In recent years, the use of mixed co-cultures and chimeric mice has highlighted the importance of non-neuronal cells in the motoneuron injury occurring in ALS (
Gong et al., 2000;
Pramatarova et al., 2001;
Lino et al., 2002;
Boillee et al., 2006;
Nagai et al., 2007;
Yamanaka et al., 2008). One of the difficulties in determining the contribution of astrocytes and microglia to disease onset and progression is the complexity of interactions occurring between non-neuronal cells and motoneurons
in vivo. On the other hand, using an
in vitro model system, where functional effects can be investigated, may represent too simplified an experimental system. In order to begin to understand the complex cross-talk between astrocytes and motoneurons, we analysed the transcriptome of astrocytes isolated from the spinal cord of presymptomatic SOD1
G93A compared with control mice. Emerging single pathways of relevance were then investigated using
in vitro models. We were able to compare the altered gene expression in astrocytes with data obtained from motoneurons at the same disease stage, as previously reported (
Ferraiuolo et al., 2007). This enabled us to focus attention on dysregulated pathways involved in the interaction between astrocytes and motoneurons. The use of ‘separated co-cultures’ was a helpful new tool allowing the investigation of functional changes triggered by the interaction between mutant SOD1 astrocytes and normal motoneurons. Finally, using our bank of human biosamples, we were able to investigate the relevance of the findings in the cellular and murine experimental model systems in relation to human ALS.
Lactate is an important source of energy for motoneurons and, according to the lactate shuttle hypothesis, astrocytes are the main providers of this substrate (
Pellerin and Magistretti, 1994). In this model, motoneurons stimulate aerobic glycolysis in astrocytes through glutamate release. Sodium-coupled re-uptake of glutamate by astrocytes results in the activation of the Na
+/K
+-ATPase pump that consumes the ATP produced by phosphoglycerate kinase (
Pgk). This triggers glucose uptake and its glycolytic processing, resulting in the release of lactate from astrocytes. Lactate can then contribute to the activity-dependent fuelling of the neuronal energy demands associated with synaptic transmission (
Pellerin et al., 2007).
The microarray data in this report suggest that astrocytes isolated from presymptomatic SOD1
G93A mice undergo a general downregulation of all the crucial transcripts involved in the lactate shuttle pathway, including the glutamate transporter Glast, Na
+/K
+-ATPase, Pgk and the lactate efflux transporter Slc16a4. Upregulation by motoneurons of transcripts involved in the tricarboxylic acid cycle and respiratory chain, as well as lipid metabolism, suggests a condition of energy deprivation that is likely to represent a reaction to the lack of substrate provision from astrocytes (
Ferraiuolo et al., 2007). Lactate measurements in the spinal cord of transgenic mice confirmed that SOD1
G93A mice develop this metabolic impairment between the age of 30 days, when lactate levels are still normal, and 40 days, when there is a 20% decrease in lactate, with a further decrease by 30% at 60 days. Recent reports indicate that initial evidence of denervation in mutant SOD1 mice can be detected at ~40 days (
Hegedus et al., 2007;
Hayworth and Gonzalez-Lima, 2009), providing an interesting link between the onset of denervation and motoneuron metabolic dysfunction.
In agreement with the lactate shuttle model, our
in vitro data show that astrocytes expressing SOD1
G93A, when cultured as a monoculture, do not show any alteration in lactate secretion, while the addition of non-transgenic motoneurons to the cultures, probably through glutamate release, triggers the impairment. These data suggest that the metabolic impairment observed does not require the expression of SOD1
G93A in the motoneurons; however, these cells are responsible for triggering the dysfunction. The upregulation of the lactate and the glucose transporters (Slc16a1 and Glut3) that was observed
in vivo in motoneurons from SOD1
G93A mice was also reproduced
in vitro, when non-transgenic motoneurons were grown on SOD1
G93A primary astrocytes. This indicates that dysregulated energy provision by mutant SOD1 astrocytes occurs in response to motoneurons, regardless of the genotype. Interestingly, a previous report has also shown that normal motoneurons grown on transgenic astrocytes develop mitochondrial membrane potential abnormalities, which could also be related to lack of energy support (
Bilsland et al., 2008).
The finding that spinal astrocytes from patients with ALS also show downregulation of Slc16a4 supports the relevance to the human disease of the impairment affecting lactate metabolism and the trafficking of lactate between motoneurons and astrocytes.
Astrocytes from SOD1
G93A mice also show high expression of trophic factors, including
Ngf. NGF is secreted by astrocytes as pro-NGF (33 kDa) and this is then cleaved in the extracellular space to produce mature NGF (13 kDa), through a complex mechanism involving several proteases (
Bruno and Cuello, 2006;
Lim et al., 2007). It was previously reported that mature NGF represents only a minor fraction of total extracellular NGF (
Bierl et al., 2005). Mature NGF is known to bind the TrkA receptor with high affinity, leading to neuronal differentiation and survival (
Moubarak et al., 2010), and binds to the p75 receptor with low affinity. Pro-NGF, however, preferentially activates the p75 receptor. During development, the p75 receptor plays a key role in axonal growth and remodelling (
Boyd and Gordon, 2001), but in adult healthy motoneurons its expression becomes undetectable. It is known that p75 expression by mature neurons can be upregulated in pathological conditions (
Dechant and Barde, 2002), and can lead to apoptosis through activation of NfkB, p53 and Bax (
Mukai et al., 2003). It is clear that the activation of a survival, or apoptotic signalling cascade, depends on a delicate balance between the ratio of pro-NGF and mature NGF in the extracellular space, the rate at which pro-NGF is processed into mature NGF, as well as the relative expression levels of the TrkA and p75 receptors. It has been previously reported that transgenic mice expressing mutant SOD1 produce in the spinal cord more total NGF than non-transgenic mice, and that NGF toxicity can be prevented by inhibiting the p75 receptor (
Pehar et al., 2004). Our
in vivo data confirm that astrocytes from SOD1
G93A mice express higher amounts of
Ngf than non-transgenic astrocytes from the presymptomatic stage of disease. In addition, we have demonstrated that SOD1
G93A astrocytes exhibit the same
Ngf overproduction
in vitro when cultured with normal motoneurons, without being activated by high levels of Lipopolysaccharide (LPS) or peroxynitrite (
Pehar et al., 2004), and that this is accompanied by overexpression of
p75 and its pro-apoptotic-associated protein,
Ngfrap1, by non-transgenic motoneurons. Remarkably, the same transcriptional changes were found in motoneurons from SOD1
G93A mice (
Ferraiuolo et al., 2007), suggesting that the expression of mutant SOD1 by astrocytes can cause, in normal motoneurons, the same alterations observed in motoneurons from mutant SOD1 transgenic mice. Our
in vitro model succeeded in reproducing pathogenic mechanisms observed
in vivo without over-stimulating the cell model and without obtaining readouts far from the physiological levels of Ngf and lactate detected in human CSF samples.
We have shown for the first time that the overall increase in total NGF previously reported (
Pehar et al., 2004) is due to an increase in the pro-NGF fraction, while the mature form of NGF tends to decrease, resulting in a pro-NGF/mature NGF ratio 2-fold higher than that detected in control conditions. Moreover, p75 over-expression by non-transgenic motoneurons correlates with and seems to be modulated by, the increasing levels of pro-NGF and is reduced by NGF immunodepletion. This offers an explanation for why total NGF immunodepletion had opposite effects on non-transgenic motoneurons depending on whether they were cultured with SOD1
G93A transgenic or non-transgenic astrocytes. In the first case, the medium was cleared of a harmful stimulus, i.e. the activation of the pro-NGF-p75 cascade. In non-transgenic co-cultures, motoneurons were deprived of a positive neurotrophic stimulus, as p75 is not highly expressed and mature NGF is likely to be signalling predominantly through the TrkA receptor. Consistent with this interpretation, p75 receptor inhibition did not affect motoneuron viability in non-transgenic co-cultures, while it rescued motoneurons growing on SOD1
G93A astrocytes. Our data suggest that pro-NGF overexpression can increase p75 receptor expression on motoneurons through a positive feedback mechanism, leading to increased cell death and p75 inhibition is related to a significant decrease in pro-NGF. How NGF regulates p75 receptor expression is still not clear (
Carter et al., 1996), but it is noteworthy that the p75 promoter has a binding site for NfkB (
http://www.sabiosciences.com/), which is a downstream effector of p75 activation (
Carter et al., 1996).
Increased expression of pro-NGF has been reported to cause neuronal degeneration following CNS injury (
Harrington et al., 2004) as well as motoneuron death in response to peroxynitrite (
Domeniconi et al., 2007). The present study shows that astrocytes expressing mutant SOD1
per se do not express more pro-NGF than normal astrocytes, but the presence of normal motoneurons is sufficient to trigger this dysregulation. The presence of either normal or mutant SOD1 expressing motoneurons seems to elicit a dysregulated response from mSOD1-expressing astrocytes. The question is what factor(s) or molecule(s) expressed by motoneurons triggers the dysregulation. We tested the hypothesis that glutamate could be responsible for the altered astrocytic response (
Magistretti et al., 1994;
Bruno and Cuello, 2006). Our
in vitro data confirmed that both lactate and NGF release increase when astrocytes are stimulated with glutamate for 14 days; however, over this period mutant SOD1 astrocytes did not display the alteration that they display when cultured with motoneurons. Interestingly, the levels of lactate released in the media following glutamate exposure are significantly lower than the levels achieved when motoneurons are in the culture, while NGF levels are lower. Our results support the hypothesis that glutamate could be involved in the astrocytic dysregulated response as a regulator of both lactate and NGF release, but we have to conclude that glutamate on its own is not responsible for the dysregulation observed
in vitro. Whether glutamate acts in synergy with other factors secreted by motoneurons or other stimuli are involved in triggering astrocytic toxicity has yet to be determined. Moreover, although NGF and lactate have a common regulator, our data are unable to show a direct interaction between the pro-NGF/p75 pathway and lactate release. Lactate treatment led to a decrease in p75 expression on motoneurons, but was not related to a shift in the balance of pro-NGF/NGF, although it completely rescued motoneuron survival. The mild, but significant, improvement in p75 expression levels could be due to a general neuroprotective effect of lactate rather than a direct interaction between the lactate and the pro-NGF/p75 pathways. In addition, anti-p75 treatment did not have any effect on lactate levels. In summary, our results indicate that the two pathways, although both dysregulated, do not interact directly, but they contribute to motoneuron degeneration through different unrelated mechanisms. However,
in vivo studies are required to fully understand the neuroprotective efficacy of intervening to correct the dysregulation of these two pathways over the time course of the disease in ALS. We also investigated the possibility that Fgf1 could be the factor responsible for pro-NGF (
Cassina et al., 2005) and lactate dysregulation. Although both transgenic and non-transgenic astrocytes secrete comparable levels of Fgf1 in the media when in co-culture with non-transgenic motoneurons, our data indicate that Fgfr1 activation is linked to pro-NGF production. However, Fgfr1 inhibition does not seem to be a valid option as a neuroprotective strategy, since PD166866 led to massive motoneuron death in both transgenic and non-transgenic co-cultures. Our data on motoneuron survival are opposite to the data previously published (
Cassina et al., 2005), but the experimental differences are likely to account for these contrasting outcomes. In our study, Fgfr1 inhibitor was added when motoneurons were already in the co-culture system, in contrast to the previous report, where astrocytes had been preconditioned with the inhibitor or high doses of Fgf1 (in the order of nanogram/millilitre) and motoneurons were plated and counted 72 h later. Our data show that an altered response to a physiological Fgf1 increase, rather than an abnormal increase in Fgf1, could be responsible for the change observed in pro-NGF/NGF ratio. The lack of changes in lactate secretion provides further confirmation that the dysregulation in NGF and lactate pathways are caused by different stimuli.
We consider our data of high relevance to human ALS. We have demonstrated for the first time increased levels of pro-NGF in the CSF of patients with ALS at the time of diagnosis. Previous studies detected increased expression in ALS spinal cord of matrix metalloproteinase 9 (MMP-9) (
Niebroj-Dobosz et al., 2010), which is one of the enzymes degrading mature NGF in the extracellular space. These findings are consistent with our data indicating that the pro-NGF/mature NGF ratio is unbalanced in disease, with increased expression of the parent molecule pro-NGF. In addition, p75 messenger RNA over-expression in the spinal cord of patients with ALS indicates that this pathway may play a role during the disease course. One recent study has reported that pro-NGF induces upregulation of PTEN (phosphatase and tensin homolog deleted on chromosome 10) via p75, leading to cell death (
Song et al., 2010). Interestingly, we have demonstrated that motoneurons that survive the disease process in human SOD1-related ALS appear to successfully downregulate the PTEN signalling pathway (
Kirby et al., 2011).
In this scenario, correcting the imbalance between pro-NGF and mature NGF could be beneficial in modifying the disease course of ALS by blocking the detrimental effects of pro-NGF signalling through the p75 receptor and by increasing the neurotrophic potential of mature NGF (
Davis-Lopez de Carrizosa et al., 2010), while therapies aiming to block the binding of both pro-NGF and mature NGF to their receptors are likely to be unsuccessful. One possible approach is inhibition of the p75 signalling cascade as shown in the
in vitro experiments reported here, where an antibody was used to block p75 receptor activation. Although we have demonstrated that this strategy is successful
in vitro, determining the right approach
in vivo is of paramount importance in order to achieve neuroprotection of motoneurons within the CNS (
Turner et al., 2004). Another possible approach would be to promote pro-NGF cleavage in order to shift the balance between its immature and mature form, re-establishing the ratio prevailing under physiological conditions.
In agreement with the findings of other groups showing that astrocytes expressing SOD1
G93A are toxic to normal motoneurons from mice and motoneurons derived from human embryonic stem cells (
Di Giorgio et al., 2007,
2008;
Nagai et al., 2007), we also detected increased cell death when non-transgenic motoneurons were plated onto SOD1
G93A astrocytes. These previous reports concluded that a soluble toxic factor was responsible for the increased motoneuronal death occurring in the mixed co-cultures, but were unable to identify this factor. Our findings add significantly to previous reports by demonstrating that pro-NGF is one toxic factor released by SOD1
G93A astrocytes, which exerts a detrimental effect on motoneuron survival. Significantly however, there is an additional failure of mutant SOD1 astrocytes to provide the metabolic support required by motoneurons. The finding that lactate supplementation can completely reverse the observed toxicity is of considerable interest, particularly as metabolic dysregulation seems to be present in the early stages of disease both in the mutant SOD1 mouse model (
Dupuis et al., 2004;
Ferraiuolo et al., 2007) and in human ALS (
Desport et al., 2000,
2005). Dietary interventions with the potential to ameliorate the motoneuron energy deficit have already been shown to be of benefit in mouse models of ALS (
Zhao et al., 2006;
Patel et al., 2010) and are being considered as a potential therapeutic approach in the human disease.
This study supports the hypothesis that motoneuron degeneration in SOD1-related ALS is a ‘non-cell-autonomous’ process. However, motoneurons themselves stimulate the pathophysiological properties in neighbouring astrocytes. Moreover, SOD1
G93A transgenic astrocytes can also alter the expression of key molecules in normal motoneurons, rendering them more vulnerable to injury and cell death. Mouse models expressing mutant SOD1 selectively in astrocytes (
Gong et al., 2000), however, failed to show motoneuron degeneration. The discrepancy between this
in vivo model and our findings could be due to a number of factors, the first being the expression levels of transgene reached in the mouse model. Variable transgene expression levels have resulted in differing results when mutant SOD1 is expressed selectively in motoneurons (
Pramatarova et al., 2001;
Lino et al., 2002;
Jaarsma et al., 2008). Moreover, although the
in vitro system can clarify how single mechanisms operate, it does not allow prediction of the contribution of other cell types present in the spinal cord. It is possible that other non-neuronal cells, when not expressing mutant SOD1, can support motoneurons and protect them from degeneration.
Taken together, the data reported here confirm that alteration in several properties of astrocytes are likely to play a crucial role in the propagation of motoneuron injury in SOD1-related ALS and indicate that manipulation of the energy supply to motoneurons as well as inhibition of p75 receptor signalling may represent valuable approaches to ameliorate disease progression in ALS.