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Grizzanti J, Moritz WR, Pait MC, Stanley M, Kaye SD, Carroll CM, Constantino NJ, Deitelzweig LJ, Snipes JA, Kellar D, Caesar EE, Pettit-Mee RJ, Day SM, Sens JP, Nicol NI, Dhillon J, Remedi MS, Kiraly DD, Karch CM, Nichols CG, Holtzman DM, Macauley SL. KATP channels are necessary for glucose-dependent increases in amyloid-β and Alzheimer's disease-related pathology. JCI Insight 2023; 8:e162454. [PMID: 37129980 PMCID: PMC10386887 DOI: 10.1172/jci.insight.162454] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 04/18/2023] [Indexed: 05/03/2023] Open
Abstract
Elevated blood glucose levels, or hyperglycemia, can increase brain excitability and amyloid-β (Aβ) release, offering a mechanistic link between type 2 diabetes and Alzheimer's disease (AD). Since the cellular mechanisms governing this relationship are poorly understood, we explored whether ATP-sensitive potassium (KATP) channels, which couple changes in energy availability with cellular excitability, play a role in AD pathogenesis. First, we demonstrate that KATP channel subunits Kir6.2/KCNJ11 and SUR1/ABCC8 were expressed on excitatory and inhibitory neurons in the human brain, and cortical expression of KCNJ11 and ABCC8 changed with AD pathology in humans and mice. Next, we explored whether eliminating neuronal KATP channel activity uncoupled the relationship between metabolism, excitability, and Aβ pathology in a potentially novel mouse model of cerebral amyloidosis and neuronal KATP channel ablation (i.e., amyloid precursor protein [APP]/PS1 Kir6.2-/- mouse). Using both acute and chronic paradigms, we demonstrate that Kir6.2-KATP channels are metabolic sensors that regulate hyperglycemia-dependent increases in interstitial fluid levels of Aβ, amyloidogenic processing of APP, and amyloid plaque formation, which may be dependent on lactate release. These studies identify a potentially new role for Kir6.2-KATP channels in AD and suggest that pharmacological manipulation of Kir6.2-KATP channels holds therapeutic promise in reducing Aβ pathology in patients with diabetes or prediabetes.
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Affiliation(s)
- John Grizzanti
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - William R. Moritz
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Morgan C. Pait
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Molly Stanley
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Department of Biology, College of Arts and Sciences, University of Vermont, Burlington, Vermont, USA
| | - Sarah D. Kaye
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Caitlin M. Carroll
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Nicholas J. Constantino
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Lily J. Deitelzweig
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - James A. Snipes
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Derek Kellar
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Emily E. Caesar
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | | | | | | | - Noelle I. Nicol
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jasmeen Dhillon
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Maria S. Remedi
- Department of Physiology and Pharmacology and
- Department of Medicine, Division of Endocrinology, Metabolism and Lipid Research
| | | | - Celeste M. Karch
- Department of Psychiatry
- Hope Center for Neurological Disorders
- Knight Alzheimer’s Disease Research Center, Department of Neurology; and
| | - Colin G. Nichols
- Center for the Investigation of Membrane Excitability Diseases, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - David M. Holtzman
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
- Hope Center for Neurological Disorders
- Knight Alzheimer’s Disease Research Center, Department of Neurology; and
| | - Shannon L. Macauley
- Department of Physiology and Pharmacology and
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Alzheimer’s Disease Research Center
- Center on Diabetes, Obesity and Metabolism
- Center for Precision Medicine; and
- Cardiovascular Sciences Center, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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Isaacson RS, Hristov H, Saif N, Hackett K, Hendrix SB, Melendez J, Safdieh J, Fink M, Lee P, Thambisetty M, Berkowitz C, Rahman A, Bellara S, Meléndez-Cabrero J, Caesar EE, Sadek G, Cohen R, Dickson SP, Lu PL, Hwang MJ, Scheyer O, Schelke MW, Niotis K, Greer CE, Attia P, Mosconi L, Krikorian R. O4-06-04: PRECISION MEDICINE INTERVENTION IN PATIENTS AT RISK FOR ALZHEIMER'S DEMENTIA. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Paige Lee
- Weill Cornell Medicine; New York NY USA
| | | | | | | | | | | | - Emily E. Caesar
- Loyola University Chicago Stritch School of Medicine; Chicago IL USA
| | | | | | | | - Pei-Lin Lu
- Zhejiang University School of Medicine Sir Run Run Shaw Hospital; Hangzhou China
| | | | | | | | | | - Christine E. Greer
- Keck School of Medicine of the University of Southern California; Los Angeles CA USA
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Hackett K, Krikorian R, Giovannetti T, Melendez-Cabrero J, Rahman A, Caesar EE, Chen JL, Hristov H, Seifan A, Mosconi L, Isaacson RS. Utility of the NIH Toolbox for assessment of prodromal Alzheimer's disease and dementia. Alzheimers Dement (Amst) 2018; 10:764-772. [PMID: 30505926 PMCID: PMC6247399 DOI: 10.1016/j.dadm.2018.10.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Introduction The NIH Toolbox Cognition Battery (NIHTB-CB) is a computer-based protocol not yet validated for clinical assessment. Methods We administered the NIHTB-CB and traditional neuropsychological tests to 247 Memory Disorders and Alzheimer's Prevention Clinic patients with subjective cognitive decline, mild cognitive impairment, mild dementia due to Alzheimer's disease, and normal cognition. Principal component analysis, partial correlations, and univariate general linear model tests were performed to assess construct validity. Discriminant function analyses compared classification accuracy. Results Principal component analysis identified three conceptually coherent factors: memory (MEMNIH), executive function (EFNIH), and crystallized intelligence (CINIH). These factors were strongly associated with corresponding traditional tests and differed across diagnostic groups as expected. Both NIHTB and traditional batteries yielded strong overall discriminative ability (>80%). Discussion The NIHTB-CB is a valid method to assess neurocognitive domains pertinent to aging and dementia and has utility for applications in a memory clinic setting.
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Affiliation(s)
- Katherine Hackett
- Department of Psychology, Temple University, Philadelphia, PA, USA
- Corresponding author. Tel.: +914-582-7581; Fax: +215-204-5539.
| | - Robert Krikorian
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | | | | | - Aneela Rahman
- Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA
| | | | - Jaclyn L. Chen
- Stony Brook University School of Medicine, New York, NY, USA
| | - Hollie Hristov
- Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA
| | | | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA
| | - Richard S. Isaacson
- Department of Neurology, Weill Cornell Medicine and NewYork-Presbyterian, New York, NY, USA
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Walker JQ, Keine D, Caesar EE, Hristov H, Hackett K, Isaacson R. [P2–584]: COMPARING CLINICALLY BASED VERSUS ALGORITHM‐GENERATED INTERVENTIONS IN THE CONTEXT OF ALZHEIMER's DISEASE (AD) PREVENTION. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.06.1243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Macauley SL, Stanley M, Caesar EE, Yamada SA, Raichle ME, Perez R, Mahan TE, Sutphen CL, Holtzman DM. Hyperglycemia modulates extracellular amyloid-β concentrations and neuronal activity in vivo. J Clin Invest 2015; 125:2463-7. [PMID: 25938784 DOI: 10.1172/jci79742] [Citation(s) in RCA: 142] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 03/27/2015] [Indexed: 12/17/2022] Open
Abstract
Epidemiological studies show that patients with type 2 diabetes (T2DM) and individuals with a diabetes-independent elevation in blood glucose have an increased risk for developing dementia, specifically dementia due to Alzheimer's disease (AD). These observations suggest that abnormal glucose metabolism likely plays a role in some aspects of AD pathogenesis, leading us to investigate the link between aberrant glucose metabolism, T2DM, and AD in murine models. Here, we combined two techniques – glucose clamps and in vivo microdialysis – as a means to dynamically modulate blood glucose levels in awake, freely moving mice while measuring real-time changes in amyloid-β (Aβ), glucose, and lactate within the hippocampal interstitial fluid (ISF). In a murine model of AD, induction of acute hyperglycemia in young animals increased ISF Aβ production and ISF lactate, which serves as a marker of neuronal activity. These effects were exacerbated in aged AD mice with marked Aβ plaque pathology. Inward rectifying, ATP-sensitive potassium (K(ATP)) channels mediated the response to elevated glucose levels, as pharmacological manipulation of K(ATP) channels in the hippocampus altered both ISF Aβ levels and neuronal activity. Taken together, these results suggest that K(ATP) channel activation mediates the response of hippocampal neurons to hyperglycemia by coupling metabolism with neuronal activity and ISF Aβ levels.
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