1. Beta Amyloid and Nitric Oxide : Putative Links Umesh Chaudhary

2. Contents Introduction Current prospects in Alzheimer therapy B-Amyloid stimulation of iNOS : TNF alpha and NF-kB dependent iNOS expression. Molecular basis of Alzheimer’s disease Nitric oxide and neurological functioning

3. Nitric Oxide A class of inter- and intra-cellular messenger molecules –Small molecular weight, Highly diffusible, Gaseous, Highly reactive stable free radical Second messenger role requires low concentrations of NO (<2  M) occurs usually via guanylate cyclase. Cytotoxic effects due to a combination of Elevated concentration (>10  M) Formation of highly reactive peroxynitrite

4. Free Radical Biology & Medicine, Vol. 25, Nos. 4/5, pp. 434–456, 1998 Direct Effects of Nitric Oxide Chemistry of Indirect Effects

5. Properties of NOS Isozymes

6. Overall reaction Catalyzed and cofactors of NOS Biochem. J. (2001) 357, 593-615 Nitric Oxide Biosynthesis

7. Nitric Oxide and Nervous System Extensive distribution of NOS positive neuron Role in long term potentiation Learning and Memory Pain perception Neuromodulatory functions Host defense against pathogens Neurotoxicity

8. Alzheimer’s Disease Epidemiology Most common Neurodegenerative disorder & dementia Currently affecting nearly 5 million individuals in USA alone. 3 Symptoms l Progressive cognitive decline affecting memory, learning, emotions and behaviour Pathology Neurofibrillary Tangles, Senile Plaques and Synapse Loss Mutation in one of the genes that codes for three transmembrane proteins- APP, PS1 and PS2 APOe4 allele is higher

9. Neuropathological Hallmarks

10. Journal of Structural Biology VARADARAJAN ET AL. 130, 184–208 (2000) Central Role of Amyloid  in Neurotoxicity

11. Journal of Structural Biology VARADARAJAN ET AL. 130, 184–208 (2000) Amyloid Precursor Protein Processing APP is 770AA Transmembrane protein, Gene located on Chromosome 21 Cleavage by   and  Secretase yields Amyloid  Conversion of soluble forms to insoluble fibrils accounts for its toxicity Amyloid  binding to RAGE leads to formation of plaque Amyloid can directly produce Hydrogen peroxide through metal ion reduction

12. l Presenilin 1 (PS1) on chromo 14 encodes 467 residue polypeptide & Presenilin 2 (PS2) on chromo 1 encodes for 448 residue polypeptide l PS1 and PS2 are found in nuclear membrane,ER and Golgi body l Necessary for Neurogenesis and Neuronal survival l 50 mutations of PS1 and 2 mutations of PS2 found in AD families Mutations in Presenilin genes All mutations enhances production of Fibrillar A  42 and Tau Hyper-phosphorylation leading to NFT’s l A plasma protein Involved in transport and metabolism of triglyceride and cholesterol l e2, e3 and e4 allelic variants l ApoE e4 allelic variant is high and linked with Alzheimer Apolipoprotein E

13. N- -C-C Microtubule binding domain (MBD) P sites l In AD Tau becomes hyper-phosphorylated p p pp p pppp Neurofibrillary Tangles l Intra neuronal lesions in degenerating neurones l Composed of hyper-phosphorylated tau-protein organised in paired helical filaments Tau is a soluble, microtubule-associated phospho-protein involved in neuronal stabilisation

14. Law et al. / Brain Research Reviews 35 (2001) 73– 96 NO Neurotoxicity and Neuroprotection in AD

15.  -Amyloid Stimulation of Inducible Nitric-oxide Synthase in Astrocytes Is Interleukin-1  - and Tumor Necrosis Factor-  (TNF  )-dependent, and Involves a TNF  Receptor-associated Factor- and NF  B- inducing Kinase-dependent Signaling Mechanism (Keith T. Akama and Linda J. Van Eldik) From the ‡Department of Cell and Molecular Biology and §Northwestern Drug Discovery Program, NorthwesternUniversity Medical School, Chicago, Illinois 60611 The Journal of Biological Chemistry, Vol-275. No. 11, March 17, pp –7918-7924

16. A-  stimulated Cytokine production occurs before iNOS Production

17. Protein synthesis inhibitor blocks A  stimulated iNOS mRNA levels

18. IL-1  Receptor antagonist Decreases the levels of Amyloid  -stimulated i-NOS and Nitrite Production

19. Dominant Negative TRAF Proteins can Block NF-  B Activation in Astrocytes

20. Dominant Negative TRAF6 Inhibits iNOS Promoter Activation by A 

21. IL-1  Localizes to Microglia and iNOS Localizes to Astrocytes in A  42 Stimulated Glial Cultures

22. SUMMARY Amyloid  activates Microglia to produce Pro-Inflammatory Cytokines such as IL-1  and TNF-  These Cytokines in turn activate surrounding Astrocytes, which exacerbate the inflammation with the production of Neurotoxic Mediators such as iNOS. The resultant NO and Peroxynitrite ultimately damages local neurons and contributes to the Neurodegeneration observed in AD

23. Evidence for NF-kB and Cytokine dependent iNOS induction

24. Other Signaling Cascade Activated by Amyloid 

25. Binding to Neurotrophin receptor leads to Apoptotic cell death Induction of Transcription of c-JUN mRNA and stimulates JUN Amino Terminal Kinase

26. Neuroscience Letters 312 (2001) 177–179

27. Science Vol 293, 21 September 2001 P- 2192- 94 Amyloid can Directly activate Caspase 3 and induce Apoptosis in Neurons

28. Potential Novel Therapeutic Approach Focusing on  -Amyloid plaques l Enhance alpha-Secretase activity or inhibit beta or gamma-Secretase activity l Correcting APP or presenilin mutations l Antioxidants such as Vitamin E and Extracts from roots of Ginko biloba Oestrogen modulate APP processing and reduce Amyloid-  42 l Vaccination with Amyloid Beta 22 Focusing on Apolipoprotein E l Replace ApoE e4 alleles with e2/3 alleles l Cholesterol lowering drugs ( Lipitor ) Tau protein based therapies l Prevent t-protein phosphorylation Gene Therapy - Nerve Growth Factor, Propentophylline

29. Conclusions Oxidative stress plays a vital role in Alzheimer Pathology Amyloid-  can initiate a variety of signalling cascades leading to Neuronal cell death in AD Amyloid-  can stimulate Pro inflammatory cytokines and ultimately contribute to Oxidative and Nitrosative Stress induced cell death and Apoptosis Further Detailed Studies needed to have a deeper Insight into Signal transduction pathways involved in Alzheimer Disease

30. Illness in Alzheimer's vaccine study AP [ SUNDAY, FEBRUARY 24, 2002 7:10:41 PM ] Twelve Alzheimer's patients injected with an experimental vaccine are suffering serious brain inflammation. The vaccine's manufacturer halted the experiment last month when it discovered that the first four patients, all from France, were suffering the encephalitis-like reaction. Since then, doctors have discovered eight more people with the apparent side effect, which can be hard to distinguish from worsening Alzheimer's. TIMES - SUNDAY, FEBRUARY 24, 2002