Alzheimers sjukdom är en kronisk och obotlig neurodegenerativ sjukdom. Sjukdomen kommer smygandes och drabbar individer sent i livet. En av flera riskfaktorer för att utveckla Alzheimers sjukdom är hyperkolesterolemi. Hyperkolesterolemi kan orsaka en ökad syntes av amyloid-β i hjärnan. Proteinet aggregeras, bildar plack och orsakar celldöd i hjärnan. Syftet med arbetet var att utvärdera om statiner har en effekt på försämrad kognition, en klinisk bild som ses hos patienter med Alzheimers sjukdom. Utvärderingen gjordes efter att vetenskapliga studier sammanställts. Studier har gjorts och görs än idag för att se om en hämmad kolesterolsyntes i hjärnan kan minska syntesen av amyloid-β och därmed reducera risken för att utveckla Alzheimers sjukdom. Alzheimers sjukdom är en komplicerad sjukdom med en oklar sjukdomsorsak och otydliga stadium innan diagnos. Detta försvårar utförandet av studier med ändamål för att utvärdera om statiner kan reducera risken för sjukdomen. Idag finns djur- och humanstudier som visar på olika resultat, både att statiner har en positiv effekt på nedsatt kognition och amyloid-β men även att statiner inte har en effekt på Alzheimers sjukdom.

La Protéine Prion cellulaire (PrPc) est une protéine ubiquitaire mais majoritairement présente dans le système nerveux central. Elle est plus particulièrement connue pour sa conversion conformationnelle en PrPSc dans les maladies à Prions qui sont des Protéinopathies comme la maladie d’Alzheimer (MA). La MA est en partie associée à des dépôts de peptides beta-amyloïdes (Aβ) agrégés de façon extracellulaire et issus des clivages successifs par la β- puis la γ-sécrétase de la protéine précurseur amyloïde (APP) exprimée dans les neurones. La PrPc et l’APP partagent des fonctions et des voies protéolytiques communes (α- ou β-sécrétase) les impliquant dans la prolifération, la différenciation, la synaptogenèse et la survie cellulaire. La PrPc est impliquée dans la régulation de la prolifération et la différenciation de différentes cellules souches : neurales adultes (NSC), hématopoïétiques (HSC), embryonnaires humaines (hESC). Si la PrP et l’APP partagent des fonctions communes, plusieurs publications montrent que la PrPc régule négativement le clivage de l'APP en Aβ et positivement le clivage de l’APP en sAPPα suggérant ainsi un rôle anti-amyloïdogénique de la PrPc. La PrP agirait également comme récepteur des Aβ à la surface neuronale induisant notamment l’inhibition des LTP et l’altération synaptique.Dans ce contexte, les objectifs spécifiques de la thèse sont :- L’étude de l’expression de la PrP, de l’APP et ses résidus de clivage au cours de l’induction neurale des hESC en NSC et de la différenciation neuronale- L’impact de la modulation de l’expression de la PrP sur le clivage de l’APP ainsi que sur les propriétés des cellules souches (survie, prolifération, différenciation).1. Induction neurale des hESC en NSC Pour ce projet nous avons utilisé des Cellules Souches Embryonnaires Humaines (hESC) pour lesquelles le laboratoire dispose d’une autorisation de l’Agence de la Biomédecine.Pour l’induction neurale, nous avons testé deux protocoles : l’un permet d’obtenir des neurosphères en suspension puis des «rosettes» constituées de NSC, l’autre protocole en monocouche mime quant à lui la corticogenèse. Une optimisation de ces protocoles a été nécessaire (densité de départ, méthodes de fixation des cellules pour améliorer la détection de la PrP) ainsi que la détermination des conditions d’analyse de l’expression de PrP, d’APP et ses résidus clivés (Aβ, sAPPα/β). 2. Différenciations à partir des NSC Les NSC obtenues ont ensuite été amplifiées puis différenciées en neurones et/ou astrocytes. Les cellules ont été caractérisées notamment par immunofluorescence et RT-qPCR pour l’expression des principaux marqueurs astrocytaires (GFAP) et neuronaux (BIII-tubuline, Doublecortine, Synaptophysine) et la disparition progressive des marqueurs de NSC. Là encore nous avons établi des conditions précises de densité cellulaire ainsi que les points des analyses cinétiques de nos différents paramètres.3. Modulation de l’expression de la PrPc Nous avons utilisés des vecteurs lentiviraux permettant l’expression ou l’inhibition de la PrPc humaine pour transduire des hESC au moment d’initier l’induction neurale et des NSC. Pour cela nous avons également dû réaliser des optimisations de différents paramètres : densité cellulaire, taille des supports d’ensemencement ou MOI de lentivirus afin d’avoir une transduction efficace tout en limitant la cytotoxicité. De même, les échantillons récoltés nous ont permis d’évaluer l’impact de la modulation de la PrPc sur le clivage de l’APP ainsi que sur la biologie des cellules souches (survie, prolifération, différenciation). / The cellular Prion Protein (PrPc) is a ubiquitary protein mainly expressed in the central nervous system. It is particularly known for its conformational conversion in PrPSc in Prion diseases, which are proteinopathies such as Alzheimer’s disease (AD). AD is associated with extracellular deposits of aggregated beta-amyloid peptides (Aβ) derived from successive β- and the γ-secretase cleavages of the amyloid precursor protein (APP) expressed by neurons. PrPc and APP share some common functions and proteolytic pathways (α- or β-secretase), involving them in proliferation, differentiation, synaptogenesis and cellular survival. PrPc is involved in the regulation of proliferation and differentiation of many stem cells: adult neural (NSC), hematopoietic (HSC) and human embryonic (hESC). Several publications also show that PrP downregulates the cleavage of APP in Aβ and positively regulates the cleavage of APP in sAPPα suggesting an anti-amyloïdogenic role of PrPc. PrP could also act as a receptor of Aβ at the neuronal surface inducing LTP inhibition and synaptic alteration. In this context, the specific objectives of my thesis were:- Study of the expression of PrP, APP and its cleavage residues during neural induction of hESC in NSC and neuronal differentiation.- Impact of the modulation of PrP expression on APP cleavages as well as on stem cells properties (survival, proliferation, differentiation). 1. Neural induction of hESC in NSCFor this project, we have used Human Embryonic Stem Cells (hESC) for which the laboratory has an authorization from the “Agence de la Biomédecine”.For the neural induction, we have tested two protocols, the first one allows the obtention of neurospheres in suspension and then figures of “rosettes” composed of NSC, and a “monolayer” protocol that mimics the beginning of corticogenesis. An optimization of these protocols has been necessary (starting cell density, cell fixation methods to improve PrP detection). We have also determined the best conditions to analyze the expression of PrP, APP and its derived peptides (Aß, sAPPα/β). 2. Differentiation of NSCNSC derived from hESC were amplified and differentiated into neurons and/or astrocytes. Cells were characterized in particular by immunofluorescence and RT-qPCR for the expression of the major astrocytic (GFAP) and neuronal markers (BIII-tubulin, doublecortin, synaptophysin) and the progressive decrease of NSC markers. Again we have determined the best conditions for cell density and kinetic time points for our analysis.3. Modulation of PrPC expression We have used lentiviral vectors allowing the expression of an anti-PrP shRNA, human PrP and respective controls. To achieve this task, lentiviral transductions of hESC and NSC were optimized: cell density, size of the seeding culture wells or MOI of lentivirus. Finaly, samples collected allowed us to evaluate the impact of PrPc modulation on the APP cleavages as well as on stem cells properties (survival, proliferation, differentiation).

Alzheimer's disease (AD) is characterised by memory loss, insidious cognitive decline, profound neurodegeneration, and the extracellular accumulation of amyloid-beta (Aβ) peptide in senile plaques and intracellular accumulation of tau in neurofibrillary tangles. Synaptic dysfunction and loss is the strongest pathological correlate of cognitive decline in AD with increasing evidence implicating neuropathological forms of both amyloid-beta and tau protein in this process. A large amount of evidence suggests that oligomeric forms of Aβ, associated with senile plaques, are toxic to synapses but the precise localisation of Aβ and which forms are synaptotoxic remain unknown. Using the high-resolution technique, array tomography, this thesis characterised the synaptic localisation of different forms of Aβ oligomers in a mouse model of amyloidopathy. These results show that different oligomeric Aβ species are present in both presynapses and postsynapses. This study highlights the potential of array tomography for rapid testing of aggregation state specific Aβ antibodies in brain tissue. Following these results, the presence of tau at synapses was examined. Despite the knowledge that tau spreads through defined synaptic circuits, it is currently unknown whether synapse loss occurs before the accumulation of tau or as a consequence. To address this, array tomography was used to examine a mouse model in which mutant P301L human tau is expressed primarily in the entorhinal cortex (rTgTauEC). It has previously been shown that rTgTauEC mice exhibit neuronal loss in the entorhinal cortex and synapse density loss in the middle molecular layer (MML) of the dentate gyrus at 24 months of age. The density of tau-expressing and total presynapses, and the spread of tau into the postsynapse in the MML of 3-6, 9, and 18 month old mice were examined. No loss of synapse density was observed in the MML up to 18 months of age, even in axons expressing tau. Despite the maintenance of synapse density, we see spread of human tau from presynaptic terminals to postsynaptic compartments in the MML at very early ages. This indicates that the spread of tau through neural circuits is not due to the degeneration of axon terminals and is an early feature of the disease process. Following examination of both synaptic amyloid-beta and tau in separate models, this thesis then examined how these two proteins may be synergistically working together to drive synaptic pathology. To investigate this a novel mouse model was used in which amyloid-beta deposits are present in combination with non-mutated human tau expression (APP/PS1 + hTau). These results suggested that the addition of human tau expression does not increase plaque associated synapse loss, neither does it increase the proportion of synapses colocalising with amyloid-beta. Similarly the presence of human tau at individual postsynapses was not enhanced in the presence of oligomeric Aβ. Surprisingly, intact long-term recognition memory was observed in APP/PS1 + hTau mice. However a hyperactive phenotype was detected in these mice that could be prevented upon tau suppression. This suggests a synergistic relationship may exist in the presentation of this phenotype. Finally in the last part of this thesis, synapses from post-mortem human Alzheimer's disease and age-matched controls were investigated. It has previously been suggested that both amyloid-beta and tau can interfere with mitochondrial transport to the synapse and mitochondrial function. For this reason the presence of synaptic mitochondria at both the presynapse and postsynapse was determined in order to investigate any alteration in the diseased state. A reduction in the proportion of presynapses with multiple mitochondria present was detected in anterior/posterior transverse temporal cortex (BA41/42). This was not observed in dorsolateral prefrontal cortex (BA46), suggesting either a selective vulnerability of the former brain region or a selective resistance of the latter brain region, to mitochondrial depletion at the synapse. The findings presented in this thesis demonstrate that when investigated in isolation, pathological forms of amyloid-beta are present at a subset of synapses where they may contribute to toxicity, whilst the spread of tau protein is an early feature of the disease process and occurs prior to overt synapse loss. This thesis also explores the proposed synergistic relationship between amyloid-beta and tau using a novel mouse model and human post-mortem brain tissue. Since these two proteins both have been implicated in synaptic dysfunction, investigating Aβ and tau in new mouse models and human brain tissue will be instrumental in furthering our understanding of mechanisms and features of synaptotoxicity that could be important therapeutic targets.

Mechanobiology is an emerging field that aims to understand how physical forces regulate cell function, morphology, and development. Cells interpret forces, such as the deformation of the membrane to encapsulate a particle, or the rigidity of the extracellular matrix (ECM), and make decisions about cell adhesion, motility, and differentiation. These cell-ECM interactions are important to maintaining homeostasis, and the disruption of this interface has pathological consequences. Common diseases, such as Alzheimer’s disease, cancer, and atherosclerosis each arise, in part, from an abnormality in the mechanotransduction pathway. Hence, understanding the contribution of this pathway and the role of the ECM in cell function, proves to be a useful tool in improving drug targeting and understanding disease progression. While size, shape and surface chemistry of nanoparticle uptake has been extensively studied, varying the particle mechanics can also be a useful design strategy to manipulate particles and improve uptake and targeting. Using model polystyrene-co-N-isopropylacrylamide (pS-co-NIPAM) particles, with varying elastic moduli, it was observed that as the particles became stiffer, there was a subsequent decrease in bound/internalized particles for phagocytic RAW264.7 macrophage and non-phagocytic HepG2 hepatoma carcinoma cells, showing that both of these cell types are sensitive to particle mechanics, even in a higher stiffness regime (MPa). ECM mechanics have recently been implicated in tissue stiffness changes that precede and drive disease development. Recent research has started looking into these effects in the progression of neurodegenerative diseases. This research found that the elasticity of the brain becomes softer with aging, and even softer in patients with AD. Analogous to the pS-co-NIPAM studies, this tissue softening could have implications on amyloid-beta endocytosis as well as neuron dystrophy in response to the peptide. Understanding the role of the ECM in the progression of AD in vitro could provide a better approach to determine an in vivo mechanism behind Alzheimer’s disease pathology. In order to mimic a softer ECM substrate, SH-SY5Y neuroblastoma and human primary neurons were plated on 2-D polyacrylamide and 3-D collagen gels with varying stiffness ranging from 0.15-25kPa. Both cell types grown using these substrates show a sensitivity to their ECM environment, and display an increase in cell spreading and the number of F-actin stress fibers with an increase in substrate rigidity. Moreover, the extent of Aβ internalization and aggregate production increased with ECM stiffness for SH-SY5Y neuroblastoma. Intracellular Aβ processing remains a central question to understanding the early-stage events in AD pathogenesis. As the ECM can modify Aβ endocytosis and aggregation, the ECM is likely influencing downstream neurotoxic effects of AD. Despite an increase in the plaque production on the soft substrates, both SH-SY5Y neuroblastoma and primary neurons showed a decreased toxicity to Aβ with decreasing substrate stiffness. This decrease in toxicity is associated with cytoskeletal actin remodeling, as cells plated on plastic, but pretreated with cytochalasin D displayed a recovery in viability in response to the oligomeric species. The softening of the ECM initiates actin cytoskeletal depolymerization, as a protective mechanism against neuronal loss and AD progression. This work demonstrates that the ECM impacts Aβ endocytosis and aggregation, and the ECM prompts neuroprotective actin reorganization against the neurotoxic effects of AD. Further, it is demonstrated the biophysical role of ECM stiffness in modifying Aβ internalization, plaque production, and toxicity offers an improved in vitro model of critical AD components. By better understanding the cytoskeletal reorganization triggered by a softening ECM, potential novel avenues of therapeutic intervention could later be determined to stop the progression of the disease.

Alzheimer’s disease (AD), identified over 100 years ago and intensively studied since the 1970s, has no effective treatments or mechanistic understanding of the underlying neurodegenerative process. Most investigators believe accumulation or aggregation of amyloid beta (Ab) proteins plays a causative role. Aβ peptides (~39-43 residues) are generated by proteolysis of the transmembrane protein APP. One reason we know so little about AD is an incomplete understanding of the cellular mechanisms responsible for Ab proteotoxicity. Human ES and iPSC models of AD are recent additions to many other models used to investigate these mechanisms. AD, however is a chronic progressive condition of old age and cultured neurons may not live long enough to model what goes wrong in neurons from AD patients. In my research, I used hESCs which directly express Ab peptides thus avoiding the time it takes to process APP. One App allele in H9 hESCs was previously edited using TALEN. A homologous recombination cassette coding directly for a secretory form of either Ab1-42 or Ab1-40 and containing a stop codon, was inserted into the first exon of App upstream of the normal translational start site. I used multiple independently isolated clones of edited cells with 3 genotypes: App/App (unedited), App/Aβ1-40 and App/Aβ1-42. Expression of Ab from edited alleles was confirmed by qRT-PCR using primers specific for the edit. I first sought to establish if editing changed any aspects of neuronal differentiation in culture. All 3 genotypes have similar embryoid body (EB) development, and similar numbers and sizes of neuronal clusters (NC) up to 34 days after EB dissociation and neural differentiation. Immunostaining of neuronal markers, NeuN and DCX (doublecortin), likewise revealed no difference among edited and unedited cells, suggesting that the edits do not affect the ability of my stem cells to differentiate into neurons. I next measured accumulation of aggregated Ab using an aggregate specific antibody, 7A1a. Data at 34-days post EB dissociation indicates NCs in the Aβ1-42 edited cells accumulate significantly more aggregates relative to either unedited or Ab1-40 edited lines, a result consistent with the increased ability for Ab1-42 to form aggregates. Aβ aggregates also appear to be concentrated around fragmented nuclei within neuronal clusters suggesting that intracellular accumulation may play a key role in proteotoxicity. Additionally, I observed a significant decrease in the number of synapsin1 puncta, a marker of synapses, another feature of AD. I documented a nearly 3-fold greater neuronal cell death in both the Aβ1-40 and Aβ1-42 neurons at 70 days after differentiation. RNA sequencing data also shows independently isolated clones group together and show differential expression of genes related to memory and neuronal cell death. The early presence of Aβaggregation and subsequent cell death is in line with the chronic and progressive nature of AD and this is the first known model to exhibit a neurodegenerative phenotype. These isogenic cell lines thus appear to be useful to screen for therapeutics that may prevent or slow Ab1-42 dependent neurodegeneration and a tool to investigate Ab-dependent mechanisms with relevance to AD.

Reversible adenosine methylation (N6-methylation; m6A) at the RNA level was described in connection to the regulation of RNA fate. The N6-methyladenosine pathway is important for cognitive function and mechanisms related to memory, including the regulation of adult neurogenesis and synaptic plasticity. The objective of this study was to test the hypothesis that a decreased activity of the RNA-demethylase FTO is associated with improved cognitive function in rats. The RNA-demethylase FTO is a key regulator of the m6A pathway. In this study, we administered MO-I-500, a pharmacological inhibitor of FTO in TgF344-AD transgenic rats, which resulted in an improvement of spatial cognition. We further investigated the cognitive enhancement induced by a caloric restriction as a possible compensatory mechanism of cognitive disorders and its effect on the proteins regulating the N6-methyladenosine pathway. Long-term caloric restriction ameliorated cognitive functions and led to changes in the expression of the major proteins controlling the m6A pathway (FTO, METTL3) which are consistent with the aforementioned hypothesis. Although we do not know the exact mechanism of action, these findings support the hypothesis that m6A pathway regulators, such as the FTO demethylase, may be a promising molecular target for...

Alzheimers disease (AD) is pathologically characterized by amyloid plaques, neurofibrillary tangles, inflammation, and neurodegeneration. According to the amyloid hypothesis of AD, the central mediating event of the disease is the deposition of amyloid. The inflammation hypothesis of AD states that it is the inflammatory response to plaques and tangles, rather than the actual lesions, which causes the disease. Studies described here combine the two approaches into a single model. Four studies are presented using a basic protocol of intrahippocampal lipopolysaccharide (LPS) injection to stimulate inflammation in transgenic mice. The first study looked at alpha7 nicotinic receptors during the glial response to Abeta deposits and LPS. Reactive astrocytes which immunolabeled for alpha7 were co-localized with Congophilic deposits in APP and APP+PS1 mice, and increased after LPS injection. Unfortunately, LPS injection into alpha7 knock out mice revealed the alpha7 labeling to be nonspecific. The second study evaluated the time course of protein and gene expression after LPS injection into nontransgenic mice. This experiment identified both a transient and chronic microglial inflammatory response, with changes in cell morphology. The third study evaluated a similar time course in APP mice. Concurrent with the inflammatory response, transient reductions in Abeta burden were seen, though compact plaque load was unaffected. The fourth and final study used dexamethasone to inhibit LPS-induced inflammation in APP mice. LPS injection reduced Abeta burden, but was completely blocked by dexamethasone co-treatment. Though dexamethasone inhibited LPS-induced CD45 and complement receptor 3 levels (markers of general microglial activation), dexamethasone had no effect on scavenger receptor A or Fc gamma receptor II/III levels. An overall hypothesis regarding LPS mediated reductions in Abeta can be proposed: It is not the presence of the LPS molecule, nor the upregulation of receptors involved in phagocytosis, but rather general glial cell activation that mediates Abeta removal. Thus, a phagocytic cell must not only bind Abeta (by various receptors) but must also be capable of engulfing the material (via general cell activation). Taken together, these studies suggest that some level of inflammation in AD is beneficial and responsible for maintaining a balance between amyloid deposition and removal.

Die vorliegende Arbeit befasst sich mit der Synthese und biologischen Testung von Anti-Alzheimer-Substanzen, die nicht nur auf einen Angriffspunkt der Krankheit abzielen, sondern an mehreren krankheitsauslösenden bzw. krankheitsfördernden Punkten inhibierend wirken können. Als Leitstruktur dienten bereits bekannte Acetylcholinesteraseinhibitoren der DUO-Reihe, welche sukzessive abgewandelt wurden, bis die entscheidenden Strukturmerkmale für eine Acetylcholinesterasehemmung herausgefiltert waren. Wichtig für die Interaktion mit der Acetylcholinesterase ist ein quartärer Stickstoff sowie aromatische Reste in seiner näheren Umgebung. Durch die Pyridylen-Hydrazone ist dies gewährleistet. Aufgrund dessen wurde eine Substanzbibliothek synthetisiert, die nun die Acetylcholinesterasehemmung mit einer Inhibition der Fibrillenbildung verbindet. Synthese: Aus 4-Chlorpyridin-Hydrochlorid wurde zuerst die freie Base freigesetzt und diese mit Hydrazin-Hydrochlorid zu 4 Hydrazinylpyridin-Hydrochlorid umgesetzt. Dieses reagierte im nächsten Schritt mit dem entsprechenden Aldehyd in einer SN2-Reaktion zu den Zwischenstufen 2-14, die nun einen variablen Rest an der Hydrazinylgruppe tragen. Im letzten Schritt erfolgte die Quarternisierung mit Hilfe des entsprechenden Alkylbromids, wodurch am Pyridylrest derivatisiert wurde und schlussendlich die Verbindungen 2A-14O erhalten wurden. Dieser letzte Schritt, welcher anfangs durch klassische Erhitzung zum Rückfluss in DMF durchgeführt wurde, konnte zuerst durch die Durchführung im Bombenrohr zeitlich verkürzt werden und schließlich in der Mikrowelle optimiert werden, was zu einer Reduktion der Reaktionszeit von 500 h auf 3 h führte. Die Testung der Substanzen bezüglich ihrer AChE- und BuChE-Hemmung erfolgte mittels Ellman’s Test. Für die Testung der hemmenden Wirkung bezüglich der Fibrillen wurde zuerst das Testsystem mit Aβ (1-42) aufgebaut und anschließend auf ein verkürztes, elf Aminosäuren langes Peptid (HHQKLVFFAED), das mit Hilfe eine Peptidsynthesizers hergestellt wurde, übertragen. Nimmt man nun wieder Bezug auf den „Multi-target-Ansatz“, so lassen sich folgende Ergebnisse festhalten: Die Verbindung eines elektronen-ziehenden Substituenten am Phenylring an der Hydrazonseite mit einem Propylrest zwischen dem Phenylring und dem Pyridinrest ist vorteilhaft für die Kombination der Hemmung der Acetylcholinesterase und der Inhibiton der Aβ-Fibrillen (vgl. 13C). Während viele Substanzen selektiv gegenüber der Acetylcholinesterase sind, gibt es nur wenige, die selektiv die Butyrylcholinesterase hemmen. Eine Hemmung aller drei Angriffspunkte im niedrigen mikromolaren Bereich zeigten nur wenige Substanzen, und zwar die Verbindung mit jeweils einem Naphthylrest sowohl an der Hydrazon- als auch der Pyridin-Seite (14K: IC50 (AChE) = 1.12 µM; IC50 (BuChE) = 2.32 µM; IC50 (Fibrillen) = 2.5 µM). Zusätzlich wurden die Substanzen auf eine mögliche ROS-Hemmung von Kooperationspartnern getestet. Sie zeigten einen kleinen aber signifikanten Beitrag zur Reduzierung der ROS. Um erfolgreiche Wirkstoffe gegen die Alzheimer-Krankheit zu entwickeln, ist deren Blut-Hirn-Schrankengängigkeit von entscheidender Bedeutung. Deshalb wurde von den Substanzen mittels HPLC der logP-Wert bestimmt. Die logP-Werte der Substanzen liegen in einem Bereich von 3.2 bis 4.4. Aufgrund dieser Ergebnisse und der berechneten pKS-Werte, welche im Bereich von 8.3 bis 10.2 liegen, kann davon ausgegangen werden, dass die Substanzen auf Grund der „sink“-Bedingungen die Blut-Hirn-Schranke überqueren können. Um eine definitive Aussage zur Blut-Hirn-Schrankengängigkeit treffen zu können, wurde ein Transwell-System mit cerebralen Endothelzellen entwickelt, die die Blut-Hirn-Schranke simulieren. Die Endothelzellen bilden hierbei eine dichte Monoschicht auf dem Filter aus, wobei die Substanzen nicht zwischen den Zellen hindurch diffundieren können, sondern den Weg durch die Zelle nehmen müssen. Die Messungen ergaben, dass die Substanzen zu ca. 90 % durch die Zellen diffundieren können und somit erfolgreich die Blut-Hirn-Schranke überqueren können. / The thesis is dealing with the synthesis and biological evaluation of substances combating Alzheimer’s disease by using a multi-target approach. Starting point was the lead structure of the known acetylcholinesterase inhibitors of the DUO-series, which was successively modified to filter the crucial structural characteristics of the inhibition of acetylcholinesterase. Important for the interaction with acetylcholinesterase is a quaternary nitrogen as well as an aromatic moiety nearby. This is combined in the pyridylene-hydrazones. Therefore a library of substances has been synthesized and evaluated for the inhibition of acetylcholinesterase and fibril formation. Synthesis: The free base of 4-chloropyridine-hydrochloride was produced and reacted with hydrazine-hydrochloride to give 4 hydrazinylpyridine-hydrochloride. Next, a corresponding aldehyde was added and the intermediates 2-14 including a variable moiety on the side of the hydrazinyl-group, were formed by a SN2-reaction. Finally the quaternization reaction with the corresponding alkylbromide was performed in order to introduce the residues at the side of the pyridyl moiety to achieve the final compounds 2A-14O. This step was carried out by classical heating to reflux in DMF, but could be improved by carrying out the reaction in a pressure vessel and even better in the microwave; here the reaction time could be reduced from 500 h to 3 h. The inhibitory activity of the compounds towards AChE and BuChE were performed with Ellman’s test. In order to determine the inhibition of fibril formation, the Thioflavin T assay was first established with Aβ (1-42) and afterwards transferred to a shortened peptide containing only eleven amino acids (HHQKLVFFAED). This peptide was synthesized with a peptide synthesizer. In summary, combining an electron-withdrawing substituent at the phenyl ring on the site of the hydrazon with a propylene spacer between the phenyl ring an the pyridyl rest is of advantage when both targets – acetylcholinesterase and Aβ fibril formation – should be equally inhibited (see 13C). While many substances are selective towards acetylcholinesterase, only a few inhibit the butyrylcholinesterase selectively. An inhibition of all of the three targets in a low micromolar range of concentration could only be revealed for few compounds, e. g. for compound 14K with naphthyl-substitution on both sides: IC50 (AChE) = 1.12 µM; IC50 (BuChE) = 2.32 µM; IC50 (fibrils) = 2.5 µM). Additionally the substances were tested on a possible ROS-inhibition, however, they showed only little, but significant influence on a reduced production of ROS. In order to develop successfully new compounds against Alzheimer’s disease, their blood-brain-penetration is very important. For this reason the logP-value of the substances has been determined by a HPLC method. The logP-values range from 3.2 to 4.4. Due to these results and the calculated pKA-values, which ranged between 8.3 and 10.2, it can be assumed that the substances are able to cross the blood-brain-barrier because of sink-conditions. In order to verify this statement, a transwell-assay with cerebral endothelial cell monolayer has been developed to simulate the blood-brain-barrier. The measurements of some representative compounds revealed a diffusion rate through the cells of about 90 %, indicating the blood-brain-penetration of the compounds.

This dissertation is a critical examination of the relationship between sleep problems and/or disorders, particularly Obstructive Sleep Apnea (OSA) and Alzheimer Disease (AD). First, I conducted an exhaustive systematic review of existing literature, and identified gaps in research that led to specific research aims. For the first aim, I conducted the first ever-published meta-analysis examining sleep, cognitive decline and AD, providing an aggregate effect of sleep on AD. Second, focusing on OSA, I conducted a study examining OSA’s effect on longitudinal changes on AD biomarkers in cognitive normal, MCI and AD subjects, using data from the Alzheimer Disease Neuroimaging Initiative (ADNI). Lastly, I conducted a review, integrating over 3 decades of research examining OSA and cognition; OSA and subsequent cognitive decline; and OSA and AD; with particular focus in appreciating the heterogeneity of OSA and its outcomes in distinct age groups. Results and implications from my research indicate that ample evidence exists linking sleep impairments and circadian regulating mechanisms directly to clinical symptoms in AD. Sleep problems and/or disorders increases your risk of cognitive decline and AD. OSA is associated with increased AD biomarker burden over time, and effects longitudinal changes in these biomarkers, such that OSA subjects progress faster than non-OSA subjects do. OSA may be age-dependent in older adults (60 – 70 years old) and the elderly (70 years and above) and is associated with neurodegenerative diseases particularly, cognitive decline and AD. Intermittent hypoxia and sleep fragmentation are two main processes by which OSA induces neurodegenerative changes. Therefore, clinical interventions aimed at OSA, such as treatment with CPAP or dental appliances, in cognitive normal and MCI patients, could possibly slow the progression of cognitive impairment to AD.

ABSTRACT Alzheimer's disease (AD) is the most common progressive age related dementia and the fourth major cause of mortality in the elderly in the United States. AD is pathologically characterized by deposition of amyloid beta (Aβ) plaques in the brain parenchyma and neurofibrillary tangles (NFTs) within the neuronal soma. While pharmacological targets have been discovered, current strategies for the symptomatic or disease-modifying treatment of AD do not significantly slow or halt the underlying pathological progression of the disease. Consequently, more effective treatment is needed. One possibility for amelioration is using human umbilical cord blood cell (HUCBC) therapy. HUCBCs comprise a population of hematopoietic stem and progenitor cells. During recent years, functional recovery has been observed from the use of HUCBCs in pre-clinical animal models of brain and spinal cord injuries. Thus, modulation by cell therapy, specifically HUCBCs, may be a suitable treatment for AD and other models because of the observed cognitive and behavioral improvements. The studies presented in this dissertation centers on the suitability of using HUBCs as a potential treatment for AD. Expanding on this, the aims of the study sought to: (I) Investigate bio-distribution of HUCBC transplantation in PSAPP mice, (II) Characterize efficacy and determine therapeutic outcome of HUCBC following short and long term multi injections at early and late disease stages in PSAPP mice and (III) Determine AD-like pathological and cognitive changes associated with multiple HUCBC-derived monocyte (CD14) injections in PSAPP mice. Thus the findings of this work evolved from experiments that characterized the effects of low-dose infusions of HUCBC and HUCBC-derived monocytes into 6 month old Presenilin 1/Amyloid Precursor Protein (PSAPP) plaque-developing transgenic AD mice. Treated mice were studied using standard behavioral tests to determine the effects of infusion on the multiple cognitive domains affected by AD, followed by biochemical and histological analyses that included Aβ load and amyloid precursor protein (APP) processing. Specifically, PSAPP mice and their wild-type (WT) littermates were treated monthly with a peripheral HUCBC infusion over a period of 6 and 10 months, followed by cognitive and motor evaluation. Additionally, based on reports that tumor cells can originate from stem cells present in HUCB, we further examined whether monocytes purified from HUCBCs would have a similar significant effect on the reduction of AD-like pathology in PSAPP mice. HUCB cells homed into tissues including the brain. The principal finding was significant reduction in Aβ levels and β–amyloid plaques following low-dose infusions of both HUCBC– derived mononuclear cells as well as HUCBC-derived monocytes, with the monocytes providing a stronger effect. Results further demonstrated that HUCBC and HUCBC– derived monocyte infusion could improve memory function and locomotor ability in treated PSAPP mice. A possible reason for behavioral improvements in these animals may be the significant reduction in both Aβ levels and plaque load. This study also identified significant reduction in microglial activation and astrocytosis, both of which can contribute to AD pathology. In conclusion, our data suggest that it might be the HUCBC–derived monocytic population rather than stem cells that are responsible for the reduction in AD pathology.