V National AriSLA Conference, Fondazione Cariplo, Milano, September 26th 2014
Pilot Grant ecypals: General Aim To test novel therapeutic approaches based on modulation of extracellular CypA (ecypa) function in in vitro and in vivo models of ALS.
Cyclophilin (CypA) 50µm ChAt CypA 18 kda-protein 0.1% total cellular proteins Highly expressed in neurons Cytoplasmic and nuclear Secreted under oxidative stress and inflammatory stimuli Merge CypA in motor neurons by Pozzi et al., unpublished
CypA functions CypA-CsA complex, X-ray structure by Mikol et al. 1993 Ligand of cyclosporine A (CsA) Peptidyl prolyl cis-trans isomerase (PPIase) Intracellularly: chaperone, protects s against oxidative stress Extracellularly: pro-inflammatory cytokine-like, metalloproteinase inducer through EMMPRIM Associated with human diseases
CypA is an hallmark of the disease in spinal cord of SOD1 G93A mouse model Presymptomatic stage % of total CypA * * WT G93A Massignan et al. BBRC, 2007
Increased CypA expression in peripheral blood mononuclear cells (PBMC) 300 * PBMC of ALS patients % of CTR 200 100 sals patients 1 2 3 4 Healthy controls % of NTg 0 200 100 0 CTR >24 <24 * NTg presymp symp SOD1 G93A rats % of total CypA 40 30 20 10 0 6.5 pi 7.5 * 1 2 3 4 ALS patients score>24 CTR ALS Nardo et al. PLoS One, 2011
CypA is aberrantly secreted in ALS Human CSF Mouse CSF SOD1 G93A * Mouse astrocyte medium CypA IR NTg SOD1 G93A
Is CypA protective or detrimental for ALS?
Non-cell autonomous mechanisms in ALS CypA??? Adapted from Nagai et al., Nature Neurosci. 2007
Astrocyte-spinal neuron co-culture ALS paradigm Motor neurons (SMI32) Neurons (NeuN) Spinal Neurons Motor neuron survival (%) Astrocytes In collaboration with Massimo Tortarolo
CypA is toxic for motor neurons in co-cultures Motor neuron survival (%) NonTg SOD1 G93A
CypA is toxic for purified motor neurons Motor neuron survival (%) NonTg motor neurons Untreated 0.5 nm CypA 5 nm CypA Motor neuron survival (%) SOD1 G93A motor neurons * * Untreated 0.5 nm CypA * 5 nm CypA Cortical neurons Granular neurons Cell viability Cell viability Untreated 0.5 nm CypA 5 nm CypA Untreated 0.5 nm CypA 5 nm CypA In collaboration with Alvaro Estevez and Roberto Chiesa
EMMPRIM is highly expressed in motor neurons and increases in the SOD1 G93A mouse EMMPRIM in lumbar spinal cord EMMPRIM EMMPRIM NTg SOD1 G93A EMMPRIM Red Ponceau
CypA is aberrantly secreted in ALS Extracellular CypA is toxic for motor neurons Is a general inhibition of CypA a good therapeutic option for amyotrophic lateral sclerosis?
CypA depletion increases TDP-43 aggregation and accelerates disease progression Triton-insoluble ptdp-43 # * * Survival (%) Disease duration (%) SOD1 G93A CypA +/+ SOD1 G93A CypA -/- CypA +/+ -/- days days Rotarod Grip strenght Extension reflex % max performance % max performance score G93A G93A es G93A G93A es Lauranzano et al., submitted
Is CsA a good option? Potent but not specific Immunosuppressive Toxic for motor neurons in vitro Intracerebrally injected: effective or toxic?
Cell-impermeable CsA derivatives are specific inhibitors of extracellular CypA CsA λ 565 nm I CsA - Hydrophilic tail MM218 - Fluorescence label Malešević et al. 2010
Cell-impermeable CsA derivatives are not toxic for motor neurons in NTg co-cultures Motor neuron survival (%) * 5 nm
MM218 rescues motor neurons in the astrocytespinal neuron co-culture ALS paradigm Motor neuron survival (%) G93A + MM218 * one-way ANOVA, Bonferroni post-hoc
MM218 protects motor neurons in co-cultures possibly by inhibiting MMP-9 MM218 * CypA EMMPRIM * * *vs G93A untreated ERK1/2 NF-kB MMP-9 Motor neuron survival (%) * * * *vs G93A untreated G93A + MM218
Preclinical trial in the SOD1 G93A mouse model icv infusion by osmotic minipump: 100 µl volume 4-week duration Vehicle MM218 1 µm MM218 10 µm n=9 n=11 n=12 Implantation 1 pump 2 pump Symptomatic Birth weeks 14 16 18 22 Death In collaboration with AriSLA-Animal Facility
MM218 increases survival in the SOD1 G93A mouse MM218 (1 µm) Vehicle MM218 (10 µm) Vehicle Days from implantation Survival in SOD1 G93A mice Survival (days) from treatment Vehicle (n = 9) MM-218 (1 µm) (n = 11 ) MM-218 (10 µm) (n = 12) 61 ± 4.6 68 ± 3.2 72 ± 2.4* 18% increase in life expectancy
MM218 shows a trend to improve the motor performance of SOD1 G93A mouse Rotarod Seconds Seconds Days from implantation
Conclusions Modulation of ecypa function is a promising therapeutic target for ALS MM218 is a promising drug and deserves further investigations: -Protective for motor neurons in vitro -Well-tolerated in vivo (icv) -Increases survival in SOD1 G93A mice (dose-dependently)
Future plans To investigate further MM218 pharmacological effect -higher doses -larger study To develop drug carriers (nanoparticles) to: -improve biodistribution -enable blood-brain-barrier passage
MARIO NEGRI Lab. Translational Proteomics Laura Pasetto Silvia Pozzi, former Eliana Lauranzano, former Mariachiara Castelnovo Katia Paolella Melissa Mombrini Melania Filareti Tania Massignan Lab. Molecular Neurobiology Massimo Tortarolo Caterina Bendotti Acknowledgments Lab. Neurobiology of Prions Elena Restelli Roberto Chiesa Max Planck, Halle, Germany Gunter Fischer, Miroslav Malešević Burke Medical Research Inst., USA Alvaro Estevez, Manuela Basso AriSLA Animal Facility Mattia Freschi Fondazione S. Maugeri, Milano Kalliopi Marinou Gabriele Mora Centro Clinico NEMO,, Milano Christian Lunetta Casa cura policlinico,, Milano Massimo Corbo Seconda Università di Napoli Maria Rosaria Monsurrò Ice -bucket challenge 2014