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Deciphering the
          mechanism
           underlying
           late-onset
    Alzheimer Disease

                       Irene Knuesel, PhD
Institute of Pharmacology and Toxicology
                      University of Zurich
             Alzforum Webinar 12.12.2012



                                             anti-Ab/DAPI
                                             anti-Ab/FluoroJ/DAPI
Approaches in Basic Research

                                                          ~1-5 % of patients
 Autosomal dominant mutations                 transgenic AD models (>95%)
                                                             Early-Onset AD


 Age
                                                  aging models of AD (<5%)
 Genetic risk factors

 Environmental risk factors (worldwide prevalence in %)
       Midlife Obesity (3.4%)
       Diabetes (6.4%)
       Midlife Hypertension (8.9%)                          CHRONIC
       Depression (13.2%)                               CELLULAR STRESS
       Physical inactivity (17.7%)
       Smoking (27.4%)
       Low education (40%)
                                                        ~95-99 % of patients
    Barnes and Yaffe, Lancet Neurology, 2011
                                                             Late-Onset AD
Modeling cellular stress in vivo
                                                                through chronic inflammation




      Maternal und fetal cytokines
           Synaptogenesis
        Glutamatergic system                                        At 15 months: PolyI:C versus NaCl offspring

            Neurogenesis                                            • Significant increase in Tau phosphorylation
       Cognitive impairments
                                                                    • Translocation from axonal to somatodendritic
  Chronic increase in cytokine levels
                                                                      compartments

Low-grade but chronic, cellular stress:                             • Significant increase in APP levels
   Accelerated cell/brain aging?                                    • Increase in proteolytic APP fragments

PolyIC = polyriboinosinic:polyribocytidylic acid; viral mimic                           Meyer et al., 2006; Krstic et al., 2012
PolyI:C Model of Alzheimer’s Dementia

                  5 mg/kg PolyI:C or NaCl




                  12 months old PolyI:C
                     or NaCl mouse

                       “Second hit”




          15 months: Tissue collection & processing

                    Neuroinflammation
                           pTau
                      APP processing
                                            Krstic et al., 2012
PolyI:C Model of AD in wt Mice: pTau




                            Krstic et al., 2012
PolyI:C Model of AD in wt Mice: APP




                           Krstic et al., 2012
PolyI:C Model of AD in wt Mice: APP




                           Krstic et al., 2012
Chronic Inflammation in tgAD Mice


                   5 mg/kg PolyI:C or NaCl




                   3xtg-AD, 4 months old




         15 months: Tissue collection & processing


                     APP processing
                         pTau
Inflammation-induced Amyloid Plaques




                           Krstic et al., 2012
Accumulation of APP Fragments

N-APP        3xTgAD
 APP
Ab 1-40/42    PolyIC   N-APP
                        3xTgAD          AD patient, 88y
 Ab
Dapi                   AbPolyIC
                         1-40/42        Hippocampus CA1
 Dapi                  Dapi




                                               Krstic et al., 2012
Amyloid-b and Tau Pathology

pTauS422
N-APP
Dapi




                       Phosphorylated Neurofilament
                          Aged Rhesus Monkey (34 y)
3xTgAD
PolyIC                         Walker and Cork, 1999
                       Alzheimer’s Disease, 2nd Edition

unpublished
From PolyI:C model to AD pathogenesis?
                                  DAPI/N-APP                       DAPI/pTau
Aged wt double-hit PolyI:C mice




   Aged tg AD PolyI:C mice




    Late-onset AD patients




                                               Krstic et al., 2012 and unpublished pictures
Sequence of neuropathological events




                   Krstic and Knuesel, Nature Rev Neurology, 2012
Step 1
15 months
      9 months
NaCl mouse mouse
      NaCl
CA1 CA1




                   MBP      Axon

  15 months
 PolyI:C mice

Doehner et al,
   2012, EJN
Step 2
                15 month-old
                PolyI:C mice




Fiala et al, 2007, Brain Struct Funct
              Aged Rhesus Monkeys
15 month-old
PolyI:C mice


                                     Step 3
 a)




                                    ChAT fibers



 b)




                                    APP-IR
                                    Rat TBI model


                 a) Gorazd et al, 2005, Science
               b) Stone et al., 2001, Exp Neurol
                                      tg AD mice
15 month-old
PolyI:C mice


                                                           Step 4

     Microinjection of biotinylated dextran amine (BDA) in M-ACSF

                                                            pTau




                                             APP/Ab


                  Xiao et al. 2011, Neurosci Bull
                        Postmortem brain slices
                                     AD patients
15 month-old
PolyI:C mice


                                                     Step 5




                                          CatD
                                          g) Cytochrome C
               CatD                          oxidase




                             autophagic
                               vacuoles   rhesus monkey 34 y

                     c-e) Nixon & Yang 2011, Neurobiol Dis
            d) Nixon et al. 2005, J Neuropathol Exp Neurol
                  f) Krstic et al. 2012, J Neuroinflammation
                                          Human AD patients
        g) Walker & Cork, 1999, Alzheimer’s Disease 2nd ed
Step 6
                                            15 month-old
                                            PolyI:C mice




Auguste D. (Alois Alzheimer's 1907)
Cerebral cortex, Bielschowsky's silver impregnation
Zeiss MIRAX scanned original tissue section
                        ©Zeiss & M. Graeber (http://www.zeiss.de/alzheimer)
Age- and disease-dependent
gene expression patterns: ND vs AD
 Genetic risk factors of late-onset AD (GWAS)
        APOE e4
        PICALM, BIN1, ABCA7, MS4A4/MS4A6E and EPHA1,
         CD33, CLU, CD2AP and CR1, PPP1R3B, TREM2
         • lipid metabolism, immune modulators, synaptic
            modulators




Disease Progression Model by Podtelezhnikov and Colleagues

Based on transcriptional profiling (>600 brains)


                                                   Podtelezhnikov et al., PLosOne, 2011
Acknowledgements
         Research Team      Former members                                                Financial support
         Dimitrije Krstic   Jana Doehner
            Tina Notter     Amrita Madhusudan
          Sandra Pfister    Myriam Rodriguez
         Tamara Weber       Prisca Vogel
                                                             Hartmann Müller Stiftung
           Maya Barben      Claudine Imhof
         Felicitas Gilgen   Samira Kocherhans
       Susanne Münzing      Martina Hilfiker
                                                                          Olga Meyenfisch Stiftung
           Ricardo Koch     Abigail Manalastas
          Tilo Gschwind     Karin Breu
       Conny Schwerdel
                            International Collaborations                   Stiftung für medizinisch-biologische Forschung

Collaborations ETHZ/UZH     Tony Wyss-Coray, PhD, Stanford
       Roger Nitsch, MD     Frank Heppner, MD, Charité Berlin
 Manuela Neumann, MD        Joachim Herz, MD, UT Southwestern
         Urs Meyer, PhD     Edwin Weeber, PhD, USF

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Kneusel - Neuroinflammation

  • 1. Deciphering the mechanism underlying late-onset Alzheimer Disease Irene Knuesel, PhD Institute of Pharmacology and Toxicology University of Zurich Alzforum Webinar 12.12.2012 anti-Ab/DAPI anti-Ab/FluoroJ/DAPI
  • 2. Approaches in Basic Research ~1-5 % of patients  Autosomal dominant mutations transgenic AD models (>95%) Early-Onset AD  Age aging models of AD (<5%)  Genetic risk factors  Environmental risk factors (worldwide prevalence in %)  Midlife Obesity (3.4%)  Diabetes (6.4%)  Midlife Hypertension (8.9%) CHRONIC  Depression (13.2%) CELLULAR STRESS  Physical inactivity (17.7%)  Smoking (27.4%)  Low education (40%) ~95-99 % of patients Barnes and Yaffe, Lancet Neurology, 2011 Late-Onset AD
  • 3. Modeling cellular stress in vivo through chronic inflammation Maternal und fetal cytokines Synaptogenesis Glutamatergic system At 15 months: PolyI:C versus NaCl offspring Neurogenesis • Significant increase in Tau phosphorylation Cognitive impairments • Translocation from axonal to somatodendritic Chronic increase in cytokine levels compartments Low-grade but chronic, cellular stress: • Significant increase in APP levels Accelerated cell/brain aging? • Increase in proteolytic APP fragments PolyIC = polyriboinosinic:polyribocytidylic acid; viral mimic Meyer et al., 2006; Krstic et al., 2012
  • 4. PolyI:C Model of Alzheimer’s Dementia 5 mg/kg PolyI:C or NaCl 12 months old PolyI:C or NaCl mouse “Second hit” 15 months: Tissue collection & processing Neuroinflammation pTau APP processing Krstic et al., 2012
  • 5. PolyI:C Model of AD in wt Mice: pTau Krstic et al., 2012
  • 6. PolyI:C Model of AD in wt Mice: APP Krstic et al., 2012
  • 7. PolyI:C Model of AD in wt Mice: APP Krstic et al., 2012
  • 8. Chronic Inflammation in tgAD Mice 5 mg/kg PolyI:C or NaCl 3xtg-AD, 4 months old 15 months: Tissue collection & processing APP processing pTau
  • 10. Accumulation of APP Fragments N-APP 3xTgAD APP Ab 1-40/42 PolyIC N-APP 3xTgAD AD patient, 88y Ab Dapi AbPolyIC 1-40/42 Hippocampus CA1 Dapi Dapi Krstic et al., 2012
  • 11. Amyloid-b and Tau Pathology pTauS422 N-APP Dapi Phosphorylated Neurofilament Aged Rhesus Monkey (34 y) 3xTgAD PolyIC Walker and Cork, 1999 Alzheimer’s Disease, 2nd Edition unpublished
  • 12. From PolyI:C model to AD pathogenesis? DAPI/N-APP DAPI/pTau Aged wt double-hit PolyI:C mice Aged tg AD PolyI:C mice Late-onset AD patients Krstic et al., 2012 and unpublished pictures
  • 13. Sequence of neuropathological events Krstic and Knuesel, Nature Rev Neurology, 2012
  • 14. Step 1 15 months 9 months NaCl mouse mouse NaCl CA1 CA1 MBP Axon 15 months PolyI:C mice Doehner et al, 2012, EJN
  • 15. Step 2 15 month-old PolyI:C mice Fiala et al, 2007, Brain Struct Funct Aged Rhesus Monkeys
  • 16. 15 month-old PolyI:C mice Step 3 a) ChAT fibers b) APP-IR Rat TBI model a) Gorazd et al, 2005, Science b) Stone et al., 2001, Exp Neurol tg AD mice
  • 17. 15 month-old PolyI:C mice Step 4 Microinjection of biotinylated dextran amine (BDA) in M-ACSF pTau APP/Ab Xiao et al. 2011, Neurosci Bull Postmortem brain slices AD patients
  • 18. 15 month-old PolyI:C mice Step 5 CatD g) Cytochrome C CatD oxidase autophagic vacuoles rhesus monkey 34 y c-e) Nixon & Yang 2011, Neurobiol Dis d) Nixon et al. 2005, J Neuropathol Exp Neurol f) Krstic et al. 2012, J Neuroinflammation Human AD patients g) Walker & Cork, 1999, Alzheimer’s Disease 2nd ed
  • 19. Step 6 15 month-old PolyI:C mice Auguste D. (Alois Alzheimer's 1907) Cerebral cortex, Bielschowsky's silver impregnation Zeiss MIRAX scanned original tissue section ©Zeiss & M. Graeber (http://www.zeiss.de/alzheimer)
  • 20. Age- and disease-dependent gene expression patterns: ND vs AD  Genetic risk factors of late-onset AD (GWAS)  APOE e4  PICALM, BIN1, ABCA7, MS4A4/MS4A6E and EPHA1, CD33, CLU, CD2AP and CR1, PPP1R3B, TREM2 • lipid metabolism, immune modulators, synaptic modulators Disease Progression Model by Podtelezhnikov and Colleagues Based on transcriptional profiling (>600 brains) Podtelezhnikov et al., PLosOne, 2011
  • 21. Acknowledgements Research Team Former members Financial support Dimitrije Krstic Jana Doehner Tina Notter Amrita Madhusudan Sandra Pfister Myriam Rodriguez Tamara Weber Prisca Vogel Hartmann Müller Stiftung Maya Barben Claudine Imhof Felicitas Gilgen Samira Kocherhans Susanne Münzing Martina Hilfiker Olga Meyenfisch Stiftung Ricardo Koch Abigail Manalastas Tilo Gschwind Karin Breu Conny Schwerdel International Collaborations Stiftung für medizinisch-biologische Forschung Collaborations ETHZ/UZH Tony Wyss-Coray, PhD, Stanford Roger Nitsch, MD Frank Heppner, MD, Charité Berlin Manuela Neumann, MD Joachim Herz, MD, UT Southwestern Urs Meyer, PhD Edwin Weeber, PhD, USF

Editor's Notes

  1. Klinik: infektionen – AuslösereinerDemenz
  2. Modified artifical CSF, staining with ABC kit and DAB staining