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Vol.3/Issue4/July-August 2021 Inter. J.

Pharma O2 ISSN: 2582-4708

International Journal of PharmaO2


Journal Home Page: http://www.ijpo.in/
(IJPO: A Peer-reviewed Bi-monthly online journal)

Review Article
Experimental Models for Elucidating the Pathogenesis of Alzheimer’s
Disease: A Brief Review.
Gopavaram Sumanth*2, Hemraj Singh1, Pooja Prakash Atpadkar2
1
Department of Pharmacology, National Institute of Pharmaceutical Education and Research
(NIPER)-Raebareli, Lucknow, India
2
Department of Medicinal Chemistry, National Institute of Pharmaceutical Education and Research
(NIPER)-Raebareli, Lucknow, India.

ARTICLE INFO ABSTRACT


Article history: Alzheimer’s disease (AD) is one of the leading factors of dementia and
Received: 27/05/2021; other cognitive problems despite that there is no curative treatment for the
Revised: 28/05/2021 cure of that disease currently. This is mainly due to the pathological
Accepted: 11/06/2021; features of disease accompanied by the extracellular senile plaques and
Available online: also the intracellular neurofibrillary tangles which leads to synaptic as
01/07/2021.
well as neuronal loss. This feature occurs prior to memory loss which is
Key Words: irreversible and becomes severe at the stage of clinical diagnosis. At this
Alzheimer’s stage experimental models of AD proved to be better tool in achieving
Disease, some of the novel therapeutic approaches and also in the development of
pathogenesis, pathogenic knowledge about the disease. The most commonly used animal
experimental models model is APP transgenic mice. This model directly corelates the
accumulation of senile plaques leading to the disease by expressing the
Please cite this genes associated with the familiar AD. This experimental model proved to
article as: Sumanth, be a useful tool for therapeutic screening. Although these models are not
G. (2021). highly efficient in revealing the disease but they gave us an insight idea
Experimental Models
about the pathological changes which occur in AD. In this report we will
for Elucidating the
Pathogenesis of
discuss about the different models used and how they are helpful in
Alzheimer ’s disease: revealing the pathogenesis of AD.
A Brief Review.
3(4), 0149- 0157.
©2021 Published by International Journal of PharmaO2. This is an open access article.
*
Corresponding author: Gopavaram Sumanth,Department of Medicinal Chemistry, National Institute of Pharmaceutical
Education and Research (NIPER)-Raebareli, Lucknow – 226002, UP, India. Contact: 9642885925, e-mail:
sumanth925@gmail.com

INTRODUCTION cause of death in just a short era. Clinical


It is the brain neurodegenerative disorder symptoms associated with AD are impaired
associated with dementia (Adav SS and Sze movement, mood disability and change in
SK, 2016). It has so much influenced the personality. This disease was first time
society that it has become the fourth leading discovered by Alois Alzheimer in 1906 in the

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patient Augustine deter. In him he found some inserted which clearly depicts the correlation of
kind of mental illness accompanied with senile plaques with Alzheimer’s. another model
hallucinations, delusions and cognitive named tau transgenic mice also shows the
impairment. Pathophysiological cause of this formation of NFTdue to the mutation in the tau
illness came into light by doing histopathology protein related gene expression (Lewis J et al,
of that patient brain which confirms the 2001). Non transgenic model consists of high
presence of senile plaques and the fat diet(HFD) induced model in which high
neurofibrillary tangles in the cerebral cortex fatty diet induced hypercholesteremia
responsible for the neuronal cell death and responsible for the inflammation
causing mental illness (Selkoe DJ, 2004; accompanying the AD. The in-vitro models are
Blessed G et al, 1968). Basically, in Alzheimer followed by cell model and tissue model which
neurodegeneration is attributed to extracellular proved to be of greater advantage and efficient
formation of amyloid beta which further causes method in studying the pathogenesis of AD
the formation of senile plaques and (Gong CX et al, 2001).
intracellularly the phosphorylation of tau
protein leads to fibrillation of tangles forming PATHOGENESIS
neurofibrillary tangles (NFT). These all- The age of onset as well as the rate of
pathological changes cause the synaptic to occurrence varies from person to person owing
dysfunction and cortical atrophy thus, leading to its complex and multifactorial nature. In this
to neuronal cell death. It is not always basically degeneration of neurons takes place
necessary that these pathological changes take accompanies with many histological changes in
place before the appearance of symptoms. They brain. Neuron’s degeneration takes place
can also take place earlier providing us the mainly due formation of extracellular senile
implementation time for the strategies to target plaques and intracellular neurofibrillary tangles
the target for the treatment of AD. Age is the formation. amyloid precursor protein
main factor affecting the occurrence of the responsible for neuron growth and repair
disease. With increase in age, the progression undergo breakdown by amyloidogenic
of Alzheimer also takes place. It becomes pathway. In the presence of beta and gamma
double at the age of 65 and 50 percent chances secretase amyloid gets break down into
are there at the age of 85 (Alzheimer’s A, amyloid monomers and then aggregate to form
2015).The probability of AD does not depend oligomers. This oligomers accumulation leads
upon the gender. It has equal probability of to dysfunction of neurons and ultimately
occurrence whether it’s a men or women. leading to their degeneration (Park SA et al,
Genetic factors also play a major role in the 2009). Normally, this amyloid beta breakdown
pathogenesis of AD. They are down syndrome, takes place by phagocytosis by microglia or
mutation in the presenilin gene and expression with the help of protein nephrilysin, so any
of the apolipoprotein (APOEe4) allele. Some of change in these activities leads to formation of
the AD forms were the result of gene mutation. amyloid oligomers and later on their
This led the researchers to develop genetically accumulation leads to AD. Second main
modified animals that could be helpful in pathological reason for the AD is formation of
depicting the features as well as the NFT. Basically, micro-tubules are responsible
pathogenesis of AD. They are also useful for to from cell highway to transport cellular
testing new therapeutics in preclinical trials. production from soma to axon terminal
Various models were developed with the help followed by retrograde and anterograde
of genetic technology to depict the pathway. Tau protein is responsible for the
pathogenesis of Alzheimer. the models stabilization of these micro-tubules during, AD
developed were transgenic, non-transgenic and amyloid beta activates protein kinase which
in-vitro models. Transgenic models consist of phosphorylates the tau protein leading to its
APP transgenic mice in which the mutated detachment from the microtubule and causing
amyloid precursor protein(APP) gene is them to dissemble and itself form NFT (Blasko
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I et al, 2004). These tangles disrupt the  Mutation in the pre senillin 1 2 genes
transport mechanism and neurons begin to die. (Obulesu M et al 2011)
Many genetic factors are also responsible for  Inheritance of the APOE e4 allele (Sing
the aggravation of the above pathological CF and Davignon J, 1985)
causes like
 Down syndrome

Amyloid precursor
APOE e4 allele Enabled risk factor
protein
Presenilin genes
Down syndrome

AMYLOID BETA Neuron’s degeneration


Tau phosphorylation FORMATION

SENILE PLAQUES

CLINICAL SYMPTOMS Cholinergic dysfunction


Neurofibrillary tangles

Fig.1: Schematic design of pathophysiological cascade of Alzheimer ’s disease

In this pathophysiological cascade flow chart, it EXPERIMENTALMODELS


is clearly depicted the main cause of AD and Experimental models play a major role in
the various other factors contributing to understanding the pathogenesis and also for the
aggravate these pathophysiological causes. preclinical testing of therapeutics. Between a
Also, it clearly represents the various genetic vast majority of animal models, transgenic
factors contributing as one of the major causes mouse is mainly used in depicting the
in developing AD. The genetic factors like pathogenesis of disease by expressing the
down syndrome in which trisomy of 21st human genes responsible for the amyloid beta
chromosome takes place which is responsible plaques formation. The gene responsible for
for the expression of genes responsible for the plaque formation is human APP and for the
AD. tangles it is human microtubule associated
protein tau (MAPT) (Boutajangout A and
ETIOLOGY Wisniewski T, 2014). Animal models basically
AD destroys the neurons of the brain that explicit the changes occurring in the AD
control the memory, including the proving as an advantage over the in vivo
hippocampus which controls the short-term models that limits the accessibility to the tissue
memory leading to short term memory failure. and prevent real time measurement of
Later it affects the cerebral cortex responsible biological changes associated with the disease.
for language and reasoning with the loss in Consequently many in vitro models have been
ability to make judgments (De Souza LC et al, developed so that the in vivo models can also
2014). Personality changes also occur which be a useful tool for us. All these models are
basically include emotional out bursts, helpful in depicting the underlying cause of AD
wandering and agitation (Bateman RJ et al, and also used in testing the differenttargets
2012). Slowly many other areas of the brain get against the disease (Shibata T and Wada K,
involved, the brain shrinks and losses functions 2011). Side by side a researcher should also
thus making the person bedridden with major have the good knowledge of the neuropathy so
health issues. that he can accurately corelate the pathological

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changes observed to human AD.Therefore, in depicts the plaques in the olfactory bulb,
this report we will basically discuss different thalamus and hypothalamus at an early stage.
types of models used and also their features These all findings correlate the senile plaques
and the limitations of using these experimental and Alzheimer but not the involvement of NFT
models in studying the pathological changes of which act as a limitation on these models but
AD. There are three types of experimental beside that they provide valuable tools
models. foramyloid beta modifying drugs (Richards JG
 Transgenic model et al, 2003).
 Non-transgenic model TAU Transgenic Mice
 In-vitro model These models were used to find the role of tau
Transgenic Models protein in the pathogenesis of AD. Based on
The knowledge of genes related to AD led to the 6 isoforms of tau protein in our body
the formation of many transgenic models either different tau protein models were formed
by transferring a gene into the existing the (Lewis J et al, 2001). A model named P301L
genetic makeup or by modifying genes using with 4 times tau protein repeat along with a
genetic technology. Mice are the most promotor was studied. It was found that tau
commonly used transgenic animal due to their protein level increases in the motor cortex of
easy manipulation and accessibility (Unger spinal cord but no NFT formation was
Lithner C. et al, 2011). Sometimes rats are also observed. Another models Thy tau 22 with 2
used although they are not widely available. mutations at G272v and P301S along with a
The different types of models are described promotor thymine 1.2 was used (Schindowski
below K et al, 2006). This time synaptic dysfunction
APP Transgenic Model along with its loss was observed. Also, the new
The first transgenic models used were APP to observation came into light which was the
explain the function of senile plaques by appearance of NFT in hippocampus. The role
expressing a transgene of human APP. Initially of glial protein was also observed in the
when the experiments were performed only the occurrence of fad AD. This directly link the
formation of amyloid beta was seen but no formation of NFT as one of the pathogenesis
senile plaques were depicted. This led to a cause AD (Forman MS et al, 2005).
suggestion that there is not anycorrelation APP/ TAUDouble Transgenic Mice
between cognitive disorder and senile plaques Till now, we depict the corelation of APP and
(Quon D et al, 1991). It was mainly due to low tau protein as the cause of AD but the
expression of the APP gene. More effort relationship between APP and TAU was not
wasmade to proof the above correlation to a established, so. To directly relate the APP and
positive view. In recent studies a different type tau, these models were used (Braidy N et al
of APP taken, this time it was associated with a 2012). To study these models a transgenicmice
platelet growth factor and the result was as carrying both the APP and tau protein genes is
expected. The formation of senile plaques was to be needed. This is done by crossing the
observed along with the synaptic loss (Games APPTg2576 and VLWharton hall lines
D et al, 1995). This led the scientist to make expressing human mutant was done resulting in
more effort in this field. They develop other the formation of transgenic mice. When this
transgenic models by taking the alternate gene model was under observation study it was
of interest. Mainly, Tg2576 and APP 73were found that it contains 7-fold increase in tau
used showing the loss in cerebral region along protein and accumulation of A beta in olfactory
with learning deficitTg2576 was observed with and amygdale (Janelsins MC et al, 2005). This
a 5-fold increase in senile plaques in just was great discovery as it directly corelates the
around 8 months and APP23 with 14- different factors playing a key role in the
foldincrease in just around 6 months (Hsiao K pathogenesis of AD. This modelstudy led to the
et al, 1996). Another model TgAPP also further detailed study of the models for the
potential target for AD treatment.
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Triple Transgenic Mice well characterized behaviour. They are also


In this model we took a transgene mice very close to humans with respect to
carrying variant gene like APP, pre genetically and physiologically. Transgenic rat
senillin(PS1) and tau which develop model containing wide type APP gene was
extracellular amyloid beta deposits in an early used as the first model which depict only the
span of 6 months observed in the main regions formation of amyloid beta deposits lacking the
like hippocampus and neocortex. Approach of senile plaques (Do Carmo S and Cuello AC,
this model was done due to same output of the 2013). But again, with the help of the PSI gene
simple APP mouse model and double the expected outcome comes with the
transgenic mice reflecting the insufficiency of occurrence of senile plaques along with
the model for the disease (Ruiz-Opazo N et al, amyloid deposits. Many efforts were done to
2004). So, a need arises to develop a model in study the models in rat but due to some
which the output in comparison to the simple limitation it was not fruitful. The embryonic
APP model. cells are difficult to acquire and a lot of
Transgenic Rat cautions are to be taken while performing the
Rats were chosen over the mouse due to many experiment (Sodhi RKet al, 2014).
reasons. They were highly rich in genes and
TABLE 1: Transgenic Models used for Pathogenesis of AD.
Transgenic APP APP23 Amyloid beta No tau (Quon D et
models TG2576 was seen. Also, protein and al, 1991)
PGF – the cognitive NFT were (Hsiao K et
APP and behavioural seen. al, 1996)
TgAPP impairment is (Games D et
observed al, 1995)
(Richards JG
et al, 2003).
TAU P301L Tau tangles can No effect of (Schindowski
Thy tau be seen with the APP is seen K et al, 2006)
motor
impairment

APP\TAU APP\TAU Both the beta Same amount (Braidy N et


double plaques as well of Aβ is seen al 2012)
transgenic as tau tangles as in case of (Janelsins
mice are visible single APP MC et al,
2005)
APP triple 3×TgAPP More severe Plaques are (Ruiz-Opazo
transgenic pathology developed N et al, 2004
mice linking with slowly
human AD

Transgenic PSIAPP Well Can’t depict (Do Carmo S


rat characterized as all the and Cuello
compared to pathological AC)
mice characteristics
of AD.
Non-transgenic Models Various animals are used as natural model
Natural Models ranging from rodents to non-human primates
which spontaneously show the AD related

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neuropathology as well as the cognitive (SAM) clearly showing the pathology features
impairment. As the first criteria for AD wad the of AD. These were selected on the phenotypic
memory loss (Solà C et al, 1993). Basically, the variation from the nine accelerated mice prone
aged animals were used as the natural models to variation.
which after studying have proved to be a High Fat Diet
valuable tool in depicting the natural pathology This model was made in use based on the role
of AD. Rodent owing to its simplicity and ease of cholesterol in the development of AD. The
to obtain made their use in large number. As role of cholesterol in the removal of amyloid
we have already studied the use of nephrilysin beta is known. HFD is highly related to AD as
and the protease enzyme in the amyloid beta it raises the level of cholesterol in the body as it
degradation (Gonzalo-Ruiz A et al, 2003). Rats is directly corelated to serum and cerebral level
have also been used to depict the effect of AD (Haley RW and Dietschy JM, 2004). As the
on the neurons which may be cholinergic or increased amount of cholesterol in body leads
glutamic (Beck M et al, 2003). along with to the accumulation of amyloid beta deposits.
effect of other environmental factors.Other This is characterized by an increase in
animals such as gerbil and guinea pigs also inflammatory response and oxidative stress.
follow the same pathway for the degradation of This risk of the development of AD increases
amyloid precursor protein but no occurrence of with decrease in tolerance of body towards
the pathological changes such as amyloid beta glucose and increase in resistance to insulin
deposits and NFT (Chen Y et al, 2014). were (Chevrier G et al, 2014). The only limitation is
seen which act as a limitation on the use of the time consumption associated with this
these model. Other model frequently used as model.
natural one was senescence accelerated model

TABLE 2: Non Transgenic Models used for Pathogenesis for AD.


Non Natural models Rats, dogs and Variation can be (Solà C et al,
transgenic various non-human seen in different 1993), (Beck
models primates are used models based on the M et al), (Chen
appearance of Y et al, 2014)
pathophysiological
characteristics.
High fat diet Linkb\w hyper- Other characteristics (Haley RW
induced model cholesterolemia and related to AD can’t and Dietschy
AD is generated. be seen JM, 2004),
(Chevrier G et
al, 2014)

In-vitro Models fragments thus inhibiting the activity of


Various tissues were cultured in the culture phosphatase enzyme resulting in the
media to depict the features associated with appearance of hyperphosphorylated tau protein
AD. The most commonly used tissue was the (Gong CX et al, 2001). They serve to be the
brain in which the hippocampus is most great models by linking the connection
important. Initially, the hippocampal neurons between neuronal and glial activity.
were extracted and cultured in the media. Then Cell Models
they were made prone to the amyloid beta Stem cell techniques gives a great urge to work
peptides which under observation proved to be on the cultured stem cell lines for the
neurotoxic to neurons of hippocampus. Other development of drug discovery. The
trial was made with the brain slices cultured in pluripotent stem cell lines are chosen
the media. They were treated with okadaic associated with AD and these are cultured to

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carry out the testing of the various drugs for the results in cell apoptosisaggregated by the acid
treatment (Yagi T et al, 2011) (Israel MA et al, which we use (Meng P et al, 2015). Also, the
2012). Other cell lines which were used were inhibition adenosine receptors increase the
human neuroblastoma cells which clearly pathological hallmark of the AD like amyloid
depict the amyloidogenic pathway followed beta aggregation and the formation of tau
during AD (Macias MP et al, 2014). When protein tau protein hyperphosphorylation
carnosic acid was made in use to neuro cells leading to the NFT.
associated with amyloid beta fragments, it

TABLE 3: In-Vitro Models used to Demonstrate The Feature Associated With AD.
In-vitro Cell Pluripotent Similar related Lack Aβ and (Yagi T et
models models stem cells to human AD NFT al, 2011)
Neuroblastoma (Israel
cells MA et al,
2012)
Tissue Brain slices Study at the Lack (Gong CX
models Cultured molecular level pathological et al,
tissues hallmarks of AD 2001)

CONCLUSION more efficient use of the genetic technology in


Great work has been done in the study field of studying the AD. Also, the positron emission
AD with the use of various types of models. tomography (PET) and magnetic resonance
The transgenic models serve as an important imaging (MRI) are the proposed tools in future
tool to study the in vivo pathological changes for studying the brain pathology as well as for
consisting of the amyloid beta senile plaques as the effective diagnostic purpose. Now a day’s
well formation of NFT. The in vivo models many studies use machine learning and
provide us the role of environment factors multivariate analysis methods to differentiate
which causes the aggravation as well as the the individuals at different stages of AD.
progression of AD. They also provide the Multivariate techniques are basically used as
various target for the treatment of AD by using they establish relationship between variables
the novel and therapeutic drugs. Also, the and are also accompanies with the chance of
morphology of the plaques was studied classification errors. In MRI techniques we
containing the amyloid fibrils giving a star usually compare the imaging of normal
shaped appearance. Presence of the microglial cognitive with the person with AD. In the
cells as well as the astroglial cells and their future these techniques are surely going to
processes was also observed. The neuritic enhance the diagnostic criteria for the AD and
profiles at different stages of swelling and will also be helpful in establishing new
degeneration in different models like APP, tau, strategies for the treatment of the disease.
PS1, triple APP\PS1 was studied which
suggests that these models are perfect to study CONFLICTS OF INTERESTS
the pathogenesis of AD as well as also helpful Authors do not have any conflicts of interests.
in designing new strategies for the treatment.
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