Conditions that compromise the blood-brain barrier (BBB) have been increasingly implicated in the pathogenesis of Alzheimer disease (AD). AGRIN is a heparan sulfate proteoglycan (HSPG) found abundantly in basement membranes of the cerebral vasculature, where it has been proposed to serve a functional role in the BBB. Furthermore, AGRIN is the major HSPG associated with amyloid plaques in AD brains. To examine the relationship of AGRIN, the BBB and AD-related pathologies, we generated mice in which the Agrn gene was deleted from either endothelial cells or neurons using gene-targeting or was overexpressed using a genomic transgene construct. These mice were combined with a transgenic model of AD that overexpresses disease-associated forms of amyloid precursor protein and presenilin1. In mice lacking endothelial cell expression of Agrn, the BBB remained intact but aquaporin 4 levels were reduced, indicating that the loss of AGRIN affects BBB-associated components. This change in Agrn resulted in an increase in β-amyloid (Aβ) in the brain. Conversely, overexpression of Agrn decreased Aβ deposition, whereas elimination of Agrn from neurons did not change Aβ levels. These results indicate that AGRIN is important for maintaining BBB composition and that changes in Agrn expression (particularly vessel-associated AGRIN) influence Aβ homeostasis in mouse models of AD.
PROMs are effective tools for characterizing symptom burden and health-related quality of life. With increasing clinical implementation, PROMs are playing an increasing role in patients' clinical decision-making.
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