Department of Clinical Pharmacology, University Hospital of Tübingen, Tübingen, Germany.
Rejuvenation Res. 2010 Apr-Jun;13(2-3):195-201. doi: 10.1089/rej.2009.0944.
The local renin-angiotensin system (RAS) in the brain is a multitasking system controlling a plethora of essential functions such as neurogenic hypertension, baroreflexes, and sympathetic activity. Aside from its vasoactive actions, brain angiotensin II (AT-II) has also been implicated in the pathogenesis of cognitive decline, and beneficial effects of angiotensin receptor blockers (ARBs) in Alzheimer (AD) and Parkinson diseases (PD) are suggested. However, the use of ARBs at antihypertensive dosages would lead to unwanted hypotensive reactions in AD patients. Here we treated the APP/PS1 transgenic mouse model of AD with the ARB losartan (10 mg/kg body weight) to determine whether blockade of the AT-II receptor subtype 1 (AT1-R) with intranasal losartan, using at a dosage far below its systemic antihypertensive dose, could maintain its neuroprotective effects independent of its systemic vasoactive action. Intranasal losartan treatment (10 mg/kg every other day for 2 months) of APP/PS1 mice decreased amyloid beta (Abeta) plaques 3.7-fold. Blood serum levels of interleukin-12 (IL-12)p40/p70, IL-1beta, and granulocyte-macrophage colony-stimulating factor (GM-CSF) were increased in the vehicle-treated APP/PS1 mice. Intranasal losartan not only decreased IL-12p40/p70, IL-1beta, and GM-CSF, but also increased IL-10, which suppresses inflammation. Furthermore, losartan markedly increased tyrosine hydroxylase expression in the striatum and locus coeruleus. In conclusion, losartan exerts direct neuroprotective effects via its Abeta-reducing and antiinflammatory effects in the central nervous system (CNS). Therefore, intranasal losartan and potentially other ARBs, at concentrations below their threshold for altering systemic blood pressure, offer a new approach for the treatment of AD.
脑内局部肾素-血管紧张素系统(RAS)是一个多任务系统,控制着许多基本功能,如神经原性高血压、压力反射和交感神经活动。除了其血管活性作用外,脑血管紧张素 II(AT-II)也与认知能力下降的发病机制有关,血管紧张素受体阻滞剂(ARB)在阿尔茨海默病(AD)和帕金森病(PD)中的有益作用也得到了提示。然而,在抗高血压剂量下使用 ARB 会导致 AD 患者出现不必要的低血压反应。在这里,我们用 ARB 洛沙坦(10mg/kg 体重)治疗 AD 的 APP/PS1 转基因小鼠模型,以确定用远低于其全身降压剂量的鼻腔内洛沙坦阻断 AT-II 受体亚型 1(AT1-R)是否可以在不影响全身血管活性作用的情况下保持其神经保护作用。鼻腔内洛沙坦治疗(每 2 天 10mg/kg,共 2 个月)可使 APP/PS1 小鼠的淀粉样β(Abeta)斑块减少 3.7 倍。在未经治疗的 APP/PS1 小鼠中,血清白细胞介素-12(IL-12)p40/p70、白细胞介素-1β(IL-1β)和粒细胞-巨噬细胞集落刺激因子(GM-CSF)水平升高。鼻腔内洛沙坦不仅降低了 IL-12p40/p70、IL-1β和 GM-CSF,还增加了抑制炎症的白细胞介素-10(IL-10)。此外,洛沙坦还显著增加了纹状体和蓝斑中酪氨酸羟化酶的表达。总之,洛沙坦通过其在中枢神经系统(CNS)中的 Abeta 减少和抗炎作用发挥直接的神经保护作用。因此,鼻腔内洛沙坦和其他可能的 ARB,在低于改变全身血压阈值的浓度下,为 AD 的治疗提供了一种新的方法。