The role of amylin in Alzheimer's disease

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Abstract

Type II diabetes mellitus (T2D) and Alzheimer's disease (AD) share aetiology and have a high incidence of co-morbidity. Evidence suggests that both diseases are caused by the pathogenic aggregation of an intrinsically disordered native amyloid peptide. Furthermore, T2D and AD share risk factors such as age, obesity and vascular health. Recent studies demonstrate that amylin, an amyloidogenic pancreatic hormone deposited in the pancreas in T2D, is also deposited in the brain in AD. We hypothesised that amylin directly contributes to AD through deposition in the brain and activation of pathogenic signalling cascades. We provide evidence to validate that amylin is deposited in the brain parenchyma and vasculature. Furthermore, we present data demonstrating amylin (IAPP) expression in the brain is significantly elevated in AD; and that amylin treatment increases amyloid-beta (AB) secretion in neuronal culture. Soluble oligomeric species of AB cause AD by initiation of downstream signalling cascades that dysregulate kinase activity, promote tau phosphorylation and result in neuronal death. One such pathway involves AB oligomer activation of the Src-family kinase Fyn, through binding to the cellular prion protein (PrPC) receptor complex. We provide evidence that amylin activates Fyn in neuroblastoma and stem cell derived neurons, this activation is possibly mediated through PrPC. Together the data presented in this thesis demonstrate multiple modes of action whereby amylin may directly propagate or indirectly exacerbate AD-associated processes. Amylin aggregation, deposition, up-regulation and signalling should be considered one of several links between T2D and AD. The pathogenic actions of AB and amylin are mediated by oligomer species. Therefore therapeutics which prevent oligomerisation or oligomer action may be valuable in AD and T2D. One such class of therapeutic are flavonoids. Our collaborators have recently demonstrated the flavonoids rutin and quercetin reduce amylin aggregation and extend lifespan in diabetic animal models. As a result of this we investigated the anti-amyloidogenic and anti-oligomeric properties of the flavonoid quercetin against AB. Quercetin treatment prevented AB oligomerisation, cell binding of pre-formed AB oligomers and also reduced APP processing in cell models. These data suggest quercetin is a multimodal therapeutic with potential utility in AD and T2D and should be explored for further drug development.

Keyword(s)

Alzheimer's disease; Amylin; Amyloid; Diabetes; Flavonoid; Islet amyloid polypeptide (IAPP); Quercetin

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