Amyloid beta-Protein Precursor

淀粉样 β 蛋白前体
  • 文章类型: Journal Article
    越来越多的证据表明,单纯疱疹病毒1型(HSV-1)与阿尔茨海默病(AD)的发生和发展有关。HSV-1感染在体外和体内诱导β-淀粉样蛋白(Aβ)沉积,但是效果和确切的机制仍然难以捉摸。这里,我们表明,HSV-1感染转基因5xFAD小鼠的大脑导致加速的Aβ沉积,胶质增生,和认知功能障碍。我们证明HSV-1感染诱导小胶质细胞募集到病毒核心,以触发HSV-GFP阳性神经元细胞的小胶质细胞吞噬作用。此外,我们发现,HSV-1感染诱导的NLRP3炎性体通路在Aβ沉积和HSV-1感染引起的AD进展中起着至关重要的作用。在HSV-1感染后,NLRP3炎性体信号传导的阻断减少了Aβ沉积并减轻了5xFAD小鼠的认知下降。我们的研究结果支持以下观点:HSV-1感染是AD病因的关键因素。证明NLRP3炎性体激活在AD中HSV-1感染和Aβ沉积的界面中起作用。
    Accumulating evidence implicates that herpes simplex virus type 1 (HSV-1) has been linked to the development and progression of Alzheimer\'s disease (AD). HSV-1 infection induces β-amyloid (Aβ) deposition in vitro and in vivo, but the effect and precise mechanism remain elusive. Here, we show that HSV-1 infection of the brains of transgenic 5xFAD mice resulted in accelerated Aβ deposition, gliosis, and cognitive dysfunction. We demonstrate that HSV-1 infection induced the recruitment of microglia to the viral core to trigger microglial phagocytosis of HSV-GFP-positive neuronal cells. In addition, we reveal that the NLRP3 inflammasome pathway induced by HSV-1 infection played a crucial role in Aβ deposition and the progression of AD caused by HSV-1 infection. Blockade of the NLRP3 inflammasome signaling reduces Aβ deposition and alleviates cognitive decline in 5xFAD mice after HSV-1 infection. Our findings support the notion that HSV-1 infection is a key factor in the etiology of AD, demonstrating that NLRP3 inflammasome activation functions in the interface of HSV-1 infection and Aβ deposition in AD.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)的特征是细胞外淀粉样蛋白斑块含有淀粉样蛋白-β(Aβ)肽,神经内神经原纤维缠结,细胞外神经纤维线,和围绕由过度磷酸化tau蛋白(pTau)组成的斑块的营养不良性神经突。Aβ还可以沉积在血管壁中,导致脑淀粉样血管病(CAA)。虽然AD大脑中的淀粉样蛋白斑块是恒定的,CAA因病例而异。该研究的重点是在APP重复(APPdup)和唐氏综合征(DS)的罕见和研究不足的患者组之间观察到的差异,据报道,与散发性AD(sAD)相比,其CAA水平升高的频率更高。大多数APP突变,和控制。我们使用质谱(MS)比较了死后脑组织中的Aβ和tau病理以及Aβ肽。我们用MS脑成像进一步表征了Aβ肽的空间分布。虽然sAD中实质内Aβ沉积众多,DS伴AD(DS-AD)和AD伴APP突变,这些在APPdup中不那么丰富。相反,APPdup和DS-AD中血管中的Aβ沉积物丰富,而只有APPdup病例在毛细血管中显示出高Aβ沉积物。对Aβ肽谱的调查显示,在APPdup病例中,Aβx-37,Aβx-38和Aβx-40有特定的增加,而在DS-AD病例中,Aβx-42没有增加。有趣的是,与所有其他组相比,N截短的Aβ2-x肽在APPdup中特别增加。通过APPdup病例的软脑膜和实质血管的MS成像证实了这一结果,提示CAA与血管中N-和C-末端截短的较短Aβ肽的积累有关。总之,这项研究确定了AD病例之间Aβ沉积物的位置和组成的显着差异,特别是应用和DS-AD,两者都携带APP基因的三个基因组拷贝。检测这些患者的CSF或血浆中的特异性Aβ肽可以改善CAA的诊断及其在抗淀粉样蛋白免疫疗法治疗中的纳入。
    Alzheimer\'s disease (AD) is characterized by extracellular amyloid plaques containing amyloid-β (Aβ) peptides, intraneuronal neurofibrillary tangles, extracellular neuropil threads, and dystrophic neurites surrounding plaques composed of hyperphosphorylated tau protein (pTau). Aβ can also deposit in blood vessel walls leading to cerebral amyloid angiopathy (CAA). While amyloid plaques in AD brains are constant, CAA varies among cases. The study focuses on differences observed between rare and poorly studied patient groups with APP duplications (APPdup) and Down syndrome (DS) reported to have higher frequencies of elevated CAA levels in comparison to sporadic AD (sAD), most of APP mutations, and controls. We compared Aβ and tau pathologies in postmortem brain tissues across cases and Aβ peptides using mass spectrometry (MS). We further characterized the spatial distribution of Aβ peptides with MS-brain imaging. While intraparenchymal Aβ deposits were numerous in sAD, DS with AD (DS-AD) and AD with APP mutations, these were less abundant in APPdup. On the contrary, Aβ deposits in the blood vessels were abundant in APPdup and DS-AD while only APPdup cases displayed high Aβ deposits in capillaries. Investigation of Aβ peptide profiles showed a specific increase in Aβx-37, Aβx-38 and Aβx-40 but not Aβx-42 in APPdup cases and to a lower extent in DS-AD cases. Interestingly, N-truncated Aβ2-x peptides were particularly increased in APPdup compared to all other groups. This result was confirmed by MS-imaging of leptomeningeal and parenchymal vessels from an APPdup case, suggesting that CAA is associated with accumulation of shorter Aβ peptides truncated both at N- and C-termini in blood vessels. Altogether, this study identified striking differences in the localization and composition of Aβ deposits between AD cases, particularly APPdup and DS-AD, both carrying three genomic copies of the APP gene. Detection of specific Aβ peptides in CSF or plasma of these patients could improve the diagnosis of CAA and their inclusion in anti-amyloid immunotherapy treatments.
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  • 文章类型: Journal Article
    背景:在阿尔茨海默病(AD)中已经报道了脉络丛(ChP)的结构和功能变化。尽管如此,ChP在AD发病机制中的作用尚不清楚。我们的目标是在小鼠和人类中使用独特的蛋白质组学方法来阐明ChP功能与核心AD发病机理之间的关系。
    方法:我们使用了APP敲入小鼠模型,APPNL-G-F,表现出淀粉样蛋白病理学,利用液相色谱-质谱联用技术研究AD脑病理与小鼠ChP组织和CSF蛋白变化的相关性。在7周龄(n=5)和40周龄(n=5)研究小鼠蛋白质组。将结果与先前发表的人ADCSF蛋白质组数据(n=496)进行比较,以鉴定与AD中ChP变化相关的关键蛋白和途径。
    结果:在APPNL-G-F小鼠中,在7周和40周时,ChP组织蛋白质组相对于野生型小鼠失调。在两个年龄段,ChP组织蛋白质组改变与上皮细胞相关,线粒体,蛋白质修饰,细胞外基质和脂质。尽管如此,一些ChP组织蛋白质组变化在整个疾病轨迹上是不同的;与溶酶体功能相关的途径,内吞作用,蛋白质形成,肌动蛋白和补体在7周时独特地失调,而与神经系统相关的通路,免疫系统,蛋白质降解和血管系统在40周时出现独特的失调.小鼠和人类的CSF蛋白质组学显示出相似的ChP相关失调途径。
    结论:一起,我们的研究结果支持AD患者ChP功能障碍的假设.这些ChP变化与淀粉样蛋白病理有关。因此,ChP可能成为新的有希望的AD治疗靶点。
    BACKGROUND: Structural and functional changes of the choroid plexus (ChP) have been reported in Alzheimer\'s disease (AD). Nonetheless, the role of the ChP in the pathogenesis of AD remains largely unknown. We aim to unravel the relation between ChP functioning and core AD pathogenesis using a unique proteomic approach in mice and humans.
    METHODS: We used an APP knock-in mouse model, APPNL-G-F, exhibiting amyloid pathology, to study the association between AD brain pathology and protein changes in mouse ChP tissue and CSF using liquid chromatography mass spectrometry. Mouse proteomes were investigated at the age of 7 weeks (n = 5) and 40 weeks (n = 5). Results were compared with previously published human AD CSF proteomic data (n = 496) to identify key proteins and pathways associated with ChP changes in AD.
    RESULTS: ChP tissue proteome was dysregulated in APPNL-G-F mice relative to wild-type mice at both 7 and 40 weeks. At both ages, ChP tissue proteomic changes were associated with epithelial cells, mitochondria, protein modification, extracellular matrix and lipids. Nonetheless, some ChP tissue proteomic changes were different across the disease trajectory; pathways related to lysosomal function, endocytosis, protein formation, actin and complement were uniquely dysregulated at 7 weeks, while pathways associated with nervous system, immune system, protein degradation and vascular system were uniquely dysregulated at 40 weeks. CSF proteomics in both mice and humans showed similar ChP-related dysregulated pathways.
    CONCLUSIONS: Together, our findings support the hypothesis of ChP dysfunction in AD. These ChP changes were related to amyloid pathology. Therefore, the ChP could become a novel promising therapeutic target for AD.
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  • 文章类型: Journal Article
    SIL1, an endoplasmic reticulum (ER)-resident protein, is reported to play a protective role in Alzheimer\'s disease (AD). However, the effect of SIL1 on amyloid precursor protein (APP) processing remains unclear. In this study, the role of SIL1 in APP processing was explored both in vitro and in vivo. In the in vitro experiment, SIL1 was either overexpressed or knocked down in cells stably expressing the human Swedish mutant APP695. In the in vivo experiment, AAV-SIL1-EGFP or AAV-EGFP was microinjected into APP23/PS45 mice and their wild-type littermates. Western blotting (WB), immunohistochemistry, RNA sequencing (RNA-seq), and behavioral experiments were performed to evaluate the relevant parameters. Results indicated that SIL1 expression decreased in APP23/PS45 mice. Overexpression of SIL1 significantly decreased the protein levels of APP, presenilin-1 (PS1), and C-terminal fragments (CTFs) of APP in vivo and in vitro. Conversely, knockdown of SIL1 increased the protein levels of APP, β-site APP cleavage enzyme 1 (BACE1), PS1, and CTFs, as well as APP mRNA expression in 2EB2 cells. Furthermore, SIL1 overexpression reduced the number of senile plaques in APP23/PS45 mice. Importantly, Y-maze and Morris Water maze tests demonstrated that SIL1 overexpression improved cognitive impairment in APP23/PS45 mice. These findings indicate that SIL1 improves cognitive impairment in APP23/PS45 mice by inhibiting APP amyloidogenic processing and suggest that SIL1 is a potential therapeutic target for AD by modulating APP processing.
    SIL1是一种内质网驻留蛋白, 已被报道在阿尔茨海默症中发挥保护作用。然而,SIL1对APP代谢的影响还不清楚。在该研究中,我们从体内外都探索了SIL1对APP代谢的影响。 在体外实验中,我们在稳转了Swedish突变的APP695细胞系中过表达或敲低SIL1。在体内实验中,我们在APP23/PS45小鼠及其同窝的野生型小鼠侧脑室中注射对照或带有SIL1过表达的腺相关病毒。我们采用蛋白免疫印迹,免疫组化,RNA测序,以及行为学等实验方法来进行相关检测。我们发现,SIL1蛋白水平在APP23/PS45小鼠中明显减少。而在体内外过表达SIL1后明显减少APP、PS1和CTFs的蛋白水平。相反,敲低SIL1后明显增加了APP、BACE1、PS1和CTFs的蛋白水平,以及APP的mRNA水平。此外,SIL1过表达减少了APP23/PS45小鼠的老年斑。更重要的是,Y-迷宫和水迷宫的结果显示SIL1过表达明显改善了APP23/PS45小鼠的认知损害。我们的结果表明,SIL1通过抑制APP的淀粉样代谢改善了APP23/PS45小鼠的认知损害,并且提示了SIL1可作为调节APP代谢治疗阿尔茨海默症的潜在靶点。.
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  • 文章类型: Journal Article
    阿尔茨海默病(AD)和额颞叶痴呆(FTD)是两种主要的神经退行性疾病,具有不同的临床和神经病理学特征。本报告的目的是在特征明确的APP中进行基于人群的调查,PSEN1,PSEN2,MAPT,GRN,和来自北方的C9orf72突变携带者/家谱,中心,意大利南部。我们回顾性分析了467名意大利人的数据。我们鉴定了21种不同的GRN突变,20PSEN1,11MAPT,9PSEN2和4APP。此外,我们通过观察每个参与者队列观察到突变频率的地理变异性,我们观察到遗传群体之间发病年龄的显著差异。我们的研究提供了证据,表明发病年龄受遗传群体的影响。需要进一步的工作来鉴定改变所有群体中的表型的遗传和环境因素。我们的研究揭示了最相关的AD/FTD致病基因之间的意大利地区差异,并强调了罕见疾病的合作研究如何提供新的见解,以扩大对发病年龄的遗传/表观遗传调节剂的认识。
    Alzheimer\'s Disease (AD) and Frontotemporal Dementia (FTD) are the two major neurodegenerative diseases with distinct clinical and neuropathological profiles. The aim of this report is to conduct a population-based investigation in well-characterized APP, PSEN1, PSEN2, MAPT, GRN, and C9orf72 mutation carriers/pedigrees from the north, the center, and the south of Italy. We retrospectively analyzed the data of 467 Italian individuals. We identified 21 different GRN mutations, 20 PSEN1, 11 MAPT, 9 PSEN2, and 4 APP. Moreover, we observed geographical variability in mutation frequencies by looking at each cohort of participants, and we observed a significant difference in age at onset among the genetic groups. Our study provides evidence that age at onset is influenced by the genetic group. Further work in identifying both genetic and environmental factors that modify the phenotypes in all groups is needed. Our study reveals Italian regional differences among the most relevant AD/FTD causative genes and emphasizes how the collaborative studies in rare diseases can provide new insights to expand knowledge on genetic/epigenetic modulators of age at onset.
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  • 文章类型: Journal Article
    二十二碳六烯酸(DHA,C22:6ω3)可能参与可以预防阿尔茨海默病(AD)的各种神经保护机制。关于内溶酶体途径的功能障碍,它的影响还很少被探索,被称为生理病理连续体触发AD的早期关键事件。这种功能障碍可能是由于AD前体蛋白降解产物的积累,特别是C99片段,能够与内体蛋白相互作用,从而有助于从AD的早期阶段改变该途径。这项研究旨在评估DHA介导的神经保护是否也可以保留内溶酶体功能。在表达瑞典形式的人淀粉样前体蛋白的分化的人SH-SY5Y神经母细胞瘤细胞中记录了AD典型的内溶酶体异常。这种改变的表型包括内体扩大,外泌体分泌减少,和更高水平的细胞凋亡,这证实了选择用于研究相关有害机制的细胞模型的相关性。第二,由DHA介导的神经保护与C99与Rab5GTP酶的相互作用减少有关,较低的内体大小,恢复了外泌体的生产,减少神经元凋亡。我们的数据表明,DHA可能会影响神经元膜环境中的蛋白质定位和相互作用,从而纠正与AD相关的内吞和囊泡运输的功能障碍。
    Docosahexaenoic acid (DHA, C22:6 ω3) may be involved in various neuroprotective mechanisms that could prevent Alzheimer\'s disease (AD). Its influence has still been little explored regarding the dysfunction of the endolysosomal pathway, known as an early key event in the physiopathological continuum triggering AD. This dysfunction could result from the accumulation of degradation products of the precursor protein of AD, in particular the C99 fragment, capable of interacting with endosomal proteins and thus contributing to altering this pathway from the early stages of AD. This study aims to evaluate whether neuroprotection mediated by DHA can also preserve the endolysosomal function. AD-typical endolysosomal abnormalities were recorded in differentiated human SH-SY5Y neuroblastoma cells expressing the Swedish form of human amyloid precursor protein. This altered phenotype included endosome enlargement, the reduced secretion of exosomes, and a higher level of apoptosis, which confirmed the relevance of the cellular model chosen for studying the associated deleterious mechanisms. Second, neuroprotection mediated by DHA was associated with a reduced interaction of C99 with the Rab5 GTPase, lower endosome size, restored exosome production, and reduced neuronal apoptosis. Our data reveal that DHA may influence protein localization and interactions in the neuronal membrane environment, thereby correcting the dysfunction of endocytosis and vesicular trafficking associated with AD.
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  • 文章类型: Journal Article
    背景:热量限制(CR)可能有效缓解/预防阿尔茨海默病(AD),但生物学机制尚不清楚。在目前的研究中,我们探讨了CR是否会引起肠道微生物组的改变并减轻AD动物模型的认知障碍。
    方法:采用30周龄雄性APP/PS1转基因小鼠作为AD模型(AD小鼠)。通过减少30%的每日自由喂养来实现CR(随意,AL)金额。用CR方案或AL方案连续6周喂养小鼠。
    结果:我们发现CR治疗,AD小鼠表现出改善的学习和空间记忆能力,和较低水平的Aβ40,Aβ42,IL-1β,TNF-α,和大脑中的ROS。通过对16SrDNA进行测序,我们发现CR治疗导致肠道菌群组成和丰度的显著多样性。在门一级,去铁杆菌(0.04%),杆菌(0.14%),Tenericutes(0.03%),和Verrucomicrobia(0.5%)在CR治疗的AD小鼠中明显减少;在属水平上,Dubosiella(10.04%),粪杆菌(0.04%),与AL饮食相比,在CR处理的AD小鼠中,CoriobacteriaceaeUCG-002(0.01%)显着增加。
    结论:我们的结果表明,在APP/PS1小鼠中,CR治疗后AD的减弱可能是由于肠道微生物组的改变所致。因此,肠道菌群可能成为AD预防和治疗的新靶点。
    BACKGROUND: Caloric restriction (CR) might be effective for alleviating/preventing Alzheimer\'s disease (AD), but the biological mechanisms remain unclear. In the current study, we explored whether CR caused an alteration of gut microbiome and resulted in the attenuation of cognitive impairment of AD animal model.
    METHODS: Thirty-week-old male APP/PS1 transgenic mice were used as AD models (AD mouse). CR was achieved by 30% reduction of daily free feeding (ad libitum, AL) amount. The mice were fed with CR protocol or AL protocol for six consecutive weeks.
    RESULTS: We found that with CR treatment, AD mice showed improved ability of learning and spatial memory, and lower levels of Aβ40, Aβ42, IL-1β, TNF-α, and ROS in the brain. By sequencing 16S rDNA, we found that CR treatment resulted in significant diversity in composition and abundance of gut flora. At the phylum level, Deferribacteres (0.04%), Patescibacteria (0.14%), Tenericutes (0.03%), and Verrucomicrobia (0.5%) were significantly decreased in CR-treated AD mice; at the genus level, Dubosiella (10.04%), Faecalibaculum (0.04%), and Coriobacteriaceae UCG-002 (0.01%) were significantly increased in CR-treated AD mice by comparing with AL diet.
    CONCLUSIONS: Our results demonstrate that the attenuation of AD following CR treatment in APP/PS1 mice may result from alterations in the gut microbiome. Thus, gut flora could be a new target for AD prevention and therapy.
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  • 文章类型: Journal Article
    背景:尽管对创伤性脑损伤(TBI)的神经生物学相关性进行了广泛的研究,对其长期后果的分子决定因素知之甚少,如痴呆和阿尔茨海默病(AD)。
    方法:这里,我们进行了行为研究和广泛的生物分子分析,包括炎症细胞因子,基因表达以及LC-HRMS和MALDI-MS成像的组合,以阐明野生型和APP-SWE小鼠大脑的靶向代谢组学和脂质组学时空改变,AD的遗传模型,在症状前阶段,受到轻度TBI。
    结果:我们发现脑损伤不会影响APP-SWE小鼠的认知能力。然而,我们发现AD的关键标志增加,包括Aβ1-42水平和BACE1表达,在受创伤的转基因小鼠的皮层中。此外,内源性大麻素(eCB)系统的显着变化,或内源性大麻素(eCBome),发生,包括APP-SWE小鼠皮质和海马中内源性大麻素2-AG的水平升高,和N-酰基血清素,第一次在大脑中发现。eCB和eCB样介质生物合成和失活酶的基因表达,以及它们的一些主要分子靶标,也发生了重大变化。我们还确定了大麻素1(CB1)和5-羟色胺能2A(5HT2A)受体之间异聚体的形成,其在APP-SWEmTBI小鼠皮质中的水平增加,可能导致由创伤引起的AD的病理生理学恶化。
    结论:轻度TBI在AD遗传易感小鼠中诱导生化改变,eCBome可能通过与5-羟色胺能系统相互作用在脑损伤和神经退行性疾病之间的发病联系中发挥作用。
    BACKGROUND: Despite extensive studies on the neurobiological correlates of traumatic brain injury (TBI), little is known about its molecular determinants on long-term consequences, such as dementia and Alzheimer\'s disease (AD).
    METHODS: Here, we carried out behavioural studies and an extensive biomolecular analysis, including inflammatory cytokines, gene expression and the combination of LC-HRMS and MALDI-MS Imaging to elucidate the targeted metabolomics and lipidomics spatiotemporal alterations of brains from wild-type and APP-SWE mice, a genetic model of AD, at the presymptomatic stage, subjected to mild TBI.
    RESULTS: We found that brain injury does not affect cognitive performance in APP-SWE mice. However, we detected an increase of key hallmarks of AD, including Aβ1-42 levels and BACE1 expression, in the cortices of traumatized transgenic mice. Moreover, significant changes in the expanded endocannabinoid (eCB) system, or endocannabinoidome (eCBome), occurred, including increased levels of the endocannabinoid 2-AG in APP-SWE mice in both the cortex and hippocampus, and N-acylserotonins, detected for the first time in the brain. The gene expression of enzymes for the biosynthesis and inactivation of eCBs and eCB-like mediators, and some of their main molecular targets, also underwent significant changes. We also identified the formation of heteromers between cannabinoid 1 (CB1) and serotonergic 2A (5HT2A) receptors, whose levels increased in the cortex of APP-SWE mTBI mice, possibly contributing to the exacerbated pathophysiology of AD induced by the trauma.
    CONCLUSIONS: Mild TBI induces biochemical changes in AD genetically predisposed mice and the eCBome may play a role in the pathogenetic link between brain injury and neurodegenerative disorders also by interacting with the serotonergic system.
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  • 文章类型: Journal Article
    致病等位基因沉默是一种有希望的治疗遗传性遗传性疾病的方法。这里,我们开发了一种RNA切割工具,TaqTth-hpRNA,由一个小的,嵌合TaqTth,和发夹RNA引导探针。具有最小的侧翼序列基序要求,体外和体内研究表明TaqTth-hpRNA能有效和特异地切割RNA。在阿尔茨海默病模型中,我们证明了突变APPswemRNA的沉默,而不改变野生型APPmRNA。值得注意的是,由于TaqTth的紧凑尺寸,我们能够在单个AAV载体中与APOE2过表达结合,这导致对病理的更强抑制。
    Pathogenic allele silencing is a promising treatment for genetic hereditary diseases. Here, we develop an RNA-cleaving tool, TaqTth-hpRNA, consisting of a small, chimeric TaqTth, and a hairpin RNA guiding probe. With a minimal flanking sequence-motif requirement, in vitro and in vivo studies show TaqTth-hpRNA cleaves RNA efficiently and specifically. In an Alzheimer\'s disease model, we demonstrate silencing of mutant APPswe mRNA without altering the wild-type APP mRNA. Notably, due to the compact size of TaqTth, we are able to combine with APOE2 overexpression in a single AAV vector, which results in stronger inhibition of pathologies.
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    背景:淀粉样β蛋白(Aβ)是阿尔茨海默病(AD)的治疗靶标。降低其母体蛋白质的产量,APP,在临床前模型中有好处。Posiphen,口服小分子,与APPmRNA中的铁响应性元素结合,并减少APP和Aβ的翻译。为了增加Posiphen的人类数据,我们评估了安全性,使用稳定同位素标记动力学(SILK)分析,耐受性和药代动力学和药效学(PD)对Aβ代谢的影响。
    方法:双盲1b期随机递增剂量临床试验,在五个地点,根据IRB批准的方案。通过低CSFAβ42/40证实的轻度认知障碍或轻度AD(早期AD)的参与者被随机分配(在每个剂量组内)到Posiphen或安慰剂。治疗前评估包括腰椎穿刺脑脊液。参与者服用Posiphen或安慰剂21-23天,然后接受了脑脊液导管放置,静脉输注13C6-亮氨酸,和CSF采样36小时。通过参与者报告评估安全性和耐受性,心电图和实验室测试。CSFSILK分析用免疫沉淀-质谱法测量Aβ40、38和42。基线和第21天CSFAPP,用免疫测定法测量Aβ和其他生物标志物。在基线和第21天进行迷你精神状态检查和ADAS-cog12。
    结果:从2017年6月到2021年12月,19名参与者被注册,在60mg/天和60mg/天2次的剂量队列(5名活性剂:3名安慰剂)内随机分组;1名参与者入组并完成60mg/天3次.10名活性药物和5名安慰剂参与者完成了所有研究程序。泊尼芬是安全且耐受性良好的。8名参与者有与CSF导管插入相关的头痛;5名需要血贴。对CSFAβ40的分数合成率(FSR)的预先确定的SILK分析显示,Posiphen与Posiphen没有明显的总体或剂量依赖性影响。安慰剂。APP动力学的综合多参数模型支持Posiphen剂量依赖性降低APP产量。Posiphen的认知测量和CSF生物标志物从基线到21天没有显着变化与安慰剂组。
    结论:Posiphen在早期AD中安全且耐受性良好。多中心SILK研究是可行的。研究结果受样本量小的限制,但提供了额外的支持性安全性和PK数据。使用SILK数据对生物标志物动力学进行综合建模可以揭示微妙的药物效应。
    背景:关于clinicaltrials.gov(2016年10月24日注册)的NCT02925650。
    Amyloid beta protein (Aβ) is a treatment target in Alzheimer\'s Disease (AD). Lowering production of its parent protein, APP, has benefits in preclinical models. Posiphen, an orally administered small molecule, binds to an iron-responsive element in APP mRNA and decreases translation of APP and Aβ. To augment human data for Posiphen, we evaluated safety, tolerability and pharmacokinetic and pharmacodynamic (PD) effects on Aβ metabolism using Stable Isotope Labeling Kinetic (SILK) analysis.
    Double-blind phase 1b randomized ascending dose clinical trial, at five sites, under an IRB-approved protocol. Participants with mild cognitive impairment or mild AD (Early AD) confirmed by low CSF Aβ42/40 were randomized (within each dose arm) to Posiphen or placebo. Pretreatment assessment included lumbar puncture for CSF. Participants took Posiphen or placebo for 21-23 days, then underwent CSF catheter placement, intravenous infusion of 13C6-leucine, and CSF sampling for 36 h. Safety and tolerability were assessed through participant reports, EKG and laboratory tests. CSF SILK analysis measured Aβ40, 38 and 42 with immunoprecipitation-mass spectrometry. Baseline and day 21 CSF APP, Aβ and other biomarkers were measured with immunoassays. The Mini-Mental State Exam and ADAS-cog12 were given at baseline and day 21.
    From June 2017 to December 2021, 19 participants were enrolled, randomized within dose cohorts (5 active: 3 placebo) of 60 mg once/day and 60 mg twice/day; 1 participant was enrolled and completed 60 mg three times/day. 10 active drug and 5 placebo participants completed all study procedures. Posiphen was safe and well-tolerated. 8 participants had headaches related to CSF catheterization; 5 needed blood patches. Prespecified SILK analyses of Fractional Synthesis Rate (FSR) for CSF Aβ40 showed no significant overall or dose-dependent effects of Posiphen vs. placebo. Comprehensive multiparameter modeling of APP kinetics supported dose-dependent lowering of APP production by Posiphen. Cognitive measures and CSF biomarkers did not change significantly from baseline to 21 days in Posiphen vs. placebo groups.
    Posiphen was safe and well-tolerated in Early AD. A multicenter SILK study was feasible. Findings are limited by small sample size but provide additional supportive safety and PK data. Comprehensive modeling of biomarker dynamics using SILK data may reveal subtle drug effects.
    NCT02925650 on clinicaltrials.gov (registered on 10-24-2016).
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