APOE immunotherapy reduces cerebral amyloid angiopathy and amyloid plaques while improving cerebrovascular function


BIBLIOGRAPHIC THERAPEUTIC AGENT ANIMAL MODEL EXPERIMENTAL DESIGN OUTCOMES

Bibliographic

Year of Publication:
2021
Contact PI Name:
David M. Holtzman
Contact PI Affiliation:
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
Co-Authors:
Monica Xiong, Hong Jiang, Javier Remolina Serrano, Ernesto R. Gonzales, Chao Wang, Maud Gratuze, Rosa Hoyle, Nga Bien-Ly, Adam P. Silverman, Patrick M. Sullivan, Ryan J. Watts, Jason D. Ulrich, Gregory J. Zipfel
Primary Reference (PubMED ID):
Funding Source:
National Institute on Aging (NIA)
National Institute of Neurological Disorders and Stroke (NINDS)
National Institute of General Medical Sciences (NIGMS)
JPB Foundation
Study Goal and Principal Findings:

The ε4 allele of the apolipoprotein E (APOE) gene is the strongest genetic risk factor for late-onset Alzheimer's disease (AD) and greatly influences the development of amyloid-β (Aβ) pathology. Our current study investigated the potential therapeutic effects of the anti-human APOE antibody HAE-4, which selectively recognizes human APOE that is co-deposited with Aβ in cerebral amyloid angiopathy (CAA) and parenchymal amyloid pathology. In addition, we tested whether HAE-4 provoked brain hemorrhages, a component of amyloid-related imaging abnormalities (ARIA). ARIA is an adverse effect secondary to treatment with anti-Aβ antibodies that can occur in blood vessels with CAA. We used 5XFAD mice expressing human APOE4 +/+ (5XE4) that have prominent CAA and parenchymal plaque pathology to assess the efficacy of HAE-4 compared to an Aβ antibody that removes parenchymal Aβ but increases ARIA in humans. In chronically treated 5XE4 mice, HAE-4 reduced Aβ deposition including CAA compared to a control antibody, whereas the anti-Aβ antibody had no effect on CAA. Furthermore, the anti-Aβ antibody exacerbated microhemorrhage severity, which highly correlated with reactive astrocytes surrounding CAA. In contrast, HAE-4 did not stimulate microhemorrhages and instead rescued CAA-induced cerebrovascular dysfunction in leptomeningeal arteries in vivo. HAE-4 not only reduced amyloid but also dampened reactive microglial, astrocytic, and proinflammatory-associated genes in the cortex. These results suggest that targeting APOE in the core of both CAA and plaques could ameliorate amyloid pathology while protecting cerebrovascular integrity and function.

Therapeutic Agent

Therapeutic Information:
Therapy Type:
Biologic - Immunotherapy(passive)
Therapeutic Agent:
HAE-4 (anti-Human ApoE Antibody)
Therapeutic Target:
Apolipoprotein E (ApoE)
Therapy Type:
Biologic - Immunotherapy(passive)
Therapeutic Agent:
Aducanumab
Therapeutic Target:
beta Amyloid Peptide
Therapeutic Notes:
Apolipoprotein E has been nominated as a potential target for AD. Nominated targets are obtained from several sources, including the National Institute on Aging's Accelerating Medicines Partnership in Alzheimer's Disease (AMP-AD) consortium. Targets have been identified using computational analyses of high-dimensional genomic, proteomic and/or metabolomic data derived from human samples. See Agora link for more information.

Animal Model

Model Information:
Species:
Mouse
Model Type:
APPxPS1
Strain/Genetic Background:
C57BL/6 x SJL
Species:
Mouse
Model Type:
ApoE
Strain/Genetic Background:
C57BL/6J
Species:
Mouse
Model Type:
APPxPS1xApoE
Strain/Genetic Background:
C57BL/6J

Experimental Design

Is the following information reported in the study?:
Power/Sample Size Calculation
Randomized into Groups
Blinded for Treatment
Blinded for Outcome Measures
Pharmacokinetic Measures
Pharmacodynamic Measures
Toxicology Measures
ADME Measures
Biomarkers
Dose
Formulation
Route of Delivery
Duration of Treatment
Frequency of Administration
Age of Animal at the Beginning of Treatment
Age of Animal at the End of Treatment
Sex as a Biological Variable
Study Balanced for Sex as a Biological Variable
Number of Premature Deaths
Number of Excluded Animals
Statistical Plan
Genetic Background
Inclusion/Exclusion Criteria Included
Conflict of Interest

Outcomes

Outcome Measured
Outcome Parameters
Histopathology
beta Amyloid Deposits
beta Amyloid Load
Cerebral Amyloid Angiopathy (CAA)
Colocalization-Astrocytes/Microglia/Amyloid Plaques
Dense-core/Compact Plaques
Fibrillar beta Amyloid Deposits
Microhemorrhages
Parenchymal Plaques
Vascular beta Amyloid Deposits
Biochemical
Brain-Guanidine Soluble beta Amyloid Peptide 40
Brain-Guanidine Soluble beta Amyloid Peptide 42
Immunochemistry
Apolipoprotein E (ApoE)
Brain-beta Amyloid Deposits
CD31
CD45
Glial Fibrillary Acidic Protein (GFAP)
Hemosiderin Deposits
Ionized Calcium Binding Adaptor Molecule 1 (Iba1)
Microscopy
Vessel Diameter
Imaging
In Vivo Microvasculature Imaging
Pharmacodynamics
Target Engagement (Reduction beta Amyloid Deposits)
Target Engagement (Reduction Amyloid Load)
Omics
Gene Expression Profile-Astrocytic Genes
Gene Expression Profile-Microglial Genes
Gene Expression Profile-Endothelial Markers
Gene Expression Profile-Inflammatory Genes
Physiology
Cerebrovascular Reactivity
Blood Gas Measurement

Source URL: http://alzped.nia.nih.gov/apoe-immunotherapy-reduces