synaptic plasticity

BackgroundIt is controversially discussed whether general anaesthesia increases the risk of Alzheimer's disease (AD) or accelerates its progression. One important factor in AD pathogenesis is the accumulation of soluble amyloid beta (Aβ) oligomers which affect N-methyl-d-aspartate (NMDA) receptor function and abolish hippocampal long-term potentiation (LTP). NMDA receptor antagonists, at concentrations allowing physiological activation, can prevent Aβ-induced deficits in LTP. The anaesthetics xenon and S-ketamine both act as NMDA receptor antagonists and have been reported to be neuroprotective. In this study, we investigated the effects of subanaesthetic concentrations of these drugs on LTP deficits induced by different Aβ oligomers and compared them to the effects of radiprodil, a NMDA subunit 2B (GluN2B)-selective antagonist. MethodsWe applied different Aβ oligomers to murine brain slices and recorded excitatory postsynaptic field potentials before and after high-frequency stimulation in the CA1 region of hippocampus. Radiprodil, xenon and S-ketamine were added and recordings evoked from a second input were measured. ResultsXenon and radiprodil, applied at low concentrations, partially restored the LTP deficit induced by pre-incubated Aβ1-42. S-ketamine showed no effect. None of the drugs tested were able to ameliorate Aβ1-40-induced LTP-deficits. ConclusionsXenon administered at subanaesthetic concentrations partially restored Aβ1-42-induced impairment of LTP, presumably via its weak NMDA receptor antagonism. The effects were in a similar range than those obtained with the NMDA-GluN2B antagonist radiprodil. Our results point to protective properties of xenon in the context of pathological distorted synaptic physiology which might be a meaningful alternative for anaesthesia in AD patients.