Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612.
Division of Research and Development, Jesse Brown Veterans Affairs Medical Center, Chicago, Illinois 60612.
J Neurosci. 2023 Mar 8;43(10):1814-1829. doi: 10.1523/JNEUROSCI.2447-21.2023. Epub 2023 Jan 25.
Juvenile neuronal ceroid lipofuscinosis (JNCL) is a fatal inherited neurodegenerative disease of children that occurs because of defective function of the lysosomal membrane glycoprotein CLN3. JNCL features glial activation and accumulation of autofluorescent storage material containing subunit c of mitochondrial ATP synthase (SCMAS), ultimately resulting into neuronal loss. Until now, no effective therapy is available for JNCL. This study underlines the possible therapeutic importance of gemfibrozil, an activator of peroxisome proliferator-activated receptor α (PPARα) and a lipid-lowering drug approved by the Food and Drug Administration in an animal model of JNCL. Oral gemfibrozil treatment reduced microglial and astroglial activation, attenuated neuroinflammation, restored the level of transcription factor EB (TFEB; the master regulator of lysosomal biogenesis), and decreased the accumulation of storage material SCMAS in somatosensory barrel field (SBF) cortex of Cln3 (Cln3ΔJNCL) mice of both sexes. Accordingly, gemfibrozil treatment also improved locomotor activities of Cln3ΔJNCL mice. While investigating the mechanism, we found marked loss of PPARα in the SBF cortex of Cln3ΔJNCL mice, which increased after gemfibrozil treatment. Oral gemfibrozil also stimulated the recruitment of PPARα to the gene promoter in the SBF cortex of Cln3ΔJNCL mice, indicating increased transcription of in the CNS by gemfibrozil treatment via PPARα. Moreover, disease pathologies aggravated in Cln3ΔJNCL mice lacking PPARα (Cln3ΔJNCL) and gemfibrozil remained unable to decrease SCMAS accumulation, reduce glial activation, and improve locomotor performance of Cln3ΔJNCL mice. These results suggest that activation of PPARα may be beneficial for JNCL and that gemfibrozil may be repurposed for the treatment of this incurable disease. Despite intense investigations, no effective therapy is available for JNCL, an incurable inherited lysosomal storage disorder. Here, we delineate that oral administration of gemfibrozil, a lipid-lowering drug, decreases glial inflammation, normalizes and/or upregulates TFEB, and reduces accumulation of autofluorescent storage material in SBF cortex to improve locomotor activities in Cln3 (Cln3ΔJNCL) mice. Aggravation of disease pathology in Cln3ΔJNCL mice lacking PPARα (Cln3ΔJNCL) and inability of gemfibrozil to decrease SCMAS accumulation, reduce glial activation, and improve locomotor performance of Cln3ΔJNCL mice delineates an important role of PPARα in this process. These studies highlight a new property of gemfibrozil and indicate its possible therapeutic use in JNCL patients.
青少年神经元蜡样脂褐质沉积症(JNCL)是一种致命的遗传性儿童神经退行性疾病,是由于溶酶体膜糖蛋白 CLN3 功能缺陷引起的。JNCL 的特征是神经胶质细胞激活和积累含有线粒体 ATP 合酶亚基 c 的自体荧光储存物质(SCMAS),最终导致神经元丧失。到目前为止,JNCL 尚无有效的治疗方法。本研究强调了吉非贝齐(一种激活过氧化物酶体增殖物激活受体 α(PPARα)的药物和一种已被美国食品和药物管理局批准的降脂药物)在 JNCL 动物模型中的潜在治疗重要性。口服吉非贝齐可减少小胶质细胞和星形胶质细胞的激活,减轻神经炎症,恢复转录因子 EB(TFEB;溶酶体生物发生的主要调节剂)的水平,并减少感觉桶场(SBF)皮层中 SCMAS 储存物质的积累Cln3(Cln3ΔJNCL)雌雄小鼠。因此,吉非贝齐治疗还改善了 Cln3ΔJNCL 小鼠的运动活动。在研究机制时,我们发现 Cln3ΔJNCL 小鼠 SBF 皮层中的 PPARα 明显丢失,吉非贝齐治疗后增加。口服吉非贝齐还刺激了 PPARα 在 Cln3ΔJNCL 小鼠 SBF 皮层中基因启动子的募集,表明吉非贝齐通过 PPARα 增加了 CNS 中基因的转录。此外,在缺乏 PPARα 的 Cln3ΔJNCL 小鼠(Cln3ΔJNCL)中,疾病病理学加重,而吉非贝齐仍然无法减少 SCMAS 积累、减少神经胶质激活并改善 Cln3ΔJNCL 小鼠的运动表现。这些结果表明激活 PPARα 可能对 JNCL 有益,并且吉非贝齐可能被重新用于治疗这种无法治愈的疾病。尽管进行了深入研究,但对于这种无法治愈的遗传性溶酶体贮积症,仍然没有有效的治疗方法。在这里,我们描述了口服降脂药物吉非贝齐可减少神经胶质炎症,使 TFEB 正常化和/或上调,并减少 SBF 皮层中自体荧光储存物质的积累,从而改善 Cln3(Cln3ΔJNCL)小鼠的运动活动。缺乏 PPARα 的 Cln3ΔJNCL 小鼠(Cln3ΔJNCL)疾病病理学加重,以及吉非贝齐无法减少 SCMAS 积累、减少神经胶质激活和改善 Cln3ΔJNCL 小鼠的运动表现,表明 PPARα 在这一过程中起着重要作用。这些研究突出了吉非贝齐的新特性,并表明其在 JNCL 患者中的潜在治疗用途。