Zinc and Alzheimer's disease: is there a direct link?

Metal chelation as a potential therapy for Alzheimer's disease

Alzheimer's disease is a rapidly worsening public health problem. The current lack of effective treatments for Alzheimer's disease makes it imperative to find new pharmacotherapies. At present, the treatment of symptoms includes use of acetylcholinesterase inhibitors, which enhance acetylcholine levels and improve cognitive functioning. Current reports provide evidence that the pathogenesis of Alzheimer's disease is linked to the characteristic neocortical amyloid-beta deposition, which may be mediated by abnormal metal interaction with A beta as well as metal-mediated oxidative stress. In light of these observations, we have considered the development of drugs that target abnormal metal accumulation and its adverse consequences, as well as prevention or reversal of amyloid-beta plaque formation. This paper reviews recent observations on the possible etiologic role of A beta deposition, its redox activity, and its interaction with transition metals that are enriched in the neocortex. We discuss the effects of metal chelators on these processes, list existing drugs with chelating properties, and explore the promise of this approach as a basis for medicinal chemistry in the development of novel Alzheimer's disease therapeutics.

Examining the zinc binding site of the amyloid-beta peptide

The amyloid beta-peptide (Abeta) is a principal component of insoluble amyloid plaques which are characteristic neuropathological features of Alzheimer's disease. Abeta also exists as a normal soluble protein that undergoes a pathogenic transition to an aggregated, fibrous form. This transition can be affected by extraneous proteinaceous and nonproteinaceous elements, such as zinc ions, which may promote aggregation and/or stabilization of the fibrils. Protein chelation of zinc is typically mediated by histidines, cysteines and carboxylates. Previous studies have demonstrated that the Abeta-Zn2+ binding site is localized within residues 6-28 and that histidines may serve as the principal sites of interaction. To localize key residues within this region, a series of Abeta peptides (residues 1-28) were synthesized that contained systematic His/Ala substitutions. Circular dichroism and electron microscopy were used to monitor the effects of Zn2+ on the peptide beta-sheet conformation and fibril aggregation. Our results indicate that substitution of either His13 or His14 but not His6 eliminates the zinc-mediated effects. These observations indicate a specific zinc binding site within Abeta that involves these central histidine residues.

Trace elements in regulation of NF-kappaB activity

In recent years several studies have shown that NF-kappaB might be a very important therapeutic target in the treatment ot various chronic inflammatory, degenerative and tumour diseases. Trace elements play essential roles in the regulation ot cell signaling mechanisms via transcription tactors and a large number of genes. An important aspect of the present review is the description ot the mechanisms by which trace elements might influence transcription factor NF-kappaB. DNA-binding activity of NF-kappaB is regulated by the redox state of the cysteine residue (Gys-62) in the DNA binding domain of the p50 subunit and impaired by different metals (Go, Cr, Ni, Cd, Pb). It has been hypothesised that the broad speciticity of interrelationships between NF-kappaB. AP-1 and various metals results from interactions of metals with specific moieties of transcription factors and IkappaB-kinases, as well as trom the existence of a metal-governed redox system. The hypothetical targets in the NF-kappaB signaling pathway affected by metals are: IkappaB-kinases, IkappaBs, NF-kappaB, proteasome degradation of NF-kappaB, kappaB-sites in DNA. Possibly, this system is required by the cell for adequate regulation ot the transcription machinery in response to changes in intracellular and intranuclear fluxes of metals and radicals and is very ancient evolutionary mechanism of stress adaptation. The role of the NF-kappaB-mediated mechanism in induction or prevention of chronic intlammatory, allergic, degenerative and tumor diseases by zinc, vanadium, manganese, copper, silica, iodine and other trace elements is discussed.

Protein synthesis-dependent but Bcl-2-independent cytochrome C release in zinc depletion-induced neuronal apoptosis

Previously, we reported that chelation of intracellular zinc with N, N,N',N'-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN)-induced macromolecule synthesis-dependent apoptosis of cultured cortical neurons. According to the current theory of apoptosis, release of mitochondrial cytochrome C into the cytosol is required for caspase activation. In the present study, we examined whether cytochrome C release is dependent on macromolecule synthesis. Exposure of cortical cultures to 2 microM TPEN for 24 hr induced apoptosis as previously described. Fluorescence immunocytochemical staining as well as immunoblots of cell extracts revealed the release of cytochrome C into the cytosol 18-20 hr after the exposure onset. The cytochrome C release was completely blocked by the addition of cycloheximide or actinomycin D. Addition of the caspase inhibitor zVAD-fmk did not attenuate the cytochrome C release, whereas it blocked TPEN-induced apoptosis. Because Bcl-2 has been shown to block cytochrome C release potently, we exposed human neuroblastoma cells (SH-SY5Y) to TPEN. Whereas Bcl-2 overexpression completely blocked both cytochrome C release and apoptosis induced by staurosporine, it attenuated neither induced by TPEN. The present results suggest that, in neurons, macromolecule synthesis inhibitors act upstream of cytochrome C release to block apoptosis and that, in addition to the classical Bcl-2 sensitive pathway, there may exist a Bcl-2-insensitive pathway for cytochrome C release.

Zinc-rich synaptic boutons in human temporal cortex biopsies

The distribution of zinc-rich synaptic boutons in biopsies of the temporal cortex from epileptic patients who had undergone surgery is described. Unfixed cryostat sections were exposed to H(2)S vapour to precipitate endogenous zinc, which was subsequently shown by silver enhancement. In the temporal cortex, the stain for zinc was arranged in bands: stain was heavy in layers II and VI, moderate-to-heavy in layers I, III and V, and low in layer IV. The white matter was virtually devoid of staining. At the electron microscope level, labelling was found in synaptic boutons that made asymmetric synaptic contacts. Immunohistochemical staining for glutamate receptor subunits GluR2/3 was observed in cell bodies in layers II, III, V and VI, coincident with the layers that showed heavy staining for zinc. Immunostaining for glutamate receptor subunit GluR1 was prominent in non-pyramidal neurons in deep cortical layers. These results support findings in other mammals and indicate that the human neocortex may contain an extensive system of zinc-rich cortico-cortical connections. This system may be altered in pathological conditions.

Alzheimer's disease, beta-amyloid protein and zinc

Alzheimer's disease (AD) is characterized by amyloid deposits within the neocortical parenchyma and the cerebrovasculature. The main component of these predominantly extracellular collections, Abeta, which is normally a soluble component of all biological fluids, is cleaved out of a ubiquitously expressed parent protein, the amyloid protein precursor (APP), one of the type 1 integral membrane glycoproteins. Considerable evidence has indicated that there is zinc dyshomeostasis and abnormal cellular zinc mobilization in AD. We have characterized both APP and Abeta as copper/zinc metalloproteins. Zinc, copper and iron have recently been reported to be concentrated to 0.5 to 1 mmol/L in amyloid plaque. In vitro, rapid Abeta aggregation is mediated by Zn(II), promoted by the alpha-helical structure of Abeta, and is reversible with chelation. In addition, Abeta produces hydrogen peroxide in a Cu(II)/Fe(III)-dependent manner, and the hydrogen peroxide formation is quenched by Zn(II). Moreover, zinc preserves the nontoxic properties of Abeta. Although the zinc-binding proteins apolipoprotein E epsilon4 allele and alpha(2)-macroglobulin have been characterized as two genetic risk factors for AD, zinc exposure as a risk factor for AD has not been rigorously studied. Based on our findings, we envisage that zinc may serve twin roles by both initiating amyloid deposition and then being involved in mechanisms attempting to quench oxidative stress and neurotoxicity derived from the amyloid mass. Hence, it remains debatable whether zinc supplementation is beneficial or deleterious for AD until additional studies clarify the issue.

Routes of zinc entry in mouse cortical neurons: role in zinc-induced neurotoxicity

Exposure of central neurons to Zn2+ triggers neuronal death. The routes of Zn2+ entry were investigated in living cortical neurons from the mouse using the specific Zn2+ fluorescent dye N-(6-methoxy-8-quinolyl)-p-toluene sulphonamide (TSQ), which preferentially detects membrane-bound Zn2+. Exposure of cortical neurons to increasing concentrations of Zn2+ (1-100 microM) induced a progressive increase in the fluorescence of TSQ. This fluorescence signal was not attenuated by the permeation of plasma membrane with digitonin. Accordingly, the major part of TSQ fluorescence (two-thirds) was associated to the particulate fraction of cortical neurons exposed to Zn2+. These results suggest that Zn2+ detected with TSQ in neurons is mainly bound to membranes. TSQ fluorescence measured in neurons exposed to 3 microM Zn2+ was enhanced by Na+-pyrithione, a Zn2+ ionophore, alpha-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA), N-methyl-D-aspartate (NMDA) or KCl-induced depolarization. However, in the absence of any treatment, TSQ labelling of neurons exposed to 3 microM Zn2+ was only decreased by NMDA receptor antagonists, whereas it remained unaltered in the presence of antagonists of AMPA receptors or L-type voltage-gated Ca2+ channels. Zn2+ entry through NMDA receptors did not contribute to Zn2+-induced neuronal death, as it was prevented by antagonists of NMDA receptors only when they were added after the Zn2+ exposure. Finally, Zn2+ induced a delayed accumulation of extracellular glutamate which might be responsible for the delayed NMDA receptor activation that leads to neuronal death.

Dimethylargininase, a nitric oxide regulatory protein, in Alzheimer disease

In this study, we show that dimethylargininase, a zinc protein involved in the regulation of nitric oxide synthase, is specifically elevated in neurons displaying cytoskeletal abnormalities and oxidative stress in Alzheimer disease (AD) while none of this enzyme was found in neurons in age-matched control cases. Seen in the context of earlier studies showing widespread nitric oxide related damage in AD and the role of dimethylargininase to activate nitric oxide synthetase, through catalytic removal of its endogenous inhibitors, these findings indicate major alterations in nitric oxide regulation in AD. Further, that low levels of zinc specifically inhibit dimethylargininase may provide a link between the numerous studies showing specific abnormalities in zinc and oxidative stress. Finally, our results provide additional evidence that oxidative stress- and nitric oxide-mediated events play important roles in the pathogenesis of AD.

Depletion of intracellular zinc induces protein synthesis-dependent neuronal apoptosis in mouse cortical culture

The central nervous system (CNS) contains a large amount of zinc; a substantial fraction of it is located inside synaptic vesicles of glutamatergic terminals in chelatable forms and released in a calcium-dependent manner with intense neuronal activity. Recently, it has been shown that excessive zinc influx can kill neurons in rats subjected to transient forebrain ischemia. On the other hand, severe depletion of zinc has been also reported to induced cell death in certain nonneuronal cells. Since decreases in tissue zinc have been associated with Alzheimer's disease (AD) and senile macular degeneration, we examined whether depletion of intracellular zinc with a zinc chelator can directly induce neuronal death in mouse cortical cultures. Exposure of cortical cultures to a cell-permeant zinc-chelator, N,N,N',N'-tetrakis (2-pyridylmethyl) ethylenediamine (TPEN, 0.5-3.0 microM) induced gradually developing neuronal degeneration accompanied by various features of apoptosis: cell body shrinkage, nuclear condensation and fragmentation, and internucleosomal DNA breakage. At higher concentrations, TPEN induced additional glial cell death. TPEN-induced cell death was completely blocked by coaddition of zinc. Addition of a protein synthesis inhibitor cycloheximide as well as a caspase inhibitor carbobenzoxy-valyl-alanyl-aspartyl-fluoromethyl ketone (zVAD-fmk) markedly attenuated TPEN-induced neuronal death. On the other hand, brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), phorbol 12-myristate 13-acetate (PMA), high K+, or an antioxidant, trolox, did not show any protective effect. The present results demonstrated that depletion of intracellular zinc induces protein synthesis-dependent neuronal apoptosis in cortical culture. Combined with the findings that extracellular zinc may promote extracellular beta-amyloid (A beta) aggregation and that total tissue zinc is reduced in AD, present results suggest a possibility that redistribution of zinc from intracellular to extracellular space may synergistically contribute to neuronal apoptosis in AD.

Increased density of metallothionein I/II-immunopositive cortical glial cells in the early stages of Alzheimer's disease

We have examined the possible role of metallothionein I/II (MT I/II) in Alzheimer's disease (AD), with a focus on the cellular localization of MT I/II relative to the astrocyte marker, glial fibrillary acidic protein (GFAP). In AD and preclinical AD cases, MT I/II immunolabeling was present in glial cells and did not show a spatial relationship with beta-amyloid plaques or neurofibrillary pathology. There was a six- to sevenfold increase in both MT I/II- and GFAP-labeled cells in the gray matter of AD cases, relative to non-AD cases. However, there was a threefold increase in MT I/II-immunoreactive cells, but not GFAP-labeled cells, in the gray matter of preclinical AD cases compared to non-AD cases. Therefore, the specific increase in MT I/II is associated with the initial stages of the disease process, perhaps due to oxidative stress or the mismetabolism of heavy metals.

Growth inhibitory factor and zinc affect neural cell cultures in a tissue specific manner

Deficiency of neuronal growth inhibitory factor (GIF) and abnormalities in zinc homeostasis have been suggested to play a role in the neuropathogenesis of Alzheimer's disease. We report here that embryonic chick cerebral cell cultures zinc and copper containing GIF in the presence of marmoset hippocampal extract reduces significantly and concentration dependently mitochondrial succinate dehydrogenase activity (MTT) and cell mass. In contrast, no indications could be found that GIF affected neural retina cell cultures. Our results suggest that the observed effects of GIF are not elicited by zinc.

Nitric oxide generators produce accumulation of chelatable zinc in hippocampal neuronal perikarya

While zinc is essential for health, it has also been implicated in the neuropathology of several disease states such as Alzheimer's disease, epilepsy and cerebral ischemia. Recent studies have shown that oxidative and nitrosylative stresses can liberate zinc from metalloproteins in vitro. Thus, nitric oxide (NO.), a radical molecule which serves as a retrograde messenger, was studied for its effects on the in vivo accumulation of zinc in neurons. Three NO. -donors, sodium nitroprusside (SNP; >/=5 nmol), spermine-nitric oxide complex (SPER-NO; </=200 nmol), and 3-morpholino-sydnonimine (SIN-1; </=200 nmol) were administered into the dorsal hippocampus of rats. Brain tissue was stained by both the Timm's method, and with N-(6-methoxy-8-quinolyl)-para-toluenesulfonamide (TSQ), a histochemical stain for metal ions and a selective fluorescent probe for zinc ions, respectively. A sporadic pattern of zinc accumulation within the perikarya, axons, and dendritic processes of certain pyramidal neurons, interneurons, and dentate granule cells was found 2 h after administrations of SNP and SPER-NO, but not with SIN-1. With SNP, sporadic perikaryal zinc staining of the pyramidal neurons and interneurons at strata oriens (SO), pyramidale (SP), and radiatum (SR) was consistently observed, but with SPER-NO, the granule cells of the dentate gyrus were preferentially stained. Administration of sodium ethylenediamine tetraacetic acid (NaEDTA, 10 nmol) 10 min before SNP resulted in a marked reduction of sporadic perikaryal zinc staining in the SO and SR. The more selective metal chelator, N,N,N', N'-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN, 10 nmol) injected 10 min before SNP abolished the staining of neuronal perikarya and surrounding neuropil. In addition, SNP, but not SPER-NO, induced convulsive activity. Groups of rats that manifested continuous wet dog shakes and/or generalized convulsions for at least 4-5 h after SNP were found to have generalized perikaryal Timm's staining of all neurons in the pyramidal cell layer of the subicular and cornu ammonis regions, similar to the staining found after seizures induced by kainic acid. However, after kainic acid-, but not SNP-induced seizures, Timm's staining of neuronal perikarya in the piriform cortex and amygdala was also observed. This is the first evidence that NO. can induce accumulation of zinc in neuronal perikarya and processes in the hippocampus in vivo. As a mechanism underlying the possible involvement of zinc in neurodegenerative disorders caused by excitotoxicity and/or oxidative stress, it is an alternative to release of synaptic vesicle zinc and uptake by damaged hippocampal neuronal perikarya.

Diverse effects of metal chelating agents on the neuronal cytotoxicity of zinc in the hippocampus

Abnormal metabolism of metal ions such as zinc may contribute to neuropathology. Complexing zinc could reduce this pathology. Thus, to examine the effectiveness of metal chelating agents in vivo, a model system was used. This involved determining the ability of chelating agents to prevent neuronal death caused by zinc chloride injected into the rat hippocampus. Significant protection against zinc toxicity was obtained with pyrithione, inositol hexakisphosphate, ethylenediamine tetraacetate (EDTA) and N,N,N',N'-tetrakis(2-pyridylmethyl)ethylenediamine (TPEN). The affinity of these agents for zinc varied between 106 M-1 and 1018 M-1. Thus, the affinity for zinc within this range does not appear to be a major factor affecting the ability of chelators to provide neuroprotection. While almost complete protection was found with EDTA and TPEN given simultaneously with zinc chloride, poor protection was obtained if TPEN was given before or after zinc chloride. Other agents either did not protect against zinc-induced neuronal death (zincon), or exacerbated zinc toxicity (BTC-5N and about 40% of rats injected with a combination of zinc chloride and diethylenetriamine pentaacetate [DTPA]). Rats showing increased damage after zinc plus BTC-5N or DTPA suffered wet dog-like shakes (WDS), suggesting that these zinc chelate complexes can induce seizures resulting in seizure-related damage. In contrast, in the 60% of rats treated with zinc chloride and DTPA that had no WDS, there was about an 80% reduction in the size of the zinc-induced lesion. The ability of chelators to cross cell membranes was examined by determining whether Timm's staining for vesicular zinc was reduced following the injection of a chelator into the hippocampus. TPEN and pyrithione reduced Timm's staining for zinc. However, cell permeability was not necessary for a chelator to protect against zinc toxicity.

Characterization of a plasma membrane zinc transporter in rat brain

Many studies now show that zinc plays a critical and unique role in central nervous system development and function. The cellular mechanisms of zinc efflux and influx are largely unknown and few models exist that describe cellular zinc transport in the brain. This report provides convincing evidence of a zinc transporter in plasma membrane vesicles isolated from rat brain. Zinc uptake was saturable (Km = 15 microM; Vmax = 10 nmol/mg per 30 s), was seen in the absence of ATP, and was unaffected by gradients for other ions such as Na+ or K+. Increasing the ionic strength of the extravesicular media with Na+, K+, or choline+ reduced zinc uptake approximately 50%. Whereas, increasing extravesicular H+ concentration (pH = 5) resulted in near complete inhibition of zinc uptake. Intravesicular zinc was rapidly released upon lowering extravesicular concentrations of zinc with the heavy metal chelator O-phenanthroline (1 mM). The results are consistent with a freely-reversible transport of zinc across the plasma membrane of neurons.

Alterations of metallothionein II and apolipoprotein J mRNA levels in kainate-treated rats

Although different mechanisms have been proposed, it has been suggested that apolipoprotein J (ApoJ) and metallothionein II (MTII), expressed by astrocytes, are protective proteins. Alterations in their expression may contribute to the involvement of astrocytes in epileptogenesis. We studied the expression of MTII and ApoJ genes 7 days following status epilepticus induced in rats by intra-amygdala injection of kainate (KA). ApoJ mRNA levels were increased in both cortex (77%, p < 0.01) and hippocampus (64%, p < 0.02), whereas, in contrast to previous findings 3 days after KA injection, DNA fragmentation was not detected on agarose gel electrophoresis. These results show that ApoJ is induced along with early genes during massive apoptosis, and remains induced after the acute phase. MTII mRNA levels were altered only in hippocampus (62%, p < 0.05), whereas KA-treated rats had no seizure for 7 days. The sustained induction of MTII mRNA shows that zinc homeostasis is not returned to normal or alternatively that astrocytes maintain an altered phenotype in spite of normal zinc release. Polyadenylated RNA and beta-actin mRNA levels were in contrast unaltered in cortex or hippocampus at this time point. These specific variations in ApoJ and MTII mRNA expression during the latent period suggest that they are part of long term biochemical and/or phenotypic alterations in astrocytes, following a single episode of severe seizures.

Zinc metabolism in the brain: relevance to human neurodegenerative disorders

Zinc is an important trace element in biology. An important pool of zinc in the brain is the one present in synaptic vesicles in a subgroup of glutamatergic neurons. In this form it can be released by electrical stimulation and may serve to modulate responses at receptors for a number of different neurotransmitters. These include both excitatory and inhibitory receptors, particularly the NMDA and GABA(A) receptors. This pool of zinc is the only form of zinc readily stained histochemically (the chelatable zinc pool), but constitutes only about 8% of the total zinc content in the brain. The remainder of the zinc is more or less tightly bound to proteins where it acts either as a component of the catalytic site of enzymes or in a structural capacity. The metabolism of zinc in the brain is regulated by a number of transport proteins, some of which have been recently characterized by gene cloning techniques. The intracellular concentration may be mediated both by efflux from the cell by the zinc transporter ZrT1 and by complexing with apothionein to form metallothlonein. Metallothionein may serve as the source of zinc for incorporation into proteins, including a number of DNA transcription factors. However, zinc is readily released from metallothionein by disulfides, increasing concentrations of which are formed under oxidative stress. Metallothionein is a very good scavenger of free radicals, and zinc itself can also reduce oxidative stress by binding to thiol groups, decreasing their oxidation. Zinc is also a very potent inhibitor of nitric oxide synthase. Increased levels of chelatable zinc have been shown to be present in cell cultures of immune cells undergoing apoptosis. This is very reminiscent of the zinc staining of neuronal perikarya dying after an episode of ischemia or seizure activity. Thus a possible role of zinc in causing neuronal death in the brain needs to be fully investigated. intraventricular injections of calcium EDTA have already been shown to reduce neuronal death after a period of ischemia. Pharmacological doses of zinc cause neuronal death, and some estimates indicate that extracellular concentrations of zinc could reach neurotoxic levels under pathological conditions. Zinc is released in high concentrations from the hippocampus during seizures. Unfortunately, there are contrasting observations as to whether this zinc serves to potentiate or decrease seizure activity. Zinc may have an additional role in causing death in at least some neurons damaged by seizure activity and be involved in the sprouting phenomenon which may give rise to recurrent seizure propagation in the hippocampus. In Alzheimer's disease, zinc has been shown to aggregate beta-amyloid, a form which is potentially neurotoxic. The zinc-dependent transcription factors NF-kappa B and Sp1 bind to the promoter region of the amyloid precursor protein (APP) gene. Zinc also inhibits enzymes which degrade APP to nonamyloidogenic peptides and which degrade the soluble form of beta-amyloid. The changes in zinc metabolism which occur during oxidative stress may be important in neurological diseases where oxidative stress is implicated, such as Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Zinc is a structural component of superoxide dismutase 1, mutations in which give rise to one form of familiar ALS. After HIV infection, zinc deficiency is found which may be secondary to immune-induced cytokine synthesis. Zinc is involved in the replication of the HIV virus at a number of sites. These observations should stimulate further research into the role of zinc in neuropathology.