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The hypothesis that oxidative stress plays a role in the pathogenesis of Alzheimer’s disease (AD) was tested by studying oxidative damage, acitvities of antioxidant enzymes and levels of reactive oxygen species (ROS) in several models. To this end, mouse models transgenic for mutant presenilin (PS1M146L) as well as mutant amyloid precursor protein (APP) and human post mortem brain tissue from sporadic AD patients and age-matched controls were studied. Aging leads to an upregulation of antioxidant enzyme activities of Cu/Zn-superoxide dismutase (Cu/Zn-SOD), glutathione peroxidase (GPx) and glutathione reductase (GR) in brains from C57BL/6J mice. Simultaneously, levels of lipid peroxidation products malondialdehyde MDA and 4-hydroxynonenal HNE were reduced. Additionally, pronounced gender effects were observed, as female mice display better protection against oxidative damage due to higher activity of GPx. Hence, antioxidant enzymes provide an important contribution to the protection against oxidative damage. In PS1M146L transgenic mice oxidative damage was only detectable in 19-22 months old mice, arguing for an additive effect of aging and the PS1 mutation. Both HNE levels in brain tissue as well as mitochondrial and cytosolic levels of ROS in splenic lymphocytes were increased in PS1M146L mice. Antioxidant defences were unaltered. In PDGF-APP and PDGF-APP/PS1 trangenic mice no changes in any of the parameters studied were observed in any age group. In contrast, Thy1-APP transgenic mice display oxidative damage as assessed by increased HNE levels. Reduced activity of Cu/Zn-SOD may explain this observation. Additionally, gender modified this effect, as female APP transgenic mice display higher b-secretase cleavage of APP and simultaneously increased HNE levels and reduced Cu/Zn-SOD activity earlier than male mice, i.e. from an age of 3 months and before the formation of Ab plaques. Reduced Cu/Zn-SOD activity was also found in another APP transgenic mouse model, in APP23 mice. In post mortem brain tissue from sporadic AD patients activities of Cu/Zn-SOD and GPx were however increased, and changes were most pronounced in temporal cortex. Simultaneously, levels of HNE but not MDA were elevated. Additionally, in vitro stimulation of lipid peroxidation led to increased MDA formation in samples from AD patients, indicating that increased activity of Cu/Zn-SOD and GPx are insufficient to protect against oxidative damage. Furthermore, the observed changes were subject to a gender effect, as samples from female AD patients showed increased activities of Cu/Zn-SOD and GPx as well as increased HNE levels, indicating that brain tissue from females is more sensitive towards oxidative damage. Levels of soluble Ab1-40 were positively correlated with with MDA levels and activities of Cu/Zn-SOD and GPx. Additionally, levels of lipid peroxidation products MDA and HNE are gene-dose-dependently modulated by the Apolipoprotein E4 allele, the most important genetic risk factor for AD known so far. While MDA levels were negatively correlated with MMSE scores, a measure for cognitive function, HNE levels were highest in AD patients with moderate cognitive impairment. Hence, increased HNE levels may play an important role in neurodegenerative events at an early disease stage. In summary, oxidative damage, as assessed by increased HNE levels, could be detected in sporadic AD patients and in different transgenic mouse models. The results of this thesis therefore support the further research of pharmacological targets aiming at augmentation of antioxidant defences for therapy or prophylaxis of Alzheimer’s disease.
Aging and age-related diseases are becoming more and more important for our society and our health care system. Alzheimer's disease (AD) is a disorder that destroys some parts of the brain and is characterized by global cognitive decline including a progressive irreversible loss of memory, orientation, and reasoning. “Healthy aging”, therefore, is one of the major aims for modern medicine. Apoptosis, or programmed cell death, plays an important role for example in fetal development, as well as for learning processes. T-lymphocytes usually undergo apoptosis in order to terminate an acute inflammation. The aim of this thesis was to explore the changes in the apoptotic mechanism of peripheral lymphocytes from Alzheimer’s disease (AD) patients in contrast to physiological aging. The experiments were conducted with lymphocytes of healthy volunteers of different ages, AD patients and young and aged mice. Moreover, transgenic mice carrying familiar AD-related mutations were examined. The aging study of peripheral cells of ‘healthy’-aged volunteers revealed an age-related increase of basal apoptosis. In addition, spontaneous apoptosis as well as apoptosis induced by oxidative stress (ROS) or by Fas engagement were enhanced in aging. A closer look at the subcellular basis of the lymphocytes (e.g. B-, NK-, CD4+-, and CD8+-T cells) determined that all lymphocyte subsets were affected by aging. Therefore, it could be concluded that the regulation of apoptosis is generally impaired in lymphocytes of aged persons. The increased susceptibility to oxidative stress supports the ‘Free radical theory of aging’ that claims the radicals to be the cause for the aging-process. In mice an increase of basal, spontaneous and ROS-induced apoptosis was detected in T cells from the spleen, as well. An oral treatment over two weeks with the Ginkgo biloba extract EGb761 showed a clear reduction of ROS-induced apoptosis in the treated group. Interestingly, basal and spontaneous apoptosis, e.g. physiological apoptosis, were not effected by the plant extract. This is an important benefit for therapy since physiological apoptosis has a great relevance in the elimination of cancer-cells for example. In conclusion, the antidementive drug EGb761 reduces specifically ROS-induced apoptosis that a plays an important role in aging as shown in this thesis. Based on the data found in healthy aging, lymphocytes from AD patients were assessed for apoptosis. The cells show enhanced levels of basal, spontaneous, and Fas-induced apoptosis. In subsequent experiments it was demonstrated that mainly the T cells were responsible for the findings. However, the NK-cells provided an important impact as well. In concordance with AD-affected neurons, peripheral lymphocytes of AD patients show clear signs of apoptotic cell death. In addition, basal apoptosis of T cells and the CD4/CD8-ratio showed a correlation with the severity of the dementia. Therefore, it could be speculated that apoptosis is due to activation-induced cell death (AICD) that occurs in acute and chronic activation of adaptive immunity. In AD there is a chronic neuroinflammation in the CNS triggering degeneration of neural tissue. In order to explore this, the experimental model of lymphocyte’s activation was established in healthy aging first. The study included the detection of various events of lymphocyte’s activation on the basis of the T cell subsets (CD4+ and CD8+). The inducibility to mitogenic stimulation clearly decreased in both subsets in aging. In contrast, T lymphocytes from AD patients showed an enhanced activation subsequent to mitogenic stimulation compared with age-matched nondemented persons. Only proliferation of CD8+ T cells was clearly reduced in AD. This data could be clues that an increased generation of memory T cells due to chronic neuroinflammation might be evident in AD. Memory T lymphocytes show increased inducibility upon mitogenic activation. Interestingly, CD8+ memory T cells display decreased prolifertive capacity. Due to activation, cells die by apoptosis later on. It could be concluded that AD patients display an increased amount of memory T cells compared to controls. The data implicate that there could be a cross talk between inflammatory within the brain and inflammatory cells of the periphery. This is an interesting point since the brain used to be assumed as immune-privileged zone. According to the experiment, the information of the diseased brain is transferred to white blood cells. The connection of those two compartments might raise the opportunity to observe and probably to influence easily not-accessible regions like the brain. Transgenic mice carrying mutations in familiar AD-relevant genes (Amyloid-Precursor-Protein, Presenilin-1, respectively) displayed enhanced levels of apoptotic T cells from the spleen, as well. It seems that those mutated proteins influence the regulation of apoptosis. Probably, they are involved in the increased cell death of T- and NK-cells, as well. Animals overexpressing Presenilin-1 showed reduced levels of apoptotic cell death. It was demonstrated with molecuar biology tools that Presenilin-1, processed during apoptosis, has an anti-apoptotic effect.