Key Laboratory of Brain Functional Genomics (Ministry of Education and Shanghai), School of Life Sciences, East China Normal University, 3663 North Zhongshan Road, Shanghai, 200062, China.
Center for Cognitive Neurology and Departments of Neurology, Pathology and Psychiatry, New York University School of Medicine, Science Building, Rm1017, 435 East 30th Street, New York, NY, 10016, USA.
Alzheimers Res Ther. 2021 Aug 28;13(1):144. doi: 10.1186/s13195-021-00890-9.
Epidemiological studies link vascular disease risk factors such as atherosclerosis, hypertension, and diabetes mellitus with Alzheimer's disease (AD). Whether there are direct links between these conditions to β-amyloid (Aβ) aggregation and tau pathology is uncertain.
To investigate the possible link between atherosclerosis and AD pathology, we subjected triple transgenic (3 × Tg) AD mice to a high-fat diet (HFD) at 3 months of age, which corresponds to early adulthood in humans.
After 9 months of treatment, HFD-treated 3 × Tg mice exhibited worse memory deficits accompanied by blood hypercoagulation, thrombocytosis, and chronic platelet activation. Procoagulant platelets from HFD-treated 3 × Tg mice actively induced the conversion of soluble Aβ40 into fibrillar Aβ aggregates, associated with increased expression of integrin αIIbβ and clusterin. At 9 months and older, platelet-associated fibrillar Aβ aggregates were observed to obstruct the cerebral blood vessels in HFD-treated 3 × Tg mice. HFD-treated 3 × Tg mice exhibited a greater cerebral amyloid angiopathy (CAA) burden and increased cerebral vascular permeability, as well as more extensive neuroinflammation, tau hyperphosphorylation, and neuron loss. Disaggregation of preexisting platelet micro-clots with humanized GPIIIa49-66 scFv Ab (A11) significantly reduced platelet-associated fibrillar Aβ aggregates in vitro and improved vascular permeability in vivo.
These findings suggest that a major contribution of atherosclerosis to AD pathology is via its effects on blood coagulation and the formation of platelet-mediated Aβ aggregates that compromise cerebral blood flow and therefore neuronal function. This leads to cognitive decline.
流行病学研究将血管疾病风险因素(如动脉粥样硬化、高血压和糖尿病)与阿尔茨海默病(AD)联系起来。这些疾病与β-淀粉样蛋白(Aβ)聚集和 tau 病理学之间是否存在直接联系尚不确定。
为了研究动脉粥样硬化与 AD 病理学之间的可能联系,我们在 3 个月大时让三转基因(3 × Tg)AD 小鼠接受高脂肪饮食(HFD),这相当于人类的成年早期。
经过 9 个月的治疗,HFD 治疗的 3 × Tg 小鼠表现出更严重的记忆缺陷,伴有血液高凝、血小板增多和慢性血小板活化。来自 HFD 治疗的 3 × Tg 小鼠的促凝血小板积极诱导可溶性 Aβ40 转化为纤维状 Aβ 聚集物,与整合素 αIIbβ 和 clusterin 的表达增加有关。在 9 个月及以上,观察到血小板相关的纤维状 Aβ 聚集物阻塞 HFD 治疗的 3 × Tg 小鼠的脑血管。HFD 治疗的 3 × Tg 小鼠表现出更大的脑淀粉样血管病(CAA)负担和增加的脑血管通透性,以及更广泛的神经炎症、tau 过度磷酸化和神经元丧失。用人类化 GPIIIa49-66 scFv Ab(A11)对预先存在的血小板微栓子进行解聚,可显著减少体外血小板相关纤维状 Aβ 聚集物,并改善体内血管通透性。
这些发现表明,动脉粥样硬化对 AD 病理学的主要贡献是通过其对血液凝固和血小板介导的 Aβ 聚集的形成的影响,这些聚集物会损害脑血流,从而损害神经元功能。这导致认知能力下降。