Neural stem cell transplantation at critical period improves learning and memory through restoring synaptic impairment in Alzheimer's disease mouse model

Alzheimer''s disease (AD) is characterized by neuronal loss in several regions of the brain. Recent studies have suggested that stem cell transplantation could serve as a potential therapeutic strategy to halt or ameliorate the inexorable disease progression. However, the optimal stage of the disease for stem cell transplantation to have a therapeutic effect has yet to be determined. Here, we demonstrated that transplantation of neural stem cells into 12-month-old Tg2576 brains markedly improved both cognitive impairments and neuropathological features by reducing β-amyloid processing and upregulating clearance of β-amyloid, secretion of anti-inflammatory cytokines, endogenous neurogenesis, as well as synapse formation. In contrast, the stem cell transplantation did not recover cognitive dysfunction and β-amyloid neuropathology in Tg2576 mice aged 15 months when the memory loss is manifest. Overall, this study underscores that stem cell therapy at optimal time frame is crucial to obtain maximal therapeutic effects that can restore functional deficits or stop the progression of AD.Alzheimer''s disease (AD) is the most common neurodegenerative disorder, and is characterized by progressive cognitive dysfunction and memory loss that are caused by the death of nerve cells in several brain regions, including the cortex and hippocampus. Pathologically, senile plaques, including amyloid beta (Aβ) and carboxy-terminal fragments (CTFs) are derived via amyloid precursor protein (APP) proteolysis, and neurofibrillary tangles, including hyperphosphorylated tau, are two representative hallmarks of AD.^{1, 2, 3} Together with the accumulation of Aβ, local inflammation, altered hippocampal neurogenesis and synaptic loss have been correlated with cognitive deficits in AD patients.^{4, 5} However, no treatment has yet been developed that can cure or prevent the progression of dementia.Accumulating evidence indicates that the transplantation of neural stem cells (NSCs) or bone marrow stem cells (BMSCs) into the hippocampus improves cognitive functions in AD animal models.^{6, 7, 8, 9, 10, 11, 12} The stem cell-induced functional recovery seems to be mediated by either neurotrophic factors and/or neuroprotective cytokines. For instance, genetically engineered stem cells that secrete nerve growth factor (NGF),^{11, 12} the co-administration of stem cells with brain-derived neurotrophic factor (BDNF) or grafting encapsulated vascular endothelial growth factor (VEGF) secreting cells substantially improved behavioral outcomes of AD animal models.^{9, 13} Thus, the functional effects of stem cell grafts involve the increase of several neurotrophic factors, such as BDNF, FGF2, insulin-like growth factor 1 (IGF1), NGF and VEGF.^{10, 14, 15} In contrast, BMSCs or adipose-derived stem cells (ASCs) transplantation induces microglial activation^{16, 17, 18} and the secretion of neuroprotective cytokines, leading to a decline of Aβ deposits and the restoration of memory deficits in AD mice.^{18, 19} However, the optimal stage of the disease for stem cell transplantation in AD models has yet to be determined.In this study, we have investigated whether the transplantation of NSCs at two distinguished stages in the disease development could have different beneficial effects in AD model mice, Tg2576 mice.²⁰ In this model, the over-production of Aβ begins at 6–7 months of age, and neuritic plaques with amyloid cores are formed from 9 to 12 months after birth followed by the onset of memory deficits at 12 months of age.^{21, 22, 23} NSCs were bilaterally transplanted into the dentate gyrus (DG) of the hippocampus and the third ventricle of 12-month-old (early stage) or 15-month-old (advanced stage) Tg2576 and age-matched wild-type (WT) mice. We determined whether the engrafted NSCs at two stages of the disease rescued cognitive deficits and the neuropathology of the mice.