Cited by 356Alzheimer's disease research and treatmentsNeuroinflammation and Neurodegeneration MechanismsPeroxisome Proliferator-Activated Receptors

The DOI matches its Crossref record; 98 of the 99 references it cites were found in a registry or an index; 28 of the 70 sources its claims cite were checked for support.

Mechanisms Underlying the Rapid Peroxisome Proliferator-Activated Receptor-γ-Mediated Amyloid Clearance and Reversal of Cognitive Deficits in a Murine Model of Alzheimer's Disease

Open access

Abstract

Alzheimer's disease is associated with a disruption of amyloid β (Aβ) homeostasis, resulting in the accumulation and subsequent deposition of Aβ peptides within the brain. The peroxisome proliferator-activated receptor-γ (PPARγ) is a ligand-activated nuclear receptor that acts in a coupled metabolic cycle with Liver X Receptors (LXRs) to increase brain apolipoprotein E (apoE) levels. apoE functions to promote the proteolytic clearance of soluble forms of Aβ, and we found that the synthetic PPARγ agonist, pioglitazone, stimulated Aβ degradation by both microglia and astrocytes in an LXR and apoE-dependent manner. Remarkably, a brief 9 d oral treatment of APPswe/PS1Δe9 mice with pioglitazone resulted in dramatic reductions in brain levels of soluble and insoluble Aβ levels which correlated with the loss of both diffuse and dense-core plaques within the cortex. The removal of preexisting amyloid deposits was associated with the appearance of abundant Aβ-laden microglia and astrocytes. Pioglitazone treatment resulted in the phenotypic polarization of microglial cells from a proinflammatory M1 state, into an anti-inflammatory M2 state that was associated with enhanced phagocytosis of deposited forms of amyloid. The reduction in amyloid levels was associated with a reversal of contextual memory deficits in the drug-treated mice. These data provide a mechanistic explanation for how PPARγ activation facilitates amyloid clearance and supports the therapeutic utility of PPARγ agonists for the treatment of Alzheimer's disease.

Overview

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Written from the paper’s full text.

TL;DR

Pioglitazone, a PPARγ agonist, rapidly cleared soluble and deposited amyloid-β in APP/PS1 mice through PPARγ–LXRα–apoE-dependent degradation and M2 microglial polarization. A 9 d treatment reversed contextual memory deficits, supporting PPARγ agonists as a therapeutic approach for Alzheimer’s disease.

Key findings

  • In primary microglia and astrocytes, pioglitazone stimulated dose-dependent intracellular degradation of soluble Aβ42; this was blocked by PPARγ antagonist T0070907 and LXR antagonist 22HC, impaired in apoe−/− cells, and restored by exogenous ApoE or ApoA1.
  • PPARγ conditional knockout mice showed >70% lower cortical pparγ mRNA and >50% reductions in cortical ABCA1 and ApoE protein, demonstrating a PPARγ–LXR linkage in brain.
  • In 6- and 12-month-old APP/PS1 mice, 9 d oral pioglitazone (80 mg·kg−1·d−1) reduced 6E10 plaque area by ~40% and ~30%, and thioS+ dense-core plaques by ~40% and ~30%, respectively; at 6 months soluble and insoluble Aβ fell by ~50%, while at 12 months soluble Aβ40 fell 40% and insoluble Aβ40/Aβ42 fell 50%/40%, with no significant change in soluble Aβ42.
  • Treatment increased M2 markers (Ym1 at 6 months; Fizz1, Ym1, Arg1 at 12 months), reduced Il-1β and tnfα at 12 months, and reversed contextual memory deficits to wild-type levels; >90% of cortical microglia in drug-treated animals internalized amyloid by qualitative assessment.

Methods

  • Primary microglia and astrocytes from postnatal C57BL/6J or apoe−/− pups were treated with pioglitazone ± T0070907, 22HC, ApoE, or ApoA1; Aβ levels were measured by ELISA, with Western blot and qPCR for related genes/proteins.
  • APP/PS1 and wild-type littermates at 6 and 12 months were gavaged with pioglitazone (80 mg·kg−1·d−1) or vehicle for 9 d; PPARγ fl/fl × GFAP-cre mice were used for conditional knockout. Brains were analyzed by immunohistochemistry (6E10, thioflavin S, Iba1, CD45, GFAP), Aβ ELISA, qPCR, and Western blot.
  • Contextual fear conditioning was performed in 12-month-old mice after 9 d treatment, with open-field testing for noncognitive behavior; plaque counts were done by a blinded observer and qPCR used the ΔΔCT method normalized to GAPDH.

Limitations

  • The paper states pioglitazone is poorly blood-brain barrier permeable, necessitating 80 mg·kg−1·d−1, a dose higher than previously administered and ~8 times the clinically approved dose, with a very short 9 d treatment interval.
  • The paper notes astrocyte Aβ quantification was limited by the GFAP marker, astrocyte cell numbers surrounding plaques could not be determined, and Aβ-positive astrocytes represented only a minor subset that was not quantitatively evaluated; microglial Aβ uptake at 6 months was difficult to assess due to few Iba1+ cells.
  • Evident from the text: the mechanistic and behavioral conclusions derive from an APP/PS1 mouse model and primary rodent glia, with several microglial/astrocytic findings based on qualitative imaging rather than fully quantitative causal assays.

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Integrity signals

Registry

Crossref · 10.1523/jneurosci.5268-11.2012

Cites

98 of 98 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

62 Own result · 31 Own interpretation · 15 Partly supported · 10 No full text of the sources · 4 Supported · 4 Sources not found · 3 Own method · 2 Not checked yet · 1 Supported so far · accuracy not yet measured

Show all 95 claims

  • Probably not a substantial claim. 14
  • It may state two separate claims as one. 25
37 of 37
  • The paper relies on this without support.

    The relationship between PPARγ and LXRs has not been explored in the brain.

    “However, these relationships have yet to be explored in the brain.”
  • The paper relies on this without support.

    Little is known about the mechanisms modulating the M2 phenotypic conversion in the AD brain.

    “While M2 gene expression has been detected in the AD brain, little is known about the mechanisms modulating this phenotypic conversion (Colton et al., 2006; Jimenez et al., 2008; Maier et al., 2008).”
  • The paper relies on this without support.

    APP/PS1 transgenic mice begin depositing fibrillar thioflavin S+ plaques at approximately 5–6 months of age.

    “The APP/PS1 transgenic mice begin depositing fibrillar thioS+ plaques at ~5–6 months of age.”
  • The paper relies on this without support.

    Robust amyloid phagocytosis in response to drug treatment, as seen in this study, has never been observed before.

    “However, robust amyloid phagocytosis in response to drug treatment, as seen here, has to our knowledge never been observed before.”
  • The paper relies on this without support.

    Astrocytes greatly outnumber microglia in the CNS.

    “Astrocytes greatly outnumber microglia in the CNS, and their ability to remove even modest amounts of Aβ in the brain may have a significant impact on amyloid clearance in the brain.”
  • The paper relies on this without support.

    Microglia are the principal immune effector cells in the CNS and the only professional phagocytes in the CNS.

    “Microglia are the principal immune effector cells in the CNS and are the only professional phagocyte in the CNS.”
  • The paper relies on this without support.

    In AD, microglia are competent phagocytes but fail to effectively clear deposited Aβ from the brain.

    “An enigmatic feature of AD is that although microglia are competent phagocytes, they fail to effectively clear deposited Aβ from the brain.”
7 of 7

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Metadata

Authors
Mandrekar-Colucci, S., Karlo, J. C., & Landreth, G. E.
Affiliations
  • Case Western Reserve University (US)
  • Case Comprehensive Cancer Center
Venue
The Journal of Neuroscience
Published
2012-07-25
Volume
32
Issue
30
Pages
10117-10128
ISSN
  • 0270-6474 (ISSN-L)
  • 1529-2401
OpenAlex
W2006505402
Cited by
355
References
99
Citations by year
2026: 6 · 2025: 16 · 2024: 16 · 2023: 18 · 2022: 22 · 2021: 32 · 2020: 20 · 2019: 27 · 2018: 36 · 2017: 25 · 2016: 34 · 2015: 28 · 2014: 35 · 2013: 34 · 2012: 6
FWCI
19.42
Type
journal article
Language
en
Open access
Locations
  • Journal of Neuroscience (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (submittedVersion)
  • PubMed Central (submittedVersion)
Funders
  • Case Western Reserve University
  • National Institutes of Health (5r01ag030482-05, 5-R01-)
  • National Institute on Aging (5-R01-AG030482, R01-AG030482)
  • National Institute of Neurological Disorders and Stroke (F31NS061445)
Topics
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
  • Life Sciences › Neuroscience › Neurology › Neuroinflammation and Neurodegeneration Mechanisms
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Peroxisome Proliferator-Activated Receptors
Keywords
Alzheimer's disease, amyloid-beta clearance, PPARγ agonists, pioglitazone, liver X receptor, apolipoprotein E, microglial polarization, M2 microglia, astrocytes, amyloid plaques, cognitive impairment, APPswe/PS1ΔE9 mice, phagocytosis, anti-inflammatory therapy
MeSH terms
Liver X Receptors, Pioglitazone, Alzheimer Disease, Animals, Apolipoproteins E, Astrocytes, Brain, Cells, Cultured, Cognition, Disease Models, Animal, Peptide Fragments, Signal Transduction, Amyloid beta-Peptides, Microglia, Maze Learning, Thiazolidinediones, PPAR gamma, Mice, Orphan Nuclear Receptors

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