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Gleevec for Alzheimer's?
1 October 2003. Gleevec, the cancer "wonder drug" that has proven effective for gastrointestinal stromal tumors might also be useful for Alzheimer's patients, if only one could deliver it to the brain effectively, according to a paper in this week's early online edition of PNAS.

Principal author Paul Greengard, and colleagues from The Rockefeller University and the Memorial Sloan-Kettering Center, both in New York, report that the kinase inhibitor, whose chemical name is imatinib mesylate, reduces γ-secretase cleavage of Aβ precursor protein (AβPP) without affecting Notch processing. The latter is fortuitous, as potential interference with Notch signaling and other pathways is one of the obstacles impeding the search for γ-secretase-targeted therapeutics (see ARF related news story), ARF news story, and scroll to Shearman in Titisee conference report).

Gleevec inhibits Abl, and several other tyrosine kinases, by blocking the enzymes' ATP binding site. Greengard and colleagues had previously shown that in a cell-free system consisting of mouse N2a neuroblastoma membranes, the γ-secretase cleavage of AβPP is ATP dependent. This prompted joint first authors William Netzer, Fei Dou, and Dongming Cai to try blocking the ATP-dependent step in the production of Aβ. When the authors added Gleevec to either the cell-free system or to N2a cells themselves, production of Aβ decreased by 50 percent. In contrast, the quantity of Notch's intracellular domain produced by the N2a cells remained constant.

The authors found that Gleevec was primarily, if not exclusively, affecting the γ-secretase step of Aβ production because it had no effect on the level of the β-secretase-generated C-terminal fragment (CTF) of AβPP. In addition, when they added Gleevec to N2a cells expressing this CTF, Aβ production was still blocked, though not as robustly as in cells expressing full-length AβPP.

When Netzer and colleagues added the kinase inhibitor to cultured primary neurons, they found a similar effect. Five μM Gleevec inhibited Aβ production by 75 percent, while the similar ATP site blocker PD173955 worked even better, inhibiting by 80 percent at a fivefold lower dose. In vivo, the kinase inhibitors were also effective. When the authors administered as little as 0.2 mg/Kg of either drug into the brains of adult albino guinea pigs, cortical levels of Aβ dropped by over half, while the levels of the β-secretase CTF rose by as much as fourfold. These results, which were statistically significant, suggest that γ-secretase cleavage can be effectively halted in vivo.

How Gleevec works in this context is uncertain. The authors show that it is just as effective at inhibiting γ-secretase in Abl-negative cells, and suggest that other tyrosine protein kinases, such as platelet-derived growth factor receptor (PDGFR) or Src kinase, may be involved. Intriguingly, Tommaso Russo's group has just reported that PDGFR and Src kinase may play a role in Aβ production (see Gianni et al., 2003).

Gleevec has FDA approval, and the authors write that "the safety of Gleevec, demonstrated by its successful application to […] tumors, and its inability to inhibit Notch-1 cleavage by γ-secretase, make this class of compounds attractive as potentially safe, Aβ-lowering drugs." If, that is, ways can be found to get them across the blood-brain barrier.—Tom Fagan.

Reference:
Netzer WJ, Dou F, Cai D, Veach D, Jean S, Li Y, Bornmann WG, Clarkson B, Xu H, Greengard P. Gleevec inhibits {beta}-amyloid production but not Notch cleavage. Proc Natl Acad Sci U S A. 2003 Oct 1 [Epub ahead of print]. Abstract

 
Comments on News and Primary Papers
  Comment by:  Tommaso Russo, ARF Advisor
Submitted 2 October 2003  |  Permalink Posted 3 October 2003
  I recommend the Primary Papers

The findings described in the paper of Netzer et Al. demonstrating that STI571/Gleevec inhibits Ab production in vivo are of significant interest at least for two reasons: the drug does not affect Notch processing and it is currently used in humans for the treatment of CML. However, another reason why this observation is of interest is that it probably contributes to our understanding of the regulation of APP processing. In agreement with the results of the Paul Greengard’s group, we have recently reported (Gianni et Al. J. Biol. Chem. 278, 9290, 2003) that the processing of APP is regulated by PDGF-BB, through a pathway including, downstream the PDGF-R, the non-receptor tyrosine kinase Src and the small G-protein Rac. We also demonstrated that a specific inhibitor of Src TK (PP2) inhibits Ab production in cultured cells. Considering that Abl appears to be not involved in the observed phenomena, it is possible to speculate that Gleevec is working as a Src TK inhibitor. In my opinion, these results open a new stimulating scenario, and many points should be now addressed. Just to...  Read more

  Comment by:  Larry Nault
Submitted 2 October 2003  |  Permalink Posted 5 October 2003
  I recommend the Primary Papers

This seems significant. Surprised it has not been tried, and reported, on transgenic mice.

View all comments by Larry Nault

  Primary Papers: Gleevec inhibits beta-amyloid production but not Notch cleavage.

Comment by:  Dennis Selkoe (Disclosure), Michael Wolfe, ARF Advisor, Weiming Xia
Submitted 9 October 2003  |  Permalink Posted 9 October 2003

The findings of Netzer and colleagues that Gleevec and related protein kinase inhibitors can lower formation of the amyloid-β protein (Aβ) opens a new avenue for Alzheimer's research. The investigation was prompted by previous observations that Aβ production is ATP-dependent. Gleevec, recently approved for treating chronic myelogenous leukemia, is a potent inhibitor of Abl kinase and is among the first anti-cancer drugs that target oncogenes and their protein products. Netzer et al. show that Gleevec and another Abl kinase inhibitor reduce Aβ levels in permeabilized cells, living cells, and the guinea pig brain. Evidence indicates that the drugs affect the proteolysis of the Aβ protein precursor (APP) by γ-secretase but not by β-secretase. Importantly, the processing of another γ-secretase substrate, the Notch receptor, is not affected. Concerns have been raised about γ-secretase as a therapeutic target because proteolysis of Notch is essential for proper cell differentiation, for instance, during the formation of new blood cells. Thus, selective inhibition of Aβ production that...  Read more

  Comment by:  Mary Reid
Submitted 8 October 2003  |  Permalink Posted 10 October 2003
  I recommend the Primary Papers

I would like to bring to your attention to my poster last July. I also forwarded my proposal to the developers at Novartis at that time, detailing reasons why Gleevec may well prove to be a beneficial treatment for those with Alzheimer's disease and Down's syndrome.

It is of interest that Dai et al. have shown entry of Gleevec into the brain to be modulated by P-glycoprotein. Perhaps we could approach treatment of Alzheimer's disease with that in mind.

Reference:
Dai H, Marbach P, Lemaire M, Hayes M, Elmquist WF. Distribution of STI-571 to the brain is limited by P-glycoprotein-mediated efflux. J Pharmacol Exp Ther. 2003 Mar;304(3):1085-92. Abstract

View all comments by Mary Reid


  Comment by:  Mary Reid
Submitted 12 October 2003  |  Permalink Posted 22 October 2003

Further to my comment of October 8, I note the study by Boucher et al. (1) in which they find that inactivation of LRP1 in vascular SMCs results in PDGFR overexpression.

In view of the study by Meng et al., (2) finding that SHP-2 is necessary to inhibit PDGFR signaling, and that H2O2 inactivates protein tyrosine phosphatases, might we expect that oxidative stress in Alzheimer's disease and Down's syndrome may result in SHP-2 inactivation?

References:
1. Boucher P, Gotthardt M, Li WP, Anderson RG, Herz J. LRP: role in vascular wall integrity and protection from atherosclerosis. Science. 2003 Apr 11;300(5617):329-32. Abstract

2. Meng TC, Fukada T, Tonks NK. Reversible oxidation and inactivation of protein tyrosine phosphatases in vivo. Mol Cell. 2002 Feb;9(2):387-99. Abstract

View all comments by Mary Reid


  Comment by:  Mary Reid
Submitted 28 October 2003  |  Permalink Posted 31 October 2003

It seems of interest that Liu and Burridge (1) have found that EGF and PDGF stimulate tyrosine phosphorylation of Vav2 with subsequent increased activity of Cdc42 downstream from growth factor receptors. Might we expect decreased activity of Cdc42 following treatment with Gleevec? Zhu et el (2) have found that Cdc42 is upregulated in select neuronal populations in Alzheimer's disease. Etienne-Manneville and Hall (3) find that Cdc42 regulates GSK-3beta and adenomatous polyposis coli to control cell polarity. Leroy et el (4) find increased adenomatous polyposis coli immunoreactivity in reactive astrocytes in Alzheimer's disease. p120 catenin binds Vav2 (5). Baki et el (6)find that PS1 and p120 bind to and mutually compete for cellular E-cadherin. 1)Mol Cell Biol. 2000 Oct;20(19):7160-9. Vav2 activates Rac1, Cdc42, and RhoA downstream from growth factor receptors but not beta1 integrins. Liu BP, Burridge K. Department of Cell Biology and Anatomy, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7090, USA. bliu@med.unc.edu The Rho family...  Read more
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