Nguyen, Thi Kim Oanh

AbstractBackgroundAlzheimer Disease (AD) currently has no effective treatments. A consistent failure of recent clinical trials focused on Aβ or pTau necessitates the identification of novel therapeutic targets and strategies. Since abnormal brain energy homeostasis and mitochondria dysfunction underlie early stages of AD, the development of treatments to restore these defects could be beneficial. We synthesized small molecules that selectively and mildly inhibit mitochondrial complex I (MCI) which restored synaptic and cognitive function in APP/PS1 and 3xTgAD mice. One of the most important mechanisms improved by the treatment included restoration of glucose uptake/utilization that resulted in augmented cellular energetics in mouse brains. However, mechanistic relationship between MCI inhibition, glucose uptake/utilization and mitochondrial function remains to be determined.MethodNeuroblastoma SH‐SY5Y cells that express mutant human APP protein (APPswe) and WT cells were treated with MCI inhibitors in a time‐ and dose‐dependent manner. Flow cytometry was used to measure the translocation of glucose transporters to the cell surface. Changes in protein expression in response to treatment were assessed using Western blot analysis. Changes in mitochondrial morphology were monitored using electron microscopy. Cellular energetics was assessed using a Seahorse Extracellular Flux Analyzer. The non‐radioactive Glucose Uptake‐Glo™ assay was utilized for measuring glucose uptake in cells.ResultsTreatment of with SH‐SY5Y‐APPswe cells with MCI inhibitors within an hour increased surface translocation of GLUTs enhancing glucose uptake and utilization. The effect persisted for 48 hrs. The mechanism of enhanced glucose uptake was associated with AMPK‐dependent activation of NRF2 pathway but not AKT. Furthermore, the improvement in the bioenergetic parameters including Spare Respiratory Capacity, an indicator of the mitochondrial ability to produce energy under stress conditions, and ATP levels were found 24 hrs after the compound treatment. Treatment activated mitochondrial morphofunctional pathway (e.g., fission, fusion, biogenesis and turnover) consistent with the improved cellular bioenergetics. Similar mechanisms were confirmed in the brain tissue of 3xTgAD mice treated with one of the compounds.ConclusionsPartial MCI inhibition activates multiple mechanisms essential for improved energy homeostasis and mitochondrial function. These mechanisms could be consistently induced by our compounds in vivo and in human brain cells support translational potential of this therapeutic strategy.

Alzheimer’s disease (AD) has no cure. Earlier, we showed that partial inhibition of mitochondrial complex I (MCI) with the small molecule CP2 induces an adaptive stress response, activating multiple neuroprotective mechanisms. Chronic treatment reduced inflammation, Aβ and pTau accumulation, improved synaptic and mitochondrial functions, and blocked neurodegeneration in symptomatic APP/PS1 mice, a translational model of AD. Here, using serial block-face scanning electron microscopy (SBFSEM) and three-dimensional (3D) EM reconstructions combined with Western blot analysis and next-generation RNA sequencing, we demonstrate that CP2 treatment also restores mitochondrial morphology and mitochondria-endoplasmic reticulum (ER) communication, reducing ER and unfolded protein response (UPR) stress in the APP/PS1 mouse brain. Using 3D EM volume reconstructions, we show that in the hippocampus of APP/PS1 mice, dendritic mitochondria primarily exist as mitochondria-on-a-string (MOAS). Compared to other morphological phenotypes, MOAS have extensive interaction with the ER membranes, forming multiple mitochondria-ER contact sites (MERCS) known to facilitate abnormal lipid and calcium homeostasis, accumulation of Aβ and pTau, abnormal mitochondrial dynamics, and apoptosis. CP2 treatment reduced MOAS formation, consistent with improved energy homeostasis in the brain, with concomitant reductions in MERCS, ER/UPR stress, and improved lipid homeostasis. These data provide novel information on the MOAS-ER interaction in AD and additional support for the further development of partial MCI inhibitors as a disease-modifying strategy for AD.

AbstractBackgroundAlzheimer Disease (AD) currently has no effective treatments. A consistent failure of recent clinical trials focused on Aβ or pTau protein accumulation necessitates the identification of novel therapeutic targets and strategies. The loss of cellular energetics is considered as an underlying dysfunction in AD. We have identified small molecule compounds that partially inhibit mitochondrial complex I (MCI), blocking neurodegeneration via the induction of multiple neuroprotective mechanisms, including the improvement of cellular energy homeostasis in vitro and in vivo in multiple AD models. Mitochondria are highly motile organelles that respond to physiologic cues through the dynamic properties of mitochondrial networks, which are balanced by the flux of fusion and fission events. This study aims to demonstrate that treatment with partial MCI inhibitors improves cellular energetics and function via modulation of mitochondrial dynamics using multiple models, including neuronal cells generated from human iPSCs derived from ApoE4+ late‐onset AD (LOAD) patients and ApoE3+ controls.MethodChanges in protein expression in response to treatment were assessed using the Western Blot analysis. The investigation of mitochondrial morphology was done using electron microscopy. Flow cytometry was used to measure the translocation of glucose transporters to the cell surface. Cellular energetics was assessed using a Seahorse Extracellular Flux Analyzer. Results were validated in 3xTgAD mice.ResultWe found that the 2D culture of LOAD cultures had accumulation of pTau and a significant reduction in the expression of proteins involved in mitochondrial dynamics and function, including mitochondrial preprotein translocase TIM23, mitochondrial transcription factor A, transcription factor FoxO3, and mitochondrial fusion proteins MFN2 and OPA1. Treatment with partial MCI inhibitors improved mitochondrial dynamics, rescuing the expression of MFN2 and OPA1, neuronal bioenergetics, and mitochondrial morphology. MCI inhibitors increased surface translocation of GLUTs enhancing glucose uptake and utilization, which could be measured in 3xTgAD mice in vivo using translational biomarker FDG‐PET.ConclusionMild stress caused by the application of MCI inhibitors induced mitochondrial fusion, improved energy homeostasis, and enhanced glucose uptake and utilization in vitro and in vivo. These findings could be instrumental for the validation of a novel medicinal approach and the development of biomarkers for therapeutic efficacy.

AbstractBackgroundNeurons and astrocytes were differentiated separately from human induced pluripotent stem cells (HiPSC) derived from Late‐Onset Alzheimer Disease (LOAD) female patients carrying Apolipoprotein E4 (ApoE4) allele. Cells from age and sex matched healthy subject carrying Apolipoprotein E3 allele were used as control. These neuronal, astrocytic, and their co‐cultures were assessed to investigate cell‐specific AD phenotypes (Figure 1). We recently demonstrated that application of a small molecule partial mitochondrial complex I inhibitor CP2 blocked neurodegeneration and cognitive decline in multiple mouse models of AD. However, the demonstration that this novel therapeutic approach is efficacious in human brain cells has not been done. Here, we aimed to validate neuroprotective mechanisms induced by CP2 using patient‐derived neuronal cells form LOAD patient. Outcomes will further support the development of these compounds for clinical application.MethodAxonal trafficking of MitoTracker Red stained mitochondria in neuron‐astrocyte co‐cultures was captured using live confocal imaging. The Seahorse XFe96 flux analyzer was used to evaluate mitochondrial bioenergetics in co‐cultures and pure neuronal or astrocytic cultures. Cell Viability Assays were used to perform H2O2 challenge. Quantitative polymerase chain reaction (qPCR), immunohistochemistry, and western blot were carried out to assess alterations in the expression of relevant genes and protein products.ResultWe have found that LOAD cells have a significant reduction in the percentage of motile mitochondria in axons, increased accumulation of neuronal phosphorylated Tau, and altered bioenergetics in neurons and astrocytes compared to the control cells. qPCR revealed elevated expression of inflammation related genes in LOAD co‐cultures. CP2 treatment at concentrations found therapeutically relevant in vivo in APP/PS1 and 3xTgAD mice improved cellular bioenergetics, rescued mitochondrial motility, and provided neuroprotection against H2O2 induced oxidative stress.ConclusionLOAD HiPSC‐derived neuronal co‐cultures and individual brain cells recapitulate mechanisms associated with LOAD allowing validation of a novel mitochondria‐targeted therapeutics. Our results support previous observation in AD mice and the hypothesis that partial inhibition of mitochondrial complex I activates neuroprotective compensatory mechanisms improving cellular energetics in LOAD human neurons even in the presence of mitochondria with abnormal dynamics and energetics. Further efforts are focused on the determination of a cell‐specific mechanisms of neuroprotection.