An in
vitro model of Aβ-mediated synapse damage was used to investigate the effects of individual components of the
Gingko biloba extract EGb 761 on the synapse damage that occurs in AD. The addition of Aβ
1–42, and to a lesser extent Aβ
1–40, reduced the synaptophysin content of cortical and hippocampal neuronal cultures. The hippocampus is thought to be involved in the formation of short term memory, the loss of which is one of the earliest clinical symptoms of AD [
10]. In all assays, the effects of Aβ peptides on the synaptophysin content of neuronal cultures occurred at concentrations significantly lower than those required to kill neurons. These observation are consistent with
in vivo observations that show that a loss of synapses and a reduction in synaptophysin levels occurs before any gross neurological damage is observed [
8-
11].
Although previous studies suggest that the flavonoglycosides have protective properties against oxidative stress
in vitro [
14,
21], no protective effects of myricetin or quercetin against Aβ
1–42-induced synapse damage were observed in these studies. Moreover, flavonoglycosides have limited bioavailability after oral administration [
14] suggesting that these compounds are less likely to be responsible for the protective effects of the EGb 761 extract. In contrast, nanomolar concentrations of both ginkgolides A and B reduced the loss of synaptophysin induced by Aβ
1–42 in cortical neuronal cultures. Pre-treatment with 1 μM ginkgolide B increased the amounts of Aβ
1–42 required to reduce the synaptophysin content of cortical neurons by 50% from 50 nM in untreated neurons to 8 μM in ginkgolide B-treated neurons. The addition of Aβ
1–42 also damaged synapses in cultured hippocampal neurons; it required only 10 nM Aβ
1–42 to reduce the synaptophysin content of these cultures by 50%. While it is tempting to suggest that hippocampal neuronal synapses are more sensitive to Aβ
1–42 than cortical neuronal synapses a direct comparison is invalid considering the differences in the ages of mice used and the number of contaminating astroglial cells. In hippocampal neuronal cultures pre-treated with ginkgolide B over 1 μM Aβ
1–42 was needed to reduce the synaptophysin content by 50%.
The mechanism of the protective effect of ginkgolides was sought. We dismissed the simplest explanation, that ginkgolides reduce the ability of neurons to bind Aβ peptides, because ginkgolide-treated neurons ingested similar amounts of biotinylated-Aβ
1–42 as untreated neurons. Aβ
1–42 peptides exist in different states ranging from small soluble oligomers or Aβ-derived diffusible ligands [
5,
6], to larger fibrillar structures [
4]. Therefore it is possible that ginkgolides bind directly to Aβ
1–42 peptides and promote the formation of an inactive conformer. Although this hypothesis cannot be totally excluded, ginkgolide-treated cultures that had been washed (which removed any non-bound ginkgolides) remained resistant to the synapse damage induced by Aβ
1–42. We note with interest an observation that Aβ fibrillogenesis is accelerated in the presence of plasma, endosomal and lysosomal membranes, but reduced in Golgi membranes. The authors suggested that the composition of these membranes affected Aβ oligomerisation [
22] and the possibility that ginkgolides affect membrane composition and subsequently Aβ fibril formation within intracellular compartments cannot be excluded.
Since Aβ peptides activate phospholipase A
2 (PLA
2) [
23], a major step in the production of PAF [
24], the possibility that synapse damage occurs as a consequence of Aβ
1–42-induced production of PAF was investigated. PAF receptors are present in synapses [
25] and PAF is required for synapse maintenance [
26] and long term potential in the hippocampus [
27]. However, higher concentrations of PAF are implicated in neurodegenerative diseases including AD [
28]. Here we report that the addition of PAF caused a dose-dependent reduction in the synaptophysin content of cortical neurons; 5 nM PAF reduced synaptophysin content by 50%. The effects of PAF are transmitted via a G-protein coupled receptor [
29] and the addition of lyso-PAF, a non-acetylated structural analogue of PAF that does not bind to the PAF receptor, did not cause synapse damage. One of the many reported effects of the ginkgolides is antagonism of PAF receptors [
19] and in the current study we demonstrated that ginkgolide-treated neurons were partially resistant to the effects of PAF, as well as that of Aβ
1–42, on synapses. The synapse-protective effect of ginkgolide B was consistently stronger than ginkgolide A, consistent with reports that ginkgolide B has greater affinity for PAF receptors than ginkgolide A [
30]. Pre-treatment with two non-related PAF antagonists, hexa-PAF and CV6209 [
31,
32], also protected synapses suggesting that antagonism of the PAF receptors mediates the synaptoprotective effects of the ginkgolides. Although pre-treatment with a combination of ginkgolide B and hexa-PAF increased the synaptophysin content of cultures relative to treatment with ginkgolide B or hexa-PAF alone, their affects appeared to be additive rather than synergistic.
Both Aβ
1–42 and PAF, but not lyso-PAF, increased the production of PGE
2 in cortical neurons
in vitro [
20] raising the possibility that the effects of PAF on synapses were mediated through the production of PGE
2. While pre-treatment with ginkgolide B reduced both Aβ
1–42 and PAF-induced production of PGE
2, it did not alter the effects of PGE
2, or two EP receptor agonists (butaprost or misoprostol), on the synaptophysin content of neuronal cultures. In contrast, the EP receptor antagonist AH13205 [
33] protected against Aβ
1–42, PAF and PGE
2-induced synaptophysin loss. These results are consistent with the hypothesis that ginkgolides protect against Aβ
1–42-mediated synapse damage by modifying the production of PGE
2. This hypothesis is also consistent with epidemiological data that show that the use of cyclo-oxygenase inhibitors reduce the severity of AD [
34]. We suggest that activation of PLA
2 by Aβ
1–42 leads to sustained production of PAF which in turn increases PGE
2 production, and that high concentrations of PGE
2 damaged synapses. PGE
2 modulates synaptic transmission [
35] and although high concentrations were reported to induce apoptosis in hippocampal neurons [
36], we found that 10 μM PGE
2 did not kill cortical neurons (data not shown). Similarly we found that although the EP receptor antagonist AH13205 reduced Aβ
1–42-induced loss of synaptophysin it did not affect Aβ
1–42-induced neuronal death (data not shown).
It is worth noting that for many
Ginkgo biloba extracts, extraction procedures are used that optimise the flavonoglycoside content. However, these procedures may result in extracts that contain different amounts of ginkgolides, and a recent analysis of commercial
Ginkgo biloba supplements by liquid chromatography/mass spectrometry demonstrated remarkable variations in ginkgolide content [
37]. Therefore, variations in the ginkgolide content of different extracts may be a factor that explains the variability of results obtained in clinical studies.