[go: up one dir, main page]
More Web Proxy on the site http://driver.im/
Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Preventive and therapeutic reduction of amyloid deposition and behavioral impairments in a model of Alzheimer’s disease by whole blood exchange

Abstract

Alzheimer’s disease (AD) is the major form of dementia in the elderly population. The main neuropathological changes in AD patients are neuronal death, synaptic alterations, brain inflammation, and the presence of cerebral protein aggregates in the form of amyloid plaques and neurofibrillary tangles. Compelling evidence suggests that the misfolding, aggregation, and cerebral deposition of amyloid-beta (Aβ) plays a central role in the disease. Thus, prevention and removal of misfolded protein aggregates is considered a promising strategy to treat AD. In the present study, we describe that the development of cerebral amyloid plaques in a transgenic mice model of AD (Tg2576) was significantly reduced by 40–80% through exchanging whole blood with normal blood from wild type mice having the same genetic background. Importantly, such reduction resulted in improvement in spatial memory performance in aged Tg2576 mice. The exact mechanism by which blood exchange reduces amyloid pathology and improves memory is presently unknown, but measurements of Aβ in plasma soon after blood exchange suggest that mobilization of Aβ from the brain to blood may be implicated. Our results suggest that a target for AD therapy may exist in the peripheral circulation, which could open a novel disease-modifying intervention for AD.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Blood exchange treatment decreases the accumulation of cerebral amyloid plaques.
Fig. 2: Blood exchange treatment improves spatial memory.
Fig. 3: Sustained reduction in the cerebral amyloid deposition by blood exchange treatment.
Fig. 4: Reduction in insoluble Aβ levels in Tg2576 mice receiving blood exchange treatment.
Fig. 5: Plasma concentrations of total Aβ increased soon after blood exchange.
Fig. 6: Changes in the cerebral amyloid burden by blood exchange treatment in aged Tg2576 mice after the onset of cerebral plaque pathology.
Fig. 7: Changes in the spatial memory by blood exchange treatment after the onset of cerebral plaque pathology.

Similar content being viewed by others

References

  1. Mucke L, Selkoe DJ. Neurotoxicity of amyloid beta-protein: synaptic and network dysfunction. Cold Spring Harb Perspect Med. 2012;2:a006338.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Yan P, Bero AW, Cirrito JR, Xiao Q, Hu X, Wang Y, et al. Characterizing the appearance and growth of amyloid plaques in APP/PS1 mice. J Neurosci. 2009;29:10706–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Mawuenyega KG, Sigurdson W, Ovod V, Munsell L, Kasten T, Morris JC, et al. Decreased clearance of CNS beta-amyloid in Alzheimer’s disease. Science. 2010;330:1774.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Potter R, Patterson BW, Elbert DL, Ovod V, Kasten T, Sigurdson W, et al. Increased in vivo amyloid-beta42 production, exchange, and loss in presenilin mutation carriers. Sci Transl Med. 2013;5:189ra177.

    Article  Google Scholar 

  5. Selkoe DJ. Cell biology of the amyloid beta-protein precursor and the mechanism of Alzheimer’s disease. Annu Rev Cell Biol. 1994;10:373–403.

    Article  CAS  PubMed  Google Scholar 

  6. Biere AL, Ostaszewski B, Stimson ER, Hyman BT, Maggio JE, Selkoe DJ. Amyloid beta-peptide is transported on lipoproteins and albumin in human plasma. J Biol Chem. 1996;271:32916–22.

    Article  CAS  PubMed  Google Scholar 

  7. Ghiso J, Calero M, Matsubara E, Governale S, Chuba J, Beavis R, et al. Alzheimer’s soluble amyloid beta is a normal component of human urine. FEBS Lett. 1997;408:105–8.

    Article  CAS  PubMed  Google Scholar 

  8. Risacher SL, Fandos N, Romero J, Sherriff I, Pesini P, Saykin AJ, et al. Plasma amyloid beta levels are associated with cerebral amyloid and tau deposition. Alzheimers Dement (Amst). 2019;11:510–9.

    Article  PubMed  Google Scholar 

  9. Koyama A, Okereke OI, Yang T, Blacker D, Selkoe DJ, Grodstein F. Plasma amyloid-beta as a predictor of dementia and cognitive decline: a systematic review and meta-analysis. Arch Neurol. 2012;69:824–31.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Luis CA, Abdullah L, Paris D, Quadros A, Mullan M, Mouzon B, et al. Serum beta-amyloid correlates with neuropsychological impairment. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2009;16:203–18.

    Article  PubMed  Google Scholar 

  11. Zlokovic BV, Ghiso J, Mackic JB, McComb JG, Weiss MH, Frangione B. Blood-brain barrier transport of circulating Alzheimer’s amyloid beta. Biochem Biophys Res Commun. 1993;197:1034–40.

    Article  CAS  PubMed  Google Scholar 

  12. Shibata M, Yamada S, Kumar SR, Calero M, Bading J, Frangione B, et al. Clearance of Alzheimer’s amyloid-ss(1-40) peptide from brain by LDL receptor-related protein-1 at the blood-brain barrier. J Clin Investig. 2000;106:1489–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Mackic JB, Bading J, Ghiso J, Walker L, Wisniewski T, Frangione B, et al. Circulating amyloid-beta peptide crosses the blood-brain barrier in aged monkeys and contributes to Alzheimer’s disease lesions. Vasc Pharm. 2002;38:303–13.

    Article  CAS  Google Scholar 

  14. DeMattos RB, Bales KR, Parsadanian M, O’Dell MA, Foss EM, Paul SM, et al. Plaque-associated disruption of CSF and plasma amyloid-beta (Abeta) equilibrium in a mouse model of Alzheimer’s disease. J Neurochem. 2002;81:229–36.

    Article  CAS  PubMed  Google Scholar 

  15. DeMattos RB, Bales KR, Cummins DJ, Dodart JC, Paul SM, Holtzman DM. Peripheral anti-A beta antibody alters CNS and plasma A beta clearance and decreases brain A beta burden in a mouse model of Alzheimer’s disease. Proc Natl Acad Sci USA. 2001;98:8850–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Lemere CA, Spooner ET, LaFrancois J, Malester B, Mori C, Leverone JF, et al. Evidence for peripheral clearance of cerebral Abeta protein following chronic, active Abeta immunization in PSAPP mice. Neurobiol Dis. 2003;14:10–8.

    Article  CAS  PubMed  Google Scholar 

  17. Bu XL, Xiang Y, Jin WS, Wang J, Shen LL, Huang ZL, et al. Blood-derived amyloid-beta protein induces Alzheimer’s disease pathologies. Mol Psychiatry. 2018;23:1948–56.

    Article  PubMed  Google Scholar 

  18. Xiang Y, Bu XL, Liu YH, Zhu C, Shen LL, Jiao SS, et al. Physiological amyloid-beta clearance in the periphery and its therapeutic potential for Alzheimer’s disease. Acta Neuropathol. 2015;130:487–99.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Burwinkel M, Lutzenberger M, Heppner FL, Schulz-Schaeffer W, Baier M. Intravenous injection of beta-amyloid seeds promotes cerebral amyloid angiopathy (CAA). Acta Neuropathol Commun. 2018;6:23.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Morales R, Duran-Aniotz C, Bravo-Alegria J, Estrada LD, Shahnawaz M, Hu PP, et al. Infusion of blood from mice displaying cerebral amyloidosis accelerates amyloid pathology in animal models of Alzheimer’s disease. Acta Neuropathol Commun. 2020;8:213.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Hsiao K, Chapman P, Nilsen S, Eckman C, Harigaya Y, Younkin S, et al. Correlative memory deficits, Abeta elevation, and amyloid plaques in transgenic mice. Science. 1996;274:99–102.

    Article  CAS  PubMed  Google Scholar 

  22. Riches AC, Sharp JG, Thomas DB, Smith SV. Blood volume determination in the mouse. J Physiol. 1973;228:279–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Davies B, Morris T. Physiological parameters in laboratory animals and humans. Pharm Res. 1993;10:1093–5.

    Article  CAS  PubMed  Google Scholar 

  24. Morales R, Estrada LD, Diaz-Espinoza R, Morales-Scheihing D, Jara MC, Castilla J, et al. Molecular cross talk between misfolded proteins in animal models of Alzheimer’s and prion diseases. J Neurosci. 2010;30:4528–35.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Erdo F, Krajcsi P. Age-Related Functional and Expressional Changes in Efflux Pathways at the Blood-Brain Barrier. Front Aging Neurosci. 2019;11:196.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Nguyen TC, Kiss JE, Goldman JR, Carcillo JA. The role of plasmapheresis in critical illness. Crit Care Clin. 2012;28:453–68. vii

    Article  PubMed  PubMed Central  Google Scholar 

  27. Boada M, Ortiz P, Anaya F, Hernandez I, Munoz J, Nunez L, et al. Amyloid-targeted therapeutics in Alzheimer’s disease: use of human albumin in plasma exchange as a novel approach for Abeta mobilization. Drug N Perspect. 2009;22:325–39.

    Article  CAS  Google Scholar 

  28. Tholen S, Schmaderer C, Chmielewski S, Forstl H, Heemann U, Baumann M, et al. Reduction of Amyloid-beta Plasma Levels by Hemodialysis: An Anti-Amyloid Treatment Strategy? J Alzheimers Dis. 2016;50:791–6.

    Article  CAS  PubMed  Google Scholar 

  29. Jin WS, Shen LL, Bu XL, Zhang WW, Chen SH, Huang ZL, et al. Peritoneal dialysis reduces amyloid-beta plasma levels in humans and attenuates Alzheimer-associated phenotypes in an APP/PS1 mouse model. Acta Neuropathol. 2017;134:207–20.

    Article  CAS  PubMed  Google Scholar 

  30. DeMattos RB, Bales KR, Cummins DJ, Paul SM, Holtzman DM. Brain to plasma amyloid-beta efflux: a measure of brain amyloid burden in a mouse model of Alzheimer’s disease. Science. 2002;295:2264–7.

    Article  CAS  PubMed  Google Scholar 

  31. Koudinov A, Matsubara E, Frangione B, Ghiso J. The soluble form of Alzheimer’s amyloid beta protein is complexed to high density lipoprotein 3 and very high density lipoprotein in normal human plasma. Biochem Biophys Res Commun. 1994;205:1164–71.

    Article  CAS  PubMed  Google Scholar 

  32. Villeda SA, Luo J, Mosher KI, Zou B, Britschgi M, Bieri G, et al. The ageing systemic milieu negatively regulates neurogenesis and cognitive function. Nature. 2011;477:90–4.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Villeda SA, Plambeck KE, Middeldorp J, Castellano JM, Mosher KI, Luo J, et al. Young blood reverses age-related impairments in cognitive function and synaptic plasticity in mice. Nat Med. 2014;20:659–63.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Middeldorp J, Lehallier B, Villeda SA, Miedema SS, Evans E, Czirr E, et al. Preclinical Assessment of Young Blood Plasma for Alzheimer Disease. JAMA Neurol. 2016;73:1325–33.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Zhu CC, Fu SY, Chen YX, Li L, Mao RL, Wang JZ, et al. Advances in Drug Therapy for Alzheimer’s Disease. Curr Med Sci. 2020;40:999–1008.

    Article  CAS  PubMed  Google Scholar 

  36. Yang AC, Stevens MY, Chen MB, Lee DP, Stahli D, Gate D, et al. Physiological blood-brain transport is impaired with age by a shift in transcytosis. Nature. 2020;583:425–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Neuwelt E, Abbott NJ, Abrey L, Banks WA, Blakley B, Davis T, et al. Strategies to advance translational research into brain barriers. Lancet Neurol. 2008;7:84–96.

    Article  CAS  PubMed  Google Scholar 

  38. Sutcliffe JG, Hedlund PB, Thomas EA, Bloom FE, Hilbush BS. Peripheral reduction of beta-amyloid is sufficient to reduce brain beta-amyloid: implications for Alzheimer’s disease. J Neurosci Res. 2011;89:808–14.

    Article  CAS  PubMed  Google Scholar 

  39. Boada M, Lopez OL, Olazaran J, Nunez L, Pfeffer M, Paricio M, et al. A randomized, controlled clinical trial of plasma exchange with albumin replacement for Alzheimer’s disease: primary results of the AMBAR Study. Alzheimers Dement. 2020;16:1412–25.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

This study was supported by the Mitchell Foundation and R01AG059321 to CS.

Author information

Authors and Affiliations

Authors

Contributions

AU developed the concept, designed the study, performed all blood exchange experiments, analyzed the histological data, prepared the final version of the figures, and wrote the paper. VK performed biochemical and behavioral studies and analyzed the data. DM-S and IM-G participated in histological image processing. SP participated in producing the revised version of this paper, figures and editing the paper. CS developed the concept, wrote the paper, managed peer-review process and provided funding for the study. All authors discussed the results and critically reviewed the paper. AU and CS are equally privileged on this work.

Corresponding authors

Correspondence to Akihiko Urayama or Claudio Soto.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Urayama, A., Moreno-Gonzalez, I., Morales-Scheihing, D. et al. Preventive and therapeutic reduction of amyloid deposition and behavioral impairments in a model of Alzheimer’s disease by whole blood exchange. Mol Psychiatry 27, 4285–4296 (2022). https://doi.org/10.1038/s41380-022-01679-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41380-022-01679-4

This article is cited by

Search

Quick links