Patricia and John Rosenwald Laboratory of Neurobiology and Genetics, The Rockefeller University, New York, NY 10065.
Electron Microscopy Resource Center, The Rockefeller University, New York, NY 10065.
Proc Natl Acad Sci U S A. 2024 Apr 23;121(17):e2314450121. doi: 10.1073/pnas.2314450121. Epub 2024 Apr 15.
Proteinaceous brain inclusions, neuroinflammation, and vascular dysfunction are common pathologies in Alzheimer's disease (AD). Vascular deficits include a compromised blood-brain barrier, which can lead to extravasation of blood proteins like fibrinogen into the brain. Fibrinogen's interaction with the amyloid-beta (Aβ) peptide is known to worsen thrombotic and cerebrovascular pathways in AD. Lecanemab, an FDA-approved antibody therapy for AD, clears Aβ plaque from the brain and slows cognitive decline. Here, we show that lecanemab blocks fibrinogen's binding to Aβ protofibrils, preventing Aβ/fibrinogen-mediated delayed fibrinolysis and clot abnormalities in vitro and in human plasma. Additionally, we show that lecanemab dissociates the Aβ/fibrinogen complex and prevents fibrinogen from exacerbating Aβ-induced synaptotoxicity in mouse organotypic hippocampal cultures. These findings reveal a possible protective mechanism by which lecanemab may slow disease progression in AD.
蛋白脑内包涵体、神经炎症和血管功能障碍是阿尔茨海默病(AD)的常见病理特征。血管缺陷包括血脑屏障受损,这可能导致纤维蛋白原等血液蛋白渗出到大脑中。已知纤维蛋白原与淀粉样β(Aβ)肽的相互作用会加重 AD 中的血栓形成和脑血管途径。Lecanemab 是一种获得 FDA 批准的 AD 抗体疗法,可清除大脑中的 Aβ斑块并减缓认知能力下降。在这里,我们表明 lecanemab 阻止纤维蛋白原与 Aβ原纤维结合,防止 Aβ/纤维蛋白原介导的延迟纤维蛋白溶解和体外及人血浆中的凝块异常。此外,我们表明 lecanemab 可使 Aβ/纤维蛋白原复合物解离,并防止纤维蛋白原加剧 Aβ诱导的小鼠器官型海马培养物中的突触毒性。这些发现揭示了 lecanemab 可能减缓 AD 疾病进展的一种保护机制。