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Jakubowski H, Zioła-Frankowska A, Frankowski M, Perła-Kaján J, Refsum H, de Jager CA, Smith AD. B Vitamins Prevent Iron-Associated Brain Atrophy and Domain-Specific Effects of Iron, Copper, Aluminum, and Silicon on Cognition in Mild Cognitive Impairment. J Alzheimers Dis 2021; 84:1039-1055. [PMID: 34602484 PMCID: PMC8673493 DOI: 10.3233/jad-215085] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Metals, silicon, and homocysteine are linked to Alzheimer’s disease. B vitamin therapy lowers homocysteine and slows brain atrophy and cognitive decline in mild cognitive impairment (MCI). Objective: Examine metals and silicon as predictors of cognition/brain atrophy in MCI, their interaction with homocysteine and cysteine, and how B vitamins affect these relationships. Methods: MCI participants (n = 266, 77.6-year-old, 60.7% female) in VITACOG trial were randomized to receive daily folic acid (0.8 mg)/vitamin B12 (0.5 mg)/vitamin B6 (20 mg) (n = 133) or placebo for two years. At baseline and end-of-study, cranial MRIs were obtained from 168 participants, cognition was analyzed by neuropsychological tests, and serum iron, copper, arsenic, aluminum, and silicon quantified by inductively-coupled plasma mass spectrometry in 196 participants. Data were analyzed by bivariate and multiple regression. Results: Baseline iron, cysteine, and homocysteine were significantly associated with brain atrophy rate. Homocysteine effects on brain atrophy rate were modified by iron and cysteine. At baseline, iron, copper, aluminum, and silicon were significantly associated with one or more domains of cognition: semantic memory, verbal episodic memory, attention/processing speed, and executive function. At end-of-study, baseline iron, copper, aluminum, and silicon predicted cognition in at least one domain: semantic memory, verbal episodic memory, visuospatial episodic memory, attention/processing speed, and global cognition in the placebo but not the B vitamin group. Conclusion: Disparate effects of serum iron, copper, aluminum, silicon, and homocysteine on cognition and brain atrophy in MCI suggest that cognitive impairment is independent of brain atrophy. These factors showed domain-specific associations with cognition, which were abrogated by B vitamin therapy.
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Affiliation(s)
- Hieronim Jakubowski
- Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, International Center for Public Health, Rutgers University, Newark, NJ, USA.,Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
| | - Anetta Zioła-Frankowska
- Department of Analytical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Poznań, Poland
| | - Marcin Frankowski
- Department of Analytical and Environmental Chemistry, Faculty of Chemistry, Adam Mickiewicz University, Poznań, Poland
| | - Joanna Perła-Kaján
- Department of Biochemistry and Biotechnology, Poznań University of Life Sciences, Poznań, Poland
| | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Celeste A de Jager
- Oxford Project to Investigate Memory and Aging (OPTIMA), Department of Pharmacology, University of Oxford, Oxford, UK.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
| | - A David Smith
- Oxford Project to Investigate Memory and Aging (OPTIMA), Department of Pharmacology, University of Oxford, Oxford, UK
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Ferreira A, Neves P, Gozzelino R. Multilevel Impacts of Iron in the Brain: The Cross Talk between Neurophysiological Mechanisms, Cognition, and Social Behavior. Pharmaceuticals (Basel) 2019; 12:ph12030126. [PMID: 31470556 PMCID: PMC6789770 DOI: 10.3390/ph12030126] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 12/12/2022] Open
Abstract
Iron is a critical element for most organisms, which plays a fundamental role in the great majority of physiological processes. So much so, that disruption of iron homeostasis has severe multi-organ impacts with the brain being particularly sensitive to such modifications. More specifically, disruption of iron homeostasis in the brain can affect neurophysiological mechanisms, cognition, and social behavior, which eventually contributes to the development of a diverse set of neuro-pathologies. This article starts by exploring the mechanisms of iron action in the brain and follows with a discussion on cognitive and behavioral implications of iron deficiency and overload and how these are framed by the social context. Subsequently, we scrutinize the implications of the disruption of iron homeostasis for the onset and progression of psychosocial disorders. Lastly, we discuss the links between biological, psychological, and social dimensions and outline potential avenues of research. The study of these interactions could ultimately contribute to a broader understanding of how individuals think and act under physiological and pathophysiological conditions.
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Affiliation(s)
- Ana Ferreira
- Centro Interdisciplinar de Ciências Sociais (CICS.NOVA), Faculdade de Ciências Sociais e Humanas da Universidade NOVA de Lisboa (NOVA FCSH), 1069-061 Lisbon, Portugal
| | - Pedro Neves
- School of Business and Economics, NOVA University of Lisbon, 2775-405 Lisbon, Portugal
| | - Raffaella Gozzelino
- Chronic Diseases Research Center (CEDOC)/NOVA Medical School, Universidade NOVA de Lisboa, 1180-052, 1150-082 Lisbon, Portugal.
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Nikseresht S, Bush AI, Ayton S. Treating Alzheimer's disease by targeting iron. Br J Pharmacol 2019; 176:3622-3635. [PMID: 30632143 DOI: 10.1111/bph.14567] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/14/2018] [Accepted: 11/27/2018] [Indexed: 12/30/2022] Open
Abstract
No disease modifying drugs have been approved for Alzheimer's disease despite recent major investments by industry and governments throughout the world. The burden of Alzheimer's disease is becoming increasingly unsustainable, and given the last decade of clinical trial failures, a renewed understanding of the disease mechanism is called for, and trialling of new therapeutic approaches to slow disease progression is warranted. Here, we review the evidence and rational for targeting brain iron in Alzheimer's disease. Although iron elevation in Alzheimer's disease was reported in the 1950s, renewed interest has been stimulated by the advancement of fluid and imaging biomarkers of brain iron that predict disease progression, and the recent discovery of the iron-dependent cell death pathway termed ferroptosis. We review these emerging clinical and biochemical findings and propose how this pathway may be targeted therapeutically to slow Alzheimer's disease progression. LINKED ARTICLES: This article is part of a themed section on Therapeutics for Dementia and Alzheimer's Disease: New Directions for Precision Medicine. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.18/issuetoc.
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Affiliation(s)
- Sara Nikseresht
- The Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ashley I Bush
- The Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Scott Ayton
- The Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Hosking DE, Ayton S, Beckett N, Booth A, Peters R. More evidence is needed. Iron, incident cognitive decline and dementia: a systematic review. Ther Adv Chronic Dis 2018; 9:241-256. [PMID: 30719269 DOI: 10.1177/2040622318788485] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 06/07/2018] [Indexed: 12/22/2022] Open
Abstract
Background Our aim was to systematically review the relationship between iron and incident cognitive decline or dementia from midlife onwards. Methods Systematic review of eligible studies using Medline, Embase and PsycINFO® for the period from 1 January 1986 to 2 December 2016 (CRD42016023800), where study populations had a mean age of over 50 years and were free of cognitive impairment or dementia at baseline. Two authors independently extracted data according to eligibility criteria and assessed study characteristics, quality and outcomes. Disagreement was resolved by discussion. Results A total of 1185 relevant records were identified with 12 full-text articles eligible for review. Six studies were excluded, leaving six texts to be included. Sample size ranged from 90 to 7173, with an average follow up of approximately 11.5 years. Baseline iron measures included brain iron (n = 2), iron-related biomarkers in blood and plasma (n = 2), and iron intake estimates from dietary records (n = 2). Outcomes were dementia incidence (n = 2) and longitudinal outcomes on neuropsychological tests (n = 4). Bias was evident across studies in one or more of the following: recruitment, iron exposure, outcome assessments, potential confounders, missing data or attrition. Conclusions Diversity across the small number of identified studies precludes conclusions regarding the role of iron in cognitive decline or dementia. Our review highlights substantial gaps in the evidence base and the need for more comprehensive, higher quality studies in this area.
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Affiliation(s)
- Diane E Hosking
- Centre for Research into Ageing Health and Wellbeing, Australian National University, Canberra, Australia
| | - Scott Ayton
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Australia
| | - Nigel Beckett
- Care of the Elderly, Imperial College London, London, UK
| | - Andrew Booth
- School of Health and Related Research, University of Sheffield, Sheffield, UK
| | - Ruth Peters
- Lifecourse Ageing Research Centre, Neuroscience Research Australia, University of New South Wales, Sydney NSW 2031, Australia
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Agrawal S, Berggren KL, Marks E, Fox JH. Impact of high iron intake on cognition and neurodegeneration in humans and in animal models: a systematic review. Nutr Rev 2017; 75:456-470. [PMID: 28505363 PMCID: PMC5914328 DOI: 10.1093/nutrit/nux015] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Context Accumulation of brain iron is linked to aging and protein-misfolding neurodegenerative diseases. High iron intake may influence important brain health outcomes in later life. Objective The aim of this systematic review was to examine evidence from animal and human studies of the effects of high iron intake or peripheral iron status on adult cognition, brain aging, and neurodegeneration. Data Sources MEDLINE, Scopus, CAB Abstracts, the Cochrane Central Register of Clinical Trials, and OpenGrey databases were searched. Study Selection Studies investigating the effect of elevated iron intake at all postnatal life stages in mammalian models and humans on measures of adult brain health were included. Data Extraction Data were extracted and evaluated by two authors independently, with discrepancies resolved by discussion. Neurodegenerative disease diagnosis and/or behavioral/cognitive, biochemical, and brain morphologic findings were used to study the effects of iron intake or peripheral iron status on brain health. Risk of bias was assessed for animal and human studies. PRISMA guidelines for reporting systematic reviews were followed. Results Thirty-four preclinical and 14 clinical studies were identified from database searches. Thirty-three preclinical studies provided evidence supporting an adverse effect of nutritionally relevant high iron intake in neonates on brain-health-related outcomes in adults. Human studies varied considerably in design, quality, and findings; none investigated the effects of high iron intake in neonates/infants. Conclusions Human studies are needed to verify whether dietary iron intake levels used in neonates/infants to prevent iron deficiency have effects on brain aging and neurodegenerative disease outcomes.
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Affiliation(s)
- Sonal Agrawal
- S. Agrawal and J.H. Fox are with the Department of Veterinary Sciences, University of Wyoming, Laramie, Wyoming, USA. K.L. Berggren is with the Department of Radiation Oncology, University of New Mexico Cancer Center, Albuquerque, New Mexico, USA. E. Marks is with the Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Kiersten L. Berggren
- S. Agrawal and J.H. Fox are with the Department of Veterinary Sciences, University of Wyoming, Laramie, Wyoming, USA. K.L. Berggren is with the Department of Radiation Oncology, University of New Mexico Cancer Center, Albuquerque, New Mexico, USA. E. Marks is with the Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Eileen Marks
- S. Agrawal and J.H. Fox are with the Department of Veterinary Sciences, University of Wyoming, Laramie, Wyoming, USA. K.L. Berggren is with the Department of Radiation Oncology, University of New Mexico Cancer Center, Albuquerque, New Mexico, USA. E. Marks is with the Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Jonathan H. Fox
- S. Agrawal and J.H. Fox are with the Department of Veterinary Sciences, University of Wyoming, Laramie, Wyoming, USA. K.L. Berggren is with the Department of Radiation Oncology, University of New Mexico Cancer Center, Albuquerque, New Mexico, USA. E. Marks is with the Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska, USA
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Wang P, Wang ZY. Metal ions influx is a double edged sword for the pathogenesis of Alzheimer's disease. Ageing Res Rev 2017; 35:265-290. [PMID: 27829171 DOI: 10.1016/j.arr.2016.10.003] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Revised: 09/08/2016] [Accepted: 10/17/2016] [Indexed: 12/17/2022]
Abstract
Alzheimer's disease (AD) is a common form of dementia in aged people, which is defined by two pathological characteristics: β-amyloid protein (Aβ) deposition and tau hyperphosphorylation. Although the mechanisms of AD development are still being debated, a series of evidence supports the idea that metals, such as copper, iron, zinc, magnesium and aluminium, are involved in the pathogenesis of the disease. In particular, the processes of Aβ deposition in senile plaques (SP) and the inclusion of phosphorylated tau in neurofibrillary tangles (NFTs) are markedly influenced by alterations in the homeostasis of the aforementioned metal ions. Moreover, the mechanisms of oxidative stress, synaptic plasticity, neurotoxicity, autophagy and apoptosis mediate the effects of metal ions-induced the aggregation state of Aβ and phosphorylated tau on AD development. More importantly, imbalance of these mechanisms finally caused cognitive decline in different experiment models. Collectively, reconstructing the signaling network that regulates AD progression by metal ions may provide novel insights for developing chelators specific for metal ions to combat AD.
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Affiliation(s)
- Pu Wang
- College of Life and Health Sciences, Northeastern University, No. 3-11, Wenhua Road, Shenyang, 110819, PR China.
| | - Zhan-You Wang
- College of Life and Health Sciences, Northeastern University, No. 3-11, Wenhua Road, Shenyang, 110819, PR China.
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P029 Association prospective entre le taux sérique de ferritine et les performances cognitives (analyses secondaires de l’étude SU.VI. MAX 2). NUTR CLIN METAB 2013. [DOI: 10.1016/s0985-0562(13)70362-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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