We studied the role of the amyloid precursor protein (APP) in ischemic brain damage using transgenic mice overexpressing APP. The middle cerebral artery (MCA) was occluded in FVB/N mice expressing APP 695 .SWE (Swedish mutation) and in nontransgenic littermates. Infarct volume (cubic millimeters) was assessed 24 hr later in thionin-stained brain sections. The infarct produced by MCA occlusion was enlarged in the transgenics (ϩ32 Ϯ 6%; n ϭ 12; p Ͻ 0.05; t test). Measurement of APP by ELISA revealed that, although relatively high levels of A were present in the brain of the transgenics (A 1-40 ϭ 80 Ϯ 19 pmol/g; n ϭ 6), there were no differences between ischemic and nonischemic hemispheres ( p Ͼ 0.05). The reduction in cerebral blood flow produced by MCA occlusion at the periphery of the ischemic territory was more pronounced in APP transgenics (Ϫ42 Ϯ 8%; n ϭ 9) than in controls (Ϫ20 Ϯ 8%; n ϭ 9). Furthermore, the vasodilatation produced by neocortical application of the endothelium-dependent vasodilator acetylcholine (10 M) was reduced by 82 Ϯ 5% (n ϭ 8; p Ͻ 0.05) in APP transgenics. The data demonstrate that APP overexpression increases the susceptibility of the brain to ischemic injury. The effect is likely to involve the A-induced disturbance in endothelium-dependent vascular reactivity that leads to more severe ischemia in regions at risk for infarction. The cerebral vascular actions of peptides deriving from APP metabolism may play a role in the pathogenic effects of APP.
Key words: middle cerebral artery; Alzheimer's disease; cerebral ischemia; stroke; cerebral blood flow; transgenic miceThere is substantial evidence that the amyloid precursor protein (APP), a constitutively expressed transmembrane glycoprotein, is involved in the pathogenesis of Alzheimer's dementia (Price and Sisodia, 1994;Selkoe et al., 1996;Mattson et al., 1997). APP is present in different isoforms derived from a single gene by alternative splicing (Lendon et al., 1997). A 39 -42 amino acid fragment of APP, A, is present in amyloid plaques in the brain of patients with Alzheimer's disease and Down's syndrome and in normal brain aging (Lendon et al., 1997). Both in vitro and in vivo evidence suggest that A is cytotoxic, an effect that may depend on the state of aggregation of A (Mattson et al., 1993a). The mechanisms of the neurotoxicity of A are thought to include perturbation of ionic homeostasis and free radical production (Mattson et al., 1993a;Fraser et al., 1997).It has been proposed that APP and A may also participate in ischemic brain damage. Although APP expression is increased in the postischemic brain (Abe et al., 1991a,b;Stephenson et al., 1992;Wakita et al., 1992;Kalaria et al., 1993;Banati et al., 1995), cerebral ischemia may facilitate cleavage of APP into the toxic A fragment (Saido et al., 1994;Yokota et al., 1996). These observations raise the possibility that ischemia leads to accumulation of A, which, in turn, could contribute to ischemic brain damage. On the other hand, there is also evidence that APP may ...