The utility of vaccine strategies to treat neurodegenerative diseases such as Alzheimer's disease (AD) may still hold promise. Both active and passive immunization strategies reduced AD-like pathology and restored cognitive deficits in transgenic mice. These results were initially met with considerable optimism; however, phase IIa clinical trials were halted because of a small but significant occurrence of meningoencephalitis. Knowledge gained from studies on amyloid-␤ peptide (A␤) immunotherapy will allow optimization of new-generation vaccines, targeting highly specific epitopes while reducing undesired side effects. In harnessing and steering the immune system, an effective response can be generated against A␤. If this proves successful, A␤ vaccination could provide the first definitive treatment for AD. Alzheimer's disease (AD) is the most common cause of age-related cognitive decline, affecting Ͼ12 million people worldwide (1). The disease is characterized in its earlier stages by progressive memory impairment and cognitive decline, altered behavior, and language deficits. Later, patients present with global amnesia and slowing of motor functions, with death typically occurring within 9 years after diagnosis (2). Current drug therapy aims at slowing cognitive decline and ameliorating the affective and behavioral symptoms associated with disease progression. However, these drugs provide limited symptomatic treatment, without targeting the underlying cause of AD. Immunization of AD patients provides a novel means of specifically targeting the neurotoxic effects of amyloid-␤ peptide (A␤) and thereby targeting disease progression. The Amyloid Cascade HypothesisThe main constituent of amyloid consists of a 40-to 43-aa peptide, A␤, and is derived from the proteolytic cleavage of a family of ubiquitously expressed membrane-spanning proteins, termed the amyloid precursor proteins (APP) (3). Under normal conditions, the most abundant species in the brain is the A␤ (1-40) peptide (A␤ 40 ); however, much of the fibrillar A␤ is composed of the longer, more fibrillogenic A␤ (1-42) peptide (A␤ 42 ) (3). These normally soluble peptides undergo conformational change and polymerize into an aggregated and toxic form, rich in ␤-structure (4). Initially, A␤ 42 is deposited in an immature, diffuse (nonfibrillar) plaque, with little or no detectable neuritic dystrophy.Early studies have shown that synthetic fibrillar forms of A␤ are toxic to cultured neurons (5-7). Several mechanisms of A␤-induced neurotoxicity have been proposed, including oxidative stress, free-radical formation, disrupted calcium homeostasis, induction of apoptosis, chronic inflammation, and activation of complement (8). Although it has been shown that increased levels of A␤ in the brain correlate with cognitive decline (9), relatively weak correlations exist between fibrillar amyloid plaque density and severity of dementia (10-12). Recent studies point to other forms of A␤, namely, small oligomers as the neurotoxic species (13,14).Recent reports using antibo...

No abstract

There is increasing evidence that toxicity of mutant superoxide dismutase-1 (SOD1) in amyotrophic lateral sclerosis (ALS) is linked to its propensity to misfold and to aggregate. Immunotargeting of differently folded states of SOD1 has provided therapeutic benefit in mutant SOD1 transgenic mice. The specific region(s) of the SOD1 protein to which these immunization approaches target are, however, unknown. In contrast, we have previously shown, using a specific antibody [SOD1 exposed dimer interface (SEDI) antibody], that the dimer interface of SOD1 is abnormally exposed both in mutant SOD1 transgenic mice and in familial ALS cases associated with mutations in the SOD1 gene (fALS1). Here, we show the beneficial effects of an active immunization strategy using the SEDI antigenic peptide displayed on a branched peptide dendrimer to target monomer/misfolded in SOD1 G37R and SOD1 G93A mutant SOD1 transgenic mice. Immunization delayed disease onset and extended disease duration, with survival times increased by an average of 40 d in SOD1 G37R mice. Importantly, this immunization strategy favored a Th2 immune response, thereby precluding deleterious neuroinflammatory effects. Furthermore, the beneficial effects of immunization correlated with a reduction in accumulation of both monomer/misfolded and oligomeric SOD1 species in the spinal cord, the intended targets of the immunization strategy. Our results support that SOD1 misfolding/aggregation plays a central role in SOD1-linked ALS pathogenesis and identifies monomeric/misfolded SOD1 as a therapeutic target for SOD1-related ALS.

No abstract

No abstract

Indian hedgehog (Ihh) is produced by growth plate pre-hypertrophic chondrocytes, and is an important regulator of endochondral ossification. However, little is known about the regulation of Ihh in chondrocytes. We have examined the role of integrins and mitogen-activated protein (MAP) kinases in Ihh mRNA regulation in CFK-2 chondrocytic cells. Cells incubated with the beta1-integrin blocking antibody had decreased Ihh mRNA levels, which was accompanied by decreases of activated extracellular signal-regulated kinases (ERK1/2) and activated p38 MAPK. Ihh mRNA levels were also inhibited by U0126, a specific MEK1/2 inhibitor, or SB203580, a specific p38 MAPK inhibitor. Cells transfected with constitutively active MEK1 or MKK3 had increased Ihh mRNA levels, which were diminished by dominant-negative MEK1, p38alpha or p38beta. Stimulation of the PTH1R with 10(-8) M rPTH (1-34) resulted in dephosphorylation of ERK1/2 that was evident within 15 min and sustained for 1 h, as well as transient dephosphorylation of p38 MAPK that was maximal after 25 min. PTH stimulation decreased Ihh mRNA levels, and this effect was blocked by transfecting the cells with constitutively active MEK1 but not by MKK3. These studies demonstrated that activation of ERK1/2 or p38 MAPK increased Ihh mRNA levels. Stimulation of the PTH1R or blocking of beta1-integrin resulted in inhibition of ERK1/2 and p38 MAPK and decreased levels of Ihh mRNA. Our data demonstrate the central role of MAPK in the regulation of Ihh in CFK-2 cells.

The utility of vaccine strategies to treat neurodegenerative diseases such as Alzheimer's disease may still hold promise. Phase IIa clinical trials were halted due to a small but significant occurrence of meningoencephalitis. Knowledge gained from studies on amyloid-beta peptide (Abeta) immunotherapy will allow optimisation of new-generation vaccines, targeting highly specific epitopes while reducing undesired side effects. In harnessing and steering the immune system, an effective response can be generated against Abeta, one that might have attenuated immune responses with robust disease-altering activity.

Alzheimer's disease (AD) is the most common cause of age-related cognitive decline. Both active and passive immunization paradigms have illustrated the potential to prevent and reverse established AD pathology in transgenic and non-transgenic animal models of AD. Follow-up studies have shown that changes in amyloid burden observed with immunization could rescue cognitive deficits in both young and aged mice. Despite the success of immunotherapy in animal models, clinical trials were halted early. It has become clear that more preclinical work was needed before initiating trials, as most of the adverse events observed in patients could have been predicted using animal models. Despite these setbacks, clinical trials have demonstrated the utility of amyloid-beta (Abeta) vaccination in reducing amyloid pathology and potentially reducing cognitive decline. Several novel approaches to immunotherapy, including modified immunogens, adjuvants and modes of administration have been designed, which hold promise for human testing. Clinical trials using a safer vaccine, which is potent enough to elicit a robust antibody response in the absence of encephalitis may prove effective in mitigating progressive neurodegeneration seen in AD. If so, Abeta vaccination could supplant current symptomatic treatment and represent one of the first therapeutic options for AD based on the amyloid cascade hypothesis.