HIV-infected patients are either aging with HIV infection or becoming newly infected at older ages. This, compounded by the amyloidogenic effects of Tat protein, and possibly the lipodystrophic effects of HAART medications seem to promote the AD-like pathology seen in some 50% of the HIV-1 infected population [
4]. Given that this type of pathology may contribute to the neurobehavioral morbidity of HIV-1 infection, we created a mouse model of HIV-1 Tat-induced AD-like pathology by crossing PSAPP and HIV-1 Tat (GT-tg) transgenic mice. This effectively mimics age-related changes in A-beta deposition [
8] with superimposed brain targeted Tat expression in the PSAPP/Tat mouse model [
9].
As expected in our initial dose ranging study in Tat transgenic mice, brain-targeted expression was sufficient to cause a dose dependent increase in neuronal degeneration (), and tau phosphorylation () while causing a decrease in the anit-apoptotic protein, Bcl-xL ( and ). The microtubule-associated protein tau is abundantly expressed in neurons, and is deposited in cells in an abnormally phosphorylated state as fibrillar lesions in many neurodegenerative diseases, particularly AD. In neurons, the protein plays a crucial role in binding and stabilizing microtubules, and regulating axonal transport. Both are controlled by site-specific phosphorylations. There is growing evidence that disruption in the normal phosphorylation state of tau followed by conformational changes plays a key role in the pathogenic events that occur in AD [
15]. HAD patients have been shown to have significantly increased total and phopshorylated-tau concentrations similar to AD [
6]. Aberrant phosphorylation of tau protein might be responsible for the breakdown of microtubules in affected neurons classically seen in AD not only because the altered protein has greatly reduced microtubule-promoting ability but also because it interacts with normal tau, making the latter unavailable for promotion of tubulin assembly into microtubules [
15]. Past
in vitro studies demonstrated HIV-1 Tat directly modulates polymerization of microtubules; a process which positively correlates with apoptosis. Thus the decrease in the anti-apoptotic Bcl-xL which positively correlated dose dependently with dox administration (and thus Tat expression) is in accord with previous studies. This effect of Tat on the self-association of tubulin may be of interest for studies on the mechanism of microtubule formation in the HIV-infected brain and could be used in the design of new agents aimed at protecting neuronal microtubules [
16]. Furthermore Campbell and colleagues demonstrated this Tat-mediated effect on microtubules occurs without the full-length protein. Indeed peptides from its central glutamine-rich and basic regions are involved in Tat-mediated apoptosis [
17].
Based on previous studies [
18] as well as the dox dose-dependent decrease in Bcl-xL and increase in neurodegeneration, we hypothesize that HIV-1 Tat is able to induce apoptosis through both the release of cytochrome c, removal of the Bcl-xL suppression of Bax, and/or an increase in intracellular Ca
2+ via the phospholipase C pathway [
19]. First, it has previously been shown that Tat is able to directly trigger cytochrome c release, a central event in the mitochondrial apoptotic pathway. A recent study also implicates Ca2+ uptake into mitochondria in Tat-dependent toxicity [
20]. Macho
et al [
21] show that, in lymphocyte cultures under low serum conditions, Tat accumulates at the mitochondria and positively correlates with disruption of the mitochondrial membrane potential [
21]. This then leads to the release of pro-apoptotic factors such as cytochrome c. Regarding exitotoxic effects and Tat-mediated cell death, induction of the phospholipase c pathway by Tat confers a rapid increase in neuronal intracellular Ca2+ in primary neuron cultures, presumably causing phospholipase C and inositol phosphate-3 release, and a subsequent response via a plasma membrane glutamate receptor [
19,
22].
In this novel PSAPP/GT-tg model of Tat-induced AD-like pathology, amyloid burden, neurodegeneration, and apoptotic signaling were significantly enhanced by Tat expression. Moreover, superimposed Tat expression appears to over-ride gender differences seen in plaque loads between male and female PSAPP mice. Previous investigations [
9] have shown that neurodegeneration and apoptosis are positively correlated with the level and spatial distribution of Tat mRNA and/or protein expression [
9] and occurred only when dox is administered but not without dox, or in dox-treated wild-type normal mice. Therefore, these findings did not result from an insertional mutation, or other unknown nonspecific effects.
Several studies have focused on Tat-mediated induction of amyloidosis
in vitro. We previously demonstrated Tat inhibits microglial uptake of A-beta1-42 peptide, a process that is enhanced by interferon-gamma (IFN- γ) and rescued by the STAT1 inhibitor (-)-epigallocatechin-3-gallate (EGCG) [
7]. It is hypothesized that reduced A-beta uptake occurs through IFN- γ mediated STAT1 activation, which promotes a phenotype switch from a phagocytic to an antigen presenting phenotype in microglia. Additionally, we showed that HIV-1 Tat significantly disrupts apolipoprotein-3 (Apo-E3) promoted microglial A-beta uptake [
7]. As microglial are a primary means for A-beta removal from brain parenchyma, this process may be involved in the enhanced amyloid burden in the PSAPP/GT-tg model compared to the PSAPP model. Tat protein has also been shown to directly interact with the neuronal low density lipoprotein (LRP) receptor and thus inhibit the uptake of its ligands including apolipoprotein E4 (Apo-E4) and A peptide [
23]. A similar inhibition of LRP may occur in microglia. Moreover Daily and colleagues [
24] have demonstrated that Tat competitively and reversibly inhibits the extracellular A-beta degrading enzyme, neprilysin. However it was also found that both Tat peptides and Tat protein were slowly hydrolyzed by neprilysin. Thus although the accumulation of Tat-derived proteolytic fragments may serve to inhibit neprilysin and increase amyloid beta peptide levels, one would suspect that there is also some level of compensatory destruction of Tat protein also, by neprilysin. Therefore the mechanisms involved in enhanced amyloid deposition mentioned above may be acting in concert in this model.
Future studies using this model will be required to delineate the molecular steps most important in HIV-1 Tat-induced AD-like pathology including amyloid burden and tau phosphorylation. Combined with behavioral testing this should lay the foundation to isolate new mechanistic underpinnings and treatment targets. Additionally the model may simulate some prognostic implications for newly HIV-infected patients in terms of brain pathology and future development of neurobehavioral deficits.