Background
Aberrant protein aggregation is a common feature of late-onset amyloidogenic diseases, such as Alzheimer's disease (AD) and Inclusion Body Myositis (IBM) [
1]. A peptide of 39–43 mer derived from the amyloid precursor protein (APP), the amyloid β-peptide (Aβ), is the main constituent of senile plaques (SPs) in AD [
2], and it is also one of the hallmarks of IBM, a common myopathy characterized by the presence of intracellular amyloid aggregates in skeletal muscle cells [
1,
3]. IBM patients show progressive muscle weakness, compromised muscle innervation [
4] and muscle fibre degeneration [
5]. Besides the presence of senile plaque-like inclusions, most molecules known to be involved in IBM are also present in AD [
6].
Dominant mutations in the APP gene are associated with rare cases of familial AD, in which brain and vascular amyloid deposits are formed earlier than in sporadic cases [
7]. One type of familial AD is linked to a point mutation in the Aβ peptide (E22G, Arctic) that accelerates aggregation of Aβ into protofibrils and fibrils
in vitro [
8‐
12]. Some transgenic mice carrying the Arctic mutation show increased plaque formation but normal learning and memory compared to strains carrying the wild type Aβ [
13]. Opposite to the Arctic variant,
in vitro studies demonstrated that the NIC mutation (V18A), which is predicted to favour the α helix conformation over the β sheet conformation, shows decreased aggregation [
14].
Although APP and Aβ have been implicated in several processes
in vitro and
in vivo, such as neuronal development and cell survival, the
in vivo functions of APP and Aβ remain unclear [
7,
15,
16]. Moreover, the inactivation of the complete APP gene family has shown that APP is necessary for neurodevelopment and cell adhesion [
17]. In addition, neither the
in vivo mechanisms of amyloid formation nor the factors required for this process have been properly established. It is also unknown if the formation of insoluble amyloid aggregates is instrumental for the onset of these amyloidogenic diseases, or if the formation of amyloid structures is the end product of the cell protective machinery. SPs are structured as metal-enriched aggregates that accumulate Cu
2+, Fe
3+, and Zn
2+ [
18‐
20]. In agreement with this, the aggregation state of Aβ-peptide is increased by Cu
2+ or Zn
2+ [
21] and reduced by metal chelators such as clioquinol [
22‐
24]. However, the role of copper as deleterious or beneficial in the context of amyloidogenic diseases is very controversial. For instance, in a transgenic APP23 mouse model, supplementation of the diet with bioavailable copper restored normal levels of SOD-1 activity and decreased the production of soluble Aβ [
25]. From these studies, the structural plasticity of the SP is becoming evident in agreement with previous structural data [
26]. In light of this evidence we postulate that the formation of the SP might be triggered by fluctuations on the levels of transition metals, and could be a part of a protective homeostatic mechanism gone off-course. However, it is unknown if these metals are accumulated in the intracellular amyloid aggregates observed in IBM and if the aggregation state of Aβ is modulated by transition metals in this intracellular muscle environment. Interestingly, IBM patients do not develop dementia and AD patients do not have the muscle weakness characteristic of IBM, which indicates that these diseases may be triggered by independent mechanisms [
1].
Caenorhabditis elegans has an APP homologue but this protein lacks a region equivalent to the Aβ-peptide [
27]. However, several studies carried out in Aβ overexpressing
C. elegans [
6] have established that the formation of amyloid deposits [
28] could induce oxidative stress [
29], stress response [
30,
31] and up- or down-regulation of different genes [
32]. However, the toxic Aβ-species responsible for these effects detected in Aβ-transgenic worms have not been thoroughly identified, but they are likely to be a specific type of Aβ oligomers rather than mature Aβ amyloid aggregates [
33‐
35]. It is important to mention that the paralysis phenotype is only observed in Aβ expressing
C. elegans in a dominant
rol-6 background (strains carrying a mutation in a collagen gene) [
32]. In fact, the great majority of IBM patients show muscle weakness that translates in a lower quality of life but not paralysis or decreased longevity [
36].
In the present work, we evaluated intrinsic and extrinsic factors on the aggregation of intracellular Aβ peptides constitutively overexpressed in muscle cells of
C. elegans. Our results indicate that intracellular Aβ aggregation is selectively affected by single amino acid substitution, which is in agreement with previously published
in vitro data [
14]. Under our experimental conditions, we find that the NIC mutation (V18A) did form fewer Thioflavine-S (ThS)-positive aggregates compared to Aβ wt. Neither non-aggregating Aβ peptide nor aggregating Aβ peptide induced strong paralysis phenotypes in these animals in a wild type background. However, Aβ wild type affected the worms' motility as they aged mimicking the muscle weakness observed in IBM patients. Therefore, we asked the question whether CuCl
2 could modulate the aggregation of intracellular Aβ-peptide in muscle cells, as it is apparent with the extracellular Aβ-peptide in transgenic vertebrate models for AD [
22,
37]. We found that Cu
2+ increases the number of intracellular ThS-positive aggregates present in this model. In contrast, the presence of the Cu-chelators histidine and clioquinol in the growing medium decreases the formation of amyloid deposits. Surprisingly, the Aβ-expressing animals, in spite of producing a great number of amyloid aggregates in the presence of Cu
2+, exhibited increased tolerance to the cytotoxic effects of CuCl
2 compared to control animals. Therefore, the present evidence suggests, for the first time, that intracellular amyloid deposits are dynamically structured by the presence of metals in muscle cells, and that the formation of intracellular Aβ aggregates could be a part of the homeostatic mechanism responsible for protecting cells against abrupt changes in Cu
2+ levels.
Discussion
Most of the studies performed to understand intracellular Aβ aggregation and amyloid formation have been done using
in vitro systems. Therefore, neither the
in vivo mechanisms of amyloid formation nor the factors required for this process have been established [
15]. In the present work, we evaluated intrinsic and extrinsic factors in the aggregation of Aβ peptides constitutively overexpressed in muscle cells of
Caenorhabditis elegans. Under our experimental conditions, we found that Aβ peptide carrying the Arctic (E22G) or the NIC mutation (V18A) did form few ThS-positive aggregates compared to Aβwt. The results obtained with the NIC (V18A) variant are in agreement with previously published
in vitro data [
14]. This mutation is expected to favor the α helix over the β sheet conformation, which would cause a decrease in amyloidosis [
14]. However, the results obtained with the Arctic mutation (E22G) are at variance with the literature [
50]. The initial delay in the formation of aggregates is in agreement with the kinetics of aggregation of the Arctic variant
in vitro in which there is a lag in the formation of amyloid in favor of the development of protofibrils, when compared with the Aβwt [
12]. However, the poor amyloidogenesis in later time points (even lower than the NIC variant) is probably due to low transgene expression since the Arctic variant is known to be highly amyloidogenic as established in studies of transgenic mice expressing this human variant in the nervous system [
13,
50]. Our inability to produce transgenic lines that constitutively express high levels of Aβ Arctic could be related to the deleterious effect of high levels of this variant during embryonic stages that may have preclude us from obtaining such strains. On the other hand, the immunofluorescence experiments show that much of the Aβ Arctic is aggregated in what appears to be amorphous deposits. Perhaps, there are muscle expressed factors that prevent the formation of mature amyloid deposits of the Aβ Arctic variant.
In our model, Aβwt peptide expression induced a clear decrease in the worms' motility (Fig.
6), which could be compared to the progressive muscle weakness present in IBM patients. The lack of muscle degeneration observed in the Aβwt expressing animals suggests that the Aβ peptide might not be sufficient to induce a stronger myopathy by itself in the muscle cells of worms, and that extra factors might be needed to fully replicate IBM symptoms in
C. elegans. The situation could be very similar to that seen in triple transgenic mice models for AD, where mice need to overexpress Aβ together with Tau and presenilin (all mutant variants) to replicate the brain human features characteristic of the pathology [
51]. Therefore, Aβ apparently needs to act with other factor/s present in the muscle to fully induce IBM symptoms in worm muscle [
1].
We also showed that Cu
2+ and the Cu
2+ chelators histidine and clioquinol can modulate the formation of intracellular amyloid aggregates in
C. elegans muscle cells. Copper ionophores like clioquinol and PBT2 show benefits in transgenic mouse models and phase 2 clinical trials of AD [
22,
24,
52]. Despite the differences in cellular location, intracellular Aβ aggregation in
C. elegans seems to be enhanced by Cu
2+ and diminished by histidine and clioquinol in accordance with previous
in vitro and
in vivo reports [
22,
23]. The increased amyloidosis could also be the result of higher Aβ expression brought about by Cu exposure and lower Aβ expression caused by Cu-chelator treatment. This situation is not likely to be the case because the constitutive
unc-54 promoter is driving Aβ expression. Moreover, it has been shown that in addition to aggregated Aβ-peptide there is an important pool of soluble peptide in worms expressing Aβ [
30]. Therefore, increased peptide synthesis is not necessary for an eventual increment in Aβ for interaction and subsequent aggregation in the presence of Cu
2+. We did, however, evaluate Aβ expression in worms subjected to the different treatments by semi-quantitative RT-PCR and found that there were no significant differences in its expression (data not shown). Therefore, these results support a pivotal role of Cu
2+ in the aggregation state of intracellular Aβ.
In the present study, the animals were treated continuously with CuCl
2, histidine or clioquinol since they were embryos; at this stage there is no Aβ aggregation that can be observed by ThS staining although some aggregates have been detected with the X-34 dye [
41]. Therefore, we have yet to establish whether treating animals with histidine or clioquinol later in life, once a significant number of deposits have been formed, can eliminate or reduce the number and/or size of the aggregates. Although we have shown an effect of Cu
2+, histidine and clioquinol on the formation of intracellular amyloid deposits in muscle cells by histochemical staining with ThS, we have not yet resolved the question of the relative concentrations of soluble versus insoluble aggregated Aβ and their changes upon treatment with Cu-chelators. It would be very informative to clarify this point by double staining with ThS or X-34 to visualize the deposits, and Aβ antibodies that recognize both soluble and insoluble forms of the amyloid peptide. This experiment would clarify whether Cu
2+ and Cu-chelators influence the equilibrium between both Aβ forms.
The differences observed among individuals exposed to the same treatments could be due to the developmental stage at which the animals start their exposure to the different agents. Even though we start the treatments on embryos, there is some difference in the actual developmental stage of the embryo (data not shown). Although this is a possibility, we do not think it is the case, since we have observed similar differences in animals cultured on standard medium. It is unlikely that the differences observed between same age individuals are due to genetic background. Self-fertilizing reproduction in
C. elegans precludes much genetic variation in the strains. The strains used in our studies are transgenic strains in which several copies of Aβ had been integrated into the genome. However, integration of a transgene into the genome does not always prevent mosaicism and/or differences in expression between individuals [
53].
Another caveat is that we do not know if there is enrichment of metals (Cu, Zn and others) in the intracellular amyloid deposits of
C. elegans muscle cells as is the case in the extracellular amyloid aggregates found in AD affected neuronal tissue [
20]. The determination of metal levels in the muscle aggregates would be an important step in drawing a firmer analogy between AD extracellular brain aggregates and intracellular muscle deposits.
Perhaps the most striking finding is that the Aβ-expressing animals, in spite of producing great number of amyloid aggregates in the presence of Cu
2+, exhibited increased tolerance to the cytotoxic effects of CuCl
2 compared to control animals and suggests that there might be less metal available to produce cell damage in this strain. The results from the behavioural experiments together with the results obtained in the toxicity assays offer strong evidence that Aβ may be providing protection to Cu
2+ toxicity. Interestingly, the Aβ expressing worms that were exposed to CuCl
2 move better than those that were not cultured in the presence of this transition metal, suggesting that perhaps the increase in amyloid deposits in these treated worms is limiting the amount of the more toxic oligomeric species [
33‐
35]. Our findings connect with those of other authors showing that increased Aβ deposition associates with decrease levels of neuronal oxidative damage in Down Syndrome and AD [
54‐
57]. It has also been suggested that the chelation of redox-active copper and iron may be the most important mechanism by which Aβ exerts its protective function [
58], and that at moderate copper concentrations, Aβ acts as an antioxidant to prevent Cu
2+ catalyzed oxidation of biomolecules [
59]. The levels of intracellular copper must be strictly regulated to prevent aberrant reactive oxygen species generation resulting in neuronal and muscle damage. In fact, intracellular free copper has been estimated to be almost nil [
60], and is under the control of a robust metalloprotein array that rapidly and efficiently buffers free copper bioavailability. However, this protein array is clearly altered in age-related diseases such as Alzheimer's disease [
61], which may explain why copper is accumulated in amyloid plaques of people suffering of this disease [
20]. Moreover, a more recent report described that total brain copper levels increase in aged mouse [
62]. Considering that age is a risk factor for AD neuropathology, brain copper rise in elderly humans may be one of the neurochemical factors relevant in the onset of AD. Moreover, cellular acidosis could facilitate the release of copper from metal binding proteins [
63]. Interestingly, brain acidosis is observed in AD [
64], which may facilitate the release of copper from copper-binding proteins increasing the formation of Aβ-Cu aggregates. This may be also part of the mechanism that increases copper bioavailability in IBM.
Therefore, the present evidence suggests that intracellular amyloid deposits are dynamically structured by metals, and that Aβ may be a component of the system that specifically controls copper homeostasis at the cellular level [
65‐
67].
Much research has been done on the possible role of copper and other metals such as zinc and iron on the development of AD, but so far no consensus has been reached in terms of the specific involvement of copper in this pathology, and conflicting reports point either to a deleterious role of copper [
68] or a beneficial one [
25]. Moreover, there is practically no data available about the possible role of metal homeostasis on other disorders characterized by amyloidosis such as sporadic IBM.
Acknowledgements
We thank Dr. Christopher Link (University of Colorado, Boulder, USA) for his generous gift of C. elegans strains and plasmid pCL12 and Dr. Jeremy Nance (New York University, New York, USA) for plasmid pJN254. We also thank Andrea S. Boccardo for technical assistance.
Some nematode strains used in this work were provided by the Caenorhabditis Genetics Center, which is funded by the NIH National Center for Research Resources (NCRR). This work was supported by the International Copper Association (ICA, New York, N.Y.), FONDAP-Biomedicine grant N° 13980001, Millennium Institute of Fundamental and Applied Biology (MIFAB), the Center for Aging and Regeneration (CARE), PFB 12/2007, Base Financing Program for Scientific and Technological Centers of Excellence, CONICYT, the Alzheimer's Association, the NHMRC and the NIA (R01AG12686 to AIB).
Competing interests
AIB is a shareholder; consultant and Scientific Advisory Board member of Prana Biotechnology Ltd. CM is a director of Prana Biotechnology Ltd., Chairperson of its Scientific Advisory Committee and stockholder. IV and RC declare competing financial interests associated to Prana Biotechnology LTD.
Authors' contributions
ANM participated in the design and coordination of the study, carried out the Aβ aggregation experiments, the toxicity assays, and drafted the manuscript, DLR performed the behavioural studies, the quantification of amyloid deposits and the statistical analysis, PMG carried out the in vitro mutagenesis and constructed the transgenic strains, RF contributed with the medical aspects of the study, RA performed the lifespan experiments and analysis, IV and RAC performed the metal quantifications, CO participated in the design and coordination of the study, CM participated in the design of the study, AIB participated in the design and coordination of the study and helped draft the manuscript, NCI conceived the study, participated in its design and coordination of the manuscript. All authors read and approved the final manuscript.