PubMed: 21718217

Title
Nuclear receptors as therapeutic targets for Alzheimer's disease.
Journal
Expert opinion on therapeutic targets
Volume
15
Issue
None
Pages
1085-97
Date
2011-09-01
Authors
Landreth GE | Mandrekar-Colucci S

Evidence 038ba0093c

Importantly, this study utilized the LXR agonist, GW3965, to activate the LXRs and induce the expression of both ApoE and ABCA1.

Evidence a9a1bca61c

Similarly, stimulation of microglia with the LXR agonist, GW3965, acts simultaneously to suppress inflammation and promote fibrillar Ab stimulated phagocytosis [47].

Evidence e492c46621

Significantly, a 4-month treatment of Tg2576 mice with GW3965 reduced plaque deposition by > 50% and improved contextual memory in these animals [13].

Evidence 960f705025

The PPAR-d agonist GW501516 induced expression of ABCA1 and apolipoprotein A1, a peripheral lipid transporter, in macrophages [71].

Evidence 665716675c

In a study reported by Kalinin et al., treatment of 5xFAD mice with the PPAR-d agonist, GW742, resulted in decreased plaque burden and an increase in the expression of two Ab proteases, neprilysin and IDE [72].

Evidence 64e07c0df7

ATRA not only activates RXR but also activates the retinoic acid receptor.

Evidence efa5c47246

Treatment of 5-month-old APP/PS1 mice for 8 weeks with ATRA (20 mg/kg/day) resulted in significant decreases in Ab deposition and tau phosphorylation in these mice. Additionally, it attenuated memory deficits seen in the Morris water maze [77].

Evidence d3f77afd3a

More recently, a naturally occurring RXR agonist, honokiol, has been identified. This agonist is capable of activating RXR/LXR heterodimers and has been shown to induce the expression of ABCA1 and ApoE and should be tested in AD models [75,78].

Evidence 64a0a34caf

Bexarotene is a highly specific RXR agonist and is currently FDA approved with a favorable side effect profile. Studies in our laboratory have shown that treatment of APP/ PS1 animals with bexarotene for only 3 days results in a dramatic induction of ApoE and ABCA1 and the rapid reversal of AD-associated pathological hallmarks including reduction in amyloid deposition and deficits in behavior as well as neural networks.

Evidence a86cd20b93

LXR receptors are activated by oxysterols, most prominently hydroxylated forms of cholesterol, and play a critical role in the control of whole body cholesterol homeostasis, as well as exerting potent anti-inflammatory actions [26].

Evidence 2d6986d9ee

LXR receptors are activated by oxysterols, most prominently hydroxylated forms of cholesterol, and play a critical role in the control of whole body cholesterol homeostasis, as well as exerting potent anti-inflammatory actions [26].

Evidence 41a525e257

The synthetic TZD PPAR-g agonists are widely prescribed for the treatment of type 2 diabetes mellitus, and have also been shown to be efficacious in a number of CNS disease models [21]. Currently, two TZD agonists, Actos (pioglitazone) and Avandia (rosiglitazone), are FDA approved for the treatment of diabetes.

Evidence c1ae607d10

When a higher dose of pioglitazone (7 days/40 mg/kg/day) was used in 10-monthold transgenic mice overexpressing the APP V717I mutation, a 20-- 25% decrease in plaque burden was observed with significant reduction in Ab42 levels within the brains of these animals [61].

Evidence db42f55e1c

Furthermore, the treatment of APP/PS1 mouse model of AD with pioglitazone (80 mg/kg/day) for 9 days lowered plaque burden by ~ 50% and reversed behavioral deficits in contextual fear conditioning assay.

Evidence 8ff1e59438

Significantly, the levels of ABCA1 and ApoE were elevated in the brains of these animals [66].

Evidence 1c41e4dbb9

In this study, pioglitazone treatment was shown to improve memory and cognition in these patients [67,68].

Evidence c9ea191a60

Pedersen and Flynn examined the effects of rosiglitazone and found that activation of PPAR-g ameliorated behavioral deficits in the Tg2576 AD mouse model. However, these animals displayed no changes in plaque pathology, but had reduced brain Ab42 levels.

Evidence 4be4415b0b

LXR activation increased the ApoE particle size of all human ApoE isoforms, suggesting that activation of this pathways may enhance Ab clearance regardless of the ApoE allele expressed [13].

Evidence 912eb97c60

These animals were treated with a low dose of rosiglitazone (3 mg/kg/ day) for 12 weeks and evaluated for plaque deposition and behavior. These animals displayed an approximate 50% decrease in amyloid deposition, a decrease in Ab oligomers, preservation of pre and postsynaptic proteins and the attenuation of cognitive deficits in the Morris water maze.

Evidence 24a064d1d8

The authors argue that the effects of rosiglitazone were due to the activation of the wnt signaling cascade which they show by an increase in b-catenin expression and a decrease in GSK-3b levels [63].

Evidence 72dfe83719

While the authors did not detect an increase in ApoE levels in the treated animals, they did observe a modest increase in ABCA1 levels and argue that the enhanced Ab clearance could be attributed to an increase in lipidation of ApoE by ABCA1 [64].

Evidence 41f21f145d

A Phase II clinical trial in which patients were treated with rosiglitazone for 6 months showed improvements in attention and memory retention, but only in patients who did not have an APOE4 allele.

Evidence 80b4c42adc

AD is a chronic neurodegenerative disease characterized by the progressive deposition of the amyloid b (Ab) in the parenchyma of the brain.

Evidence dd554dd68b

It has been postulated that soluble or small oligomeric forms of Ab have deleterious effects in the brain, inducing impaired synaptic function and promoting neuronal degeneration [5].

Evidence 946fe71f3f

The ApoE4 allele is most important genetic risk factor for AD, while the ApoE2 allele is thought to be protective.

Evidence dfa5bf8465

Mice expressing the ApoE4 isoform exhibited higher levels of Ab deposition in comparison to ApoE3 or ApoE2 expressing animals [36].

Evidence 25883fc57f

The deposition of fibrillar Ab in the AD brain results in the recruitment of microglia to the plaques owing to their expression of CCL2, which acts to attract microglia [82].

Evidence 6f41241991

The development of dense-core amyloid plaques is associated with a robust immune response mediated by microglial cells.

Evidence 5da2d8427c

The appearance of amyloid deposition in the AD brain coincides with a dramatic phenotypic activation of microglial cells in the surrounding area.

Evidence ba0a0d8811

The plaque-associated microglia secrete a variety of cytotoxic species including the inflammatory cytokines, INF-g, TNF-a, IL-1b and IL-6 and chemokines, most prominently CCL2 [10-12].

Evidence 7c7bfe2eaa

The M2c macrophages are thought to be in an ‘acquired deactivation’ state induced by IL-10, TGF-b, glucocorticoids or contact with apoptotic cells, and are associated with a suppression of the innate immune response.

Evidence 30825cfcde

PPARs have been shown to play essential roles in energy metabolism, adipocyte differentiation, insulin sensitization and tumor suppression.

Evidence a6045dfe22

PPARs have been shown to play essential roles in energy metabolism, adipocyte differentiation, insulin sensitization and tumor suppression.

Evidence 5194c612f6

PPAR-b/-d is the most abundant isoform and plays a role in fatty acid oxidation [22].

Evidence 845390c859

PPAR-g is involved in lipid storage, insulin sensitivity and energy metabolism and has been shown to promote adipocyte differentiation [21].

Evidence 7ad65ed30e

PPAR-g is involved in lipid storage, insulin sensitivity and energy metabolism and has been shown to promote adipocyte differentiation [21].

Evidence 89f9079f6a

They act as dominant regulators of lipid metabolism through their ability to transactivate genes encoding enzymes of lipid metabolism, providing a key linkage between the diet and the genome.

Evidence c5be711952

Indeed, treatment of AD mouse models with LXR or PPAR agonists has resulted in the suppression of microglial activation [44,45,47,59,63].

Evidence 4bbf207303

RXR activation by numerous ligands has shown to increase levels of both ApoE and ABCA1 in vitro [74-76].

Evidence 16b4cf5aba

In the past decade, drugs targeting the NRs, peroxisome proliferator-activated receptor g (PPARg) and liver X receptor (LXR) have shown to ameliorate pathogenesis in animal models of AD.

Evidence fcf55b6a5c

Recently, they have been shown to promote the degradation of the Ab peptides in the brain by activating genes responsible for reverse cholesterol transport [13].

Evidence d3f1147995

Activation of these receptors has been shown to suppress microglial-mediated inflammatory responses both in vitro and in vivo.

Evidence 261259e41f

Numerous studies have shown that both PPAR-g and LXRs induce the expression of ApoE and ABCA1 and it is through the expression of these proteins that they exert their effects on amyloid pathology.

Evidence 30455a46e8

A different result was reported by Vanmierlo et al. who found that LXR agonist treatment resulted in restoration of memory, but did not find a change in plaque burden [48].

Evidence 389c7a57db

The ApoE4 allele is most important genetic risk factor for AD, while the ApoE2 allele is thought to be protective.

Evidence bdb07c325b

The loss of abca1 resulted in not only the reduction of ApoE levels but also a paradoxical increase in Ab deposition in the brain parenchyma of these animals owing to enhanced deposition of poorly lipidated ApoE in the brain [50-52].

Evidence 3661d2ce48

The Ab peptide is generated by the sequential cleavage of the amyloid precursor protein (APP) by the b and g secretases, resulting in the generation of peptides 40 or 42 amino acids in length [2].

Evidence 705a207f7e

ApoE acts to scaffold the formation of high-density lipoproteins (HDL) that function to transport cholesterol and lipids throughout the body and in the brain.

Evidence 558e9a30f6

They were able to show that the lipidation of ApoE enhanced the degradation of soluble species of Ab by neprilysin in the endolytic compartments of microglia as well as extracellularly through the actions of the insulindegrading enzyme (IDE) [13].

Evidence d812ecb0b3

PPAR-a is known to regulate lipid oxidation but is not highly expressed in the brain [20].

Evidence 0f85da5998

PPAR-d activation has also been shown to promote reverse cholesterol transport.

Evidence f62b4e9926

PPAR-d activation has also been shown to have robust anti-inflammatory actions [73].

Evidence 91eab7661a

Activation of PPAR-g or PPAR-d has been shown to induce Arg1 and IL-4 expression [105,106].

Evidence 713a2f5ba0

Additionally, PPAR-g can also induce the expression of LXRa creating a metabolically linked cycle.

Evidence d45d1ce38b

Conversely, overexpression of ABCA1 in a mouse model of AD was shown to decrease both soluble and fibrillar pools of Ab in 12-month-old mice and reduce plaque burden [53].

Evidence 2a9f6386b8

Alzheimer’s disease (AD) is the leading cause of dementia in the elderly.

Evidence 8000bd644b

In this study, it was shown that samples from human AD brains as well as two aged mouse models of AD showed increased mRNA levels of the M2 markers, Arg1 and Ym1, when compared to age matched controls [101].

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