The Role of Astrocytes and Blood–Brain Barrier Disruption in Alzheimer’s Disease

The blood–brain barrier (BBB) is a highly intricate neurovascular structure that plays a crucial role in maintaining neural homeostasis by selectively allowing certain molecules to enter the central nervous system (CNS). However, in the context of Alzheimer’s Disease (AD), a progressive neurodegenerative disorder characterized by a gradual decline in cognitive function, the BBB’s functionality becomes impaired. This impairment leads to the breakdown of the barrier and disrupts its ability to regulate molecular transport effectively. Consequently, cellular infiltration into the CNS occurs, along with aberrant signaling and clearance of molecules, ultimately contributing to neurological deficits. One of the key factors implicated in the failure of amyloid-beta (Aβ) transport, a hallmark of AD, is the decreased expression of low-density lipoprotein receptor-related protein 1 (LRP1). LRP1 plays a crucial role in facilitating the transport of Aβ across the BBB. Additionally, the increased levels of the receptor for advanced glycation end products (RAGE) further contribute to the deregulation of the BBB in AD. These molecular imbalances significantly impact Aβ clearance and contribute to the development and progression of AD. In this review, we aimed to summarize the critical aspects of Aβ transporters in the BBB that become dysfunctional during the pathogenesis of AD.

[1]  A. Rezai,et al.  Ultrasound-mediated blood–brain barrier opening uncovers an intracerebral perivenous fluid network in persons with Alzheimer’s disease , 2023, Fluids and Barriers of the CNS.

[2]  2023 Alzheimer's disease facts and figures , 2023, Alzheimer's & dementia : the journal of the Alzheimer's Association.

[3]  Jonathan M. Brunger,et al.  Reactive astrocytes transduce inflammation in a blood-brain barrier model through a TNF-STAT3 signaling axis and secretion of alpha 1-antichymotrypsin , 2022, Nature Communications.

[4]  J. Mélendez,et al.  Cognitive Stimulation in Moderate Alzheimer’s Disease , 2022, Journal of applied gerontology : the official journal of the Southern Gerontological Society.

[5]  T. Ilić,et al.  Intermittent Theta Burst Stimulation Ameliorates Cognitive Deficit and Attenuates Neuroinflammation via PI3K/Akt/mTOR Signaling Pathway in Alzheimer’s-Like Disease Model , 2022, Frontiers in Aging Neuroscience.

[6]  M. Stevanović,et al.  Reactive and Senescent Astroglial Phenotypes as Hallmarks of Brain Pathologies , 2022, International journal of molecular sciences.

[7]  S. Ribaric Physical Exercise, a Potential Non-Pharmacological Intervention for Attenuating Neuroinflammation and Cognitive Decline in Alzheimer’s Disease Patients , 2022, International Journal of Molecular Sciences.

[8]  M. P. Hoi,et al.  Murine Beta-Amyloid (1–42) Oligomers Disrupt Endothelial Barrier Integrity and VEGFR Signaling via Activating Astrocytes to Release Deleterious Soluble Factors , 2022, International journal of molecular sciences.

[9]  K. Blennow,et al.  Astrocyte biomarker signatures of amyloid-β and tau pathologies in Alzheimer’s disease , 2022, Molecular Psychiatry.

[10]  Y. Zhang,et al.  Brain-derived neurotrophic factor in Alzheimer’s disease and its pharmaceutical potential , 2022, Translational neurodegeneration.

[11]  P. Kind,et al.  Reactive astrocytes acquire neuroprotective as well as deleterious signatures in response to Tau and Aß pathology , 2022, Nature Communications.

[12]  Rosemary J. Jackson,et al.  APOE4 derived from astrocytes leads to blood–brain barrier impairment , 2021, Brain : a journal of neurology.

[13]  R. Perneczky,et al.  Dysfunction of the blood–brain barrier in Alzheimer's disease: Evidence from human studies , 2021, Neuropathology and applied neurobiology.

[14]  B. Delatour,et al.  Pilot study of repeated blood-brain barrier disruption in patients with mild Alzheimer’s disease with an implantable ultrasound device , 2021, Alzheimer's research & therapy.

[15]  Jun Xiang,et al.  Bilobalide inhibits inflammation and promotes the expression of Aβ degrading enzymes in astrocytes to rescue neuronal deficiency in AD models , 2021, Translational Psychiatry.

[16]  Y. Guan,et al.  PET Imaging of Neuroinflammation in Alzheimer’s Disease , 2021, Frontiers in Immunology.

[17]  Fan Gao,et al.  Blood Triglyceride and High-Density Lipoprotein Levels Are Associated with Plasma Amyloid-β Transport: A Population-Based Cross-Sectional Study. , 2021, Journal of Alzheimer's disease : JAD.

[18]  S. Dohgu,et al.  Blood-Brain Barrier Dysfunction Amplifies the Development of Neuroinflammation: Understanding of Cellular Events in Brain Microvascular Endothelial Cells for Prevention and Treatment of BBB Dysfunction , 2021, Frontiers in Cellular Neuroscience.

[19]  P. Matthews,et al.  Relationship between astrocyte reactivity, using novel 11C-BU99008 PET, and glucose metabolism, grey matter volume and amyloid load in cognitively impaired individuals , 2021, Molecular Psychiatry.

[20]  G. Bloom,et al.  A Novel Inhibitor Targeting NLRP3 Inflammasome Reduces Neuropathology and Improves Cognitive Function in Alzheimer's Disease Transgenic Mice. , 2021, Journal of Alzheimer's disease : JAD.

[21]  M. Pomper,et al.  Blocking microglial activation of reactive astrocytes is neuroprotective in models of Alzheimer’s disease , 2021, Acta neuropathologica communications.

[22]  M. Vogelbaum,et al.  Therapeutic Delivery to Central Nervous System. , 2021, Neurosurgery clinics of North America.

[23]  G. Terstappen,et al.  Strategies for delivering therapeutics across the blood–brain barrier , 2021, Nature Reviews Drug Discovery.

[24]  I. Gelissen,et al.  New Evidence for P-gp-Mediated Export of Amyloid-β Peptides in Molecular, Blood-Brain Barrier and Neuronal Models , 2020, International journal of molecular sciences.

[25]  Yanxing Chen,et al.  TLR4 Targeting as a Promising Therapeutic Strategy for Alzheimer Disease Treatment , 2020, Frontiers in Neuroscience.

[26]  M. Tremblay,et al.  Synaptic Loss in Alzheimer's Disease: Mechanistic Insights Provided by Two-Photon in vivo Imaging of Transgenic Mouse Models , 2020, Frontiers in Cellular Neuroscience.

[27]  P. Edison,et al.  Neuroinflammation and microglial activation in Alzheimer disease: where do we go from here? , 2020, Nature Reviews Neurology.

[28]  E. Abner,et al.  Protecting P-glycoprotein at the blood–brain barrier from degradation in an Alzheimer’s disease mouse model , 2020, Fluids and Barriers of the CNS.

[29]  R. H. Khan,et al.  Review on Alzheimer's disease: Inhibition of amyloid beta and tau tangle formation. , 2020, International journal of biological macromolecules.

[30]  M. Sastre,et al.  Pharmacological ablation of astrocytes reduces Aβ degradation and synaptic connectivity in an ex vivo model of Alzheimer’s disease , 2020, Journal of neuroinflammation.

[31]  N. Toni,et al.  Tau accumulation in astrocytes of the dentate gyrus induces neuronal dysfunction and memory deficits in Alzheimer’s disease , 2020, Nature Neuroscience.

[32]  M. Lepage,et al.  Pharmacological Modulation of Blood–Brain Barrier Permeability by Kinin Analogs in Normal and Pathologic Conditions , 2020, Pharmaceuticals.

[33]  M. Schäfers,et al.  Characterization of the inflammatory post-ischemic tissue by full volumetric analysis of a multimodal imaging dataset , 2020, NeuroImage.

[34]  A. Rezai,et al.  Noninvasive hippocampal blood−brain barrier opening in Alzheimer’s disease with focused ultrasound , 2020, Proceedings of the National Academy of Sciences.

[35]  A. Gee,et al.  Radiolabeling of [11C]FPS-ZM1, a receptor for advanced glycation end products-targeting positron emission tomography radiotracer, using a [11C]CO2-to-[11C]CO chemical conversion. , 2020, Future medicinal chemistry.

[36]  Iekhsan Othman,et al.  Impact of HMGB1, RAGE, and TLR4 in Alzheimer’s Disease (AD): From Risk Factors to Therapeutic Targeting , 2020, Cells.

[37]  M. Aschner,et al.  The role of astrocytic glutamate transporters GLT-1 and GLAST in neurological disorders: Potential targets for neurotherapeutics , 2019, Neuropharmacology.

[38]  L. Goldstein,et al.  Amyloid-β-independent regulators of tau pathology in Alzheimer disease , 2019, Nature Reviews Neuroscience.

[39]  G. Gilmour,et al.  Targeting the Synapse in Alzheimer’s Disease , 2019, Front. Neurosci..

[40]  Manoj Kumar,et al.  INGE GRUNDKE-IQBAL AWARD FOR ALZHEIMER’S RESEARCH: NEUROTOXIC REACTIVE ASTROCYTES ARE INDUCED BY ACTIVATED MICROGLIA , 2019, Alzheimer's & Dementia.

[41]  J. Götz,et al.  Repeated ultrasound treatment of tau transgenic mice clears neuronal tau by autophagy and improves behavioral functions , 2019, Theranostics.

[42]  Yoon Kyung Choi,et al.  The Role of Astrocytes in the Central Nervous System Focused on BK Channel and Heme Oxygenase Metabolites: A Review , 2019, Antioxidants.

[43]  Á. Kelly Exercise-Induced Modulation of Neuroinflammation in Models of Alzheimer’s Disease , 2018, Brain plasticity.

[44]  S. Oliet,et al.  Modulation of astrocyte reactivity improves functional deficits in mouse models of Alzheimer’s disease , 2018, Acta Neuropathologica Communications.

[45]  Nir Lipsman,et al.  Blood–brain barrier opening in Alzheimer’s disease using MR-guided focused ultrasound , 2018, Nature Communications.

[46]  Liam J. Drew An age-old story of dementia , 2018, Nature.

[47]  D. Velakoulis,et al.  Alzheimer’s disease: clinical update on epidemiology, pathophysiology and diagnosis , 2018, Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists.

[48]  O. Arancio,et al.  RAGE mediates A&bgr; accumulation in a mouse model of Alzheimer’s disease via modulation of &bgr;- and &ggr;-secretase activity , 2018, Human molecular genetics.

[49]  Koji Ando,et al.  A molecular atlas of cell types and zonation in the brain vasculature , 2018, Nature.

[50]  R. González-Reyes,et al.  Involvement of Astrocytes in Alzheimer’s Disease from a Neuroinflammatory and Oxidative Stress Perspective , 2017, Front. Mol. Neurosci..

[51]  B. Zlokovic,et al.  Alzheimer’s disease: A matter of blood–brain barrier dysfunction? , 2017, The Journal of experimental medicine.

[52]  Sangyun Jeong,et al.  Molecular and Cellular Basis of Neurodegeneration in Alzheimer’s Disease , 2017, Molecules and cells.

[53]  F. Gomes,et al.  Astrocyte Transforming Growth Factor Beta 1 Protects Synapses against Aβ Oligomers in Alzheimer's Disease Model , 2017, The Journal of Neuroscience.

[54]  Axel Montagne,et al.  Cerebral blood flow regulation and neurovascular dysfunction in Alzheimer disease , 2017, Nature Reviews Neuroscience.

[55]  M. Sastre,et al.  Mechanisms of Aβ Clearance and Degradation by Glial Cells , 2016, Front. Aging Neurosci..

[56]  B. de Strooper,et al.  The amyloid cascade hypothesis: are we poised for success or failure? , 2016, Journal of neurochemistry.

[57]  Paul Edison,et al.  Neuroinflammation in Alzheimer's disease: Current evidence and future directions , 2016, Alzheimer's & Dementia.

[58]  D. Yew,et al.  Mutated tau, amyloid and neuroinflammation in Alzheimer disease-A brief review. , 2016, Progress in histochemistry and cytochemistry.

[59]  J. Schneider,et al.  Central role for PICALM in amyloid–β blood–brain barrier transcytosis and clearance , 2015, Nature Neuroscience.

[60]  S. Linnarsson,et al.  Cell types in the mouse cortex and hippocampus revealed by single-cell RNA-seq , 2015, Science.

[61]  R. Mahley,et al.  Apolipoprotein E: Structure and function in lipid metabolism, neurobiology, and Alzheimer's diseases , 2014, Neurobiology of Disease.

[62]  T. Wisniewski,et al.  Tau-Based Therapeutic Approaches for Alzheimer's Disease - A Mini-Review , 2014, Gerontology.

[63]  S. Estus,et al.  Soluble apoE/Aβ complex: mechanism and therapeutic target for APOE4-induced AD risk , 2014, Molecular Neurodegeneration.

[64]  A. Verkhratsky,et al.  Homeostatic function of astrocytes: Ca2+ and Na+ signalling , 2012, Translational neuroscience.

[65]  C. Dobson,et al.  Amyloid-β oligomers are sequestered by both intracellular and extracellular chaperones. , 2012, Biochemistry.

[66]  Nathan T. Ross,et al.  A multimodal RAGE-specific inhibitor reduces amyloid β-mediated brain disorder in a mouse model of Alzheimer disease. , 2012, The Journal of clinical investigation.

[67]  David Klenerman,et al.  The extracellular chaperone clusterin sequesters oligomeric forms of the amyloid-β1−40 peptide , 2011, Nature Structural &Molecular Biology.

[68]  B. Strooper,et al.  The amyloid cascade hypothesis for Alzheimer's disease: an appraisal for the development of therapeutics , 2011, Nature Reviews Drug Discovery.

[69]  W. M. van der Flier,et al.  Blood-brain barrier p-glycoprotein function in Alzheimer's disease , 2011, Alzheimer's & Dementia.

[70]  Bengt R. Johansson,et al.  Pericytes regulate the blood–brain barrier , 2010, Nature.

[71]  H. Kroemer,et al.  MDR1–P‐glycoprotein (ABCB1)‐Mediated Disposition of Amyloid‐β Peptides: Implications for the Pathogenesis and Therapy of Alzheimer's Disease , 2010, Clinical pharmacology and therapeutics.

[72]  M. O’Banion,et al.  Neuroinflammatory processes in Alzheimer’s disease , 2010, Journal of Neural Transmission.

[73]  Bo Li,et al.  Amyloid β Interaction with Receptor for Advanced Glycation End Products Up-Regulates Brain Endothelial CCR5 Expression and Promotes T Cells Crossing the Blood-Brain Barrier1 , 2009, The Journal of Immunology.

[74]  R. Deane,et al.  SRF and myocardin regulate LRP-mediated amyloid-β clearance in brain vascular cells , 2009, Nature Cell Biology.

[75]  Uwe Haberkorn,et al.  Reduced cerebral glucose metabolism in patients at risk for Alzheimer's disease , 2007, Psychiatry Research: Neuroimaging.

[76]  D. Holtzman,et al.  Transport Pathways for Clearance of Human Alzheimer's Amyloid β-Peptide and Apolipoproteins E and J in the Mouse Central Nervous System , 2007, Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism.

[77]  R. Deane,et al.  Role of the blood-brain barrier in the pathogenesis of Alzheimer's disease. , 2007, Current Alzheimer research.

[78]  R. Bendayan,et al.  In Situ Localization of P-glycoprotein (ABCB1) in Human and Rat Brain , 2006, The journal of histochemistry and cytochemistry : official journal of the Histochemistry Society.

[79]  A. Schousboe,et al.  The glutamate/GABA‐glutamine cycle: aspects of transport, neurotransmitter homeostasis and ammonia transfer , 2006, Journal of neurochemistry.

[80]  Don L. Armstrong,et al.  Role of the MEOX2 homeobox gene in neurovascular dysfunction in Alzheimer disease , 2005, Nature Medicine.

[81]  J. Wuu,et al.  Precursor form of brain‐derived neurotrophic factor and mature brain‐derived neurotrophic factor are decreased in the pre‐clinical stages of Alzheimer's disease , 2005, Journal of neurochemistry.

[82]  D. Quartermain,et al.  An Attenuated Immune Response Is Sufficient to Enhance Cognition in an Alzheimer's Disease Mouse Model Immunized with Amyloid-β Derivatives , 2004, The Journal of Neuroscience.

[83]  Bruce J Aronow,et al.  ApoE and Clusterin Cooperatively Suppress Aβ Levels and Deposition Evidence that ApoE Regulates Extracellular Aβ Metabolism In Vivo , 2004, Neuron.

[84]  A. Palmer The role of the blood brain barrier in neurodegenerative disorders and their treatment. , 2011, Journal of Alzheimer's disease : JAD.

[85]  E. Hansson,et al.  Astrocyte–endothelial interactions at the blood–brain barrier , 2006, Nature Reviews Neuroscience.