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Loeffler DA. Antibody-Mediated Clearance of Brain Amyloid-β: Mechanisms of Action, Effects of Natural and Monoclonal Anti-Aβ Antibodies, and Downstream Effects. J Alzheimers Dis Rep 2023; 7:873-899. [PMID: 37662616 PMCID: PMC10473157 DOI: 10.3233/adr-230025] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/05/2023] [Indexed: 09/05/2023] Open
Abstract
Immunotherapeutic efforts to slow the clinical progression of Alzheimer's disease (AD) by lowering brain amyloid-β (Aβ) have included Aβ vaccination, intravenous immunoglobulin (IVIG) products, and anti-Aβ monoclonal antibodies. Neither Aβ vaccination nor IVIG slowed disease progression. Despite conflicting phase III results, the monoclonal antibody Aducanumab received Food and Drug Administration (FDA) approval for treatment of AD in June 2021. The only treatments unequivocally demonstrated to slow AD progression to date are the monoclonal antibodies Lecanemab and Donanemab. Lecanemab received FDA approval in January 2023 based on phase II results showing lowering of PET-detectable Aβ; phase III results released at that time indicated slowing of disease progression. Topline results released in May 2023 for Donanemab's phase III trial revealed that primary and secondary end points had been met. Antibody binding to Aβ facilitates its clearance from the brain via multiple mechanisms including promoting its microglial phagocytosis, activating complement, dissolving fibrillar Aβ, and binding of antibody-Aβ complexes to blood-brain barrier receptors. Antibody binding to Aβ in peripheral blood may also promote cerebral efflux of Aβ by a peripheral sink mechanism. According to the amyloid hypothesis, for Aβ targeting to slow AD progression, it must decrease downstream neuropathological processes including tau aggregation and phosphorylation and (possibly) inflammation and oxidative stress. This review discusses antibody-mediated mechanisms of Aβ clearance, findings in AD trials involving Aβ vaccination, IVIG, and anti-Aβ monoclonal antibodies, downstream effects reported in those trials, and approaches which might improve the Aβ-clearing ability of monoclonal antibodies.
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Affiliation(s)
- David A. Loeffler
- Beaumont Research Institute, Department of Neurology, Corewell Health, Royal Oak, MI, USA
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Sun Z, Zhang Y, Zhang M, Zhou S, Cheng W, Xue L, Zhou P, Li X, Zhang Z, Zuo L. Integrated brain and plasma dual-channel metabolomics to explore the treatment effects of Alpinia oxyphyllaFructus on Alzheimer's disease. PLoS One 2023; 18:e0285401. [PMID: 37552694 PMCID: PMC10409282 DOI: 10.1371/journal.pone.0285401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 04/22/2023] [Indexed: 08/10/2023] Open
Abstract
Alpinia oxyphylla Fructus, called Yizhi in Chinese, is the dried fruit of Alpinia oxyphylla Miquel. It has been used in traditional Chinese medicine to treat dementia and memory defects of Alzheimer's disease for many years. However, the underlying mechanism is still unclear. In this study, we used a rat Alzheimer's disease model on intrahippocampal injection of aggregated Aβ1-42 to study the effects of Alpinia oxyphylla Fructus. A brain and plasma dual-channel metabolomics approach combined with multivariate statistical analysis was further performed to determine the effects of Alpinia oxyphylla Fructus on Alzheimer's disease animals. As a result, in the Morris water maze test, Alpinia oxyphylla Fructus had a clear ability to ameliorate the impaired learning and memory of Alzheimer's disease rats. 11 differential biomarkers were detected in AD rats' brains. The compounds mainly included amino acids and phospholipids; after Alpinia oxyphylla Fructus administration, 9 regulated biomarkers were detected compared with the AD model group. In the plasma of AD rats, 29 differential biomarkers, primarily amino acids, phospholipids and fatty acids, were identified; After administration, 23 regulated biomarkers were detected. The metabolic pathways of regulated metabolites suggest that Alpinia oxyphylla Fructus ameliorates memory and learning deficits in AD rats principally by regulating amino acid metabolism, lipids metabolism, and energy metabolism. In conclusion, our results confirm and enhance our current understanding of the therapeutic effects of Alpinia oxyphylla Fructus on Alzheimer's disease. Meanwhile, our work provides new insight into the potential intervention mechanism of Alpinia oxyphylla Fructus for Alzheimer's disease treatment.
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Affiliation(s)
- Zhi Sun
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Yuanyuan Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Mengya Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Shengnan Zhou
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Wenbo Cheng
- Suzhou Institute of Biomedical Engineering and Technology, Chinese Academy of Sciences, Suzhou, China
| | - Lianping Xue
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Peipei Zhou
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Xiaojing Li
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Zhibo Zhang
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
| | - Lihua Zuo
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, China
- Henan Engineering Research Center of Clinical Mass Spectrometry for Precision Medicine, Zhengzhou, Henan Province, China
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Li J, Liu Y, Li W, Wang Z, Guo P, Li L, Li N. Metabolic profiling of the effects of ginsenoside Re in an Alzheimer's disease mouse model. Behav Brain Res 2017; 337:160-172. [PMID: 28927718 DOI: 10.1016/j.bbr.2017.09.027] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 09/10/2017] [Accepted: 09/16/2017] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD) is one of the major neurological diseases among the elderly, and there are presently no approved treatments that can slow its progression. It has been reported that ginsenoside Re (G-Re), an active pharmacological component of ginseng, can ameliorate the symptoms of AD, but the underlying mechanisms are not clear. The current study was designed to test the effects of G-Re by investigating the metabolite profiles of AD mice. An AD animal model was induced by intracerebroventricular injection of β-amyloid in Kunming mice. Model mice were administered G-Re intragastrically (4mg/kg/day as a high dose and 1mg/kg/day as a low dose) for 30days. Cognitive function of the mice was tested using a Morris water maze, and pathological changes in the brain tissue were assessed by immunohistochemistry. Global metabolite profiling using ultra performance liquid chromatography-mass spectrometry was carried out to identify the metabolites that were differentially expressed in the plasma of mice. A total of 10 potential biomarkers were identified in AD mice. The peak intensities of tryptophan, hexadecasphinganine, phytosphingosine, and various lysophosphatidylcholines were lower whereas that of phenylalanine was higher in the AD mice than in the control mice. G-Re treatment (4mg/kg) affected all of these metabolic pathways. This is the first metabonomics study to biochemically profile the plasma metabolic pathways of AD animals affected by G-Re. These outcomes provide reliable evidence that illuminates the biochemical mechanisms of AD and facilitates investigation of the therapeutic benefits of G-Re in AD treatment.
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Affiliation(s)
- Jingyuan Li
- Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Ying Liu
- Department of Emergency Medicine, Laboratory of PLA Wound and Trauma Center, The General Hospital of Shenyang Military, Shenyang 110016, Liaoning, China
| | - Wei Li
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang 110016, Liaoning, China
| | - Zhe Wang
- Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Pan Guo
- Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China
| | - Lin Li
- Department of Neurology, The Second Affiliated Hospital of Shenyang Medical College, Shenyang 110002, Liaoning, China
| | - Naijing Li
- Department of Gerontology, Shengjing Hospital of China Medical University, Shenyang 110004, Liaoning, China.
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Li N, Liu Y, Li W, Zhou L, Li Q, Wang X, He P. A UPLC/MS-based metabolomics investigation of the protective effect of ginsenosides Rg1 and Rg2 in mice with Alzheimer's disease. J Ginseng Res 2015; 40:9-17. [PMID: 26843817 PMCID: PMC4703800 DOI: 10.1016/j.jgr.2015.04.006] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 04/20/2015] [Accepted: 04/20/2015] [Indexed: 01/10/2023] Open
Abstract
Background Alzheimer's disease (AD) is a progressive brain disease, for which there is no effective drug therapy at present. Ginsenoside Rg1 (G-Rg1) and G-Rg2 have been reported to alleviate memory deterioration. However, the mechanism of their anti-AD effect has not yet been clearly elucidated. Methods Ultra performance liquid chromatography tandem MS (UPLC/MS)-based metabolomics was used to identify metabolites that are differentially expressed in the brains of AD mice with or without ginsenoside treatment. The cognitive function of mice and pathological changes in the brain were also assessed using the Morris water maze (MWM) and immunohistochemistry, respectively. Results The impaired cognitive function and increased hippocampal Aβ deposition in AD mice were ameliorated by G-Rg1 and G-Rg2. In addition, a total of 11 potential biomarkers that are associated with the metabolism of lysophosphatidylcholines (LPCs), hypoxanthine, and sphingolipids were identified in the brains of AD mice and their levels were partly restored after treatment with G-Rg1 and G-Rg2. G-Rg1 and G-Rg2 treatment influenced the levels of hypoxanthine, dihydrosphingosine, hexadecasphinganine, LPC C 16:0, and LPC C 18:0 in AD mice. Additionally, G-Rg1 treatment also influenced the levels of phytosphingosine, LPC C 13:0, LPC C 15:0, LPC C 18:1, and LPC C 18:3 in AD mice. Conclusion These results indicate that the improvements in cognitive function and morphological changes produced by G-Rg1 and G-Rg2 treatment are caused by regulation of related brain metabolic pathways. This will extend our understanding of the mechanisms involved in the effects of G-Rg1 and G-Rg2 on AD.
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Affiliation(s)
- Naijing Li
- Department of Gerontology, The Shengjing Affiliated Hospital, China Medical University, Shenyang, China
| | - Ying Liu
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Wei Li
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Ling Zhou
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Qing Li
- College of Pharmacy, Shenyang Pharmaceutical University, Shenyang, China
| | - Xueqing Wang
- Department of Gastroenterology, The Shengjing Affiliated Hospital, China Medical University, Shenyang, China
| | - Ping He
- Department of Gerontology, The Shengjing Affiliated Hospital, China Medical University, Shenyang, China
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Wang CM, Liu MY, Wang F, Wei MJ, Wang S, Wu CF, Yang JY. Anti-amnesic effect of pseudoginsenoside-F11 in two mouse models of Alzheimer's disease. Pharmacol Biochem Behav 2013; 106:57-67. [DOI: 10.1016/j.pbb.2013.03.010] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Revised: 03/12/2013] [Accepted: 03/16/2013] [Indexed: 11/15/2022]
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