Evidence for the role of gonadotropin hormones in the development of Alzheimer disease.

Differences in the prevalence and age of onset of Alzheimer disease (AD) in men and women, and observations that hormone replacement therapy (HRT) may prevent the development of AD, caused many to hypothesize that estrogen deficiency contributes to AD. However, recent trials using estrogen failed to show any benefit in preventing or alleviating the disease. To address this and other inconsistencies in the estrogen hypothesis, we suspect that another hormone of the hypothalamic-pituitary-gonadal axis, luteinizing hormone (LH), as a major factor in AD pathogenesis. Individuals with AD have elevated levels of LH when compared with controls, and both LH and its receptor are present in increased quantities in brain regions susceptible to degeneration in AD. LH is also known to be mitogenic, and could therefore initiate the cell cycle abnormalities known to be present in AD-affected neurons. In cell culture, LH increases amyloidogenic processing of amyloid-beta protein precursor, and in animal models of AD, pharmacologic suppression of LH and FSH reduces plaque formation. Given the evidence supporting a pathogenic role for LH in AD, a trial of leuprolide acetate, which suppresses LH release, has been initiated in patients.

Mitotic and gender parallels in Alzheimer disease: therapeutic opportunities.

In this review, we discuss the role of cell cycle dysfunction in the pathogenesis of Alzheimer disease and propose that such mitotic catastrophe, as one of the earliest events in neuronal degeneration, may, in fact, be sufficient to initiate the neurodegenerative cascade. The question as to what molecule initiates cell cycle dysfunction is now beginning to become understood and, in this regard, the gender-predication, age-related penetrance and regional susceptibility of specific neuronal populations led us to consider luteinizing hormone as a key mediator of the abnormal mitotic process. As such, agents targeted toward luteinizing hormone or downstream sequelae may be of great therapeutic value in the treatment of Alzheimer disease.

Endothelin and dopamine release.

Endothelins and endothelin receptors are widespread in the brain. There is increasing evidence that endothelins play a role in brain mechanisms associated with behaviour and neuroendocrine regulation as well as cardiovascular control. We review the evidence for an interaction of endothelin with brain dopaminergic mechanisms. Our work has shown that particularly endothelin-1 and ET(B) receptors are present at significant levels in typical brain dopaminergic regions such as the striatum. Moreover, lesion studies showed that ET(B) receptors are present on dopaminergic neuronal terminals in striatum and studies with local administration of endothelins into the ventral striatum showed that activation of these receptors causes dopamine release, as measured both with in vivo voltammetry and behavioural methods. While several previous studies have focussed on the possible role of very high levels of endothelins in ischemic and pathological mechanisms in the brain, possibly mediated by ET(A) receptors, we propose that physiological levels of these peptides play an important role in normal brain function, at least partly by interacting with dopamine release through ET(B) receptors.

Endothelin induces dopamine release from rat striatum via endothelin-B receptors.

The aim of the present study was to determine whether local administration of endothelin induces the release of dopamine in the rat striatum and to characterize and localize endothelin receptors in this brain region. Local injection of endothelin-1 (10 pmol) into the ventral striatum of urethane-anaesthetized rats caused an increase of 8 microM in the extracellular concentration of dopamine as measured by in vivo chronoamperometry. The peak increase in dopamine concentration occurred within 5 min of endothelin injection. Injection of the selective endothelin-B receptor agonist [Ala1.3,11.15]endothelin-1 (10 pmol) also caused an increase in extracellular dopamine concentration, suggesting that endothelin is acting at the endothelin-B receptor to elicit its effect. In rats with unilateral 6-hydroxydopamine lesions of the nigrostriatal pathway, the response to local injection of endothelin-1 (10 pmol) was significantly inhibited on the lesioned side as compared to the non-lesioned side. In contrast, pretreatment of the rats with the N-methyl-D-aspartate receptor antagonist dizocilpine maleate (5 mg/kg, i.p.) or the nitric oxide synthase inhibitor NG-nitro-L-arginine (3 mg/kg, i.p.) did not alter the endothelin-induced release of dopamine. In binding studies, addition of endothelin-1 displaced [125I]endothelin-1 with a Ki of 220 pM. The endothelin-B receptor antagonist BQ788 displaced [125I]endothelin-1 with a Ki of 120 nM, whereas the endothelin-A receptor antagonist BQ123 produced only a 25% displacement at 10 microM, suggesting that endothelin receptors in the striatum are of the endothelin-B subtype. In rats with unilateral 6-hydroxydopamine lesions of the nigrostriatal dopamine system, [125I]endothelin-1 binding was reduced by 53% in lesioned striatum compared to non-lesioned striatum, with no difference in the Kd. These data provide evidence that endothelin acts on a homogeneous population of endothelin-B receptors within the striatum to cause the release of dopamine and that a significant proportion of these receptors is located on dopaminergic neurons.

Endothelin interactions with brain dopamine systems.

We examined the interactions of endothelin (ET) with dopaminergic systems in rat brain. Using HPLC and radioimmunoassay, we found that striatum contained the highest levels of predominantly ET-1, whereas highest levels of predominantly ET-3 were found in the pituitary. Dopamine depletion in the striatum did not change the levels of immunoreactive ET, even though we have previously found a decrease in the density of ET receptors. In a comparison of spontaneously hypertensive rats (SHR) with Wistar-Kyoto (WKY) rats, ET levels were lower in cerebellum and medulla, with no difference in striatum or in other brain areas. In conclusion, ET is present in high levels in striatum, but these levels are not affected by dopamine depletion or in SHR.

Intrastriatal injection of endothelin evokes dopaminergic turning behaviour in rats through activation of the ETB receptor.

Contralateral intrastriatal injection of 0.1 pmol or 1 pmol of endothelin-1 produced ipsilateral turning behaviour in rats with unilateral 6-hydroxydopamine (6-OHDA) lesions of the nigrostriatal pathway. This effect could be abolished by pretreatment with either the endothelin ETA/B receptor antagonist bosentan (1 nmol, intrastriatally) or the dopamine D2 receptor antagonist raclopride (0.1 mg/kg, s.c.) suggesting that endothelin is acting at endothelin receptors to evoke ipsilateral turning behaviour and that this response is mediated by dopamine. Similar ipsilateral turning behaviour was observed upon intrastriatal injection of 1 pmol of endothelin-3 or the specific ETB receptor agonist, [Ala1,3,11,15]endothelin-1 when compared to endothelin-1. Pretreatment with the specific ETB receptor antagonist BQ788 blocked the ipsilateral turning response to intrastriatal injection of endothelin-1 while pretreatment with the specific ETA receptor antagonist BQ123 did not significantly change the response to injection of endothelin-1. This indicates that endothelin-1, which has affinity for both ETA and ETB receptors, is most likely acting at the ETB receptor to elicit its effect. These results suggest that low doses of endothelin may act at ETB receptors to evoke the release of dopamine from the striatum in vivo.