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Abeta42 mice, IBM

Abeta42 mice, IBM
Abeta42 mice, IBM

Musculoskeletal Pathology

Genetically Augmenting A?42Levels in Skeletal Muscle Exacerbates Inclusion Body Myositis-Like Pathology and Motor Deficits in Transgenic Mice

Masashi Kitazawa,Kim N.Green,

Antonella Caccamo,and Frank https://www.wendangku.net/doc/187371275.html,Ferla

From the Department of Neurobiology and Behavior,Laboratory of Molecular Neuropathogenesis,University of California,Irvine, Irvine,California

The pathogenic basis of inclusion body myositis (IBM),the leading muscle degenerative disease afflict-ing the elderly,is unknown,although the histopatho-logical features are remarkably similar to those ob-served in Alzheimer’s disease.One leading hypothesis is that the buildup of amyloid-?(A?)peptide within selective skeletal muscle fibers contributes to the de-generative phenotype.A?is a small peptide derived via endoproteolysis of the amyloid precursor protein (APP).To determine the pathogenic effect of aug-menting A?42levels in skeletal muscle,we used a genetic approach to replace the endogenous wild-type presenilin-1(PS1)allele with the PS1

M146V

allele in MCK-APP mice.Although APP transgene expres-sion was unaltered,A?levels,particularly A?42, were elevated in skeletal muscle of the double trans-genic(MCK-APP/PS1)mice compared to the parental MCK-APP line.Elevated phospho-tau accumulation was found in the MCK-APP/PS1mice,and the greater activation of GSK-3?and cdk5were observed.Other IBM-like pathological features,such as inclusion bod-ies and inflammatory infiltrates,were more severe and prominent in the MCK-APP/PS1mice.Motor co-ordination and balance were more adversely affected and manifested at an earlier age in the MCK-APP/PS1 mice.The data presented here provide experimental evidence that A?42plays a proximal and critical role in the muscle degenerative process.(Am J Pathol2006, 168:1986–1997;DOI:10.2353/ajpath.2006.051232)

Inclusion body myositis(IBM),the most prevalent muscle disorder among the elderly,is characterized by proximal and distal skeletal muscle weakness.1–3The clinical fea-tures of this disorder are characterized by muscle weak-ness and atrophy,with selective involvement of both proximal and distal muscle groups,including the quad-riceps,iliopsoas,triceps,and biceps muscles.In spo-radic IBM,the majority of patients usually exhibit proximal weakness,and the quadriceps are more severely af-fected compared to other lower limb muscles.3In hered-itary IBM,however,affected muscles may exhibit a more restricted focus.For example,the quadriceps may be selectively spared in certain autosomal recessive cas-es.4,5Histopathologically,both sporadic and hereditary IBM are characterized by atrophic muscle fibers and fibers containing rimmed vacuoles and abnormal protein aggregates,particularly amyloid-?(A?),which is derived via endoproteolysis of the amyloid precursor protein (APP),and hyperphosphorylated tau.2,6–10

IBM and Alzheimer’s disease(AD)share many patho-histological features including the buildup of aggregated proteins such as A?and tau.In this regard,IBM can also be considered as a proteinopathy.As in AD,the role of the A?peptide is unresolved,although evidence sug-gests that it plays an early and critical role in the muscle degeneration.IBM remains the only known condition in which A?accumulates pathologically outside the central nervous system,except for age-related macular degen-eration.11This distinction implicates a critical role for A?in the pathogenesis of IBM.A noteworthy difference be-tween two degenerative processes is the location in which A?accumulates.In AD,A?has been traditionally viewed to exert its pathological effects extracellularly where it builds up in amyloid plaques,whereas it is only found intracellularly in IBM.12However,recent studies have demonstrated that various assembly states of A?found intracellularly contribute to pathophysiological changes in AD as well,including our own studies in transgenic mice in which intraneuronal A?appears to induce deficits in synaptic plasticity and trigger the onset of cognitive decline.13,14Moreover,soluble oligomeric Supported by the National Institutes of Health(grant AG20335).

Accepted for publication February28,2006.

Address reprint requests to Frank https://www.wendangku.net/doc/187371275.html,Ferla,Ph.D.,Department of Neurobiology and Behavior,1109Gillespie Neuroscience Facility,Univer-sity of California,Irvine,Irvine,CA92697-4545.E-mail:laferla@https://www.wendangku.net/doc/187371275.html,. American Journal of Pathology,Vol.168,No.6,June2006

Copyright?American Society for Investigative Pathology

DOI:10.2353/ajpath.2006.051232

1986

A?is now considered to be a potent neurotoxic compo-nent,found in the AD brain,and the levels of A?oli-gomers in brain,unlike fibrillar A?levels,correlates well with cognitive decline.15–18It is important to note that there is evidence that this species of A?occurs intra-neuronally.19,20Taken together,these data suggest a critical pathogenic role for intracellular A?in AD.

We previously developed a transgenic model of IBM by overexpressing the human Swedish APP mutation in skeletal muscle under the control of the muscle creatine kinase(MCK)promoter.21These mice generate A?,al-though the predominant isoform is the less amyloido-genic A?40peptide.Although A?42is considered more pathogenic in AD,it remains unclear whether it is more pathogenic in skeletal muscle compared to A?40.Here we used a genetic approach to selectively increase A?42 levels.Mutations in the presenilin-1(PS1)gene associ-ated with familial AD(FAD)are well known to modulate ?-secretase function to selectively increase the formation of the more amyloidogenic A?42peptide in neurons.22,23 Notably,this effect is not limited to neurons because FAD mutations in PS1are also known to significantly augment A?42levels in various cell culture models and transgenic animals.22,24,25We report that MCK-APP mice harboring the PS1

M146V

knock-in mutation(MCK-APP/PS1)produce markedly higher levels of A?42than the parental MCK-APP mice.The double transgenic mice develop his-topathological features resembling IBM,including centric nuclei,intracellular accumulation of A?peptide,and en-hanced inflammation around affected muscle fibers.No-tably,elevated A?42levels further lead to increased phosphorylation of tau in skeletal muscle.We also find that enzymatic activity for cyclin-dependent kinase5 (cdk5)and glycogen synthase kinase3?(GSK-3?)are elevated.These pathophysiological changes lead to an earlier onset of motor deficits in the MCK-APP/PS1mice. These results implicate an integral role for A?42in the progression of muscle degeneration,and suggest that A?-directed therapies may be effective for the treatment of human IBM patients.

Materials and Methods

Generation of Double Transgenic Mice Hemizygous MCK-APP mice(of the A6line)were

crossed to homozygous PS1

M146V

knock-in(PS1-KI)

mice to generate F

1

offspring.21,26PS1-KI mice,main-tained on a C57BL/6background like the MCK-APP transgenic mice,are homozygous for the mutant

PS1

M146V

allele.Because the mutation was knocked-in, expression of the mutant PS1protein is under the tran-scriptional control of the endogenous promoter,thereby ensuring expression in skeletal muscle.

For biochemical analyses,skeletal muscle tissues from nontransgenic(wild-type C57BL/6background:non-Tg), PS1-KI,single transgenic MCK-APP,and double trans-genic MCK-APP/PS1mice were homogenized in T-PER extraction buffer(Pierce,Rockford,IL)in the presence of protease inhibitor cocktail(Roche Applied Science,Indi-anapolis,IN)and phosphatase inhibitors(5mmol/L so-dium fluoride and50?mol/L sodium orthovanadate).The detergent-soluble fraction was isolated by centrifugation at100,000?g for1hour at4°C.The resultant pellet was homogenized in70%formic acid followed by centrifuga-tion at100,000?g for1hour at4°C to isolate the detergent-insoluble fraction.

Expression Analysis

Calf muscles,quadriceps,and triceps were dissected from4-month-old MCK-APP/PS1double transgenic mice and controls(PS1-KI),and total RNA was isolated using TRI reagent(Molecular Research Center,Cincinnati, OH).To determine levels of human APP expression,iso-lated RNA(10?g)was analyzed by Northern blot using 32P-labeled0.24-kb simian virus40(SV40)poly(A)DNA fragment as described previously.21Briefly,the human APP transgene was constructed with the use of the MCK promoter so that gene expression would be targeted to skeletal muscle.The transgene also included the polyad-enylation signal from SV40.Because the SV40sequence is not present in PS1-KI mice,this sequence can serve as a specific probe to detect the human APP transgene mRNA product selectively in the transgenic mice.Equal RNA loading was confirmed by probing for GAPDH (Ambion,Austin,TX).

Immunohistochemical Analysis

Skeletal muscle tissue was snap-frozen in liquid nitrogen-cooled isopentane and stored at?80°C.Cryosections were cut at10?m,placed onto silane-coated slides,and stored at?20°C.Hematoxylin and eosin staining was performed to determine the general morphology of the muscle.Serial sections were immunostained to deter-mine the localization of APP and A?fragments.Mouse anti-human A?antibody6E10(Signet,Dedham,MA)was used to stain both human APP and A?-containing frag-ments,P2-1antibody recognizes full-length human APP (gift from Dr.William Van Nostrand,State University of New York at Stony Brook),and anti-mouse CD8anti-body(Serotec,Raleigh,NC)was used to detect activated inflammatory T cells. Immunoprecipitation

Immunoprecipitation was performed before the kinase assay.One hundred?g of skeletal muscles from6-and 14-month-old PS1-KI or MCK-APP/PS1mice were immu-noprecipitated with protein A-agarose(Calbiochem,La Jolla,CA)for cdk5antibody or protein G-agarose(Roche Applied Science)for GSK-3?or AT8antibodies overnight at4°C.The resultant protein-antibody-agarose complex was washed three times with0.5?STEN(25mmol/L Tris, pH7.6,75mmol/L NaCl,1mmol/L ethylenediaminetet-raacetic acid,and0.1%Nonidet P-40).For immunoblot-ting,the complex was then resuspended in2?loading buffer and incubated for10minutes at70°C.

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Immunoblot Analysis

Equal amounts of protein from each fraction were re-solved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis(4to12%Bis-Tris gel from Invitrogen, Carlsbad,CA).After transfer onto nitrocellulose,the blots were incubated with the respective antibodies:6E10(1: 1000);anti-C-terminal fragment of APP(1:5000;Cell Sig-naling Technology,Beverly,MA);anti-PS1(1:500,Cell Signaling Technology);AT8(phosphorylated tau at serine202and threonine205;1:2000;Innogenetics, Alpharetta,GA);anti-cdk5(1:1000,Calbiochem);anti-GSK-3?(1:1000;BD Transduction Laboratories,San Diego,CA);anti-GSK-3?(phosphorylated at serine9, 1:1000;Cell Signaling Technology),anti-p38MAPK(1: 1000,Cell Signaling Technology),anti-phospho-p38 MAPK(phosphorylated at threonine180and tyrosine 182,1:1000;Cell Signaling Technology),anti-JNK(1: 1000;Cell Signaling Technology),and anti-phospho-JNK (phosphorylated at threonine183and tyrosine185, 1:1000;Cell Signaling Technology)followed by horserad-ish peroxidase-conjugated secondary antibodies.Protein bands were detected by enhanced chemiluminescence plus(Amersham Biosciences,Piscataway,NJ).Mem-branes were reprobed with antibody against GAPDH(1: 5000;Santa Cruz Biotechnology,Santa Cruz,CA)to con-trol for protein loading.

Enzyme-Linked Immunosorbent Assay(ELISA) A?Measurement

Both detergent-soluble and-insoluble fractions were used to detect A?40and A?42by ELISA as described previously.14,21,27MaxiSorp immunoplates(Nalge Nunc, Rochester,NY)were coated with antibody against A?1-17(gift from Dr.William Van Nostrand)at a concen-tration of25?g/?l,and A?40and A?42were detected by specific horseradish peroxidase-conjugated antibody against A?35-40(MM32-13.1.1)or A?35-42(MM40-21.3.4),respectively.

GSK-3?and cdk5Kinase Assays

Kinase assays were performed as described previous-ly.27Briefly,after immunoprecipitation with GSK-3?or cdk5antibodies,samples were mixed with50?l of reac-tion mixture containing20mmol/L MOPS,pH7.2,5 mmol/L MgCl

2

,1mmol/L sodium orthovanadate,5 mmol/L NaF,100?mol/L ATP,2.5?Ci[?-32P]ATP,and 0.2mmol/L cdk5substrate(Calbiochem)or0.2mmol/L GSK-3?substrate(Calbiochem).The reaction transpired for1hour at37°C,then35?l of supernatant was placed on Immobilon-nitrocellulose membrane(Millipore,Bil-lerica,MA).The membranes were washed in0.3%phos-phoric acid and counted in a scintillation counter to de-termine the kinase activity.Isolation of mRNA and Quantification of Inflammation by Real-Time Polymerase Chain Reaction(RT-PCR)

Total RNA was isolated from quadriceps of non-Tg,PS1-

KI,MCK-APP,and MCK-APP/PS1mice(14and24 months old)using TRI reagent(Molecular Research Cen-ter),and cDNA was synthesized using iScript cDNA syn-thesis kit(Bio-Rad Laboratories,Hercules,CA)as de-scribed previously.27Equal amounts of cDNA(?1?g) were subject to RT-PCR reaction for mouse CD8mRNA by iQ SYBR Green supermix(Bio-Rad Laboratories)us-ing primer pair of5?-TGT GAA GCC AGA GGA CAG TG-3?and5?-CAG GAT GCA GAC TAC CAG CA-3?. Cycle threshold(Ct)values were calculated by MyiQ software(Bio-Rad Laboratories),and the relative fold changes in mRNA were determined as relative to GAPDH mRNA levels in each treatment group(mouse GAPDH primer pair:5?-AAC TTT GGC ATT GTG GAA GG-3?and 5?-ACA CAT TGG GGG TAG GAA CA-3?).

Rotarod Motor Test

Motor performance was evaluated using the accelerating rotarod(Accuscan Instruments,Columbus,OH)as de-scribed previously.21Mice were placed on a rotating dowel and required to continuously walk forward to avoid falling off.The rod was accelerated throughout20sec-onds to a constant speed of10rpm,and each trial was ended at60seconds.Non-Tg,PS1-KI,MCK-APP,and MCK-APP/PS1mice(ages1to23months)were given10 training trials per day for2consecutive days,and probe trials were completed on the third day.In the probe trial, each mouse was tested five times and time of fall-off was recorded and averaged.

Statistical Analysis

All data were analyzed using one-way analysis of vari-ance or unpaired t-test,and P?0.05or lower was considered to be significant.

Results

Introduction of PS1

M146V

Allele Does Not Alter Transgene Expression and Steady-State Levels To test the phenotypic consequences of augmenting A?42levels in skeletal muscle,we used a genetic ap-proach to introduce a mutant PS1allele into the MCK-APP single transgenic line by crossing them to homozy-gous PS1-KI mice.Double transgenic mice,referred to as MCK-APP/PS1mice consisted of the following genotype:

homozygous for the PS1

M146V

allele and hemizygous for the MCK-APP transgene.It was first necessary to deter-mine whether the expression profile of the MCK-APP transgene was altered in the MCK-APP/PS1mice.We analyzed total mRNA from various tissues by Northern blot and found that,as in the parental MCK-APP trans-

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genic line,21expression of the human APP transgene was exclusively directed to muscle tissue (data not shown).We next compared the expression levels of APP in vari-ous skeletal muscles of the double transgenic MCK-APP/PS1mice to the same muscles from the parental PS1-KI or MCK-APP mice.As expected,human APP mRNA is only apparent in the double transgenic mice and not in the PS1-KI mice (Figure 1A).Likewise,the levels of the transgene transcript are comparable between the MCK-APP and MCK-APP/PS1mice,suggesting that the intro-duction of the PS1M146V mutation did not alter the ex-pression pattern or levels of the human APP transgene (Figure 1B).

We next determined the effect of introducing the PS1M146V knockin mutation on human APP steady-state levels in skeletal muscle.Notably,human APP steady-state levels were comparable between both mouse groups,indicating that the introduction of the mutant PS1gene did not alter the steady-state levels of the human APP protein (Figure 1C).As expected,no signal was detected in muscle from non-Tg and PS1-KI mice after probing with the human-specific APP antibody (Figure 1C).The levels of PS1in skeletal muscle were also ex-amined and compared by Western blotting among the non-Tg,PS1-KI,MCK-APP,and MCK-APP/PS1mice and revealed that there was no difference in the steady-state levels among the four mouse groups,indicating that the PS1M146V mutant protein was maintained at physio-logical levels and not altered by the MCK-APP transgene (Figure 1C).

We next determined whether the steady-state levels of the human APP protein changed as a function of age.We compared three ages:6,14,and 24months of age.Interestingly,the steady-state levels of the holoprotein as well as its proteolytic fragment C99differed as the mice aged.The highest level of holoprotein was detected

at

Figure 1.Expression of the transgene and steady-state levels of APP and PS1in skeletal muscle is not altered between MCK-APP and MCK-APP/PS1transgenic mice.A:Northern blot analysis of human APP transgene mRNA from calf muscle (C),quadriceps (Q),and triceps (T),of PS1-KI and MCK-APP/PS1mice reveals the human APP transgene is only expressed in MCK-APP/PS1mice.Quadriceps has the highest transgene expression levels among other muscles.B:Densitometric comparison of the level of human APP transgene expression between the single transgenic MCK-APP mice and double transgenic MCK-APP/PS1mice.Graph represents densitometric analysis of human mRNA band.No overall difference in the expression level is apparent,indicating that PS1-KI allele does not alter expression of the MCK-APP transgene in the MCK-APP/PS1mice.C:Immunoblotting of transgene products from calf muscle (C)and quadriceps (Q)of nontransgenic (non-Tg),PS1-KI,MCK-APP,and MCK-APP/PS1mice shows that the steady-state levels of APP detected by 6E10antibody is present in MCK-APP and MCK-APP/PS1mice but not in non-Tg or PS1-KI.Membranes were reprobed for GAPDH as a loading control.Graphs represent the intensity of APP (left )and PS1(right )in the immunoblotting.D:Age-dependent change in APP steady-state levels in the MCK-APP/PS1mice.Quadriceps from 6-,14-,and 24-month-old MCK-APP/PS1mice shows highest APP levels at 14months,and lower levels at 24months.C99levels were highest at 6to 14months and also decreased with age.MCK levels showed a similar trend,indicating that the reduction in APP steady-state levels is attributable to the decreased activity of the MCK promoter.Membranes were reprobed for GAPDH to control for equal loading.E:The steady-state levels of C99between the MCK-APP and MCK-APP/PS1mice at 14months of age.No apparent difference was detected in the C99levels,indicating no alteration of BACE cleavage by introduction of PS1mutation.

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?14months of age,and was markedly lower in skeletal muscle from 24-month-old mice (Figure 1D).This pattern was consistent with our previous finding in the single MCK-APP line.21This age-related decrease in transgene levels appears to be attributable to an age-associated decline in the activity of the MCK promoter,as we find that the steady-state levels of the endogenous mouse MCK protein are also markedly decreased at 24months (Figure 1D).Compared to the age-matched parental MCK-APP mice,C99levels were slightly increased in the MCK-APP/PS1mice at 14months of age although the difference did not achieve statistical significance (Figure 1E).Therefore,because the pattern and levels of the human APP transgene were not modulated by the intro-duction of PS1M146V gene,and the levels of PS1protein were also maintained at physiological levels,any change in the onset of the phenotype must be due to modulating APP processing to favor A ?42formation.

Augmenting A ?42Exacerbates the IBM-Like Pathology in Skeletal Muscle of the MCK-APP/PS1Transgenic Mice

A key question to resolve is whether the processing of the APP protein in skeletal muscle is altered in response to the introduction of the PS1mutation and to determine which A ?species,A ?40or A ?42,predominates.In our previous study,both A ?40and A ?42were produced in skeletal muscle of the parental MCK-APP transgenic mice based on SELDI-MS analysis,although it was clear that A ?40levels were much higher than A ?42levels.28This observation confirms that both A ?40and A ?42are produced in skeletal muscle of the MCK-APP mice and that these levels are markedly higher than those in age-matched non-Tg mice.28Because the goal of this current study was to specifically augment A ?42levels,we next quantitatively determined the levels of both A ?species in muscles of the MCK-APP/PS1mice by ELISA using end-specific antibodies against A ?40and A ?42.Protein ex-tracts were prepared from the quadriceps and calf mus-cle of 14-month-old non-Tg,PS1-KI control,MCK-APP,and MCK-APP/PS1mice.No detectable A ?40or A ?42was found in muscle from non-Tg or PS1-KI mice (data

not shown),whereas relatively high levels of detergent-insoluble A ?40and A ?42were detected in muscle from the MCK-APP/PS1mice (Figure 2,A and B).Furthermore,the ratio of A ?42/A ?40was markedly elevated in the MCK-APP/PS1mice compared to the parental MCK-APP mice (Figure 2C).Therefore,as in neurons,the introduc-tion of the PS1mutation in muscle shifted the processing of APP to favor the generation of A ?42and also in-creased total A ?production.

We further examined the age-dependent processing of APP in the MCK-APP/PS1mice.Both calf muscle and quadriceps were harvested from MCK-APP/PS1mice at 3,6,14,and 24months of age,and detergent-soluble A ?40and A ?42were measured.The levels of A ?40and A ?42in calf muscles and quadriceps increased in an age-dependent manner up to 14months of age but were lower at 24months (data not shown).This change corre-sponded to the lower APP steady-state levels that were observed at 24months of age (Figure 1D).

Having demonstrated that the introduction of the mu-tant PS1allele into the MCK-APP mice augments A ?42levels,we next histopathologically evaluated the double MCK-APP/PS1transgenic mice using several criteria.First,we compared muscle sections from aged mice stained with the general stain hematoxylin and eosin and compared results to the parental PS1-KI and MCK-APP transgenic lines.No alterations in muscle cytoarchitec-ture were apparent in PS1-KI mice and the muscle ap-peared normal with peripherally localized nuclei and in-tact smooth muscle linings even in mice as old as 24months of age (Figure 3,A and B).In contrast,muscle (calf and quadriceps)from MCK-APP/PS1mice exhibited abundant centric nuclei (Figure 3,C and D).A similar histological feature was also observed in age-matched MCK-APP mice muscle (Figure 3I).Centric nuclei are a general marker of muscle pathology often observed in muscle disorders,although they can occasionally be found in normal mouse and human tissue at a low fre-quency of ?1to 3%;centric nuclei are also a feature of IBM myopathology.29In addition,histological analysis revealed that a significant proportion of the muscle fibers in the MCK-APP/PS1mice were smaller in size compared to control mice.These affected muscle cells were

sur-

Figure 2.Augmenting A ?42production in skeletal muscle of MCK-APP/PS1mice.A and B:Both detergent-soluble and -insoluble fractions from calf muscle and quadriceps of 14-to 15-month-old MCK-APP (open bars )or MCK-APP/PS1(filled bars )mice were used to measure total A ?40and A ?42by ELISA using specific antibodies against A ?35-40(MM32-13.1.1)and A ?35-42(MM40-21.3.4),respectively.Significant (P ?0.05or less)increases in A ?40and A ?42were detected in skeletal muscle from MCK-APP/PS1mice.*P ?0.05or **P ?0.01as compared between MCK-APP and MCK-APP/PS1mice.Number of mice used:n ?6(MCK-APP)and n ?7(MCK-APP/PS1).C:The A ?42/A ?40ratio significantly increases in MCK-APP/PS1mice as compared to MCK-APP mice at 14months of age.*P ?0.05.

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rounded by a relatively large number of hematoxylin-positive nuclei,most likely inflammatory cells.

Another major pathological hallmark of IBM is immune infiltration.Consequently,we analyzed and compared muscle tissue from MCK-APP/PS1mice to age-matched PS1-KI mice (Figure 3E).We observed extensive num-bers of CD8-immunopositive T cells surrounding or infil-trated into muscle fibers from the MCK-APP/PS1mice (Figure 3F).Thus,whereas the single MCK-APP line showed neutrophil rather than T-cell infiltration,21by aug-menting A ?42levels in skeletal muscle of the MCK-APP/PS1mice,we have derived a model that better mimics the inflammatory response of human IBM by inducing T-cell https://www.wendangku.net/doc/187371275.html,ing immunohistochemistry,we showed that human APP was readily apparent in skeletal muscle using anti-body P2-1antibody.In contrast,no staining was ob-served in muscles from the PS1-KI mice (Figure 3G).Both MCK-APP and MCK-APP/PS1mice showed high levels of P2-1-immunopositive muscle fibers (Figure 3,H and J),confirming the buildup of the transgene product in certain muscle fibers.The numbers of P2-1-immunopositive muscle fibers were comparable between the two trans-genic mice.As a rule,these P2-1-immunoreactive fibers were relatively smaller in size compared to other nonre-active muscle cells.

Inclusion bodies are the defining hallmark feature of IBM and are believed to play an important

pathogenic

Figure 3.IBM-like histopathological hallmarks are evident in skeletal muscle from the MCK-APP/PS1mice.H&E staining of calf muscle (A )and quadriceps (B )from 24-month-old PS1-KI or calf muscle (C )and quadriceps (D )of 24-month-old MCK-APP/PS1mice.E and F:CD8immunostaining of quadriceps from 24-month-old PS1-KI mice and MCK-APP/PS1mice.F:Skeletal muscle from MCK-APP/PS1mice exhibits increased numbers of CD8-positive activated T cells around muscle fibers.Inset is a higher magnification view of CD8-positive T cells.G:Full-length human APP immunostaining (P2-1)of quadriceps muscle from 24-month-old PS1-KI.H:P2-1immunostaining of quadriceps from 24-month-old MCK-APP/PS1,confirming the presence of APP in muscle fibers,and APP-immunopositive fibers tend to be smaller in size compared to nonstained fibers.I and J:Calf muscle from 24-month-old MCK-APP mice was stained with H&E (I )or P2-1antibody (J )for comparison with MCK-APP/PS1mice.The histopathological staining shows similar histopathological patterns with MCK-APP/PS1mice shown above.K:Intracellular A ?staining in quadriceps of MCK-APP/PS1mice,and at higher magnification (L ).M:The percentage of centric nuclei-containing muscle fibers in the parental MCK-APP and MCK-APP/PS1mice at 14or 24months of age.The graph represents mean ?SEM of seven animals per group.N:The number of A ?-containing inclusions in the parental MCK-APP and MCK-APP/PS1mice at 14or 24months of age.Muscle sections were immunostained with 6E10antibody,and intracellular A ?inclusions were counted in random field.The graph represents mean ?SEM of seven animals per group.O:RT-PCR for CD8mRNA levels in quadriceps of MCK-APP or MCK-APP/PS1mice.The expression levels were individually normalized by GAPDH mRNA levels.The graph represents relative CD8mRNA levels to age-matched non-Tg or PS1-KI mice.There was no significant difference between non-Tg and PS1-KI mice.

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role in muscle degeneration.ELISA data showed that A ?42was predominantly produced in the skeletal muscle of the MCK-APP/PS1mice (Figure 2,A–C).We immuno-stained muscle with A ?-specific antibodies and observed prominent accumulation of A ?intracellularly.Quadriceps from aged MCK-APP/PS1mice showed numerous intra-cellular inclusions that were immunoreactive with the A ?-specific antibodies (Figure 3,K and L),indicating that the MCK-APP/PS1mice mimic this important pathological feature of human IBM.

We next quantitatively measured pathological hall-marks of IBM including centric nuclei,A ?inclusion bod-ies,and inflammatory responses between the MCK-APP and MCK-APP/PS1mice at 14and 24months of age.

Numbers of centric nuclei were markedly higher in skel-etal muscle of MCK-APP/PS1at 14months compared to age-matched parental MCK-APP mice (P ?0.05;Figure 3M).By the age of 24months,the relative percentage of centric nuclei-containing cells was not different between the two mouse groups (Figure 3M).Similarly,the number of A ?-containing inclusion bodies was greater in the MCK-APP/PS1mice than the parental MCK-APP mice (Figure 3N).Furthermore,we noted that inflammation,as determined by CD8mRNA expression,in skeletal muscle occurred earlier in the MCK-APP/PS1mice compared to the parental line.CD8mRNA levels increased approxi-mately two times in 14-month-old MCK-APP/PS1mice compared to the MCK-APP mice (Figure 3O).Taken to-gether,these results show that augmenting A ?42exac-erbates the IBM-like muscle pathology in the double transgenic mouse model.

Enhanced GSK-3?and cdk5Activity in Skeletal Muscle of the MCK-APP/PS1Mice

Hyperphosphorylation of tau and subsequent accumula-tion of tau tangles in skeletal muscles are a major patho-logical hallmark of IBM.We examined whether tau phos-phorylation was affected by the exacerbation of

the

Figure 4.Tau phosphorylation is elevated in skeletal muscle of MCK-APP/PS1mice.The steady-state levels of phosphorylated tau were examined using antibody AT8.Tau-immunoreactive band from calf muscles of 6-or 14-month-old non-Tg,PS1-KI,MCK-APP,and MCK-APP/PS1mice are shown.Data are representative of four mice per group per age,and mem-branes were reprobed for GAPDH to control for equal loading (data not

shown).

Figure 5.Increased tau phosphorylation in skeletal muscle of MCK-APP/PS1mice is mediated by GSK-3?and cdk5.Steady-state levels of JNK,p38-MAPK,cdk5,GSK-3?,and their phosphorylated states were examined from 6-(A )and 14-month-old mice (B ).Specifically,we determined whether each kinase was phosphorylated at selective residues known to affect their activity:threonine 183and tyrosine 185for JNK,threonine 180and tyrosine 182for p38-MAPK,and serine 9for GSK-3?.The graphs represent ratio of the intensity of phosphorylated state relative to total level of corresponding kinase.*P ?0.05or **P ?0.01compared to non-Tg and PS1-KI,and ??P ?0.01compared to MCK-APP.

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amyloid pathology in skeletal muscle at6and14months of age.No shift in the AT8-positive tau(phosphorylated at serine202and threonine205;S202/T205)band was apparent in either non-Tg or PS1-KI mice at all ages tested,indicating that the PS1

M146V

mutation alone did not alter the tau phosphorylation pattern(Figure4).No-tably,we found that the levels of AT8-positive tau were increased in the MCK-APP/PS1mice compared to the MCK-APP mice(Figure4).The difference in phosphory-lated tau levels between the MCK-APP and the MCK-APP/PS1mice was even more apparent at14months of age,where approximately fourfold more phosphorylated (AT8-positive)tau was observed in the MCK-APP/PS1 mice(Figure4).

Several kinases including c-Jun N-terminal kinase (JNK),p38mitogen-activated protein kinase(p38-MAPK),cyclin-dependent kinase5(cdk5),and glycogen synthase kinase-3?(GSK-3?),have been extensively evaluated for their role in the phosphorylation of tau in AD.30–33We examined whether these putative kinases were also involved in the phosphorylation of tau in skel-etal muscle,and whether modulating A?42levels in the MCK-APP/PS1mice altered their activation state.The steady-state levels of total JNK,p38-MAPK,cdk5,and GSK-3?were not significantly altered among the trans-genic mice at the ages tested(Figure5,A and B).We first examined the activation/inactivation states of these ki-nases by measuring the phosphorylation profile of each kinase at specific amino acid residues.JNK and p38-MAPK are activated when phosphorylated at threonine 183and tyrosine185or threonine180and tyrosine182,

respectively,34,35whereas phosphorylation at serine9in GSK-3?is considered to cause inactivation of its kinase activity.36,37At6months of age,we found lower levels of phosphorylated GSK-3?in the MCK-APP/PS1mice(Fig-ure5A),and the reduction was significantly different from the other three groups(P?0.01).At14months of age,a marked reduction of phosphorylated GSK-3?was also observed only in the MCK-APP/PS1mice(Figure5B). Interestingly,at14months of age,the activation of p38-MAPK was also significantly increased as detected by the elevation of phosphorylated levels in both the MCK-APP and MCK-APP/PS1mice(Figure5B).Phosphory-lated JNK levels were slightly decreased only in MCK-APP mice,whereas the levels in MCK-APP/PS1mice were comparable to those in the non-Tg or PS1-KI mice (Figure5B).

To further assess the involvement of these kinases in tau phosphorylation in the skeletal muscle of the MCK-APP/PS1mice,we examined the association of these kinases with tau in skeletal muscle.We first immunopre-cipitated proteins using the phospho-tau-specific anti-body AT8and determined which kinases were physically associated with phosphorylated tau in skeletal muscle. Markedly higher levels of cdk5were detected in6-month-old MCK-APP/PS1mice,whereas higher levels of GSK-3?were found at14months(Figure6A).Although increased activation of p38-MAPK was initially observed at14months,p38-MAPK as well as JNK were not co-immunoprecipitated with phosphorylated tau(data not shown),indicating that both p38-MAPK and JNK may be less involved in tau phosphorylation in skeletal muscle. Moreover,immunoprecipitation with antibodies cdk5or GSK-3?followed by immunoblotting with a tau antibody further confirmed the involvement of cdk5and GSK-3?in tau phosphorylation in skeletal muscle of MCK-APP/PS1 mice(Figure6B).

To further verify the activation states of cdk5and GSK-3?,we measured the activity of these kinases. GSK-3?activity in skeletal muscle from the MCK-APP/ PS1mice was significantly higher at14months of age (P?0.05),whereas cdk5activity was increased in the MCK-APP/PS1mice at6months of age(Figure6C). Although it was not significant,the GSK-3?activity at6 months in the MCK-APP/PS1was higher than PS1-KI mice,and it partially correlates with the reduction of phospho-GSK-3?levels(Figures5A and6C).Taken together,our results suggest that both GSK-3?and cdk5are likely to be the primary kinases involved in the phosphorylation of tau in skeletal muscle of MCK-APP/ PS1mice,and that JNK and p38-MAPK are not likely to play a major role.

Motor Impairment Associates with the Levels of A?42in Skeletal Muscle

To assess the effect of the PS1mutation and the sub-sequent enhancement of A?42levels on another func-tion,we directly compared the performance of the double transgenic mice to controls using the

acceler-Figure6.GSK-3?and cdk5are activated and associated with phosphory-lated tau in skeletal muscle from the MCK-APP/PS1mice.A:Immunoblotting of cdk5and GSK-3?after immunoprecipitation with antibody AT8in skeletal muscle of6-and14-month-old PS1-KI or MCK-APP/PS1mice.Asterisk indicates higher kinase levels associated with phosphorylated tau in the skeletal muscle.B:Reverse immunoprecipitation/immunoblot further con-firms a physical association of cdk5or GSK-3?with phosphorylated tau (recognized by AT8).C:Kinase activity of cdk5(left)and GSK-3?(right) was measured from skeletal muscle of6-and14-month-old PS1-KI and MCK-APP/PS1mice.Data represent mean?SEM from four mice per group. *P?0.05compared to age-matched PS1-KI group.

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ating rotarod.The motor performance of non-Tg,PS1-KI,MCK-APP,and double transgenic MCK-APP/PS1mice was evaluated as a function of age.Five age groups were tested:1to 2,5to 6,11to 12,15to 18,and 21to 23months.Whereas the MCK-APP mice did not show impairments in motor performance until age 15to 18months,the MCK-APP/PS1mice showed sig-nificant (P ?0.05)impairment by 11to 12months of age (Figure 7A).Thus,augmenting A ?42levels in skel-etal muscle shifted the onset age of impairment by several months.The disparity in motor performance was most notable between the two groups at 15to 18months of age,as the MCK-APP/PS1mice were se-verely impaired compared to the single MCK-APP mice.By 21to 23months,the MCK-APP mice per-formed as poorly as the MCK-APP/PS1mice.Both non-Tg and PS1-KI did not exhibit any significant re-duction in motor performance at any of the ages tested.The impaired motor performance observed in the MCK-APP/PS1mice strongly correlated with the buildup of A ?42in skeletal muscle (r 2?0.6478;Figure 7B),whereas it was correlated in lesser degree with A ?40(r 2?0.2618;Figure 7C),providing corroborating evi-dence for a pathogenic role for A ?42in muscle degen-eration.In summary,we demonstrate that introduction of the mutant PS1M146V allele specifically increased the formation of A ?42and exacerbated the IBM-like phenotype.

Because there is a strong male predominance in IBM,we next evaluated male and female mice to determine whether there was a difference in performance between the sexes.Notably,we find that 11-to 12-month-old male

MCK-APP/PS1mice performed significantly (P ?0.05)poorer on the accelerating rotarod compared to age-matched female mice (Figure 7D).This disparity in motor performance was most apparent at this time point and diminished with age (Figure 7,E and F).Likewise,the male MCK-APP single transgenic mice were more se-verely impaired than the female counterparts at age 21to 23months (Figure 7F).Because the MCK-APP mice dis-play less pathological features of IBM than the MCK-APP/PS1mice,longer times are likely required for impairments to manifest in motor performance.In sum,we show that the phenotype of the MCK-APP and MCK-APP/PS1mice correlates with the level of A ?42in skeletal muscle,with the higher A ?42levels in the MCK-APP/PS1accelerating and exacerbating the phenotype relative to the MCK-APP mice.

Discussion

The accumulation of A ?within skeletal muscle fibers is one of the hallmark pathological features of IBM.Ab-normal accumulation of A ?-containing inclusions are present in skeletal muscle of IBM patients,and these inclusion bodies are found in nearly 100%of vacuo-lated muscle fibers.9,38Notably,these abnormal mus-cle fibers also accumulate presenilin-1,39which is con-sidered to be the catalytic subunit of ?-secretase,suggesting that dysregulation of APP processing is involved in the disease onset and/or progression.How-ever,it remains to be determined whether this buildup of A ?is an epiphenomenon/consequence of the

dis-

Figure 7.Augmenting A ?42exacerbates motor performance of the MCK-APP/PS1mice.A:Age-dependent reduction of motor performance in both the MCK-APP and MCK-APP/PS1mice.*P ?0.05or **P ?0.01as compared with non-Tg or PS1-KI.?P ?0.05or ??P ?0.01as compared between MCK-APP and MCK-APP/PS1mice.B and C:Correlation between accumulation of A ?42(B )or A ?40(C )in skeletal muscle and motor performance in MCK-APP/PS1mice.The x axis represents rotarod performance,and y axis represents A ?levels in skeletal muscle.D–F:Sex difference in motor performance was analyzed at age 11to 12months (D ),15to 18months (E ),and 21to 23months (F ).Open and filled bars represent males and females,respectively.For all experiments,numbers of mice were used in each group:n ?4to 7for 1to 2months,n ?4to 5for 5to 6months,n ?8(four males and four females)for 11to 12months,n ?8to 13(four to six males and four to seven females)for 15to 18months,and n ?8to 15(four to six males and four to nine females)for 21to 23months.*P ?0.05compared between male and female.

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ease process or whether it plays a more direct role in

contributing to the degenerative phenotype.Discrimi-nating between these two possibilities is not readily feasible by analyzing histopathological muscle sam-ples from affected human patients.Likewise,in vivo imaging methods have not yet reached the required point of sensitivity to address this question in living patients afflicted with the disease.

One means to better evaluate the role of A?in the pathogenesis of skeletal muscle disorders such as IBM is to use animal models.Because IBM is a chronic,age-related disorder like AD,we used an aggressive genetic approach to generate a mouse model that exhibits rele-vant pathology by overexpressing APP selectively in skel-etal muscle.Notably,there is evidence that APP mRNA levels are selectively enhanced in human IBM samples,40 thereby providing physiological justification for the over-expression of this protein in transgenic mice.We previ-ously generated a transgenic model of this myopathy by selectively targeting the precursor of A?(APP)to skeletal muscle fibers with the use of the MCK promoter.21These MCK-APP transgenic mice develop IBM-like pathology as well as an age-dependent motor impairment.The mice also predominantly produce the less amyloidogenic A?40isoform.However,it is well established,at least for brain amyloid disorders like AD,that the longer A?42 species is far more pathogenic.Consequently,here we used a genetic approach to modulate?-secretase activ-ity to favor production of A?42,by introducing a mutant PS1

M146V

allele into the MCK-APP transgenic mice.This goal was readily achieved by crossing the MCK-APP

mice to the PS1

M146V

knock-in mice.These double trans-genic MCK-APP/PS1mice produce significantly higher levels of the A?42peptide in skeletal muscle relative to single,parental line.Likewise,the A?42/40ratio is also significantly higher.Through analysis of the single and double transgenic lines developed here,we were able to determine whether A?40or A?42plays a more detrimen-tal role in skeletal muscle.As shown in the result,higher levels of A?42in skeletal muscle seem to exacerbate the phenotype,leading to the earlier manifestation of the IBM-like histopathological features and the motor impair-ment relative to the parental line.

Because the phenotype is exacerbated by the in-creased levels of A?42,it provides strong in vivo evi-dence that this peptide likely plays a pathogenic role in IBM,and likely not to be simply a marker or epiphenom-enon.It is critical to emphasize that the introduction of the mutant PS1allele did not enhance or alter the cellular profile of APP expression,thus the accelerated pheno-type is solely due to the modulation of APP processing and elevated levels of A?42.Higher A?42levels can have detrimental consequences for the AD brain,and our present findings demonstrate a similar finding is also true for skeletal muscle.Although our data show that aug-menting A?42levels in muscle accelerates the pathology and motor deficits,it does not address the mechanism by which high levels of the intracellular A?42peptide cause disease.

Several pathogenic mechanisms induced by misme-tabolism of APP have been proposed,and one or more of these mechanisms may underlie the exacerbated pheno-type we described here.Christensen and colleagues41 recently found a marked elevation of basal calcium stores in cultured myogenic cells overexpressing A?42,and they also found that the sensitivity of ryanodine receptors to caffeine was significantly increased in the presence of A?42in these cells.Although the exact consequences of altering calcium levels in skeletal muscle remain to be elucidated,their results indicate that calcium dysho-meostasis may be one of the pathogenic causes of IBM, and further work will be required to determine whether a similar alteration occurs in the transgenic mice.

Another potential mechanism that may be affected is the proteasome.APP/A?-mediated proteasome inhibition was recently reported by Fratta and colleagues.42They studied skeletal muscles from sporadic IBM patients and found that proteasome subunit(20S?)was co-localized with APP/A?,and its proteolytic activity was significantly reduced compared to healthy skeletal muscles.Further-more,cultured muscle fibers overexpressing APP showed a marked reduction of proteasome activity,and a proteasome inhibitor,epoxomicin,increased the forma-tion of inclusion bodies.42These data strongly suggest that pathological features of IBM including A?and hyper-phosphorylated tau-containing inclusion bodies and vac-uole formation may be partially due to proteasome inhi-bition caused by the abnormal buildup of A?in muscle fibers.

Interestingly,the MCK-APP/PS1mice showed a marked elevation of phosphorylated tau in skeletal mus-cle in an age-dependent manner.Increased levels of AT8-positive tau correlated well with production of intra-muscular A?levels and were likely mediated by the dif-ferential activation of cdk5and GSK-3?.Our current data strongly suggest that cellular mechanisms of tau pathol-ogy in this IBM model are similar to those in AD because both cdk5and GSK-3?play a critical role in the patho-genesis of neurofibrillary tangles.43–45In IBM-afflicted skeletal muscle,higher levels of cdk5have been ob-served,and it is co-localized with phosphorylated tau.46,47

Although the molecular basis that triggers the onset of IBM remains unknown,the findings of this study indicate that mechanisms underlying IBM may be similar to those in AD.In both disorders,A?seems to play a pivotal pathogenic role.Of course,the ultimate demonstration that A?is critically involved in the pathogenesis of IBM will await clinical trials.Given the remarkable pathobio-chemical similarities between AD and IBM,it will be in-teresting to determine whether A?-directed therapies that are in preclinical or clinical development for AD,such as BACE or?-secretase inhibitors or A?immunotherapy have therapeutically beneficial results for IBM patients as well.

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AJP June2006,Vol.168,No.6

工艺、技术管理制度

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