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Neuronal response in Alzheimer’s and Parkinson’s disease: the effect of toxic proteins on intracellular pathways

Neuronal response in Alzheimer’s and Parkinson’s disease: the effect of toxic proteins on... Accumulation of protein aggregates is the leading cause of cellular dysfunction in neurodegenerative disorders. Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease, Prion disease and motor disorders such as amyotrophic lateral sclerosis, present with a similar pattern of progressive neuronal death, nervous system deteriora- tion and cognitive impairment. The common characteristic is an unusual misfolding of proteins which is believed to cause protein deposition and trigger degenerative signals in the neurons. A similar clinical presentation seen in many neurodegenerative disorders suggests the possibility of shared neuronal responses in different disorders. Despite the difference in core elements of deposits in each neurodegenerative disorder, the cascade of neuronal reactions such as activation of glycogen synthase kinase-3 beta, mitogen-activated protein kinases, cell cycle re-entry and oxidative stress leading to a progressive neurodegeneration are surprisingly similar. This review focuses on protein toxicity in two neurodegenerative diseases, AD and PD. We reviewed the activated mechanisms of neurotoxicity in response to misfolded beta-amyloid and α-synuclein, two major toxic proteins in AD and PD, leading to neuronal apoptosis. The interaction between the proteins in producing an overlapping pathological pattern will be also discussed. Keywords: Alzheimer’s disease, Parkinson’s disease, Beta-amyloid, Alpha-synuclein, Intracellular signalling, Neurotoxicity, Neurodegeneration Pathophysiology of toxic proteins Background All the proteins implicated in neurodegenerative diseases Protein misfolding and aggregation contribute to the share the common pattern of dysfunctional structure pathophysiology of neurodegenerative disorders such as due to an unusual folding [5–7]. Through folding, pro - Alzheimer’s (AD) and Parkinson’s diseases (PD). In physi- teins acquire the three dimensional structures required ological situations protein misfolding is sensed by the cel- to undertake their biological functions. This process is lular control systems as a threat which is then followed prone to errors, causing the protein not to acheive its by an immediate response. Any delay detecting the mis- functional structure, building a toxic protein deposition. folded proteins, may result in damage and progression of When an aggregation status is established, disaggregation neurodegenerative disorders [1, 2]. Unfortunately, not all rarely occurs because under physiological conditions, the cellular responses to misfolded proteins are neuro- the equilibrium is in favour of aggregation [8–11]. These protective. Activation of some intracellular pathways as a early aggregates are believed to be the source of toxicity part of this response occasionally create further damage, in neurodegenerative disorders. interruption in synaptic connections and neuronal apop- tosis [3, 4]. Alzheimer’s disease (AD) AD is the most common form of dementia and among the leading causes of death in adults. AD is associ- *Correspondence: shohreh.majd@flinders.edu.au Centre for Neuroscience and Paramedic Unit, School of Medicine, ated with two main lesions: extracellular plaques made Flinders University of South Australia, Adelaide, SA 5042, Australia of beta-amyloid (Aβ) and intracellular neurofibrillary Full list of author information is available at the end of the article © 2015 Majd et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Majd et al. BMC Neurosci (2015) 16:69 Page 2 of 13 tangles (NFT) made of tau protein [12, 13]. The plaques was obtained for both Aβ 1-40 and 1–42, two of the most are the consequences of abnormal protein folding and toxic forms of amyloid protein [35, 36]. aggregation with direct and indirect toxic effects on neu - Aβ oligomers can be generated both extra- and intra- ronal survival [14, 15]. cellularly. Extracellular Aβ toxicity could be mediated through binding to receptors such as NMDA and dis- Aβ biochemical structure and toxicity rupting the calcium balance of the neuron [37, 38]. Extra- Aβ, the principle protein implicated in development of cellular Aβ is internalized, stored in the lysosomes and AD, is derived from amyloid precursor protein (APP). can leak into the cytosol by destabilization of the lyso- More than ten isoforms of the protein are characterized some membrane. Aβ oligomers have the ability to inhibit by different lengths of amino acid chains, and among the function of proteasomes causing neuronal apopto- them APP695 is exclusively expressed in neurons. The sis [39, 40]. Toxicity of fibrillar and oligomers of Aβ also transmembrane region of APP is placed near the c-termi- occurs through cytoskeletal disruption, tangle develop- nus, and contains a Kunitz-type protease inhibitor (KPI) ment, loss of synapses and inhibition of hippocampal domain, which acts as a potent inhibitor of coagulation long-term potentiation (LTP). This is the so-called “Aβ factors IXa and XIa, however, APP695 lacks the KPI cascade theory” of AD [12, 41, 42]. domain [16, 17]. Intracellular inclusions of Aβ have been found within APP can act as a receptor for a signalling glycoprotein neuronal compartments. [43, 44]. Internalization of F-spondin that is released by neurons and possesses roles Aβ occurs either via binding to low-density lipopro- in axonal guidance, neuronal differentiation and neuro- tein related protein-2 (LRP2) [45], LRP-1 [46, 47] or to repair [18, 19]. Some other functions of APP have also a receptor for advanced glycation end-product (RAGE) been proposed, including serving as a link between kine- [48]. The presence of Aβ in various subcellular com - sin and synaptic vesicles being an adhesion protein, a role partments, suggests different sites for APP proteolysis, in metal ion homeostasis, neuroprotection and a func- such as Aβ40 in the trans-Golgi network and Aβ42 in tion relating to promotion of neurite growth [16, 20]. the endoplasmic reticulum (ER) [49, 50] as well as Golgi APP is degraded in lysosomes [21–23] (Fig.  1). Aβ is compartments [51]. Autophagic vacuoles enriched with produced when a normal cleavage of APP occurs α and β presenilin-1 (PS1), APP and Aβ are found frequently in secretase cleave APP, outside the membrane. Also three degenerating neurons in patients with AD. This suggests members of a family of peptidase proteins, ADAM, (a an essential role for autophagy in clearing the aggregated disintegrin and metalloproteinase) have a recognized peptide through a lysosomal-dependent pathway [52]. role cleaving the extracellular portion of APP, in the same Aβ disrupts APP trafficking, and initiates a pathological way that α-secretase does [24]. Proteolysis of APP by cascade of Aβ accumulation [39, 43]. An accumulation of β-secretase cleaves APP695 after Met-596 and produces vacuoles filled with Aβ occurs as a result of interruption a large soluble N-terminal (sAPPβ) and a small mem- to neuronal trafficking associated with the disruption of brane-bound C-terminal fragment (C99), sAPPβ, is neu- autopghgosomes [53]. Aβ itself is also able to activate the roprotective and regulates synaptic plasticity. This larger adenosine monophosphate kinase (AMPK) pathway, gen- fragment of APP can also act as a microtubule associated erating more autophagic vacuoles [54]. Thus, AD patients protein (MAP) [25]. appear to produce abundant extracellular Aβ, resulting APP can undergo proteolysis at the cell surface. Its C99 in plaque formation with a high level of toxicity causing fragment can be processed by γ- secretase, presenilin 1 extensive neuronal apoptosis [55–57]. and 2, γ-secretase produces Aβ isoforms of 1-40, 1-42 or 1-43 [17, 26–28]. These peptides are made throughout Aß and kinases life, but in AD they accumulate due to either increased Glycogen synthase kinase‑3 beta (GSK‑3β) production or decreased degradation or removal. Glycogen synthase kinase-3 beta (GSK-3β) is well-known Remaining Aβ has the potential to enhance its own pro- for its role in glycogen metabolism, activation of tran- duction in cerebrovascular smooth muscles and hip- scription factors and phosphorylation of tau. GSK3 is pocampal neurons [29, 30]. Excess peptides, particular modulated through a variety of pathways including wnt, those of Aβ 1-40, 1-42 and 1-43, form toxic aggregates, phosphatidylinositide-3 kinase (PI3K) and Akt deacti- which result in progression of AD [16, 31, 32]. vate GSK-3β by phosphorylating Ser9 [58, 59], increasing Filaments of amyloid structure are approximately GSK-3β, in pre-tangles which is closely associated with 10  nm wide and 0.1–10  μm long with a β-sheet struc- tangle-bearing neurons suggesting a role in tau hyper- ture in their motif [33, 34]. Using Electron Paramagnetic phosphorylation in AD [60–64]. A recent report associ- Resonance Spectroscopy (EPRS) the β-sheet structure ated GSK-3β gene variants with the level of tau and Aβ42 Majd et al. BMC Neurosci (2015) 16:69 Page 3 of 13 Fig. 1 Cellular trafficking of APP and Aβ. APP cleavage to peptides occurs both in lysosomes after its endocytosis and at the surface of cell mem- brane. The proteolysis products accumulate intracellularly or are released into extracellular space in cerebrospinal fluid in AD as well as cognitive function pathway [74, 75]. MAPKs are a family of serine/threo- [65]. Further in vivo evidence of GSK-3β’s role in AD has nine kinases that contribute to the hyperprocessing of come from transgenic mouse models over-expressing this APP and hyper-phosphorylation of tau associated with kinase with a presentation of tau hyper-phosphorylation, AD [76, 77]. MAPKs phosphorylate proteins with regula- astrocytosis, and neuronal death [66, 67]. The concurrent tory functions including other kinases, transcription fac- hyper-phosphorylation of other cellular structures such tors and enzymes [78–80]. Stimulation of MAPK by Aβ as presinilines, β-catenin and GSK3-cAMP responsive in a Ras-dependent manner, leads to tau phosphorylation element-binding protein also produces some of the path- [81–84]. It has also been demonstrated that activation of ological features of AD [61, 68, 69]. MAPK by neurotrophins as well as Aβ induces p35, the Aβ exposure induces GSK-3β activity, extensive phos- specific activator of cyclin dependent kinase 5 (cdk5) in phorylation of tau and cell death. Aβ inhibits PI3K and the cell cycle. Thus another means of damaging the neu - Akt pathways and inactivates the wnt cascade,. Because ron through MAPK activation by Aβ could be re-activa- these pathways eventually deactivate GSK3, their inhibi- tion of the cell cycle, which is considered a lethal event tion will result in hyperactivity of GSK3 [70, 71] (Fig.  2). for neurons [78–85]. This Aβ-induced GSK-3β hyperactivity triggers the mito - chondrial fragmentation leading to neuronal apoptosis Aß, cytoskeleton and axonal transport [72]. GSK-3β also interacts with pyruvate dehydrogenase A constant interaction between microtubules and MAPs (PDH), thereby reducing levels of acetyl-CoA [73]. such as tau is a necessary element for axonal transport [86]. Tau holds the microtubular tracks in place and plays Mitogen‑activated protein kinases (MAPK) a key role in their stability [87]. When tau is subjected Aβ affects another intracellular second messenger the to hyper-phosphorylation, it loses the ability to bind to extracellular signal regulated Kinase (ERK)/MAPK microtubules and to maintain their structure, causing tau Majd et al. BMC Neurosci (2015) 16:69 Page 4 of 13 Fig. 2 Aβ and GSK3. Aβ binding to membrane receptors such as insulin receptor (IR) inhibits the activity of Akt and wnt through PI3K inhibition. Inactivation of Akt and wnt consequently dephosphorylate GSK3 which causes tau hyper-phosphorylation and microtubular disorganisation aggregation into paired helical filaments (PHF) and NFTs Aβ and apolipoprotein E (apoE) [88]. The number of NFTs is linked to the degree of demen - ApoE is a normal constituent of cells. In the nervous tia, suggesting a correlation between NFT, dystrophic neu- system, it acts as the main lipid transport protein with a rite formation and neuronal dysfunction [89–91]. It seems wide variety of roles in intracellular signalling, immune that interrupting axonal transport will interrupt neuronal modulation, glucose metabolism, lipid movement and function and lead to eventual death [92–94]. lipoprotein metabolism [102]. ApoE has been detected in Deposition of Aβ plaques precedes tau phosphoryla- the amyloid plaques in AD [103]. tion and exerts a damaging effect upon the cytoskeleton The ability of ApoE to interact with Aβ, demonstrated giving rise to PHF formation. [41]. Intraneuronal for- its critical role in amyloid deposition and clearance [91, mation of Aβ also happens prior to appearance of PHF, 102, 104]. The apoE4 allele of ApoE is associated with making it the upstream step in triggering the neurode- high cholesterol in cardiovascular disease and particu- generative events [95, 96]. larly AD, however, the apoE2 allele confers some protec- Further evidence that Aβ formation precedes PHF for- tion against hypercholesterolemia [102, 105, 106]. ApoE2 mation comes from a tau mutation study when tau muta- and E3 formed stable complexes with Aβ at levels of 20 tion produced tau-inclusion tangles but not plaques, fold greater than those occurring with apoE4 [107]. The however, APP or presenilin mutations caused both greater affinity of ApoE2 and E3 for Aβ protects neurons plaques and tangles. Transgenic mice doubly mutant for from neurotoxic effects of Aβ by facilitating the uptake mutant APP and tau have more tangles than mice with of these complexes by apoE receptors. Conversely, apoE4 the single mutant tau transgene [97, 98]. Tau phospho- accelerates Aβ deposition and progression/growth of Aβ rylation occurs through activation of c-Jun N-terminal seeds to larger Aβ plaques [108, 109]. kinase (JNK), a member of MAPK [99]. In a study, amy- loid injections exacerbated tangle pathology in mutant- Aβ, mitochondria and oxidative stress tau mice but why Aβ injections did not stimulate tau The central role of Aβ isoforms, in elevating free radi - pathology with wild-type tau is not known [100], when cal levels and oxidative stress led to the introduction of other transgenic mice overexpressing wild-type tau an Aβ-oxidative stress model for neurotoxicity in AD exhibited tangles [101]. [110–112]. Majd et al. BMC Neurosci (2015) 16:69 Page 5 of 13 Post-mortem studies revealed a wide range of [126]. Oxidative stress also elicits an inflammatory Aβ-derived mitochondrial dysfunction in AD patients response [127] through microglial activation [128, 129] [113–115]. Intracellular Aβ can be localized to mito- and release of pro inflammatory cytokines [130], promot - chondrial membranes, where it interrupts the normal ing inflammation and invasion of Aβ plaques by astro - mitochondrial function through blocking mitochondrial cytes [131] which mature plaques into neuritic plaques, a channels and inhibiting mitochondrial protein activ- common finding in AD patients. ity. By blocking the electron transport chain, Aβ accu- mulation leads to an increase in reactive oxygen species Aβ and cell cycle (ROS), causing oxidative stress [114, 116–118] (Fig.  3) Inappropriate cell cycle activation is an early event seen which leads to a deregulation of the ROS signalling path- in AD brains [132]. Although adult neurons are con- way in AD [119]. Superoxide radicals, produced due to sidered to be in a terminally-differentiated state, accu - mitochondrial dysfunction oxidate different neuronal mulation of associated cell cycle-related proteins have compartments such as proteins, lipids and DNA [117, been described in degenerating neurons [133–137]. It 120]. The evidence of oxidative damage in patients with is assumed that ectopic localization of cyclins, cyclin- mild cognitive dementia (MCD) shows that the oxida- dependent kinases (cdks) and cdk inhibitors are the tion insult occurs as one of the first steps of AD [121]. results of abortive attempt by neurons to re-enter the cell Chronic oxidative stress inhibits tau dephosphorylation cycle. Re-entering the cell cycle is a consequence of mito- by inhibiting tau phosphatase as well as increasing the gen factors and perhaps is promoted by the recruitment phosphorylation of tau by activating p38 [119]. of mitogenic signal transduction mechanisms [138, 139]. The other aspect of oxidative stress relates to pro - Subjecting neurons to Aβ, forces the cell to re-enter the tein oxidation. Oxidative modification of proteins is cell cycle, cross the G1/S phase transition and begin de important in aging and age-related neurodegenerative novo DNA synthesis before apoptotic death occurs [140– disorders [122]. Protein oxidation results in protein dys- 142], this could be inhibited by cell-cycle inhibitors [143, function associated with conformational changes. The 144]. These findings led to the hypothesis that vulner - oxidized protein may also have a higher resistance to pro- able neurons re-enter the cell cycle and proceed through teolysis and protein cross-linking and aggregation will be S phase, but then abort somatic division and eventually increased [123]. The aggregated misfolded proteins then degenerate [145]. get trapped in proteasome’s pore leading to proteasomal dysfunction [124, 125]. A vicious cycle of misfolded pro- Parkinson’s disease (PD) tein accumulation is then established. Parkinson’s disease (PD) is the second most common Aggregated peptides have the potential to initiate oxi- neurodegenerative disorder among the adults. The pro - dative stress through cellular dysfunction leading to cal- gressive impaired motor function in patients with PD is cium accumulation and increased tau polymerization an outcome of dopaminergic neuronal loss particularly in the substantia nigra (SN) [146]. A common finding from degenerating dopaminergic cells includes intracellular inclusions of particles, known as Lewy bodies (LBs) [147, 148]. The major component of LBs is the fibrillar form of α-Syn and this suggests the role of protein misfolding in Parkinson’s pathology [149, 150]. α‑Synuclein structure and toxicity α-Syn is an acidic synaptic protein (14  kDa), which is expressed in a wide range of tissues including the brain [151–153]. α-Syn retains the ability of building a β-sheet structure after prolonged incubation due to its posses- sion of a hydrophobic region of amino acids from 66 to 95 [154]. As a vesicle associated protein, the main func- Fig. 3 Aβ and mitochondrial dysfunction. Attachment of Aβ to inner tions of α-Syn are regulating membrane stability, neu- membrane of mitochondria alters the different aspects of mitochon- ronal plasticity, synaptic rearrangement, controlling drial activity. Blocking electron chain through reducing complex IV activity, damaging mitochondrial DNA (mtDNA), inhibiting tricarbo- vesicular trafficking and neurotransmission through a xylic acid ( TCA) cycle and ATP production, enhancing cytochrome chaperon-like function to other proteins [134, 155–159]. c release and activation of apoptotic pathways, and increasing the Due to the ability α-Syn to interact with tubulin, α-Syn mitochondria production of ROS are some of the examples also shows a microtubule-associated activity [160–162]. Majd et al. BMC Neurosci (2015) 16:69 Page 6 of 13 Lesions from autopsied PD brains show a marked decreased MTT levels, reduction of glutathione and high increase in S129 hyperphosphorylated α-Syn [163] which levels of iron, in brain tissue confirmed the presence of creates high molecular weight α-Syn with a high poten- oxidative stress as a common finding in PD [189–193] 2+ tial for self-assembly. This makes it a likely candidate to Oxidative stress affects the Ca shift and balance in be a toxic protein in the event of aggregation [164, 165]. cytoplasm, leading to stimulation of mitochondrial nitric α-Syn could also be phosphorylated on Tyr39 with no oxide synthase (mtNOS) [194, 195]. α-Syn also has the link between this phosphorylation and pathological fea- ability of binding to pro apoptotic protein BAD, a mem- tures [166]. ber of Bcl-2 family [182]. As the result of this attachment, Fibrillar α-Syn as the main component of LBs, is pre- Bcl-2 protein is removed from mitochondrial pores, sent in many dying cells in PD [167], however, oligomeric allowing cytochrome c to be released from the mito- α-Syn also possesses enough toxicity to damage neu- chondria. This event triggers neuronal apoptosis dem - rons [168]. The process of misfolding of α-Syn has been onstrating a link between mitochondrial dysfunction and shown to be accelerated by many metals such as copper synaptic accumulation of α-Syn in PD [195, 196]. [169] and ferric ion and also by elevated intracellular cytochrome c [170]. Conformational changes leads to α‑Synuclein and axonal trafficking protein misfolding reduce the ability of α-Syn to inter- α-Syn ability to act as a MAP, allows microtubules to act with the vesicular trafficking and modulating neuro - maintain their stability, to carry cargos in an energy- transmission [171–174]. Conformational changes and dependent manner, and to facilitate neurotransmitter consequent aggregation α-Syn also triggers a cascade of release [159, 161]. Overexpression and phosporylation neuronal response such as autophagy, one of the main of α-Syn, however, affects the normal function of ER pathways of α-Syn degradation [175, 176]. and Golgi system. α-Syn directly binds to ER and the Golgi apparatus and inhibits the soluble NSF attach- α‑Synuclein and MAPK ment protein receptor (SNARE) complex assembly [197, Regulation of MAPK pathway is a downstream effect of 198]. The SNARE complex is made of vesicular SNARE α-Syn. In neurons, α-Syn binding to MAPK inhibits this proteins (v-SNARE) and target membrane SNARE pro- pathway. In particular, α-Syn binds directly to ERK2 and teins (t-SNARE). It possesses the ability of self-assembly indirectly to Elk-1, which is also an ERK2 substrate [177]. and allows vesicular fusion to cell membrane [199, 200]. u Th s α-Syn reduces dopamine transporter (DAT) inser - Blocking this assembly by α-Syn overexpression inter- tion in the synaptic membranes of axonal terminals [178]. feres with neurotransmitter release and reuptake (Fig. 4). α-Syn also decreases MAPK activation through reducing Consequently, relocating cellular proteins within the cell the phosphorylation of p38 and down regulating c-fos or from the cell toward the membrane and eventual neu- gene [179, 180]. rotransmission will be disturbed [201]. The eventual out - Phosphorylation and accumulation of MAPK elements come would include protein accumulation inside the cell, have been reported in PD patients [81, 172]. One of the Golgi system fragmentation, a decrease in neurotrans- MAPK elements is JNK, that is phosphorylated in PD and mitter release and neuronal apoptosis [202–204]. α-Syn activates the transcription factor of c-jun. Activation of also reduces polymerization of tubulin. Whether reduc- c-jun increases the level of cell death genes expression in ing polymerization of tubulin is a direct outcome or an dopaminergic neurons [82, 181]. JNK also inhibits Bcl-2 indirect one, through generating mitochondrial dysfunc- survival protein by activation of pro-apoptotic proteins tion and lack of ATP for polymerization, the outcome of Bad and Bim [182, 183]. The misregulation of MAPK represents itself as a disrupted axonal transport and neu- eventually leads to neuronal apoptosis. Inhibiting JNK rite degeneration [20, 203, 205]. phosphorylation, however, can protect neurons from death [184]. Activation of ERK has also been reported in α‑Syn and Aβ interaction glial cells which consequently starts a cascade of inflam - Both AD and PD show similar clinical presentations in matory responses and blocking that pathway reduces their mid to late stages [206, 207] suggesting the possibil- microglial activation [185, 186]. ity of interaction between α-Syn and Aβ [25, 144, 208]. It has been shown that instead of immediate cell death, α‑Synuclein and oxidative stress affected neurons live for several months in a near- func - α-Syn overexpression causes the impairment of mito- tional state [209, 210]. Constant production of both pro- chondrial homeostasis [187] leading to oxidative stress teins allows continuing protein–protein interaction and and dopamine oxidation [188]. Formation of giant as a result, a reciprocal induction between α-Syn and Aβ mitochondria and laminated bodies, autophagozomes, could cause a gradual increase in the protein levels of Majd et al. BMC Neurosci (2015) 16:69 Page 7 of 13 Fig. 4 α-Syn in normal condition binds to synaptic vesicle membrane and also v-SNARE. v-SNARE assembly to t-SNARE creates SNARE complex and results in synaptic vesicle fusion to cell membrane and neurotransmitter release. α-Syn clusters synaptic vesicles in the axonal terminal and produces a high concentration of presynaptic vesicles at a certain area of plasma membrane. Vesicular α-Syn also binds to early endosomes and facilitates neurotransmitter refilling of vesicles. α-Syn accumulation/fibrilation inhibits vesicular refilling, blocks SNARE complex formation and reduces the number of docking neurotransmitter vesicles Abbreviations both types, before neurodegeneration commences [144]. Aβ: beta-amyloid; AD: Alzheimer’s disease; apoE: apolipoprotein E; APP: amy- The PI3K pathway and ApoE could contribute to this loid precursor protein; α-Syn: alpha-synuclein; cdk: cyclin dependent kinase; interaction, as manipulation of PI3K reduced the recipro- ER: endoplasmic reticulum; ERK: extracellular signal regulated kinase; GSK-3β: glycogen synthase kinase-3 Beta; JNK: Jun N-terminal kinase; KPI: Kunitz-type cal elevation of α-Syn and Aβ [144]. Deletion of ApoE in protease inhibitor; LBs: Lewy bodies; LRP2: low-density lipoprotein related pro- α-Syn transgenic mice decreased the levels of Aβ, thereby tein-2; LTP: long-term potentiation; MAPK: mitogen-activated protein kinases; alleviating the onset of disease [211]. More research is mtNOS: mitochondrial nitric oxide synthase; NFT: neurofibrillary tangles; NGF: nerve growth factor; PD: Parkinson’s disease; PDH: pyruvate dehydrogenase; still required to achieve a complete understanding of the PHF: paired helical filaments; PI3K: phosphatidylinositide-3kinase; RAGE: glyca- underlying mechanisms. tion end-product; ROS: reactive oxygen species; SN: substantia nigra; SNARE: NSF attachment protein receptor; t-SNARE: target membrane SNARE protein; v-SNARE: vesicular SNARE protein. Conclusion Although the process of neuronal death is a common Authors’ contributions feature in AD and PD, the underlying mechanisms are SM, HG and JP conceived and drafted the manuscript. All authors read and approved the final manuscript. still under investigation. Some aspects of toxicity may be specific for a distinct type of neurodegenerative disorder Author details however common cellular mechanisms with a substan- Centre for Neuroscience and Paramedic Unit, School of Medicine, Flinders University of South Australia, Adelaide, SA 5042, Australia. Department tial overlap underlie the neuronal responses to the toxic of Human Physiology, School of Medicine, Flinders University of South Aus- proteins. tralia, Adelaide, SA 5042, Australia. In conclusion, neuronal death in neurodegenera- Acknowledgements tive disorders is not a single-cause event and establish- SM was a member of Alzheimer’s and Parkinson’s lab at Flinders University of ing the exact links between the activation mechanisms South Australia when she started writing the manuscript and we would like to in response to toxic proteins could open a window for thank the lab members for their enthusiastic discussions about protein toxicity in neurodegenerative disorders. promising therapeutic interventions. Majd et al. BMC Neurosci (2015) 16:69 Page 8 of 13 Competing interests 21. Gouras GK, Xu H, Jovanovic JN, Buxbaum JD, Wang R, Greengard P, The authors declare that they have no competing interests. Relkin NR, Gandy S. Generation and regulation of beta-amyloid peptide variants by neurons. J Neurochem. 1998;71(5):1920–5. Received: 12 January 2015 Accepted: 13 October 2015 22. Schneider A, Rajendran L, Honsho M, Gralle M, Donnert G, Wouters F, Hell SW, Simons M. 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Neuronal response in Alzheimer’s and Parkinson’s disease: the effect of toxic proteins on intracellular pathways

BMC Neuroscience , Volume 16 (1) – Oct 23, 2015

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References (211)

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Springer Journals
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Copyright © 2015 by Majd et al.
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Biomedicine; Neurosciences; Neurobiology; Animal Models
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1471-2202
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10.1186/s12868-015-0211-1
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26499115
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Abstract

Accumulation of protein aggregates is the leading cause of cellular dysfunction in neurodegenerative disorders. Alzheimer’s disease (AD), Parkinson’s disease (PD), Huntington’s disease, Prion disease and motor disorders such as amyotrophic lateral sclerosis, present with a similar pattern of progressive neuronal death, nervous system deteriora- tion and cognitive impairment. The common characteristic is an unusual misfolding of proteins which is believed to cause protein deposition and trigger degenerative signals in the neurons. A similar clinical presentation seen in many neurodegenerative disorders suggests the possibility of shared neuronal responses in different disorders. Despite the difference in core elements of deposits in each neurodegenerative disorder, the cascade of neuronal reactions such as activation of glycogen synthase kinase-3 beta, mitogen-activated protein kinases, cell cycle re-entry and oxidative stress leading to a progressive neurodegeneration are surprisingly similar. This review focuses on protein toxicity in two neurodegenerative diseases, AD and PD. We reviewed the activated mechanisms of neurotoxicity in response to misfolded beta-amyloid and α-synuclein, two major toxic proteins in AD and PD, leading to neuronal apoptosis. The interaction between the proteins in producing an overlapping pathological pattern will be also discussed. Keywords: Alzheimer’s disease, Parkinson’s disease, Beta-amyloid, Alpha-synuclein, Intracellular signalling, Neurotoxicity, Neurodegeneration Pathophysiology of toxic proteins Background All the proteins implicated in neurodegenerative diseases Protein misfolding and aggregation contribute to the share the common pattern of dysfunctional structure pathophysiology of neurodegenerative disorders such as due to an unusual folding [5–7]. Through folding, pro - Alzheimer’s (AD) and Parkinson’s diseases (PD). In physi- teins acquire the three dimensional structures required ological situations protein misfolding is sensed by the cel- to undertake their biological functions. This process is lular control systems as a threat which is then followed prone to errors, causing the protein not to acheive its by an immediate response. Any delay detecting the mis- functional structure, building a toxic protein deposition. folded proteins, may result in damage and progression of When an aggregation status is established, disaggregation neurodegenerative disorders [1, 2]. Unfortunately, not all rarely occurs because under physiological conditions, the cellular responses to misfolded proteins are neuro- the equilibrium is in favour of aggregation [8–11]. These protective. Activation of some intracellular pathways as a early aggregates are believed to be the source of toxicity part of this response occasionally create further damage, in neurodegenerative disorders. interruption in synaptic connections and neuronal apop- tosis [3, 4]. Alzheimer’s disease (AD) AD is the most common form of dementia and among the leading causes of death in adults. AD is associ- *Correspondence: shohreh.majd@flinders.edu.au Centre for Neuroscience and Paramedic Unit, School of Medicine, ated with two main lesions: extracellular plaques made Flinders University of South Australia, Adelaide, SA 5042, Australia of beta-amyloid (Aβ) and intracellular neurofibrillary Full list of author information is available at the end of the article © 2015 Majd et al. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/ publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Majd et al. BMC Neurosci (2015) 16:69 Page 2 of 13 tangles (NFT) made of tau protein [12, 13]. The plaques was obtained for both Aβ 1-40 and 1–42, two of the most are the consequences of abnormal protein folding and toxic forms of amyloid protein [35, 36]. aggregation with direct and indirect toxic effects on neu - Aβ oligomers can be generated both extra- and intra- ronal survival [14, 15]. cellularly. Extracellular Aβ toxicity could be mediated through binding to receptors such as NMDA and dis- Aβ biochemical structure and toxicity rupting the calcium balance of the neuron [37, 38]. Extra- Aβ, the principle protein implicated in development of cellular Aβ is internalized, stored in the lysosomes and AD, is derived from amyloid precursor protein (APP). can leak into the cytosol by destabilization of the lyso- More than ten isoforms of the protein are characterized some membrane. Aβ oligomers have the ability to inhibit by different lengths of amino acid chains, and among the function of proteasomes causing neuronal apopto- them APP695 is exclusively expressed in neurons. The sis [39, 40]. Toxicity of fibrillar and oligomers of Aβ also transmembrane region of APP is placed near the c-termi- occurs through cytoskeletal disruption, tangle develop- nus, and contains a Kunitz-type protease inhibitor (KPI) ment, loss of synapses and inhibition of hippocampal domain, which acts as a potent inhibitor of coagulation long-term potentiation (LTP). This is the so-called “Aβ factors IXa and XIa, however, APP695 lacks the KPI cascade theory” of AD [12, 41, 42]. domain [16, 17]. Intracellular inclusions of Aβ have been found within APP can act as a receptor for a signalling glycoprotein neuronal compartments. [43, 44]. Internalization of F-spondin that is released by neurons and possesses roles Aβ occurs either via binding to low-density lipopro- in axonal guidance, neuronal differentiation and neuro- tein related protein-2 (LRP2) [45], LRP-1 [46, 47] or to repair [18, 19]. Some other functions of APP have also a receptor for advanced glycation end-product (RAGE) been proposed, including serving as a link between kine- [48]. The presence of Aβ in various subcellular com - sin and synaptic vesicles being an adhesion protein, a role partments, suggests different sites for APP proteolysis, in metal ion homeostasis, neuroprotection and a func- such as Aβ40 in the trans-Golgi network and Aβ42 in tion relating to promotion of neurite growth [16, 20]. the endoplasmic reticulum (ER) [49, 50] as well as Golgi APP is degraded in lysosomes [21–23] (Fig.  1). Aβ is compartments [51]. Autophagic vacuoles enriched with produced when a normal cleavage of APP occurs α and β presenilin-1 (PS1), APP and Aβ are found frequently in secretase cleave APP, outside the membrane. Also three degenerating neurons in patients with AD. This suggests members of a family of peptidase proteins, ADAM, (a an essential role for autophagy in clearing the aggregated disintegrin and metalloproteinase) have a recognized peptide through a lysosomal-dependent pathway [52]. role cleaving the extracellular portion of APP, in the same Aβ disrupts APP trafficking, and initiates a pathological way that α-secretase does [24]. Proteolysis of APP by cascade of Aβ accumulation [39, 43]. An accumulation of β-secretase cleaves APP695 after Met-596 and produces vacuoles filled with Aβ occurs as a result of interruption a large soluble N-terminal (sAPPβ) and a small mem- to neuronal trafficking associated with the disruption of brane-bound C-terminal fragment (C99), sAPPβ, is neu- autopghgosomes [53]. Aβ itself is also able to activate the roprotective and regulates synaptic plasticity. This larger adenosine monophosphate kinase (AMPK) pathway, gen- fragment of APP can also act as a microtubule associated erating more autophagic vacuoles [54]. Thus, AD patients protein (MAP) [25]. appear to produce abundant extracellular Aβ, resulting APP can undergo proteolysis at the cell surface. Its C99 in plaque formation with a high level of toxicity causing fragment can be processed by γ- secretase, presenilin 1 extensive neuronal apoptosis [55–57]. and 2, γ-secretase produces Aβ isoforms of 1-40, 1-42 or 1-43 [17, 26–28]. These peptides are made throughout Aß and kinases life, but in AD they accumulate due to either increased Glycogen synthase kinase‑3 beta (GSK‑3β) production or decreased degradation or removal. Glycogen synthase kinase-3 beta (GSK-3β) is well-known Remaining Aβ has the potential to enhance its own pro- for its role in glycogen metabolism, activation of tran- duction in cerebrovascular smooth muscles and hip- scription factors and phosphorylation of tau. GSK3 is pocampal neurons [29, 30]. Excess peptides, particular modulated through a variety of pathways including wnt, those of Aβ 1-40, 1-42 and 1-43, form toxic aggregates, phosphatidylinositide-3 kinase (PI3K) and Akt deacti- which result in progression of AD [16, 31, 32]. vate GSK-3β by phosphorylating Ser9 [58, 59], increasing Filaments of amyloid structure are approximately GSK-3β, in pre-tangles which is closely associated with 10  nm wide and 0.1–10  μm long with a β-sheet struc- tangle-bearing neurons suggesting a role in tau hyper- ture in their motif [33, 34]. Using Electron Paramagnetic phosphorylation in AD [60–64]. A recent report associ- Resonance Spectroscopy (EPRS) the β-sheet structure ated GSK-3β gene variants with the level of tau and Aβ42 Majd et al. BMC Neurosci (2015) 16:69 Page 3 of 13 Fig. 1 Cellular trafficking of APP and Aβ. APP cleavage to peptides occurs both in lysosomes after its endocytosis and at the surface of cell mem- brane. The proteolysis products accumulate intracellularly or are released into extracellular space in cerebrospinal fluid in AD as well as cognitive function pathway [74, 75]. MAPKs are a family of serine/threo- [65]. Further in vivo evidence of GSK-3β’s role in AD has nine kinases that contribute to the hyperprocessing of come from transgenic mouse models over-expressing this APP and hyper-phosphorylation of tau associated with kinase with a presentation of tau hyper-phosphorylation, AD [76, 77]. MAPKs phosphorylate proteins with regula- astrocytosis, and neuronal death [66, 67]. The concurrent tory functions including other kinases, transcription fac- hyper-phosphorylation of other cellular structures such tors and enzymes [78–80]. Stimulation of MAPK by Aβ as presinilines, β-catenin and GSK3-cAMP responsive in a Ras-dependent manner, leads to tau phosphorylation element-binding protein also produces some of the path- [81–84]. It has also been demonstrated that activation of ological features of AD [61, 68, 69]. MAPK by neurotrophins as well as Aβ induces p35, the Aβ exposure induces GSK-3β activity, extensive phos- specific activator of cyclin dependent kinase 5 (cdk5) in phorylation of tau and cell death. Aβ inhibits PI3K and the cell cycle. Thus another means of damaging the neu - Akt pathways and inactivates the wnt cascade,. Because ron through MAPK activation by Aβ could be re-activa- these pathways eventually deactivate GSK3, their inhibi- tion of the cell cycle, which is considered a lethal event tion will result in hyperactivity of GSK3 [70, 71] (Fig.  2). for neurons [78–85]. This Aβ-induced GSK-3β hyperactivity triggers the mito - chondrial fragmentation leading to neuronal apoptosis Aß, cytoskeleton and axonal transport [72]. GSK-3β also interacts with pyruvate dehydrogenase A constant interaction between microtubules and MAPs (PDH), thereby reducing levels of acetyl-CoA [73]. such as tau is a necessary element for axonal transport [86]. Tau holds the microtubular tracks in place and plays Mitogen‑activated protein kinases (MAPK) a key role in their stability [87]. When tau is subjected Aβ affects another intracellular second messenger the to hyper-phosphorylation, it loses the ability to bind to extracellular signal regulated Kinase (ERK)/MAPK microtubules and to maintain their structure, causing tau Majd et al. BMC Neurosci (2015) 16:69 Page 4 of 13 Fig. 2 Aβ and GSK3. Aβ binding to membrane receptors such as insulin receptor (IR) inhibits the activity of Akt and wnt through PI3K inhibition. Inactivation of Akt and wnt consequently dephosphorylate GSK3 which causes tau hyper-phosphorylation and microtubular disorganisation aggregation into paired helical filaments (PHF) and NFTs Aβ and apolipoprotein E (apoE) [88]. The number of NFTs is linked to the degree of demen - ApoE is a normal constituent of cells. In the nervous tia, suggesting a correlation between NFT, dystrophic neu- system, it acts as the main lipid transport protein with a rite formation and neuronal dysfunction [89–91]. It seems wide variety of roles in intracellular signalling, immune that interrupting axonal transport will interrupt neuronal modulation, glucose metabolism, lipid movement and function and lead to eventual death [92–94]. lipoprotein metabolism [102]. ApoE has been detected in Deposition of Aβ plaques precedes tau phosphoryla- the amyloid plaques in AD [103]. tion and exerts a damaging effect upon the cytoskeleton The ability of ApoE to interact with Aβ, demonstrated giving rise to PHF formation. [41]. Intraneuronal for- its critical role in amyloid deposition and clearance [91, mation of Aβ also happens prior to appearance of PHF, 102, 104]. The apoE4 allele of ApoE is associated with making it the upstream step in triggering the neurode- high cholesterol in cardiovascular disease and particu- generative events [95, 96]. larly AD, however, the apoE2 allele confers some protec- Further evidence that Aβ formation precedes PHF for- tion against hypercholesterolemia [102, 105, 106]. ApoE2 mation comes from a tau mutation study when tau muta- and E3 formed stable complexes with Aβ at levels of 20 tion produced tau-inclusion tangles but not plaques, fold greater than those occurring with apoE4 [107]. The however, APP or presenilin mutations caused both greater affinity of ApoE2 and E3 for Aβ protects neurons plaques and tangles. Transgenic mice doubly mutant for from neurotoxic effects of Aβ by facilitating the uptake mutant APP and tau have more tangles than mice with of these complexes by apoE receptors. Conversely, apoE4 the single mutant tau transgene [97, 98]. Tau phospho- accelerates Aβ deposition and progression/growth of Aβ rylation occurs through activation of c-Jun N-terminal seeds to larger Aβ plaques [108, 109]. kinase (JNK), a member of MAPK [99]. In a study, amy- loid injections exacerbated tangle pathology in mutant- Aβ, mitochondria and oxidative stress tau mice but why Aβ injections did not stimulate tau The central role of Aβ isoforms, in elevating free radi - pathology with wild-type tau is not known [100], when cal levels and oxidative stress led to the introduction of other transgenic mice overexpressing wild-type tau an Aβ-oxidative stress model for neurotoxicity in AD exhibited tangles [101]. [110–112]. Majd et al. BMC Neurosci (2015) 16:69 Page 5 of 13 Post-mortem studies revealed a wide range of [126]. Oxidative stress also elicits an inflammatory Aβ-derived mitochondrial dysfunction in AD patients response [127] through microglial activation [128, 129] [113–115]. Intracellular Aβ can be localized to mito- and release of pro inflammatory cytokines [130], promot - chondrial membranes, where it interrupts the normal ing inflammation and invasion of Aβ plaques by astro - mitochondrial function through blocking mitochondrial cytes [131] which mature plaques into neuritic plaques, a channels and inhibiting mitochondrial protein activ- common finding in AD patients. ity. By blocking the electron transport chain, Aβ accu- mulation leads to an increase in reactive oxygen species Aβ and cell cycle (ROS), causing oxidative stress [114, 116–118] (Fig.  3) Inappropriate cell cycle activation is an early event seen which leads to a deregulation of the ROS signalling path- in AD brains [132]. Although adult neurons are con- way in AD [119]. Superoxide radicals, produced due to sidered to be in a terminally-differentiated state, accu - mitochondrial dysfunction oxidate different neuronal mulation of associated cell cycle-related proteins have compartments such as proteins, lipids and DNA [117, been described in degenerating neurons [133–137]. It 120]. The evidence of oxidative damage in patients with is assumed that ectopic localization of cyclins, cyclin- mild cognitive dementia (MCD) shows that the oxida- dependent kinases (cdks) and cdk inhibitors are the tion insult occurs as one of the first steps of AD [121]. results of abortive attempt by neurons to re-enter the cell Chronic oxidative stress inhibits tau dephosphorylation cycle. Re-entering the cell cycle is a consequence of mito- by inhibiting tau phosphatase as well as increasing the gen factors and perhaps is promoted by the recruitment phosphorylation of tau by activating p38 [119]. of mitogenic signal transduction mechanisms [138, 139]. The other aspect of oxidative stress relates to pro - Subjecting neurons to Aβ, forces the cell to re-enter the tein oxidation. Oxidative modification of proteins is cell cycle, cross the G1/S phase transition and begin de important in aging and age-related neurodegenerative novo DNA synthesis before apoptotic death occurs [140– disorders [122]. Protein oxidation results in protein dys- 142], this could be inhibited by cell-cycle inhibitors [143, function associated with conformational changes. The 144]. These findings led to the hypothesis that vulner - oxidized protein may also have a higher resistance to pro- able neurons re-enter the cell cycle and proceed through teolysis and protein cross-linking and aggregation will be S phase, but then abort somatic division and eventually increased [123]. The aggregated misfolded proteins then degenerate [145]. get trapped in proteasome’s pore leading to proteasomal dysfunction [124, 125]. A vicious cycle of misfolded pro- Parkinson’s disease (PD) tein accumulation is then established. Parkinson’s disease (PD) is the second most common Aggregated peptides have the potential to initiate oxi- neurodegenerative disorder among the adults. The pro - dative stress through cellular dysfunction leading to cal- gressive impaired motor function in patients with PD is cium accumulation and increased tau polymerization an outcome of dopaminergic neuronal loss particularly in the substantia nigra (SN) [146]. A common finding from degenerating dopaminergic cells includes intracellular inclusions of particles, known as Lewy bodies (LBs) [147, 148]. The major component of LBs is the fibrillar form of α-Syn and this suggests the role of protein misfolding in Parkinson’s pathology [149, 150]. α‑Synuclein structure and toxicity α-Syn is an acidic synaptic protein (14  kDa), which is expressed in a wide range of tissues including the brain [151–153]. α-Syn retains the ability of building a β-sheet structure after prolonged incubation due to its posses- sion of a hydrophobic region of amino acids from 66 to 95 [154]. As a vesicle associated protein, the main func- Fig. 3 Aβ and mitochondrial dysfunction. Attachment of Aβ to inner tions of α-Syn are regulating membrane stability, neu- membrane of mitochondria alters the different aspects of mitochon- ronal plasticity, synaptic rearrangement, controlling drial activity. Blocking electron chain through reducing complex IV activity, damaging mitochondrial DNA (mtDNA), inhibiting tricarbo- vesicular trafficking and neurotransmission through a xylic acid ( TCA) cycle and ATP production, enhancing cytochrome chaperon-like function to other proteins [134, 155–159]. c release and activation of apoptotic pathways, and increasing the Due to the ability α-Syn to interact with tubulin, α-Syn mitochondria production of ROS are some of the examples also shows a microtubule-associated activity [160–162]. Majd et al. BMC Neurosci (2015) 16:69 Page 6 of 13 Lesions from autopsied PD brains show a marked decreased MTT levels, reduction of glutathione and high increase in S129 hyperphosphorylated α-Syn [163] which levels of iron, in brain tissue confirmed the presence of creates high molecular weight α-Syn with a high poten- oxidative stress as a common finding in PD [189–193] 2+ tial for self-assembly. This makes it a likely candidate to Oxidative stress affects the Ca shift and balance in be a toxic protein in the event of aggregation [164, 165]. cytoplasm, leading to stimulation of mitochondrial nitric α-Syn could also be phosphorylated on Tyr39 with no oxide synthase (mtNOS) [194, 195]. α-Syn also has the link between this phosphorylation and pathological fea- ability of binding to pro apoptotic protein BAD, a mem- tures [166]. ber of Bcl-2 family [182]. As the result of this attachment, Fibrillar α-Syn as the main component of LBs, is pre- Bcl-2 protein is removed from mitochondrial pores, sent in many dying cells in PD [167], however, oligomeric allowing cytochrome c to be released from the mito- α-Syn also possesses enough toxicity to damage neu- chondria. This event triggers neuronal apoptosis dem - rons [168]. The process of misfolding of α-Syn has been onstrating a link between mitochondrial dysfunction and shown to be accelerated by many metals such as copper synaptic accumulation of α-Syn in PD [195, 196]. [169] and ferric ion and also by elevated intracellular cytochrome c [170]. Conformational changes leads to α‑Synuclein and axonal trafficking protein misfolding reduce the ability of α-Syn to inter- α-Syn ability to act as a MAP, allows microtubules to act with the vesicular trafficking and modulating neuro - maintain their stability, to carry cargos in an energy- transmission [171–174]. Conformational changes and dependent manner, and to facilitate neurotransmitter consequent aggregation α-Syn also triggers a cascade of release [159, 161]. Overexpression and phosporylation neuronal response such as autophagy, one of the main of α-Syn, however, affects the normal function of ER pathways of α-Syn degradation [175, 176]. and Golgi system. α-Syn directly binds to ER and the Golgi apparatus and inhibits the soluble NSF attach- α‑Synuclein and MAPK ment protein receptor (SNARE) complex assembly [197, Regulation of MAPK pathway is a downstream effect of 198]. The SNARE complex is made of vesicular SNARE α-Syn. In neurons, α-Syn binding to MAPK inhibits this proteins (v-SNARE) and target membrane SNARE pro- pathway. In particular, α-Syn binds directly to ERK2 and teins (t-SNARE). It possesses the ability of self-assembly indirectly to Elk-1, which is also an ERK2 substrate [177]. and allows vesicular fusion to cell membrane [199, 200]. u Th s α-Syn reduces dopamine transporter (DAT) inser - Blocking this assembly by α-Syn overexpression inter- tion in the synaptic membranes of axonal terminals [178]. feres with neurotransmitter release and reuptake (Fig. 4). α-Syn also decreases MAPK activation through reducing Consequently, relocating cellular proteins within the cell the phosphorylation of p38 and down regulating c-fos or from the cell toward the membrane and eventual neu- gene [179, 180]. rotransmission will be disturbed [201]. The eventual out - Phosphorylation and accumulation of MAPK elements come would include protein accumulation inside the cell, have been reported in PD patients [81, 172]. One of the Golgi system fragmentation, a decrease in neurotrans- MAPK elements is JNK, that is phosphorylated in PD and mitter release and neuronal apoptosis [202–204]. α-Syn activates the transcription factor of c-jun. Activation of also reduces polymerization of tubulin. Whether reduc- c-jun increases the level of cell death genes expression in ing polymerization of tubulin is a direct outcome or an dopaminergic neurons [82, 181]. JNK also inhibits Bcl-2 indirect one, through generating mitochondrial dysfunc- survival protein by activation of pro-apoptotic proteins tion and lack of ATP for polymerization, the outcome of Bad and Bim [182, 183]. The misregulation of MAPK represents itself as a disrupted axonal transport and neu- eventually leads to neuronal apoptosis. Inhibiting JNK rite degeneration [20, 203, 205]. phosphorylation, however, can protect neurons from death [184]. Activation of ERK has also been reported in α‑Syn and Aβ interaction glial cells which consequently starts a cascade of inflam - Both AD and PD show similar clinical presentations in matory responses and blocking that pathway reduces their mid to late stages [206, 207] suggesting the possibil- microglial activation [185, 186]. ity of interaction between α-Syn and Aβ [25, 144, 208]. It has been shown that instead of immediate cell death, α‑Synuclein and oxidative stress affected neurons live for several months in a near- func - α-Syn overexpression causes the impairment of mito- tional state [209, 210]. Constant production of both pro- chondrial homeostasis [187] leading to oxidative stress teins allows continuing protein–protein interaction and and dopamine oxidation [188]. Formation of giant as a result, a reciprocal induction between α-Syn and Aβ mitochondria and laminated bodies, autophagozomes, could cause a gradual increase in the protein levels of Majd et al. BMC Neurosci (2015) 16:69 Page 7 of 13 Fig. 4 α-Syn in normal condition binds to synaptic vesicle membrane and also v-SNARE. v-SNARE assembly to t-SNARE creates SNARE complex and results in synaptic vesicle fusion to cell membrane and neurotransmitter release. α-Syn clusters synaptic vesicles in the axonal terminal and produces a high concentration of presynaptic vesicles at a certain area of plasma membrane. Vesicular α-Syn also binds to early endosomes and facilitates neurotransmitter refilling of vesicles. α-Syn accumulation/fibrilation inhibits vesicular refilling, blocks SNARE complex formation and reduces the number of docking neurotransmitter vesicles Abbreviations both types, before neurodegeneration commences [144]. Aβ: beta-amyloid; AD: Alzheimer’s disease; apoE: apolipoprotein E; APP: amy- The PI3K pathway and ApoE could contribute to this loid precursor protein; α-Syn: alpha-synuclein; cdk: cyclin dependent kinase; interaction, as manipulation of PI3K reduced the recipro- ER: endoplasmic reticulum; ERK: extracellular signal regulated kinase; GSK-3β: glycogen synthase kinase-3 Beta; JNK: Jun N-terminal kinase; KPI: Kunitz-type cal elevation of α-Syn and Aβ [144]. Deletion of ApoE in protease inhibitor; LBs: Lewy bodies; LRP2: low-density lipoprotein related pro- α-Syn transgenic mice decreased the levels of Aβ, thereby tein-2; LTP: long-term potentiation; MAPK: mitogen-activated protein kinases; alleviating the onset of disease [211]. More research is mtNOS: mitochondrial nitric oxide synthase; NFT: neurofibrillary tangles; NGF: nerve growth factor; PD: Parkinson’s disease; PDH: pyruvate dehydrogenase; still required to achieve a complete understanding of the PHF: paired helical filaments; PI3K: phosphatidylinositide-3kinase; RAGE: glyca- underlying mechanisms. tion end-product; ROS: reactive oxygen species; SN: substantia nigra; SNARE: NSF attachment protein receptor; t-SNARE: target membrane SNARE protein; v-SNARE: vesicular SNARE protein. Conclusion Although the process of neuronal death is a common Authors’ contributions feature in AD and PD, the underlying mechanisms are SM, HG and JP conceived and drafted the manuscript. All authors read and approved the final manuscript. still under investigation. Some aspects of toxicity may be specific for a distinct type of neurodegenerative disorder Author details however common cellular mechanisms with a substan- Centre for Neuroscience and Paramedic Unit, School of Medicine, Flinders University of South Australia, Adelaide, SA 5042, Australia. Department tial overlap underlie the neuronal responses to the toxic of Human Physiology, School of Medicine, Flinders University of South Aus- proteins. tralia, Adelaide, SA 5042, Australia. In conclusion, neuronal death in neurodegenera- Acknowledgements tive disorders is not a single-cause event and establish- SM was a member of Alzheimer’s and Parkinson’s lab at Flinders University of ing the exact links between the activation mechanisms South Australia when she started writing the manuscript and we would like to in response to toxic proteins could open a window for thank the lab members for their enthusiastic discussions about protein toxicity in neurodegenerative disorders. promising therapeutic interventions. Majd et al. BMC Neurosci (2015) 16:69 Page 8 of 13 Competing interests 21. Gouras GK, Xu H, Jovanovic JN, Buxbaum JD, Wang R, Greengard P, The authors declare that they have no competing interests. Relkin NR, Gandy S. Generation and regulation of beta-amyloid peptide variants by neurons. J Neurochem. 1998;71(5):1920–5. Received: 12 January 2015 Accepted: 13 October 2015 22. Schneider A, Rajendran L, Honsho M, Gralle M, Donnert G, Wouters F, Hell SW, Simons M. 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Published: Oct 23, 2015

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