The reduced clearance of amyloid-
β peptide (A
β) from the brain partly accounts for the neurotoxic accumulation of A
β in Alzheimer''s disease (AD). Recently, it has been suggested that P-glycoprotein (P-gp), which is an efflux transporter expressed on the luminal membrane of the brain capillary endothelium, is capable of transporting A
β out of the brain. Although evidence has shown that restoring P-gp reduces brain A
β in a mouse model of AD, the molecular mechanisms underlying the decrease in P-gp expression in AD is largely unknown. We found that A
β1–42 reduced P-gp expression in the murine brain endothelial cell line bEnd.3, which was consistent with our
in vivo data that P-gp expression was significantly reduced, especially near amyloid plaques in the brains of five familial AD mutations (5XFAD) mice that are used as an animal model for AD. A neutralizing antibody against the receptor for advanced glycation end products (RAGE) and an inhibitor of nuclear factor-kappa B (NF-
κB) signaling prevented the decrease in A
β1–42-induced P-gp expression, suggesting that A
β reduced P-gp expression through NF-
κB signaling by interacting with RAGE. In addition, we observed that the P-gp reduction by A
β was rescued in bEnd.3 cells receiving inductive signals or factors from astrocytes making contacts with endothelial cells (ECs). These results support that alterations of astrocyte–EC contacts were closely associated with P-gp expression. This suggestion was further supported by the observation of a loss of astrocyte polarity in the brains of 5XFAD mice. Taken together, we found that P-gp downregulation by A
β was mediated through RAGE–NF-
κB signaling pathway in ECs and that the contact between astrocytes and ECs was an important factor in the regulation of P-gp expression.Alzheimer''s disease (AD) is a neurodegenerative disorder that is characterized by a progressive loss of cognitive function leading to dementia. The major pathological hallmark of AD is the deposition of neurotoxic amyloid-
β peptide (A
β) within the brain.
1 The amyloid hypothesis proposes that the accumulation of A
β is caused by an imbalance between A
β production and clearance.
2 Although genetic alterations increase the production of A
β in rare familial AD, reduced A
β clearance from the brain likely accounts for sporadic AD, which is much more common.
3 The mechanisms that are involved in clearing A
β from the brain include enzymatic degradation, perivascular drainage, and the most significant, active transport across the blood–brain barrier (BBB).
4The BBB regulates molecular exchanges at the interface between the blood and the brain.
5 It plays a critical role in maintaining the brain microenvironment.
6 The BBB, which is formed by cerebral endothelial cells (ECs) and which, interacts with astrocytes, neurons, pericytes, and the extracellular matrix, is organized into a neurovascular unit.
7, 8 Although the relationship between BBB breakdown and AD pathology is unclear,
9 it has been proposed that the BBB loses its A
β clearing capability, thus increasing amyloid deposition in the outer capillary membrane and resulting in the distortion of the neurovascular unit with neuronal loss.
10Recently, it has been suggested that P-glycoprotein (P-gp), which is an ATP-driven efflux transporter that is highly expressed in the luminal membrane of the brain capillary endothelium, is also involved in the clearance of A
β from the brain.
11 P-gp, which is able to transport various kinds of substrates, has been shown to play an important role in clearing toxic substances in the brain and protecting it from harmful molecules in the circulation.
12 Along with other BBB properties, P-gp expression is induced when ECs are in contact with astrocytes
in vitro and
in vivo.
13, 14 ECs respond to inductive signals or factors from astrocytes that encircle the capillary endothelium.
13Several lines of evidence have shown that P-gp plays an important role in A
β clearance. It has been shown
in vitro that P-gp mediates the transport of A
β and that blocking P-gp function reduces the clearance of A
β.
15, 16 In addition, cerebral A
β deposition in elderly non-demented individuals has been demonstrated to be inversely correlated with brain capillary P-gp expression.
17 Furthermore, in P-gp knockout mice, A
β deposition is increased by the reduced efflux of A
β,
18 while it has been shown that restoring P-gp at the BBB reduces brain A
β in a mouse model of AD.
19 However, the molecular mechanisms underlying the decrease in P-gp expression that is observed in AD have not been identified. We found that A
β decreased P-gp expression by increasing nuclear factor-kappa B (NF-
κB) through an interaction with the receptor for advanced glycation end products (RAGE). Moreover, we observed that the P-gp reduction by A
β was rescued by inductive signals or factors from astrocytes that made contact with ECs in bEnd.3 cells. These results suggested that alterations in astrocyte–EC contact in AD likely decrease P-gp expression by A
β. Together, we identified a mechanism by which the A
β–RAGE interaction mediated the downregulation of P-gp in the BBB by increasing NF-
κB signaling in AD and that astrocyte–EC contact played a critical role in maintaining P-gp expression.
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