Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by two main pathologic hallmarks: 1) extracellular senile plaques primarily comprised of accumulated amyloid β (Aβ) peptide and 2) intracellular neurofibrillary tangles comprised mainly of aggregated hyperphosphorylated tau
[1],
[2]. A large body of evidence has demonstrated that pathologically altered amyloid precursor protein (APP) processing is a central player in the AD etiology
[1]. Additionally, there is significant evidence implicating oxidative stress as a key proponent in the events leading to AD
[3]. High reactive oxygen species (ROS) levels are typically associated with the aging process, where there is ROS overproduction in conjunction with a reduction in the cellular antioxidant defense
[4]. Most cases of AD present with signs of oxidative damage including lipid peroxidation, protein carbonylation, and DNA damage
[5],
[6],
[7]. In addition, aspects of Aβ toxicity have been attributed to its oxidative capability. Indeed, Aβ has been shown to promote oxidation in several model systems
[8],
[9], increase hydrogen peroxide levels, and decrease cytochrome C oxidase activity in the Tg2576 mouse model of AD
[10]. Aβ has also been shown to induce the formation of ROS in mature hippocampal neurons, mediated via N-methyl-D-Aspartate (NMDA) receptors. This effect was blocked by a mitochondrial uncoupler, indicating that the oxidative stress is of mitochondrial origin
[11]. Additionally, Aβ has been shown to enter mitochondria and compromise their integrity through inactivation of the superoxide dismutase 2 (SOD-2) and a subsequent increase in superoxide levels
[12]. Aβ-induced mitochondrial dysfunction has further been linked to AD through studies showing that the genetic reduction of SOD-2 in AD model mice can amplify multiple AD symptoms
[13],
[14] and lead to increased plaque deposition
[15]. Conversely SOD-2 overexpression can alleviate several AD-related symptoms, most notably the learning and memory deficits characteristic of AD
[16],
[17].
There is clearly a prominent role for mitochondrial superoxide in mediating the effects of Aβ on neuronal function
[16]. Aβ, however, not only accumulates in neuronal parenchyma, but can also deposit on blood vessel walls in a process referred to as cerebral amyloid angiopathy (CAA)
[18],
[19]. CAA has been documented extensively in AD, with a wealth of evidence linking AD with vascular dysfunction. This evidence includes existence of cerebrovascular disease in the AD brain, blood brain barrier dysfunction, and several common predisposing cerebrovascular risk factors, such as stroke, heart disease, hypertension and atherosclerosis
[20],
[21],
[22],
[23]. The endothelial nitric oxide synthase (eNOS) produces nitric oxide (NO)
[24], which is responsible for smooth muscle relaxation and regulation of muscle tone
[25],
[26],
[27]. During conditions of oxidative stress, production of superoxide and its derived oxidants, induce uncoupling of eNOS leading to the production of NOS-derived superoxide instead of NO
[28],
[29]. This effect is mediated primarily by Akt-dependent phosphorylation of eNOS at serine 1177
[30],
[31]. The subsequent imbalance between NO and superoxide potentiates oxidative stress and can contribute to the onset of a variety of vascular diseases in multiple organs
[32], including the brain which is particularly vulnerable to oxidative damage
[33].
Although ROS have been well documented to contribute to both vascular and neurodegenerative diseases, the specific source of ROS for each particular disease is still unresolved. Given the solid link between mitochondrial dysfunction and AD, our interest lies in elucidating the effects of mitochondrial ROS on AD pathology. We have already demonstrated the involvement of mitochondrial superoxide in the learning and memory deficits characteristic of AD
[16]. Our next step was to identify whether this effect extended systemically to the vascular system. Multiple studies implicate mitochondrial ROS with vascular and neuronal dysfunction. For example, using mutant mice with reduced expression of SOD-2, Wenzel and colleagues demonstrated an increased oxidative stress with disrupted vascular function in these animals in relation to cardiac disease
[34]. Iadecola and colleagues used an NADPH oxidase mutant mouse and showed similar effect of ROS on the brain vasculature
[35].
Vascular homeostasis is of paramount importance for proper neuronal function, as blood flow is required to maintain normal neuronal physiology. AD-related blood flow deficits have been correlated with neuronal dysfunction characteristic of the disease
[36],
[37]. Of particular interest is the disruption of axonal transport during AD
[38]. Axonal transport relies amongst other on a network of cytoskeletal proteins and their associated molecules. One such microtubule-associated protein is tau, of which the involvement in the pathology of AD has been extensively documented. Tau functions as a microtubule stabilizing protein and its partial phosphorylation is required for its normal function. Tau hyperphosporylation, however, leads to two negative consequences: 1) loss of function by dislodging from microtubules and subsequently destabilizing them and 2) gain of toxic function by its capacity to sequester normal tau and other microtubule associated proteins. Therefore there is little doubt that abnormal tau metabolism contributes to decreased axonal transport associated with AD
[39]. Aβ and oxidative stress have also been suggested to contribute to the axonal pathology observed in AD
[40]. Less clear, however, is the mechanism by which this contribution occurs.
AD-related vascular, mitochondrial, and neuronal dysfunctions collectively led us to the formulation of our hypothesis that mitochondrial superoxide is a central player in the mechanisms by which Aβ instills multiple AD pathologies, including vascular and neuronal dysfunction. Therefore, we posited that SOD-2 overexpression could prevent AD-related blood flow impairments and axonal transport deficits in the Tg2576 mouse model of AD. To test this hypothesis, we utilized magnetic resonance imaging (MRI) to assess cerebral blood flow and the rates of axonal transport in the Tg2576 mice overexpressing SOD-2 at ages ranging from 4 to 16 months. Levels of eNOS and tau as well as their modulation by phosphorylation were also determined.
Our findings suggest that Aβ can exert widespread effects partially via mitochondrial ROS impacting multiple systems, most notably vascular and neuronal physiology. This impact may be a key event in the etiology of AD-related blood flow and axonal transport deficits and helps elucidate the cellular mechanisms that precipitate neuronal degeneration. The understanding of such events is crucial to preventing or potentially reducing neuronal injury during AD.