INTRODUCTION
AD (Alzheimer's disease) is the most prevalent form of dementia affecting over 5.3 million people in the U.S.A. (
Alzheimer's Association 2010), and 35 million worldwide (World Health Organization). With the disproportional increase in the ageing population in the next decade, these numbers are likely to double by 2050. Although the progressive deterioration in memory and cognitive functions in AD is marked by an increase in neuronal loss and synaptic impairment in specific regions of the brain (
Selkoe, 2002), the molecular mechanisms leading to the pathogenesis of the disease are still not well understood (
Querfurth and LaFerla, 2010). Recent studies have recognized the ability of Aβ (amyloid β-peptide) to aggregate into oligomeric form and induce toxicity in neurons (
Shankar et al., 2007;
Walsh and Selkoe, 2007;
Palop and Mucke, 2010). However, understanding the mechanisms whereby Aβ oligomers impair synaptic function remains elusive.
High oxygen consumption in the brain is associated with oxidative stress, and overproduction of ROS (reactive oxygen species) is known to play an important role in the cytotoxic effects of Aβ (
Butterfield et al., 2001;
Sultana and Butterfield, 2010). Recent studies have demonstrated NADPH oxidase, the superoxide producing enzyme, as an important source of ROS production in brain cells (
Sorce and Krause, 2009). Activation of NADPH oxidase is linked to excitotoxity mediated by the ionotropic glutamate receptors (
Kishida et al., 2005;
Brennan et al., 2009). Our studies further show that Aβ can also enhance ROS production in neurons via the NMDA (
N-methyl-
d-aspartate) receptor-dependent NADPH oxidase pathway. In turn, this receptor activation and ROS production can lead to activation of downstream signalling pathway for MAPKs (mitogen-activated protein kinases) and cPLA
2 (cytosolic phospholipase A
2) (
Shelat et al., 2008). Although the involvement in Aβ-induced neuronal dysfunction that underlies the progression of AD has not been fully investigated, there is evidence for involvement of NADPH oxidase activity in oxidative and inflammatory responses in a number of neurodegenerative diseases (
Sun et al., 2007).
Despite the increasing recognition of a link between oligomeric Aβ and NMDA receptor function, the extent of neuronal damage due to prolonged exposure of neurons to this toxic form of Aβ has not been investigated in detail. In the present study, we investigated the effects of oligomeric Aβ on rat primary cortical neurons and determined that prolonged exposure of neurons to oligomeric Aβ led to accumulation of NADPH oxidase-dependent ROS production, and in turn mitochondrial dysfunction, NMDA receptor-mediated Ca2+ influx and AA (arachidonic acid) release. We further demonstrated that EGCG [(–)-epigallocatechin-3-gallate], a major polyphenol from green tea, can protect neurons from the cytotoxic effects of oligomeric Aβ.
DISCUSSION
Despite the fact that AD was discovered over 100 years ago, the pathogenesis of the disease is still not well understood and effective treatment for the disease remains elusive. Although many studies in the past regarded amyloid accumulation to be a pathological landmark of the disease, the ‘amyloid hypothesis’ has been subjected to challenges (
Hardy, 2009). A major problem regarding this hypothesis is the inability to link amyloid accumulation to the severity of the disease, and difficulty in demonstrating toxic forms of Aβ in AD brain. Nevertheless, recent studies have provided convincing evidence that Aβ aggregates, especially when present in the oligomeric forms, can alter neuronal circuitry and impair synaptic activity, events that underlie the cognitive decline in AD (
Palop and Mucke, 2010). Work by Shankar's group further demonstrated the release of soluble Aβ oligomers (mainly dimers and trimers) from hippocampal slices of AD transgenic mice, and that low concentrations of the Aβ oligomers in the conditioned media can cause neurotoxic effects and inhibit NMDA-induced Ca
2+ influx into synaptic spines (
Shankar et al., 2007,
2008). With regard to the presence of Aβ oligomers in the AD brain, a recent study provided strong support for the progressive accumulation of these toxic forms of Aβ with increasing degree of synaptic loss and severity of cognitive impairment (
Pham et al., 2010). It is obvious that different types of tissue or cell preparations can produce different patterns of Aβ oligomers, leading to different magnitude of toxicity. In fact, different ratios of Aβ
1-42 to Aβ
1-40 can offer different patterns of aggregation kinetics and elicit different degrees of neurotoxicity (
Kuperstein et al., 2010). In the present study, aggregation of synthetic Aβ using the instruction described by LaDu's group was shown to produce trimers and tetramers, with no obvious presence of dimers or higher-molecular-mass oligomers (
Dahlgren et al., 2002;
Stine et al., 2003). As discussed in a recent review by
Stine et al. (2010), Aβ oligomer aggregation pattern may vary depending on acidity and the ionic strength of the solvent used (
Stine et al., 2010). In our hands, this instruction for Aβ aggregation has consistently produced oligomers that impair mitochondrial function in neurons, as demonstrated using the MTT assay. However, despite the decrease in mitochondrial function, exposure to 1 μM oligomeric Aβ for 24 h did not result in neuronal cell death or change in membrane integrity (
Figure 1). In line with the progressive nature of AD, it is not surprising that Aβ oligomers produce subtle neurotoxic effects that progress to full impairment of synaptic plasticity and cognitive function before cell death (
Ronicke et al., 2010).
Several earlier studies have demonstrated the ability of oligomeric Aβ to exert cytotoxic effects on neurons. Aβ was shown to suppress NMDA-induced currents in cortical neurons, and this effect was attributed in part to alteration of signalling pathways leading to endocytosis of NMDA receptors (
Snyder et al., 2005). Other studies showed an interaction between oligomeric Aβ and the NMDA receptor trafficking pathway in neurons, and in turn resulting in alterations of intracellular Ca
2+ homoeostasis (
Walsh and Selkoe, 2007). Aβ oligomers can cause Ca
2+ influx due to stimulation of NMDA and AMPA (α-amino-3-hydroxy-5-methylisoxazole-4-propionic acid) receptors, and this type of glutamate receptor-induced excitotoxicity can stimulate downstream pathways leading to mitochondrial membrane dysfunction and neuronal cell death (
Alberdi et al., 2010). Indeed, dysregulation of Ca
2+ homoeostasis is an important consequence of amyloid toxicity (
Demuro et al., 2010;
Paul and Connor 2010).
Studies
in vivo and
in vitro have demonstrated that neuronal excitotoxic events, such as NMDA receptor activation, are linked to ROS production through activation of NADPH oxidase (
Kishida et al., 2005;
Shelat et al., 2008;
Brennan et al., 2009). In a study with hippocampal slices, ROS from NADPH oxidase was shown to activate signalling pathways leading to the activation of ERK1/2 (
Serrano et al., 2009). Since ERK1/2 is an important kinase for phosphorylation of cPLA
2, it is reasonable that oligomeric Aβ can induce activation of cPLA
2 and the subsequent release of AA (
Shelat et al., 2008). cPLA
2 can perturb membrane phospholipids, and besides being a precursor for the synthesis of eicosanoids, AA is an important lipid mediator for regulation of multiplesignalling pathways (
Bazan, 2003). In the present study, prolonged Aβ exposure to neurons results in the decrease in NMDA receptor activity and AA release (
Figure 3). These results lend further support to the ability of oligomeric Aβ to impair a variety of neuronal functions (
Shi et al., 2010). The ability of oligomeric Aβ to inhibit NMDA receptor function may also be due to a number of other factors. Besides modulation of receptor endocytosis (
Snyder et al., 2005), there is evidence that Aβ may bind directly to the NMDA receptor subunits (
De Felice et al., 2007;
Ronicke et al., 2010). Although the mechanism whereby prolonged Aβ exposure impairs NMDA receptor response is not yet clearly understood, our results with an gp91ds-tat clearly demonstrate the important role of NADPH oxidase and ROS in mediating the damaging effects elicited by Aβ.
AD pathology is associated with an increase in mitochondrial abnormalities and a decrease in ATP production (
Hirai et al., 2001;
Moreira et al., 2010). In fact, oxidatively modified proteins are found in mitochondria (
Sultana and Butterfield, 2009), and increased levels of oxidative stress marker proteins and lipids, such as protein carbonyls, 3-nitrotyrosine, hydroxynonenal and isoprostanes, are found in MCI (mild cognitive impairment) brains (
Keller et al., 2005;
Mattson, 2009). Whether subunits of NMDA receptors are particularly susceptible to these oxidative effects remains to be investigated. Furthermore, despite evidence for soluble Aβ to cross the cell membrane and to directly interact with mitochondrial enzymes, the mechanism underlying mitochondrial dysfunction is not yet fully understood (
Yan and Stern, 2005;
Krafft and Klein, 2010). Studies with neurons and astrocytes have demonstrated activation of cPLA2 by oligomeric Aβ and, subsequently, this leads to alteration of mitochondrial membrane (
Kriem et al., 2005;
Zhu et al., 2006). ROS are small molecules with important pleiotropic functions. Besides regulating MAPK activity, ROS can perturb membrane lipids and alter membrane proteins. Therefore the increase in ROS production due to prolonged exposure of neurons to Aβ canbe animportant underlying mechanism for explaining the oxidative-induced impairment in synaptic function in AD (
Ronicke et al., 2010).
Another important finding from this study is the ability of botanical antioxidants to protect neurons from the cytotoxic effects of oligomeric Aβ. Our results show that EGCG from green tea is particularly effective in inhibiting ROS, and protects neurons from Aβ-induced inhibition of NMDA-stimulated Ca
2+ influx and mitochondrial dysfunction. Indeed, a number of studies have demonstrated EGCG to elicit neuroprotective effects (
Choi et al., 2001;
Kim et al., 2005;
Rezai-Zadeh et al., 2005;
Mandel et al., 2006;
Kalfon et al., 2007;
Li et al., 2009), and to protect neurons against Aβ-induced toxicity (
Bastianetto et al., 2006). EGCG is readily soluble and can cross the blood–brain barrier (
Mandel et al., 2006). In animal studies, long-term oral administration of 0.05% or 0.1% EGCG in drinking water (for 6 months) to SAMP8 (senescence-accelerated mice prone-8) mice could decrease levels of Aβ in the hippocampus and improve learning and memory (
Li et al., 2009). In cultured hippocampal neurons, EGCG increased neuronal survival after a 48-h exposure to Aβ and this effect was associated with a decrease in the level of MDA (malondialdehyde), a marker for lipid peroxidation (
Choi et al., 2001). In our study, EGCG up to 100 μM exerted no toxic effects in neurons, and 10 μM of EGCG was already sufficient to protect neurons from Aβ-induced neurotoxicity (
Figure 5). Besides inhibition of Aβ-induced toxicity, there is evidence suggesting multiple effects of EGCG, including inhibition of BACE1 (β-secretase) (
Jeon et al., 2003) and aggregation or remodelling of Aβ oligomers (
Ono et al., 2003;
Bastianetto et al., 2006). An
in vitro study with 7PA2 cells demonstrated that EGCG can convert Aβ oligomers into non-toxic spherical assemblies (
Bieschke et al., 2010). In transgenic mice over-expressing human APPsw, EGCG increased a-secretase activity and enhanced the production of non-amyloidogenic APP-α (amyloid precursor protein-α) as opposed to the cytotoxic Aβ (
Rezai-Zadeh et al., 2005). Other studies with endothelial cells and astrocytes have demonstrated that EGCG inhibits NADPH oxidase activity (
Steffen et al., 2008;
Jensen et al., 2009).
In summary, results from this study demonstrated impairment of neuronal function on prolonged exposure to oligomeric Aβ. As shown in
Figure 7, short-term exposure of Aβ to neurons can cause excitatory events including activation of NMDA receptor, increase in Ca
2+ influx, ROS production and stimulation of signalling pathways leading to the activation of cPLA
2 and AA release (
Shelat et al., 2008). In the present study, we show that more ROS is produced on prolonged exposure to Aβ and this event is accompanied by impairment of NMDA-mediated Ca
2+ influx and AA release, and mitochondrial dysfunction (
Figure 7). Since ROS production on prolonged exposure of neurons to Aβ is inhibited by gp91ds-tat, this study further demonstrates the important role of NADPH oxidase in producing the ROS that mediates the cytotoxic effects of Aβ. Thus besides providing an understanding of the molecular and cellular pathways whereby oligomeric Aβ conveys toxic effects and impairs neuronal function, this study further opens opportunities to target the NADPH oxidase pathway to ameliorate the Aβ effects. In the present study, we demonstrate the ability of EGCG to prevent Aβ-induced ROS accumulation and NMDA receptor dysfunction. These results suggest the possibility for use of other botanical antioxidants as well as dietary polyphenols for delaying the onset or retarding the progression of AD.