Immune reactive cells in senile plaques and cognitive decline in Alzheimer's disease

Cortical interneurons become activated by deafferentation and instruct the apoptosis of pyramidal neurons

Unlike peripheral nervous system neurons and certain groups of nerve cells in the CNS, cortical projection neurons are tolerant of axonal lesions. This resistance is incongruent with the massive death of pyramidal neurons in age-associated neurodegenerative diseases that proceed along corticocortical connections. Some insights have emerged from our previous work showing that pyramidal cells in piriform cortex undergo classical apoptosis within 24 h after bulbectomy via transsynaptic, but not retrograde, signaling. These findings allow the investigation of cellular and molecular changes that take place in the context of experimental cortical degeneration. In the present study, we show that the transsynaptic death of pyramidal neurons in piriform cortex is a nitric oxide-mediated event signaled by activated interneurons in layer I. Thus, we demonstrate that cortical interneurons play an essential role in transducing injury to apoptotic signaling that selectively targets pyramidal neurons. We propose that this mechanism may be generic to cortical degenerations and amenable to therapeutic interventions.

Increased TNFalpha production and Cox-2 activity in organotypic brain slice cultures from APPsw transgenic mice

beta-Amyloid (Abeta) peptides are the principal component of senile plaques and vascular deposits in Alzheimer's disease and are derived from the proteolytic cleavage of the beta-amyloid precursor protein (APP). We have previously shown that synthetic Abeta can stimulate cyclooxygenase-2 (Cox-2) activity in brain organotypic slice cultures. In the present study, we used brain slices from transgenic APP Swedish (TgAPPsw) mice and control littermates of different age groups to determine the effect of APP overexpression on the levels of prostaglandin and tumor necrosis factor alpha (TNFalpha) release. The production of eicosanoid and TNFalpha was increased as a function of age in organotypic brain slice culture from TgAPPsw mice compared to age matched control littermates. We also showed that the selective Cox-2 inhibitor NS-398 reduces the production of eicosanoid and TNFalpha in organotypic brain slice cultures of TgAPPsw mice. In conclusion, our data suggest that either activity or expression of Cox-2 is increased in TgAPPsw mice brains as a function of age, contributing to an increased production of pro-inflammatory eicosanoids and TNFalpha.

Inflammatory processes in Alzheimer's disease

Neuroinflammation is a characteristic of pathologically affected tissue in several neurodegenerative disorders. These changes are particularly observed in affected brain areas of Alzheimer's disease (AD) cases. They include an accumulation of large numbers of activated microglia and astrocytes as well as small numbers of T-cells, mostly adhering to postcapillary venules. Accompanying biochemical alterations include the appearance or up-regulation of numerous molecules characteristic of inflammation and free radical attack. Particularly important may be the complement proteins, acute phase reactants and inflammatory cytokines. These brain phenomena combined with epidemiological evidence of a protective effect of antiinflammatory agents suggest that such agents may have a role to play in treating the disease.

Clinically tested drugs for Alzheimer's disease

Alzheimer's disease poses a major health problem in developed countries and vigorous research is underway aimed at finding effective treatments. Acetylcholinesterase inhibitors are approved but give only temporary cognitive benefit to a percentage of patients. Their relative ineffectiveness is not surprising since the neuronal loss comprises much more than the forebrain cholinergic system. What is needed is a drug that will halt the neuronal death and thus progression of the disease. Avenues being explored are aimed at pathological features of the disease, i.e., drugs aimed at removing the amyloid burden which forms the plaques or reducing the neurotoxic neuroinflammation and oxidative stress which characterise the diseased brain regions. There are some promising leads, but more definitive clinical trials are required. Any agent designed to slow progression should clearly be used at an early stage of the disorder; therefore methods of early diagnosis are also essential.