RSC Drug Discovery Edited by Ana Martinez Emerging Drugs and Targets for Alzheimer’s Disease Volume 1: Beta-Amyloid, Tau Protein and Glucose Metabolism AE lm z he er g i mi n eg r ’sD r Du ig ss e aa sn ed : V T a o r lug e m t s e f 1o r M a r t in e z Emerging Drugs and Targets for Alzheimer’s Disease Volume 1: Beta-Amyloid, Tau Protein and Glucose Metabolism RSC Drug Discovery Series Editor-in-cheif: ProfessorDavidThurston,LondonSchoolofPharmacy,UK SeriesEditor: DrDavidFox,PfizerGlobalResearchandDevelopment,Sandwich,UK ProfessorSalvatoreGuccione,UniversityofCatania,Italy ProfessorAnaMartinez,InstitutodeQuimicaMedica-CSIC,Spain DrDavidRotella,WyethResearch,USA AdvisortotheBoard: ProfessorRobinGanellin,UniversityCollegeLondon,UK TitlesintheSeries: 1: Metabolism, Pharmacokinetics and Toxicity of Functional Groups: Impact of the BuildingBlocksofMedicinalChemistryonADMET 2: Emerging Drugs and Targets for Alzheimer’s Disease; Volume 1: Beta-Amyloid, TauProteinandGlucoseMetabolism 3: EmergingDrugsandTargetsforAlzheimer’sDisease;Volume2:NeuronalPlasti- city,NeuronalProtectionandOtherMiscellaneousStrategies Howtoobtainfuturetitlesonpublication: Astandingorderplanisavailableforthisseries.Astandingorderwillbringdeliveryof eachnewvolumeimmediatelyonpublication. Forfurtherinformationpleasecontact: BookSalesDepartment,RoyalSocietyofChemistry, ThomasGrahamHouse,SciencePark,MiltonRoad,Cambridge,CB40WF,UK Telephone:+44(0)1223420066,Fax:+44(0)1223420247,Email:[email protected] Visitourwebsiteathttp://www.rsc.org/Shop/Books/ Emerging Drugs and Targets for Alzheimer’s Disease Volume 1: Beta-Amyloid, Tau Protein and Glucose Metabolism Edited by Ana Martinez Instituto de Quimica Medica-CSIC, Madrid, Spain RSCDrugDiscoverySeriesNo.2 ISBN: 978-1-84973-063-1 ISSN: 2041-3203 AcataloguerecordforthisbookisavailablefromtheBritishLibrary rRoyalSocietyofChemistry2010 Allrightsreserved Apartfromfairdealingforthepurposesofresearchfornon-commercialpurposesorfor privatestudy,criticismorreview,aspermittedundertheCopyright,DesignsandPatents Act1988andtheCopyrightandRelatedRightsRegulations2003,thispublicationmaynot bereproduced,storedortransmitted,inanyformorbyanymeans,withouttheprior permissioninwritingofTheRoyalSocietyofChemistryorthecopyrightowner,orinthe caseofreproductioninaccordancewiththetermsoflicencesissuedbytheCopyright LicensingAgencyintheUK,orinaccordancewiththetermsofthelicencesissuedbythe appropriateReproductionRightsOrganizationoutsidetheUK. Enquiriesconcerning reproductionoutsidethetermsstatedhereshouldbesenttoTheRoyalSocietyof Chemistryattheaddressprintedonthispage. TheRSCisnotresponsibleforindividualopinionsexpressedinthiswork. PublishedbyTheRoyalSocietyofChemistry, ThomasGrahamHouse,SciencePark,MiltonRoad, CambridgeCB40WF,UK RegisteredCharityNumber207890 Forfurtherinformationseeourwebsiteatwww.rsc.org Foreword It is a great honour to have been asked to write the foreword to this book in which several distinguished experts in the field have commented on possible therapeutic approaches for the treatment of Alzheimer’s disease (AD) and, in some cases, for the possible side effects of those treatments. Onehundredyearsago,thefirstpatientwiththisdiseasewasdescribed,1but during this time we have been unable not only to cure but even to prevent the disease. However, during the last 25 years knowledge of several molecular aspectsofthediseasehasdramaticallyincreased.InfamilialAD,weknowthat theoriginoftheneurodegenerationisaconsequenceofmutationsinoneofthe threefollowinggenes:app,ps-1andps-2.2APP(amyloidprecursorprotein)is the product of app,3 and ps-1 and ps-2 code for the proteins, presenilin-1 and presenilin-2.4FromthepioneeringworkofGlennerandWang,5weknowthat themaincomponentofsenileplaques,foundinthebrainofAlzheimerpatients isafragment(thebetaamyloidpeptide)ofAPP.Itiswellknownthatthemain componentoftheotheraberrantstructurefoundinthebrainofthosepatients, neurofibrillary tangles, is the cytoskeletal protein tau, modified by hyperpho- sphorylation.6 The kinases involved in that aberrant phosphorylation and the aggregationoftauhavebeenalsostudied.6–8Lessisknownabouttheoriginof sporadic Alzheimer disease, but there are some risk factors, like aging (that could promote oxidative damage), or the presence of a specific isoform of the protein ApoE, involved in cholesterol transport in the nervous system.9 On the other hand, mutations in ps-1 gene could affect glial cells, like microglia, inducing an aberrant activation of those cells.10 That activation could have some consequences, such as aberrant induction of proliferation of neuronal precursors and inflammation. Indeed, AD can be defined as a CNS disorder with an inflammatory component. OtherstudieshavesuggestedthatADisaninsulin-resistancediseaseorthat factors related to insulin could act as putative therapeutic agents for the dis- order.11 Other changes in the amount of growth factors, or changes in brain metabolism, have been associated with other aspects of the disease, and, in addition,fromthepioneerworkofDavidandMaloney,12changesinthelevel of different neurotransmitters have been found in AD patients. v vi Foreword Inspection of the web site, clinicaltrials.gov, reveals that more than two hundred compounds are currently in clinical trials for AD treatment, and cur- rentlytherearenobroadlyeffectiveagentsforADtreatment.Thus,theaimof this book is to comment on emerging drugs and targets for Alzheimer disease. Amongthosetargetsarethoseproteases(bandgsecretase)thatareinvolvedin APPcleavage,yieldingbetaamyloidpeptide(Ab),althoughinhibitionofthese proteins(mainlyg-secretase)couldresultindangeroussecondaryeffects.13Also, sincedimers,dodecamers,otheroligomersandhigherpolymersofAbcouldbe toxic for neurons,14 Ab anti-aggregates have been tested. On the other hand, some kinases or phosphatases involved in the aberrant phosphorylation of tau protein, the main components of NFT, have been described as possible targets to prevent tau pathology, together with antitau aggregates that could prevent the formation of filamentous tau polymers. In the case of sporadic Alzheimer disease, alterations in the metabolism of cholesterol have been studied,15 and modulation of cholesterol levels has been suggested for the treatment of the disease. The27chaptersofthisbookprovideabroadbasedanddeepreviewonsome of the above-mentioned targetsfor Alzheimerdisease. In Volume 1, the initial section considers strategies aimed at lowering Ab levels and blocking Ab aggregation by targetting Ab secretases, or by other approaches, including immunotherapy. This part includes six chapters, from Drs. Wolfe, Xia, Dotti andLedesma, Soreq, McLaurin and Solomon. Therapeutictargetsfocusedon tauproteinfollows,focusingontheregulationofitsdephosphorylation,mainly bytaukinaseI,16,17(orGSK3),oritsdephosphorylationbyphosphataseslike PP2A.18Thissectionincludesadiscussionoftherationalefortau-aggregation inhibitor therapy inthe lastchapter ofthis part. The authors forthese aspects related to tau pathology are Drs. Iqbal, Jope, Martı´nez,Hovensand Wischik. The third part of the book is related to neuron glucose metabolism as a possible target, discussing the possibility of AD being an insulin-resistance disease, about the possible use of insulin-like growth factor 1 as an AD ther- apeutic or the use of ketone bodies in the potential treatment of AD. The authorsforthesethreechaptersareDrs.DelaMonte,TorresandHenderson. In Volume II the first part is related to aspects of neuronal plasticity. The possibilityforregenerationofdegeneratedbrainandtheuseofgrowthfactors likeNGFisdiscussed.Theuseofinducedpluripotentcellsfrompatientscould facilitatethesearchforspecificdrugsinthetreatmentofthediseaseorhowto promotesynapticresilienceinADpatients.Theauthorsforthesechaptersare Drs Grundke-Iqbal, Cattaneo, Sugaya and Menniti. The second part of Volume II is related to different ways for neuronal pro- tection, trying to prevent oxidative damage, microtubule breakdown or inflammatory processes. Four chapters are dedicated to those subjects from Drs. Smith, Ghozes, Vallano and Heneka. The final section of Volume II is entitled ‘‘Miscellaneous targets and stra- tegies’’ and, as indicated by the title, tries to look for additional solutions beyond the targets previously described. Five chapters are dedicated to this topic from Drs. Lezoualc’h, Ridell, Melchiorre, Nawrot and Kennedy. Foreword vii Insummary,awidevarietyofconceptuallydistinctapproachesarepresented in an attempt to treat or prevent Alzheimer disease, a disease discovered 100 years ago whose incidence has dramatically increased since that time. Hope- fully, memories of this dreaded disease will disappear before the 200th anni- versary of its description. Jesu´s Avila Centro de Biologı´a Molecular ‘‘Severo Ochoa’’ (CSIC-UAM), Madrid, Spain References 1. Alzheimer, Psych. genchtl. Med., 1907, 64, 146. 2. D. L. Price and S. S. Sisodia, Ann. Rev. Neurosci., 1998, 21, 479. 3. C.L.Masters,G.Simms,N.A.Weinman,G.Multhaup,B.L.McDonald and K. Beyreuther, Proc. Nat. Acad. Sci. USA., 1985, 82, 4245. 4. R. Sherrington, E. I. Rogaev, Y. Liang, E. A. Rogaeva, G. Levesque, M. Ikeda,H.Chi,C.Lin,G.LiandK.Holman,etal.,Nature,1995,375,754. 5. G. G. Glenner and C. W. Wong, Biochem. Biophys. Res. Commun., 1984, 122, 1131. 6. I. Grundke-Iqbal, K. Iqbal, M. Quinlan, Y. C. Tung, M. S. Zaidi and H. M. Wisniewski, J. Biol. Chem., 1986, 261, 6084. 7. I. Grundke-Iqbal, K. Iqbal, Y. C. Tung, M. Quinlan, H. M. Wisniewski and L. I. Binder, Proc. Nat. Acad. Sci. USA., 1986, 83, 4913. 8. E. Montejo de Garcini, L. Serrano and J. Avila, Biochem. Biophys. Res. Commun., 1986, 141, 790–796. 9. E. H. Corder, A. M. Saunders, W. J. Strittmatter, D. E. Schmechel, P. C. Gaskell,G.W.Small,A.D.Roses,J.L.HainesandM.A.Pericak-Vance, Science, 1993, 261, 921. 10. S.H.Choi,K.Veeraraghavalu,O.Lazarov,S.Marler,R.M.Ransohoff,J. M. Ramirez and S. S. Sisodia, Neuron, 2008, 59, 568. 11. E. Carro, J. L. Trejo, T. Gomez-Isla, D. LeRoith and I. Torres-Aleman, Nature Med., 2002, 8, 1390. 12. P. Davies and A. J. Maloney, Lancet, 1976, 2, 1403. 13. E. Inoue, M. Deguchi-Tawarada, A. Togawa, C. Matsui, K. Arita, S. Katahira-Tayama, T. Sato, E. Yamauchi, Y. Oda and Y. Takai, J. Cell Biol., 2009, 185, 551. 14. C. Haass and D. J. Selkoe, Nature Rev., 2007, 8, 101. 15. M.D.Ledesma,J.Abad-Rodriguez,C.Galvan,E.Biondi,P.Navarro,A. Delacourte, C. Dingwall and C. G. Dotti, EMBO Rep., 2003, 4, 1190. 16. K.Ishiguro, A.Shiratsuchi, S.Sato, A.Omori, M.Arioka,S.Kobayashi, T. Uchida and K. Imahori, FEBS Lett., 1993, 325, 167. 17. J.J.Lucas,F.Hernandez,P.Gomez-Ramos,M.A.Moran,R.HenandJ. Avila, EMBO J., 2001, 20, 27. 18. C.X.Gong,T.Lidsky,J.Wegiel,L.Zuck,I.Grundke-IqbalandK.Iqbal, The J. Biol. Chem., 2000, 275, 5535. Preface ‘‘Over the next century, experts estimate that Alzheimer’s disease will be more prevalent than AIDS, cancer and all cardiovascular diseases’’ World Health Organization Alzheimer0s disease, the most common form of dementia, is a progressive and neurodegenerative brain disorder that results in symptoms such as loss of memory, impaired reasoning and changes in mood and behavior. The risk of suffering thispathology increasessharplywithageandposesone ofthemajor public health problems, both emotional and financial, not only to the present society, but even more to the coming generation. The lack of a cure and an effective form of treatment means that our current society must find effective ways to slow the progression of Alzheimer’s disease and develop effective and efficient strategies to meet the needs of those with this challenging disease. Recent research advances in molecular biology and technology have pro- vided multiple credible hypotheses around which therapeutic agents can be developed. This book collects some of the most outstanding examples of new drugs currently under pharmaceutical development or new targets in the vali- dation process that will reach the Alzheimer’s drugs market over the next few years as disease modifying drugs. I wish to thank all the contributors to the chapters in this book for their effortstosummarizethemostrelevantdataontheirtopicsandmainly,fortheir faith in the project. I also extend special thanks to my colleagues Guadalupe Mengod,CarmenGil,AnaPerez-Castillo,ManuelSarasa,JesusAvila,Khalid IqbalandDanielPerezfortheirsupportinreviewingsomeofthechapters.My special thanks and undying gratitude to Valle Palomo for her help with the RSCDrugDiscoverySeriesNo.2 EmergingDrugsandTargetsforAlzheimer’sDisease Volume1:Beta-Amyloid,TauProteinandGlucoseMetabolism EditedbyAnaMartinez rRoyalSocietyofChemistry2010 PublishedbytheRoyalSocietyofChemistry,www.rsc.org ix