Department of Brain Sciences, Imperial College London, London, UK.
Biological Imaging Centre, Imperial College London, London, UK.
Brain. 2021 Jun 22;144(5):1526-1541. doi: 10.1093/brain/awab050.
Alzheimer's disease, characterized by brain deposits of amyloid-β plaques and neurofibrillary tangles, is also linked to neurovascular dysfunction and blood-brain barrier breakdown, affecting the passage of substances into and out of the brain. We hypothesized that treatment of neurovascular alterations could be beneficial in Alzheimer's disease. Annexin A1 (ANXA1) is a mediator of glucocorticoid anti-inflammatory action that can suppress microglial activation and reduce blood-brain barrier leakage. We have reported recently that treatment with recombinant human ANXA1 (hrANXA1) reduced amyloid-β levels by increased degradation in neuroblastoma cells and phagocytosis by microglia. Here, we show the beneficial effects of hrANXA1 in vivo by restoring efficient blood-brain barrier function and decreasing amyloid-β and tau pathology in 5xFAD mice and Tau-P301L mice. We demonstrate that young 5xFAD mice already suffer cerebrovascular damage, while acute pre-administration of hrANXA1 rescued the vascular defects. Interestingly, the ameliorated blood-brain barrier permeability in young 5xFAD mice by hrANXA1 correlated with reduced brain amyloid-β load, due to increased clearance and degradation of amyloid-β by insulin degrading enzyme (IDE). The systemic anti-inflammatory properties of hrANXA1 were also observed in 5xFAD mice, increasing IL-10 and reducing TNF-α expression. Additionally, the prolonged treatment with hrANXA1 reduced the memory deficits and increased synaptic density in young 5xFAD mice. Similarly, in Tau-P301L mice, acute hrANXA1 administration restored vascular architecture integrity, affecting the distribution of tight junctions, and reduced tau phosphorylation. The combined data support the hypothesis that blood-brain barrier breakdown early in Alzheimer's disease can be restored by hrANXA1 as a potential therapeutic approach.
阿尔茨海默病的特征是大脑中淀粉样β斑块和神经原纤维缠结的沉积,也与神经血管功能障碍和血脑屏障破坏有关,影响物质进出大脑的通道。我们假设,治疗神经血管改变可能对阿尔茨海默病有益。膜联蛋白 A1(ANXA1)是糖皮质激素抗炎作用的介质,可抑制小胶质细胞激活并减少血脑屏障渗漏。我们最近报道,用重组人 ANXA1(hrANXA1)治疗可通过增加神经母细胞瘤细胞的降解和小胶质细胞的吞噬作用来降低淀粉样β水平。在这里,我们通过恢复有效的血脑屏障功能并减少 5xFAD 小鼠和 Tau-P301L 小鼠中的淀粉样β和 tau 病理学,显示了 hrANXA1 的体内有益作用。我们证明,年轻的 5xFAD 小鼠已经遭受脑血管损伤,而 hrANXA1 的急性预先给药挽救了血管缺陷。有趣的是,hrANXA1 改善年轻 5xFAD 小鼠的血脑屏障通透性与脑内淀粉样β负荷降低有关,这是由于胰岛素降解酶(IDE)增加了淀粉样β的清除和降解。hrANXA1 的全身性抗炎特性也在 5xFAD 小鼠中观察到,增加了 IL-10 并减少了 TNF-α 的表达。此外,hrANXA1 的长期治疗减少了年轻 5xFAD 小鼠的记忆缺陷并增加了突触密度。同样,在 Tau-P301L 小鼠中,急性 hrANXA1 给药恢复了血管结构完整性,影响了紧密连接的分布,并减少了 tau 磷酸化。综合数据支持这样的假设,即阿尔茨海默病早期的血脑屏障破坏可以通过 hrANXA1 恢复,作为一种潜在的治疗方法。
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