1
The Miles researchers retracted their paper in March in Science, oy a week after Kawabata, Higgins and Gordon retracted theirs. As Wirak and his co- authors noted, they had not examined enough normal C57 mice to become aware of the occurrence of the clusters. Because the clusters have a "nonspecific stickiness" for many antibodies, Walker explas, they bound antibodies against beta-amyloid and misled Wak's group into identifying them as plaques of beta-amyloid. doubt, but as Cordell acknowledges, it is too incomplete as a disease model to use in realistic tests of potential treat- ments. Many other transgenic mice are now being developed, Selkoe says, but none of them are known to produce much amyloid protein or to form it readily into plaques. "The whole expe- rience with transgenic mice so far indi- cates that it's very hard to get them to express the amyloid precursor protein and to slice it up in a way that makes plaques," he concludes. hausted. Moreover, Walker believes all the transgenic mice, even those -of the retracted models, still hold promise. "Even if the mice don't develop frank Alzheimer's-like pathology in the nor- mal course of events, it might still be possible to perturb the system in some way to induce those changes," he ex- plains, adding, "It's a hot field, and I hope this setback won't throw too much cold water on it." Martin notes that researchers at the are working on new transgenic models. "We're encour- aging them to be cautious," he says, with good reason. -John Rennie The two retractions leave only the Cordell mouse. Its validity is not in The quest for an animal model of Alzheimer's disease is by no means ex- The Estrogen Factor E strogen's sphere of influence seems to keep grow- ing. The queen of hormones orchestrates aspects of sexual differentiation in the developing brain, directs female reproduction and can slow osteoporosis. Now it appears that estrogen may have a part to play in the treat- ment of Alzheimer's disease as well. Researchers at Columbia University have found that re- ceptors for estrogen and nerve growth factor coexist in certain neurons in an area of the brain called the basal forebrain. This finding suggests that estrogen and nerve growth factor may act synergistically or reciprocally to in- fluence the survival and health of these neurons. "It is a very important finding," comments Patricia Goldman-Ra- kic, professor of neuroscience at Yale University. The dis- covery of "their interaction is really novel. " The implications for Alzheimer's disease are straightfor- ward, Goldman-Rakic says. Although the study, which was led by C. Dominique Toran-Allerand, was conducted in rats and mice, the basal forebrain of all mammals contains cholinergic neurons. These nerve cells produce the neuro- transmitter acetylcholine, which is vital for memory. One characteristic of Alzheimer's disease is that cholinergic neurons can no longer produce acetylcholine-hence the loss of memory. Many scientists are examining ways to treat cholinergic neurons with nerve growth factor, a com- pound that stimulates the growth of axons and dendrites and that keeps nerve cells alive. In the presence of nerve growth factor, cholinergic neurons do not degenerate. Toran-Allerand's findings suggest that nerve growth fac- tor alone may not always be sufficient. Some neurons in the basal forebrain as well as other areas have receptors for nerve growth factor or for estrogen alone. But because receptors for estrogen and nerve growth factor are present in some of the same neurons, both compounds may influ- ence the same cell, she explains. In addition, Toran-Allerand says she has found other potential evidence of such inter- action. The gene sequence of nerve growth factor contains what is called an estrogen response element. "Everywhere there is nerve growth factor, it appears there is estrogen," Toran-Allerand notes. "It may be a universal principle. " This discovery may hold particular relevance for women. More than half of the estimated four million Americans who have Alzheimer's disease are women. But whereas the prev- alence rates for women are greater than those for men- perhaps because women live longer-it has also been sug - gested that women acquire the disease more frequently. If estrogen is necessary for the development and survival of 26 SCIENTIFIC ERICAN June 1992 neurons in the basal forebrain, then losing their major source of estrogen during and after menopause or after ovariectomy may put vulnerable women at greater risk of Alzheimer's disease, Toran-Allerand says. (Men, in contrast, have an intrinsic source of estrogen in testosterone, which can be converted to estrogen in the brain.) Although they have been few and far between, several studies support this hypothesis. During the early 1980s, Victoria N. Luine, now at Hunter College, found that estro- gen could cause the production ofthe enzyme that synthe- sizes acetylcholine in parts of the brain of ovariectomized female rats. Luine's findings prompted Howard Fillit, now at the Mount Sinai Medical Center-and, later, a team of Japanese scientists-to give estrogen to a small group of women with Alzheimer's disease. Both groups found that aspects of dementia diminished in certain patients after treatment. But some researchers were critical of the studies. They questioned the small sam- ple size and argued that estrogen had already been shown to improve mood in postmenopausal women. Therefore, they contended, mood enhancement accounted for the ap- parent reversal of aspects of dementia. Nevertheless, many researchers remain intrigued. Bar- bara B. Sherwin and Susana Phillips of McGill University, who study estrogen replacement therapy in women, have found that it enhances short-term memory. But Sherwin observes that "mood in and of itself cannot account for the changes in cognitive function that we see." "A number of very smart, well-trained people have said anecdotally that in clinics where elderly women are treat- ed with estrogen replacement therapy, they don't see Alz- heimer's disease," observes Teresa Radebaugh, chief of the dementia and aging branch at the National Institute on Aging. "It could be a total mirage, but it is certainly worth looking at, particularly given Toran-Allerand's findings." The idea that estrogen deficiency could contribute to Alzheimer's disease has other support. Miriam K. Aronson of the Albert Einstein College of Medicine found that women with myocardial infarction-heart attacks some - times associated in postmenopausal women with plum- meting estrogen levels-were five times more prone to develop dementia than were those without such a history. Further research is planned, including looking at the re- lation, if any, between estrogen replacement therapy and dementia in a large, ongoing study. "A number of people are starting to talk about it," Radebaugh says. "It is a fasci- nating question." -Marguerite Holloway © 1992 SCIENTIFIC AMERICAN, INC

The Estrogen Factor

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The Miles researchers retracted their paper in March in Science, only a week after Kawabata, Higgins and Gordon retracted theirs. As Wirak and his co­authors noted, they had not examined enough normal C57 mice to become aware of the occurrence of the clusters. Because the clusters have a "nonspecific stickiness" for many antibodies, Walker explains, they bound antibodies against beta-amyloid and misled Wirak's group into identifying them as plaques of beta -amyloid.

doubt, but as Cordell acknowledges, it is too incomplete as a disease model to use in realistic tests of potential treat­ments. Many other transgenic mice are now being developed, Selkoe says, but none of them are known to produce much amyloid protein or to form it readily into plaques. "The whole expe­rience with transgenic mice so far indi­cates that it's very hard to get them to express the amyloid precursor protein and to slice it up in a way that makes plaques," he concludes.

hausted. Moreover, Walker believes all the transgenic mice, even those -of the retracted models, still hold promise. "Even if the mice don't develop frank Alzheimer's-like pathology in the nor­mal course of events, it might still be possible to perturb the system in some way to induce those changes," he ex­plains, adding, "It's a hot field, and I hope this setback won't throw too much cold water on it." Martin notes that researchers at the NIA are working on new transgenic models. "We're encour­aging them to be cautious," he says, with good reason. -John Rennie

The two retractions leave only the Cordell mouse. Its validity is not in

The quest for an animal model of Alzheimer's disease is by no means ex-

The Estrogen Factor

Estroge n's s p h e re of i nfl u e nce s e e m s to keep g row­i n g . The q u e e n of hormones o rc h e s trate s aspects of sexual d i ffe re ntiati o n in the deve l o p i n g b rai n , d i rects

fe m a l e re p rod u cti o n a n d can s l ow oste o p o ro s i s . Now i t appears that e stroge n m ay have a part to p lay i n the treat­m e n t of Al z h e i m e r's d i sease as we l l .

Re searc h e rs a t Co l u m b ia Unive r s i ty h ave fo u n d that re­ce ptors fo r e s trog e n and n e rve g rowth factor coe x i s t i n c e rta i n n e u ro n s i n an a rea o f the b ra i n ca l l ed the basal fo re b ra i n . Th i s fi n d i n g s u g g e sts that e s trog e n a n d n e rve g rowth facto r m ay act syne rg i st ica l ly or rec i p rocal ly to i n ­fl u e nce t h e s u rvival a n d h e a l th of t h e s e n e u ro n s . " I t i s a ve ry i m p o rtan t fi n d i n g , " c o m m e nts Patr i c i a G o l d man-Ra­k i c , p rofe s s o r of n e u ro s c i e n c e at Yal e Un ive rs i ty. The d i s ­cove ry of "th e i r i n te racti o n i s rea l l y nove l . "

T h e i m p l i cati o n s fo r Al z h e i m e r's d i sease are stra i g h tfo r­ward , G o l d m an-Rakic says. Alth o u g h the study, w h i c h was led by C. Dom i n iq u e Toran-Al l e ran d , was conducted in rats a n d m i c e , the basal fo re b ra i n of a l l m a m m a l s conta i n s c h o l i n e rg i c n e u ro n s . These n e rve ce l l s p roduce t h e n e u ro­tran s m i tte r acetyl c h o l i n e , w h i c h is v i ta l fo r m e m o ry. One c h a racte r i st ic of Al z h e i m e r's d i sease is that c h o l i n e rg i c n e u ro n s c a n n o l o n g e r p ro d u c e acety l c h o l i n e-h e n ce the loss of m e m o ry. Many s c i e n ti sts are exam i n i n g ways to treat c h o l i n e rg i c n e u ro n s w i th n e rve g rowth facto r, a com­pound that sti m u l ate s the g rowth of axo n s and d e n d rites a n d that keeps n e rve ce l l s a l ive. In the presence of n e rve g rowth facto r, c h o l i n e rg i c n e u ro n s do not d e g e n e rate.

Toran -Al l e rand's fi n d i n g s s u g g e s t that n e rve g rowth fac­to r a l o n e m ay not a l ways be s u ffi c i e nt. Some n e u ro n s i n the basal fo re b rai n a s we l l a s oth e r areas have rece ptors fo r n e rve g rowth facto r o r fo r e strogen a lone . But because rece ptors for estrog e n and n e rve g rowth factor are p resent i n some of the same n e u ro n s , both com pou n d s may i n fl u ­ence the same ce l l , she explai ns. I n add i ti o n , Toran-Al lerand says she has fo u n d oth e r pote ntial evi d e nce of such i n te r­action . The gene seque nce of n e rve g rowth factor conta i n s w h at i s cal led an estrogen re s po n s e e l e m e n t. "Eve rywh e re there i s n e rve g rowth facto r, it appears there is estrog e n , " To ran-Al l e rand notes . " I t m ay be a u n ive rsal p r i n c i p l e . "

T h i s d i scove ry may ho ld particu lar re l evance for wom e n . More than h a l f of t h e est imated fou r m i l l ion Americans w h o have Alz h e i m e r's d i sease are women. But whereas t h e p rev­a lence rates for women are g reate r than those for m e n ­perhaps because women l ive longer-it h a s a lso b e e n sug­g ested that wo m e n acq u i re the d i sease m o re fre q u e ntly. I f estrogen i s neces sary fo r the deve l o p m e n t and s u rvival of

26 SCIENTIFIC AMERICAN June 1992

n e u ro n s in the basal fo re b rai n , then l o s i n g th e i r m aj o r s o u rce of estro g e n d u ri n g a n d afte r m e n o p a u s e o r afte r ovariectomy m ay put v u l n e rab le wo m e n at g reate r r i s k of Al z h e i m e r's d i sease, Toran-Al l e rand says. (Me n , in contrast, have an i n tri n s i c s o u rce of estrogen in testoste ro n e , w h i c h c a n be conve rted t o estrogen i n t h e b rai n.)

Alth o u g h they h ave b e e n few and far betwe e n , several stu d i e s s u p po rt th i s hypoth e s i s . D u r i n g the ear ly 1 9 80 s , Victor ia N . Lu i n e , now a t H u nte r Col l e g e , fo u n d that e s tro­g e n cou ld cause the p rod u ction of the e n zyme that synthe­s i ze s acetylch o l i n e in parts of the b rai n of ovariecto m ized fe male rats . Lu i n e's fi n d i n g s p ro m pted Howard Fi l l i t , now at the Mo u n t S i na i Med ica l Ce nter-a n d , l ate r, a tea m of Japa n e s e s c i e n ti s ts-to g ive estro g e n to a s m al l g ro u p of women w i th Al z h e i m e r's d i sease.

Both g ro u p s fo u n d that aspects of d e m e ntia d i m i n i s h e d i n ce rta i n pati e n ts afte r treatm e n t. B u t s o m e re searc h e rs were c rit ical of the stud ies . They q u e stioned the s m a l l sam­p l e s ize and arg u e d that estroge n had a l ready been s h ow n t o i m p rove mood i n postm e n o pausa l wo m e n . Th e refo re , they conte n d e d , m ood e n hance ment acc o u n ted for the ap­pare n t reve rsal of as pects of d e m e ntia.

N eve rth e l e s s , many re searc h e rs re m a i n i ntr i g u e d . Bar­bara B. S h e rw i n a n d S u sa n a Ph i l l i p s of McG i l l Un ive r s i ty, w h o study estro g e n re p l ace m e n t th e rapy i n wo m e n , have fo u n d that i t e n hances s h o rt-te rm m e m o ry. B u t S h e r w i n o b s e rves that " m o o d i n a n d of itse l f cannot acco u nt fo r the changes i n cog n i tive fu nct ion that we see. "

"A n u m be r of ve ry s m a rt, we l l -tra i n ed p e o p l e h ave sa id anecdota l l y that i n c l i n i cs w h e re e l d e r ly w o m e n a re treat­ed w i th estro g e n re p l ace m e n t the rapy, they don 't see Alz­h e i m e r's d i seas e , " observes Te resa Radebau g h , c h ief of the d e m e ntia and ag i n g branch at the Nati o n a l I n s titute on Ag i ng . " It c o u l d be a total m i rag e , but i t i s c e rta i n l y wo rth look i n g at, parti c u l ar ly g iven Toran-Al l e rand 's fi n d i n g s."

The i d e a that e stro g e n d e fi c i e n cy c o u l d contr i b u te to Al z h e i m e r's d i sease has oth e r s u p po rt. Mi r iam K. Aro n s o n of the Al b e rt Ei n s te i n Co l l ege of Med i c i n e fo u n d that wo m e n w i th myocard ia l i n farcti o n-h eart attac ks s o m e ­ti m e s assoc iated i n postm e n o pa u s a l w o m e n w i th p l u m ­m eti n g e s tro g e n l eve l s-w e re five ti m e s m o re p ro n e to deve l o p d e m e ntia than w e re those with o u t s u c h a h i s to ry.

Fu rth e r re search i s p l a n n e d , i n c l u d i n g look i n g at the re­lati o n , if any, betwee n e strogen re p l ace m e n t the rapy a n d d e m e ntia i n a l a rg e , o n g o i n g study. " A n u m be r of p e o p l e are starti ng t o tal k a b o u t it , " Rad e ba u g h says. " I t i s a fasc i ­n ati n g q ue s ti o n . " -Marguerite Holloway

© 1992 SCIENTIFIC AMERICAN, INC