Central Nervous System Delivery of Intranasal Insulin: Mechanisms of Uptake and Effects on Cognition.

Intranasal insulin has shown efficacy in patients with Alzheimer's disease (AD), but there are no preclinical studies determining whether or how it reaches the brain. Here, we showed that insulin applied at the level of the cribriform plate via the nasal route quickly distributed throughout the brain and reversed learning and memory deficits in an AD mouse model. Intranasal insulin entered the blood stream poorly and had no peripheral metabolic effects. Uptake into the brain from the cribriform plate was saturable, stimulated by PKC inhibition, and responded differently to cellular pathway inhibitors than did insulin transport at the blood-brain barrier. In summary, these results show intranasal delivery to be an effective way to deliver insulin to the brain.

[1]  R. Thorne,et al.  Rapid Transport within Cerebral Perivascular Spaces Underlies Widespread Tracer Distribution in the Brain after Intranasal Administration , 2015, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[2]  M. Rosenbloom,et al.  A Single-Dose Pilot Trial of Intranasal Rapid-Acting Insulin in Apolipoprotein E4 Carriers with Mild–Moderate Alzheimer’s Disease , 2014, CNS Drugs.

[3]  W. Banks,et al.  Intranasal Administration as a Route for Drug Delivery to the Brain: Evidence for a Unique Pathway for Albumin , 2014, The Journal of Pharmacology and Experimental Therapeutics.

[4]  Chun-ling Dai,et al.  Intranasal insulin prevents anesthesia-induced hyperphosphorylation of tau in 3xTg-AD mice , 2014, Front. Aging Neurosci..

[5]  S. M. de la Monte,et al.  Brain metabolic dysfunction at the core of Alzheimer's disease. , 2014, Biochemical pharmacology.

[6]  D. Butterfield,et al.  Antisense oligonucleotide against GSK-3β in brain of SAMP8 mice improves learning and memory and decreases oxidative stress: Involvement of transcription factor Nrf2 and implications for Alzheimer disease. , 2014, Free radical biology & medicine.

[7]  D. Butterfield,et al.  Antisense directed against PS-1 gene decreases brain oxidative markers in aged senescence accelerated mice (SAMP8) and reverses learning and memory impairment: a proteomics study. , 2013, Free radical biology & medicine.

[8]  Michael F. Green,et al.  Effects of single dose intranasal oxytocin on social cognition in schizophrenia , 2013, Schizophrenia Research.

[9]  M. Baxter,et al.  Selective Anesthesia-induced Neuroinflammation in Developing Mouse Brain and Cognitive Impairment , 2013, Anesthesiology.

[10]  W. Banks,et al.  Intranasal administration of PACAP: Uptake by brain and regional brain targeting with cyclodextrins , 2012, Peptides.

[11]  Yiying Zhang,et al.  Anesthetic Isoflurane Increases Phosphorylated Tau Levels Mediated by Caspase Activation and Aβ Generation , 2012, PloS one.

[12]  R. Thorne,et al.  Intranasal delivery of biologics to the central nervous system. , 2012, Advanced drug delivery reviews.

[13]  J. Morley,et al.  The senescence accelerated mouse (SAMP8) as a model for oxidative stress and Alzheimer's disease. , 2012, Biochimica et biophysica acta.

[14]  J. Schneider,et al.  Demonstrated brain insulin resistance in Alzheimer's disease patients is associated with IGF-1 resistance, IRS-1 dysregulation, and cognitive decline. , 2012, The Journal of clinical investigation.

[15]  Christian Hölscher,et al.  New roles for insulin-like hormones in neuronal signalling and protection: New hopes for novel treatments of Alzheimer’s disease? , 2010, Neurobiology of Aging.

[16]  R. Sherwin,et al.  Hippocampal memory processes are modulated by insulin and high-fat-induced insulin resistance , 2010, Neurobiology of Learning and Memory.

[17]  M. Eckenhoff,et al.  Brain and behavior changes in 12-month-old Tg2576 and nontransgenic mice exposed to anesthetics , 2008, Neurobiology of Aging.

[18]  W. Banks,et al.  Anti-amyloid beta protein antibody passage across the blood–brain barrier in the SAMP8 mouse model of Alzheimer's disease: An age-related selective uptake with reversal of learning impairment , 2007, Experimental Neurology.

[19]  G. Schellenberg,et al.  Effects of intranasal insulin on cognition in memory-impaired older adults: Modulation by APOE genotype , 2006, Neurobiology of Aging.

[20]  E. Verspohl Effect of PAO (phenylarsine oxide) on the inhibitory effect of insulin and IGF-1 on insulin release from INS-1 cells. , 2006, Endocrine journal.

[21]  Jens C. Brüning,et al.  The role of insulin receptor signaling in the brain , 2005, Trends in Endocrinology & Metabolism.

[22]  Jan Born,et al.  Intranasal insulin improves memory in humans , 2004, Psychoneuroendocrinology.

[23]  D. Butterfield,et al.  Antisense directed at the Aβ region of APP decreases brain oxidative markers in aged senescence accelerated mice , 2004, Brain Research.

[24]  R. Stackman,et al.  On the delay-dependent involvement of the hippocampus in object recognition memory , 2004, Neurobiology of Learning and Memory.

[25]  W. Banks,et al.  Glucagon-like peptide-1 receptor is involved in learning and neuroprotection , 2003, Nature Medicine.

[26]  D. Butterfield,et al.  The antioxidants α‐lipoic acid and N‐acetylcysteine reverse memory impairment and brain oxidative stress in aged SAMP8 mice , 2003, Journal of neurochemistry.

[27]  J. Born,et al.  Improving Influence of Insulin on Cognitive Functions in Humans , 2001, Neuroendocrinology.

[28]  J. Morley,et al.  Permeability of the blood-brain barrier to albumin and insulin in the young and aged SAMP8 mouse. , 2000, The journals of gerontology. Series A, Biological sciences and medical sciences.

[29]  M. Abbott,et al.  The Insulin Receptor Tyrosine Kinase Substrate p58/53 and the Insulin Receptor Are Components of CNS Synapses , 1999, The Journal of Neuroscience.

[30]  W. Banks,et al.  Differential Permeability of the Blood–Brain Barrier to Two Pancreatic Peptides: Insulin and Amylin , 1998, Peptides.

[31]  W. Banks,et al.  Transport of Insulin Across the Blood-Brain Barrier: Saturability at Euglycemic Doses of Insulin , 1997, Peptides.

[32]  G. Williams,et al.  Insulin receptors are widely distributed in human brain and bind human and porcine insulin with equal affinity , 1997, Diabetic medicine : a journal of the British Diabetic Association.

[33]  C Cobelli,et al.  Saturable transport of insulin from plasma into the central nervous system of dogs in vivo. A mechanism for regulated insulin delivery to the brain. , 1993, The Journal of clinical investigation.

[34]  C. Pert,et al.  Autoradiographic localization of insulin receptors in rat brain: Prominence in olfactory and limbic areas , 1986, Neuroscience.

[35]  D. Porte,et al.  Regional concentrations of insulin in the rat brain. , 1983, Endocrinology.

[36]  L. Iversen,et al.  REGIONAL STUDIES OF CATECHOLAMINES IN THE RAT BRAIN‐I , 1966, Journal of neurochemistry.

[37]  F. Greenwood,et al.  THE PREPARATION OF I-131-LABELLED HUMAN GROWTH HORMONE OF HIGH SPECIFIC RADIOACTIVITY. , 1963, The Biochemical journal.

[38]  W. Banks,et al.  Central and peripheral administration of antisense oligonucleotide targeting amyloid-β protein precursor improves learning and memory and reduces neuroinflammatory cytokines in Tg2576 (AβPPswe) mice. , 2014, Journal of Alzheimer's disease : JAD.

[39]  Suzanne Craft,et al.  Sex and ApoE genotype differences in treatment response to two doses of intranasal insulin in adults with mild cognitive impairment or Alzheimer's disease. , 2013, Journal of Alzheimer's disease : JAD.

[40]  W. Banks,et al.  Peripheral administration of antisense oligonucleotides targeting the amyloid-β protein precursor reverses AβPP and LRP-1 overexpression in the aged SAMP8 mouse brain. , 2012, Journal of Alzheimer's disease : JAD.

[41]  L. S. Quinn,et al.  IL-15 Overexpression Promotes Endurance, Oxidative Energy Metabolism, and Muscle PPAR (cid:1) , SIRT1, PGC-1 (cid:2) , and PGC-1 (cid:3) Expression in Male Mice , 2012 .

[42]  T. Montine,et al.  Intranasal Insulin Therapy for Alzheimer Disease and Amnestic Mild Cognitive Impairment A Pilot Clinical Trial , 2011 .

[43]  J. Wands,et al.  Insulin and insulin-like growth factor expression and function deteriorate with progression of Alzheimer's disease: link to brain reductions in acetylcholine. , 2005, Journal of Alzheimer's disease : JAD.

[44]  J. Wands,et al.  Impaired insulin and insulin-like growth factor expression and signaling mechanisms in Alzheimer's disease--is this type 3 diabetes? , 2005, Journal of Alzheimer's disease : JAD.