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Wen G, Zhan X, Xu X, Xia X, Jiang S, Ren X, Ren W, Lou H, Lu L, Hermenean A, Yao J, Gao L, Li B, Lu Y, Wu X. Ketamine Improves the Glymphatic Pathway by Reducing the Pyroptosis of Hippocampal Astrocytes in the Chronic Unpredictable Mild Stress Model. Mol Neurobiol 2024; 61:2049-2062. [PMID: 37840071 DOI: 10.1007/s12035-023-03669-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/20/2023] [Indexed: 10/17/2023]
Abstract
Ketamine as a glutamate receptor antagonist has a rapid, potent, and long-lasting antidepressant effect, but its specific mechanism is still not fully understood. Depression is associated with elevated levels of glutamate and astrocyte loss in the brain; the exploration of the relationships between ketamine's antidepressant effect and astrocytes has drawn great attention. Astrocytes and aquaporin 4 (AQP4) are essential components of the glymphatic system, which is a brain-wide perivascular pathway to help transport nutrients to the parenchyma and remove metabolic wastes. In this study, we investigated pyroptosis-associated protein Nlrp3/Caspase-1/Gsdmd-N expression in the hippocampus of mice and the toxic effect of high levels of glutamate on primary astrocytes. On this basis, the protective mechanism of ketamine is explored. A single administration of ketamine (10 mg/kg) remarkably relieved anxious and depressive behaviors in the sucrose preference test, elevated plus maze test, and forced swim test. Meanwhile, ketamine reduced the level of hippocampus Nlrp3 and the expression of its downstream molecules in chronic unpredictable mild stress (CUMS) mice model by western blot and reduced the colocalization of Gfap and Gsdmd by nearly 25% via immunofluorescent staining. Ketamine also increased the Gfap-positive cells and AQP4 expression in the hippocampus of the CUMS mice. More important, ketamine increased the distribution of the fluorescent tracer of CUMS mice. Treatment with 128 mM glutamate in cortical and hippocampus astrocytes increased the level of Nlrp3, and Gsdmd-N, and ketamine alleviated high glutamate-induced pyroptosis-associated proteins. In summary, these results suggest that high glutamate-induced astrocyte pyroptosis through the Nlrp3/Caspase-1/Gsdmd-N pathway which was inhibited by ketamine and ketamine can improve the damaged glymphatic function of the CUMS mice. The present study indicates that inhibiting astrocyte pyroptosis and promoting the glymphatic circulation function are a new mechanism of ketamine's antidepressant effect, and astrocyte pyroptosis may be a new target for other antidepressant medicines.
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Affiliation(s)
- Gehua Wen
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Xiaoni Zhan
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Xiaoming Xu
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Xi Xia
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Shukun Jiang
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Xinghua Ren
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Weishu Ren
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Haoyang Lou
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Lei Lu
- Department of pediatrics Neonatology, University of Chicago, Chicago, IL 60615, U.S., Chicago, USA, IL
| | - Anca Hermenean
- Faculty of Medicine, Vasile Goldis Western University of Arad, Arad, Romania
| | - Jun Yao
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Lina Gao
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China
- China Medical University Center of Forensic Investigation, Shenyang, China
| | - Baoman Li
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China.
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China.
- China Medical University Center of Forensic Investigation, Shenyang, China.
| | - Yan Lu
- Key Laboratory of Health Ministry in Congenital Malformation, Affiliated Shengjing Hospital of China Medical University, Shenyang, China, Shenyang, Liaoning, China.
| | - Xu Wu
- China Medical University School of Forensic Medicine, No.77 Puhe Road, Shenyang, China.
- Liaoning Province Key Laboratory of Forensic Bio-evidence Sciences, Shenyang, China.
- China Medical University Center of Forensic Investigation, Shenyang, China.
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Das S, van Engelen MPE, Goossens J, Jacobs D, Bongers B, Fieldhouse JLP, Pijnenburg YAL, Teunissen CE, Vanmechelen E, Verberk IMW. The use of synaptic biomarkers in cerebrospinal fluid to differentiate behavioral variant of frontotemporal dementia from primary psychiatric disorders and Alzheimer's disease. Alzheimers Res Ther 2024; 16:34. [PMID: 38355535 PMCID: PMC10865562 DOI: 10.1186/s13195-024-01409-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 02/04/2024] [Indexed: 02/16/2024]
Abstract
BACKGROUND Lack of early molecular biomarkers in sporadic behavioral variants of frontotemporal dementia (bvFTD) and its clinical overlap with primary psychiatric disorders (PPD) hampers its diagnostic distinction. Synaptic dysfunction is an early feature in bvFTD and identification of specific biomarkers might improve its diagnostic accuracy. Our goal was to understand the differential diagnostic potential of cerebrospinal fluid (CSF) synaptic biomarkers in bvFTD versus PPD and their specificity towards bvFTD compared with Alzheimer's disease (AD) and controls. Additionally, we explored the association of CSF synaptic biomarkers with social cognition, cognitive performance, and disease severity in these clinical groups. METHODS Participants with probable bvFTD (n = 57), PPD (n = 71), AD (n = 60), and cognitively normal controls (n = 39) with available CSF, cognitive tests, and disease severity as frontotemporal lobar degeneration-modified clinical dementia rating scale (FTLD-CDR) were included. In a subset of bvFTD and PPD cases, Ekman 60 faces test scores for social cognition were available. CSF synaptosomal-associated protein 25 (SNAP25), neurogranin (Ng), neuronal pentraxin 2 (NPTX2), and glutamate receptor 4 (GluR4) were measured, along with neurofilament light (NfL), and compared between groups using analysis of covariance (ANCOVA) and logistic regression. Diagnostic accuracy was assessed using ROC analyses, and biomarker panels were selected using Wald's backward selection. Correlations with cognitive measures were performed using Pearson's partial correlation analysis. RESULTS NPTX2 concentrations were lower in the bvFTD group compared with PPD (p < 0.001) and controls (p = 0.003) but not compared with AD. Concentrations of SNAP25 (p < 0.001) and Ng (p < 0.001) were elevated in patients with AD versus those with bvFTD and controls. The modeled panel for differential diagnosis of bvFTD versus PPD consisted of NfL and NPTX2 (AUC = 0.96, CI: 0.93-0.99, p < 0.001). In bvFTD versus AD, the modeled panel consisted of NfL, SNAP25, Ng, and GluR4 (AUC = 0.86, CI: 0.79-0.92, p < 0.001). In bvFTD, lower NPTX2 (Pearson's r = 0.29, p = 0.036) and GluR4 (Pearson's r = 0.34, p = 0.014) concentrations were weakly associated with worse performance of total cognitive score. Lower GluR4 concentrations were also associated with worse MMSE scores (Pearson's r = 0.41, p = 0.002) as well as with worse executive functioning (Pearson's r = 0.36, p = 0.011) in bvFTD. There were no associations between synaptic markers and social cognition or disease severity in bvFTD. CONCLUSION Our findings of involvement of NTPX2 in bvFTD but not PPD contribute towards better understanding of bvFTD disease pathology.
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Affiliation(s)
- Shreyasee Das
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- ADx NeuroSciences, Technologiepark-Zwijnaarde 6, 9052, Gent, Belgium
| | - Marie-Paule E van Engelen
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Julie Goossens
- ADx NeuroSciences, Technologiepark-Zwijnaarde 6, 9052, Gent, Belgium
| | - Dirk Jacobs
- ADx NeuroSciences, Technologiepark-Zwijnaarde 6, 9052, Gent, Belgium
| | - Bram Bongers
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
| | - Jay L P Fieldhouse
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Yolande A L Pijnenburg
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | - Charlotte E Teunissen
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands
| | | | - Inge M W Verberk
- Department of Laboratory Medicine, Neurochemistry Laboratory, Amsterdam, UMC location VrijeUniversiteit Amsterdam, Boelelaan 1117, Amsterdam, 1081 HV, The Netherlands.
- Neurology, Amsterdam UMC location VUmc, Alzheimer Center Amsterdam, VrijeUniversiteit Amsterdam, De Boelelaan 1118, Amsterdam, 1081 HZ, The Netherlands.
- Amsterdam Neuroscience, Neurodegeneration, De Boelelaan 1085, Amsterdam, 1081 HV, The Netherlands.
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Das S, Goossens J, Jacobs D, Dewit N, Pijnenburg YAL, In 't Veld SGJG, Teunissen CE, Vanmechelen E. Synaptic biomarkers in the cerebrospinal fluid associate differentially with classical neuronal biomarkers in patients with Alzheimer's disease and frontotemporal dementia. Alzheimers Res Ther 2023; 15:62. [PMID: 36964594 PMCID: PMC10037899 DOI: 10.1186/s13195-023-01212-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 03/14/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Loss of synaptic functionality has been recently identified as an early-stage indicator of neurological diseases. Consequently, monitoring changes in synaptic protein levels may be relevant for observing disease evolution or treatment responses in patients. Here, we have studied the relationship between fluid biomarkers of neurodegeneration and synaptic dysfunction in patients with Alzheimer's disease (AD), frontotemporal dementia (FTD), and subjective cognitive decline (SCD). METHODS The exploratory cohort consisted of cerebrospinal fluid (CSF) samples (n = 60) from patients diagnosed with AD (n = 20), FTD (n = 20), and SCD (n = 20) from the Amsterdam Dementia Cohort. We developed two novel immunoassays for the synaptic proteins synaptosomal-associated protein-25 (SNAP25) and vesicle-associated membrane protein-2 (VAMP2). We measured the levels of these biomarkers in CSF, in addition to neuronal pentraxin-2 (NPTX2), glutamate ionotropic receptor-4 (GluR4), and neurogranin (Ng) for this cohort. All in-house immunoassays were validated and analytically qualified prior to clinical application. CSF neurogranin (Ng) was measured using a commercially available ELISA. RESULTS This pilot study indicated that SNAP25, VAMP2, and Ng may not be specific biomarkers for AD as their levels were significantly elevated in patients with both AD and FTD compared to SCD. Moreover, the strength of the correlations between synaptic proteins was lower in the AD and FTD clinical groups compared to SCD. SNAP25, VAMP2, and Ng correlated strongly with each other as well as with total Tau (Tau) and phosphorylated Tau (PTau) in all three clinical groups. However, this correlation was weakened or absent with NPTX2 and GluR4. None of the synaptic proteins correlated to neurofilament light (NfL) in any clinical group. CONCLUSION The correlation of the synaptic biomarkers with CSF Tau and PTau but the lack thereof with NfL implies that distinct pathological pathways may be involved in synaptic versus axonal degeneration. Our results reflect the diversity of synaptic pathology in neurodegenerative dementias.
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Affiliation(s)
- Shreyasee Das
- ADxNeuroSciences NV, Zwijnaarde 94, 9052, Ghent, Belgium
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Julie Goossens
- ADxNeuroSciences NV, Zwijnaarde 94, 9052, Ghent, Belgium
| | - Dirk Jacobs
- ADxNeuroSciences NV, Zwijnaarde 94, 9052, Ghent, Belgium
| | - Nele Dewit
- Medpace, Technologielaan 11, 3001, Leuven, Belgium
| | - Yolande A L Pijnenburg
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Sjors G J G In 't Veld
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Program Neurodegeneration, Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV, Amsterdam, The Netherlands
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