Improved mitochondrial function in brain aging and Alzheimer disease – the new mechanism of action of the old metabolic enhancer piracetam
Walter E. Müller
- Piracetam, the prototype of the so-called nootropic drugs’ is used since many years in different countries to treat cognitive impairment in aging and dementia. Findings that piracetam enhances fluidity of brain mitochondrial membranes led to the hypothesis that piracetam might improve mitochondrial function, e.g., might enhance ATP synthesis. This assumption has recently been supported by a number of observations showing enhanced mitochondrial membrane potential, enhanced ATP production, and reduced sensitivity for apoptosis in a variety of cell and animal models for aging and Alzheimer disease. As a specific consequence, substantial evidence for elevated neuronal plasticity as a specific effect of piracetam has emerged. Taken together, this new findings can explain many of the therapeutic effects of piracetam on cognition in aging and dementia as well as different situations of brain dysfunctions. Keywords: mitochondrial dysfunction, alzheimer’s disease, aging, oxidative stress, piracetam
Oxidative stress during aging and in Alzheimer's disease : a comparative study of oxidative damage and antioxidant enzymatic activities in mouse models and human brain tissue
- 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.
Age-related increase of oxidative stress-induced apoptosis in mice prevention by Ginkgo biloba extract (EGb761)
Walter E. Müller
- Enhanced apoptosis and elevated levels of reactive oxygen species (ROS) play a major role in aging. In addition, several neurodegenerative diseases are associated with increased oxidative stress and apoptosis in neuronal tissue. Antioxidative treatment has neuro-protective effects. The aim of the present study was to evaluate changes of susceptibility to apoptotic cell death by oxidative stress in aging and its inhibition by the antioxidant Ginkgo biloba extract EGb761. We investigated basal and ROS-induced levels of apoptotic lymphocytes derived from the spleen in young (3 months) and old (24 months) mice. ROS were induced by 2-deoxy-D-ribose (dRib) that depletes the intracellular pool of reduced glutathione. Lymphocytes from aged mice accumulate apoptotic cells to a significantly higher extent under basal conditions compared to cells from young mice. Treatment with dRib enhanced this difference, implicating a higher sensitivity to ROS in aging. Apoptosis can be reduced in vitro by treatment with EGb761. In addition, mice were treated daily with 100mg/kg EGb761 per os over a period of two weeks. ROS-induced apoptosis was significantly reduced in the EGb761 group. Interestingly, this effect seemed to be more pronounced in old mice.
Quantification of isoprenoids in brain tissue - cerebral regulation of FPP and GGPP in Alzheimer's Disease and aging
Gero P. Hooff
- Over the last years there has been an increasing interest in the involvement of the MVA-pathway and of members of the small GTPases, in the development and progression of AD. Earlier investigations mainly focused on the role of cholesterol in disease pathology. This research was supported by retrospective cohort studies, initially showing beneficial effects of the long-term intake of cholesterol lowering statins, on the incidence of the development of sporadic AD. However, in more recent literature increasing attention has been paid to the isoprenoids, FPP and GGPP, due to their crucial role in the post-translational modifications of members of the superfamily of small GTPases. In AD, these proteins were amongst others shown to be involved in mechanisms affecting APP processing, ROS generation and synaptic plasticity. A major factor impeding the clarification of the role of the MVA-pathway intermediates in these mechanisms was the lack of a sensitive and accurate method to determine FPP and GGPP levels in brain tissue. Hence, a state of the art HPLC-FLD method for the quantification of the isoprenoids FPP and GGPP in brain tissue was successfully developed. After the introduction of a double clean-up step from complex brain matrix samples and the synthesis of an appropriate IS (DNP), the method was fully validated according to the latest FDA guideline for bioanalytical method validation. Furthermore, this method was transferred to a faster and more sensitive, state of the art UHPLC-MS/MS application. Additionally, the method was shown to be applicable for mouse brain tissue and data was generated from an in vivo mouse simvastatin study and for different mouse models. According to the aims of the thesis, the current work describes for the first time absolute isoprenoid concentrations in human frontal cortex white and grey matter. Furthermore, this is the first report of isoprenoid levels in the frontal cortex of human AD brains. Further results were shown from mouse brains originating from different mouse models, including the Thy-1 APP mouse model mimicking AD pathology in terms of Aβ formation or C57Bl/6 mice at different ages. AD prevalence can be clearly correlated with increasing age. Therefore, three different generations of mice were investigated. The study demonstrated constant isoprenoid and cholesterol levels in the first half of their life followed by a significant increase of FPP and GGPP in the second half (between 12 and 24 month of age). Cholesterol levels were also elevated in the aged group, but again the effect was less pronounced than shown for the isoprenoids. These results lead to the tentative conclusion that cerebral isoprenoid levels are elevated during aging and that this accumulation is amplified during AD leading to accelerated neuronal dysfunction. In a different mouse study, using the C57Bl/6 mice, in vivo drug intervention with the HMG-CoA reductase inhibitor simvastatin revealed strong inhibition of the rate limiting step of the mevalonate/isoprenoid/cholesterol pathway and resulted in the first report of significantly reduced FPP and GGPP levels in brain tissue of statin treated mice. These results open for the first time the possibility to monitor drug effects on cerebral isoprenoid levels and correlate these data with a modulation of APP processing, which was shown by our group in previous studies. Interestingly, apart from the isoprenoid reduction following statin treatment the reduction of brain cholesterol was also significant but to a lesser extent. These findings support the notion that isoprenoid levels are more susceptible to statin treatment than cholesterol levels. Furthermore, this suggests a strong cellular dependence on FPP and GGPP, as the pool seems to be easily depleted, which finally could lead to cell death. The first investigations of farnesylated Ras and geranylgeranylated Rac protein levels by means of immuno-blotting, substantiated the notion of a decreased abundance of prenylated small GTPases under statin influence as a consequence of reduced isoprenoid levels. These findings demonstrate for the first time a correlation of FPP and GGPP levels with the abundance of small GTPases. These findings together with the results from the AD study prove that isoprenoid levels are not strictly subject to the same regulation as cholesterol levels. To further understand the physiological regulation in the cell, in vitro experiments with different inhibitors of the mevalonate/isoprenoid/cholesterol pathway were conducted. These results confirmed the isoprenoid and cholesterol reducing effects of statin treatment as observed in the aforementioned in vivo mouse study. Interestingly, cholesterol synthesis inhibition targeted after FPP as the branch point, led to significantly elevated FPP levels. FTase inhibition led to significantly reduced FPP levels, whereas inhibition of the GGTase I did not show a significant change of either isoprenoid levels.