Swaminathan, Suresh Kumar

Abstract Background Brain insulin resistance and cerebrovascular dysfunction emerge early in late-onset Alzheimer’s disease, but how amyloid-β (Aβ) disrupts insulin signaling at the cerebrovascular blood–brain barrier—a major site of insulin receptor signaling and transport into the brain—remains unclear. Methods We exposed two distinct human blood-brain-barrier endothelial cell models to soluble Aβ40 or Aβ42 for 1 h, followed by 100 nM insulin for 10 min. Protein and phosphoprotein responses were quantified by reverse-phase protein array, and differential expression was evaluated using linear models. Results Aβ40 reduced insulin-stimulated Akt activation and converted insulin’s normal inhibition of AMPK into modest stimulation. Aβ42 did not alter insulin-stimulated Akt signaling but moderately suppressed basal Akt activation. Conclusions These findings suggest that Aβ40 acutely impairs insulin signal transduction in BBB endothelial cells, supporting a model in which vascular Aβ exposure contributes directly to the early development of brain insulin resistance in AD.

AbstractBackgroundDecreased brain insulin levels exacerbate cognitive decline in AD. Insulin in the brain is derived from systemic circulation via the blood‐brain barrier (BBB). We hypothesize that type II diabetes (T2D) sequelae and Aβ peptide exposure disrupt insulin signaling at the BBB and inhibit insulin delivery to brain. Further, we propose insulin signaling defects at the BBB contribute to Aβ accumulation in AD brain.MethodsThe following studies were performed in wild‐type (WT) mice on regular chow (RC) diet, WT mice on high fat (HF) diet (manifest insulin resistance), APP/PS1 transgenic mice on RC diet (overexpress Aβ), and APP/PS1 mice on HF diet (overexpress Aβ + insulin resistance). After femoral injection of 125I‐insulin or 125I‐Aβ42, the brain accumulation was monitored between 0‐40 min by dynamic SPECT/CT imaging. The brain influx clearance was estimated by the slope obtained from Gjedde‐Patlak graphical analysis. Cerebral microvessels were harvested, and reverse phase protein array (RPPA) was performed to examine insulin signaling changes. Differentially expressed targets were subsequently confirmed by western blot. The brain influx of 125I‐insulin and 125I‐Aβ42 were further assessed in WT‐RC mice after internal carotid infusion with AG1024, a kinase inhibitor of the insulin receptor (IR) and insulin‐like growth factor receptor (IGF‐1R).ResultsCompared to WT‐RC, 125I‐insulin influx was decreased in WT‐HF and APP/PS1‐RC, and was further decreased in APP/PS1‐HF (4.1, 3.4, 3.5 and 2.6*10‐4 mL/min, respectively). Compared to WT‐RC, 125I‐Aβ42 influx was increased in WT‐HF and APP/PS1‐RC (8.6, 28 and 23*10‐4 mL/min, respectively). RPPA analysis revealed global disruptions in BBB insulin signaling pathways. Western blots confirmed reduced expression of IR‐β, p‐AKT and p‐GSK3β in WT‐HF and APP/PS1‐RC compared to WT‐RC. Moreover, the largest decreases were observed in APP/PS1‐HF. Infusion with AG1024 was shown to decrease 125I‐insulin influx, but increase 125I‐Aβ42 influx.ConclusionsBoth T2D and AD mice exhibited decreased brain influx of insulin and increased influx of Aβ42. This was associated with altered expression/activity of insulin signaling kinases at the BBB. Further, IR and/or IGF‐1R kinase activity were shown to differentially regulate BBB trafficking of insulin and Aβ42. Thus, BBB insulin signaling is important for delivering insulin to brain and restricting pathological uptake of Aβ.

Abstract OBJECTIVE The K16ApoE peptide enhances delivery of multiple agents across the blood-brain barrier (BBB). Transgenic mouse models are central to elucidating the underlying pathophysiology of Alzheimer’s Disease (AD) and provide a system for evaluating novel therapeutic strategies. PET imaging plays a central clinical role in diagnosing human cases of AD but has had variable performance in mouse models. We investigated the role of K16ApoE to enhance delivery of a radiolabeled PET imaging tracer, 11C-PiB and assess whether this corresponds to improved PET sensitivity in APP/PS1 transgenic mice. METHODS Brain-delivery of 11C-PiB was accomplished by successive injections of K16ApoE and 11C-PiB. Distribution of 11C-PiB to the brain and heart was quantified via dynamic PET/CT imaging and digital autoradiography. RESULTS K16ApoE increased the brain uptake of 11C-PiB in both wild-type (WT) and APP/PS1 mice. Administration of K16ApoE increased the PET standard uptake value of 11C-PiB at 5 minutes in WT mice from 1.132 to 2.963 (p=0.006) and in APP/PS1 mice from 0.842 to 3.268 (p=0.016). Enhancement peaked at 5 minutes. Binding was reversible with similarly increased kinetics in both WT and APP/PS1 mice. The absolute values were higher in APP/PS1 mice suggesting increased retention. The increased retention in APP/PS1 mice was consistent with specific binding to A-beta plaques as unlabeled PiB reduced 11C-PiB signal retention. CONCLUSION K16ApoE mediates enhancement of 11C-PiB signal in APP/PS1 mice brains with increased PET sensitivity. There is increased uptake kinetics in both WT and APP/PS1 mice with specific A-beta plaque binding in the latter. This enhanced delivery of the PET tracer has implications for development and testing of new hypotheses and the efficacy of novel therapeutic paradigms. K16ApoE has potential for improving delivery of several agents across the BBB. This has implication for delivery of diagnostic and therapeutic agents for neurodegenerative and neuro-oncologic diseases.

Impaired brain clearance of amyloid-beta peptides (Aβ) 40 and 42 across the blood–brain barrier (BBB) is believed to be one of the pathways responsible for Alzheimer’s disease (AD) pathogenesis. Hyperinsulinemia prevalent in type II diabetes was shown to damage cerebral vasculature and increase Aβ accumulation in AD brain. However, there is no clarity on how aberrations in peripheral insulin levels affect Aβ accumulation in the brain. This study describes, for the first time, an intricate relation between plasma insulin and Aβ transport at the BBB. Upon peripheral insulin administration in wild-type mice: the plasma clearance of Aβ40 increased, but Aβ42 clearance reduced; the plasma-to-brain influx of Aβ40 increased, and that of Aβ42 reduced; and the clearance of intracerebrally injected Aβ40 decreased, whereas Aβ42 clearance increased. In hCMEC/D3 monolayers (in vitro BBB model) exposed to insulin, the luminal uptake and luminal-to-abluminal permeability of Aβ40 increased and that of Aβ42 reduced; the abluminal-to-luminal permeability of Aβ40 decreased, whereas Aβ42 permeability increased. Moreover, Aβ cellular trafficking machinery was altered. In summary, Aβ40 and Aβ42 demonstrated distinct distribution kinetics in plasma and brain compartments, and insulin differentially modulated their distribution. Cerebrovascular disease and metabolic disorders may disrupt this intricate homeostasis and aggravate AD pathology.