Faculty Bibliography

Background: Manipulation of the immune system is becoming a promising treatment approach for Alzheimer's disease (AD). However, when this approach was tried in humans, in contrast to results in AD animal models, encephalitis emerged as a significant form of toxicity in some patients. Vaccination studies have so far mainly targeted the adaptive immune system. Our research group postulated stimulation of the innate immune system as possible alternative method for ameliorating AD related pathology, without associated toxicity. Our prior work in prion disease, suggested that this could be done effectively via Toll-like receptor 9 (TLR9). Objective: To assess the utility of TLR 9 agonist CpG ODN to stimulate the innate immune system and prevent AD pathology in a mouse model. Methods: Female Tg2576 mice were injected with either the TLR9 agonist type B CpG oligodeoxynucleotide 1826 or vehicle beginning at 6 weeks of age, and once a month thereafter for a total of 14 injections. Controls were non-transgenic C57BL/6 x SJL mice injected with vehicle on the same schedule. At the age of sixteen months, the mice were subjected to behav-ioral testing. Results: No difference between Tg groups was found in any of the locomotor parameters. CpG treatment led to working memory improvement in APP Tg2576 mice as indicated by radial arm maze testing (two-way ANOVA p = 0.019, post-hoc Tg-CpG vs Tg-vehicle, p = 0.026). In evaluating the efficacy of CpG ODN peripheral administration in AD mice, we found that stimulation of TLR9 signaling led to 66%(p = 0.0001) reduction in cortical and 59% (p = 0.002) reduction in hippocampal amyloid burden compared to vehicle treated Tg animals. This re-markable reduction of amyloid burden was paralleled by a reduction in the numbers of activated microglia and astrocytes. When analyzed sepa-rately, we observed a significant decrease in vascular amyloid burden with-out any evidence of increased cerebral microhemmorhages. Furthermore, treatment with CpG ODN was highly effective at reducing the brain Abeta levels along with Abeta oligomers. Conclusions: These results validate the feasibility of TLR9 ligand CpG ODN currently in clinical trials for a variety of other diseases as a new highly effective agent for the prevention and/or treatment of AD

Background: PS1 mutations may increase Abeta production but their effect on tau expressionphosphorylation and/or aggregation has not been thoroughly assessed.We have previously shown that the M146L mutation does not lead to tau pathology in mice expressing one isoform of wild-type human tau (ON3R) but it does promote tau phosphorylation and aggregation inmice expressing all six isoforms of wild-type human tau on a mouse tau knock-out background (htau/PS1/mtau-/-). Methods: We have now analyzed further this accelerated pathologyand its time-dependence compared to htau/mtau-/- littermatesand are studying the possible pathways involved in this important interaction. The mice were killed at 2-35-6 and 8-9 months for brain analyses. Results: Pathological tau was observed on brain sections in the htau/PS1/mtau-/- mice but not in controls as early as at 2 months of ageit increased with ageand was routinely positive with Thioflavin S and occasionally with Gallyas silver stain. Total tau levels did not differ between the groups at any age but human tau CP27 bands shifted to a higher MW (hyperphosphorylation) in the new model compared to controls. Also, in those animals PHF1 IR soluble tau was increased by 142% and 219% compared to their htau/mtau-/- littermates at 5-6 months (p<0.02) and 8-9 months (p<0.002), respectively. Likewise, IHC analysis revealed an 83% increase in PHF1 IR tau in the pyriform cortex at 8-9 months, (p=0.02), and a comparable increase at 5-6 months and in AT8 IR (IHC and Western) that are being quantitated. Importantly, the htau/PS1/mtau-/- mice were more cognitively impaired than controls in the Radial Arm Maze (p<0.03). Analyses of other cortical and hippocampal regions with advanced tau pathology, with other tau antibodies as well as of insoluble tau is underway. Further-more, older animals, tau-related pathology and the potential involvement of various signaling pathways are being assessed. Conclusions: The M146L mutation promotes age-related tau phosphorylation and aggregation, and impairs cognition compared to controls, suggesting that PS1/tau interaction may be important in the etiology and/or pathogenesis of AD. This novel model can be very useful for studying the onset and progression of AD as well as for therapeutic studies

The pathogenesis of Alzheimer's disease (AD) is thought to be related to the accumulation of amyloid beta (Abeta) in amyloid deposits and toxic oligomeric species. Immunomodulation is emerging as an effective means of shifting the equilibrium from Abeta accumulation to clearance; however, excessive cell mediated inflammation and cerebral microhemorrhages are two forms of toxicity which can occur with this approach. Vaccination studies have so far mainly targeted the adaptive immune system. In the present study, we have stimulated the innate immune system via the Toll-like receptor 9 (TLR9) with cytosine-guanosine-containing DNA oligodeoxynucleotides in Tg2576 AD model transgenic mice. This treatment produced a 66% and 80% reduction in the cortical (p = 0.0001) and vascular (p = 0.0039) amyloid burden, respectively, compared with nontreated AD mice. This was in association with significant reductions in Abeta42, Abeta40, and Abeta oligomer levels. We also show that treated Tg mice performed similarly to wild-type mice on a radial arm maze. Our data suggest that stimulation of innate immunity via TLR9 is highly effective at reducing the parenchymal and vascular amyloid burden, along with Abeta oligomers, without apparent toxicity

Immunotherapy holds great promise for Alzheimer's disease (AD) and other conformational disorders but certain adverse reactions need to be overcome. Prior to the side effects in the first Elan/Wyeth AD vaccine trial, we proposed using amyloid-beta (Abeta) derivatives as a safer approach. The route of administration may also affect vaccine safety. To assess the feasibility of oral immunization that promotes mucosal immunity, Tg2576 AD model mice were treated prophylactically three times over 6 weeks starting at 3-5 months of age with a Salmonella vaccine expressing K6Abeta<formula> _{1-30}</formula>. At 22-24 months of age, cortical Abeta plaque burden and total Abeta<formula>_{40}</formula>/<formula>_{42}</formula> levels were reduced by 48-75% in the immunized mice compared to controls, which received unmodified Salmonella. Plaque clearance was not associated with increased microglial activation which may be explained by the long treatment period. Furthermore, cerebral microhemorrhages were not increased in the treated mice in contrast to several passive Abeta antibody studies. These results further support our findings with this immunogen delivered subcutaneously and demonstrate its efficacy when given orally which may provide added benefits for human use

Immunotherapies for various neurodegenerative diseases have recently emerged as a promising approach for clearing pathological protein conformers in these disorders. This type of treatment has not been assessed in models that develop neuronal tau aggregates as observed in frontotemporal dementia and Alzheimer's disease. Here, we present that active immunization with a phosphorylated tau epitope, in P301L tangle model mice, reduces aggregated tau in the brain and slows progression of the tangle-related behavioral phenotype. Females had more tau pathology than males but were also more receptive to the immunotherapy. The tau antibodies generated in these animals recognized pathological tau on brain sections. Performance on behavioral assays that require extensive motor coordination correlated with tau pathology in corresponding brain areas, and antibody levels against the immunogen correlated inversely with tau pathology. Interestingly, age-dependent autoantibodies that recognized recombinant tau protein but not the immunogen were detected in the P301L mice. To confirm that anti-tau antibodies could enter the brain and bind to pathological tau, FITC-tagged antibodies purified from a P301L mouse, with a high antibody titer against the immunogen, were injected into the carotid artery of P301L mice. These antibodies were subsequently detected within the brain and colocalized with PHF1 and MC1 antibodies that recognize pathological tau. Currently, no treatment is available for clearing tau aggregates. Our present findings may lead to a novel therapy targeting one of the major hallmarks of Alzheimer's disease and frontotemporal dementia

Abstract Immunotherapy holds great promise for Alzheimer's disease (AD) and other conformational disorders but certain adverse reactions need to be overcome. The meningoencephalitis observed in the first AD vaccination trial was likely related to excessive cell-mediated immunity caused by the immunogen, amyloid-beta (Abeta) 1-42, and the adjuvant, QS-21. To avoid this toxicity, we have been using Abeta derivatives in alum adjuvant that promotes humoral immunity. Other potential side effects of immunotherapy are increased vascular amyloid and associated microhemorrhages that may be related to rapid clearance of parenchymal amyloid. Here, we determined if our immunization strategy was associated with this form of toxicity, and if the therapeutic effect was age-dependent. Tg2576 mice and wild-type littermates were immunized from 11 or 19 months and their behaviour evaluated prior to killing at 24 months. Subsequently, plaque- and vascular-Abeta burden, Abeta levels and associated pathology was assessed. The therapy started at the cusp of amyloidosis reduced cortical Abeta deposit burden by 31% and Abeta levels by 30-37%, which was associated with cognitive improvements. In contrast, treatment from 19 months, when pathology is well established, was not immunogenic and therefore did not reduce Abeta burden or improve cognition. Significantly, the immunotherapy in the 11-24 months treatment group, that reduced Abeta burden, did not increase cerebral bleeding or vascular Abeta deposits in contrast to several Abeta antibody studies. These findings indicate that our approach age-dependently improves cognition and reduces Abeta burden when used with an adjuvant suitable for humans, without increasing vascular Abeta deposits or microhemorrhages