Delayed Clinical Manifestation of Parkinson's Disease Among Physically Active: Do Participants in a Long-Distance Ski Race Have a Motor Reserve?

BACKGROUND: Physical activity is associated with reduced risk of Parkinson's disease (PD). The explanations for this association are not completely elucidated. We use long-term PD-incidence data from long-distance skiers to study the relationship between exercise and PD. OBJECTIVE: We aimed to investigate if physical activity is associated with long-term lower risk of PD and if this association could be explained by physically active people being able to sustain more PD neuropathology before clinical symptoms, a motor reserve. METHODS: Using a prospective observational design, we studied whether long-distance skiers of the Swedish Vasaloppet (n = 197,685), exhibited reduced incidence of PD compared to matched individuals from the general population (n = 197,684) during 21 years of follow-up (median 10, interquartile range (IQR) 5-15 years). RESULTS: Vasaloppet skiers (median age 36.0 years [IQR 29.0-46.0], 38% women) had lower incidence of PD (HR: 0.71; 95 % CI 0.56-0.90) compared to non-skiers. When reducing risk for reverse causation by excluding PD cases within the first five years from race participation, there was still a trend for lower risk of PD (HR: 0.80; 95 % CI 0.62-1.03). Further, the PD prevalence converged between skiers and non-skiers after 15 years of follow-up, which is more consistent with a motor reserve in the physically active rather than neuroprotection. CONCLUSIONS: A physical active lifestyle is associated with reduced risk for PD. This association weakens with time and might be explained by a motor reserve among the physically active.

Prion-like seeding and nucleation of intracellular amyloid-ß.

Alzheimer's disease (AD) brain tissue can act as a seed to accelerate aggregation of amyloid-ß (Aß) into plaques in AD transgenic mice. Aß seeds have been hypothesized to accelerate plaque formation in a prion-like manner of templated seeding and intercellular propagation. However, the structure(s) and location(s) of the Aß seeds remain unknown. Moreover, in contrast to tau and α-synuclein, an in vitro system with prion-like Aß has not been reported. Here we treat human APP expressing N2a cells with AD transgenic mouse brain extracts to induce inclusions of Aß in a subset of cells. We isolate cells with induced Aß inclusions and using immunocytochemistry, western blot and infrared spectroscopy show that these cells produce oligomeric Aß over multiple replicative generations. Further, we demonstrate that cell lysates of clones with induced oligomeric Aß can induce aggregation in previously untreated N2a APP cells. These data strengthen the case that Aß acts as a prion-like protein, demonstrate that Aß seeds can be intracellular oligomers and for the first time provide a cellular model of nucleated seeding of Aß.

A cell culture model for monitoring α-synuclein cell-to-cell transfer.

The transfer of α-synuclein (α-syn) between cells has been proposed to be the primary mechanism of disease spreading in Parkinson's disease. Several cellular models exist that monitor the uptake of recombinant α-syn from the culture medium. Here we established a more physiologically relevant model system in which α-syn is produced and transferred between mammalian neurons. We generated cell lines expressing either α-syn tagged with fluorescent proteins or fluorescent tags alone then we co-cultured these cell lines to measure protein uptake. We used live-cell imaging to demonstrate intercellular α-syn transfer and used flow cytometry and high content analysis to quantify the transfer. We then successfully inhibited intercellular protein transfer genetically by down-regulating dynamin or pharmacologically using dynasore or heparin. In addition, we differentiated human induced pluripotent stem cells carrying a triplication of the α-syn gene into dopaminergic neurons. These cells secreted high levels of α-syn, which was taken up by neighboring neurons. Collectively, our co-culture systems provide simple but physiologically relevant tools for the identification of genetic modifiers or small molecules that inhibit α-syn cell-to-cell transfer.

ß-Amyloid peptides and amyloid plaques in Alzheimer's disease.

Many lines of evidence support that ß-amyloid (Aß) peptides play an important role in Alzheimer's disease (AD), the most common cause of dementia. But despite much effort the molecular mechanisms of how Aß contributes to AD remain unclear. While Aß is generated from its precursor protein throughout life, the peptide is best known as the main component of amyloid plaques, the neuropathological hallmark of AD. Reduction in Aß has been the major target of recent experimental therapies against AD. Unfortunately, human clinical trials targeting Aß have not shown the hoped-for benefits. Thus, doubts have been growing about the role of Aß as a therapeutic target. Here we review evidence supporting the involvement of Aß in AD, highlight the importance of differentiating between various forms of Aß, and suggest that a better understanding of Aß's precise pathophysiological role in the disease is important for correctly targeting it for potential future therapy.