Elisabet Barbero-Camps1, Vicente Roca-Agujetas1, Isabel Bartolessis1, Cristina de Dios1,2, Jose C Fernández-Checa1,3, Montserrat Marí1, Albert Morales1, Tobias Hartmann4, Anna Colell1,5. 1. a Department of Cell Death and Proliferation , Institut d'Investigacions Biomèdiques de Barcelona, Consejo Superior de Investigaciones Científicas (CSIC), Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) , Barcelona , Spain. 2. c Departament de Biomedicina, Facultat de Medicina , Universitat de Barcelona , Barcelona , Spain. 3. d Liver Unit , Hospital Clinic, CIBEREHD , Barcelona , Spain , Research Center for Alcoholic Liver and Pancreatic Diseases , Keck School of Medicine of the University of Southern California , Los Angeles , CA , USA. 4. e Experimental Neurology , Saarland University , Homburg/Saar , Germany. 5. b Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED) , Spain.
Abstract
Macroautophagy/autophagy failure with the accumulation of autophagosomes is an early neuropathological feature of Alzheimer disease (AD) that directly affects amyloid beta (Aβ) metabolism. Although loss of presenilin 1 function has been reported to impair lysosomal function and prevent autophagy flux, the detailed mechanism leading to autophagy dysfunction in AD remains to be elucidated. The resemblance between pathological hallmarks of AD and Niemann-Pick Type C disease, including endosome-lysosome abnormalities and impaired autophagy, suggests cholesterol accumulation as a common link. Using a mouse model of AD (APP-PSEN1-SREBF2 mice), expressing chimeric mouse-human amyloid precursor protein with the familial Alzheimer Swedish mutation (APP695swe) and mutant presenilin 1 (PSEN1-dE9), together with a dominant-positive, truncated and active form of SREBF2/SREBP2 (sterol regulatory element binding factor 2), we demonstrated that high brain cholesterol enhanced autophagosome formation, but disrupted its fusion with endosomal-lysosomal vesicles. The combination of these alterations resulted in impaired degradation of Aβ and endogenous MAPT (microtubule associated protein tau), and stimulated autophagy-dependent Aβ secretion. Exacerbated Aβ-induced oxidative stress in APP-PSEN1-SREBF2 mice, due to cholesterol-mediated depletion of mitochondrial glutathione/mGSH, is critical for autophagy induction. In agreement, in vivo mitochondrial GSH recovery with GSH ethyl ester, inhibited autophagosome synthesis by preventing the oxidative inhibition of ATG4B deconjugation activity exerted by Aβ. Moreover, cholesterol-enrichment within the endosomes-lysosomes modified the levels and membrane distribution of RAB7A and SNAP receptors (SNAREs), which affected its fusogenic ability. Accordingly, in vivo treatment with 2-hydroxypropyl-β-cyclodextrin completely rescued these alterations, making it a potential therapeutic tool for AD.
Macroautophagy/autophagy failure with the accumulation of autophagosomes is an early neuropathological feature of Alzheimer disease (AD) that directly affects amyloid beta (Aβ) metabolism. Although loss of presenilin 1 function has been reported to impair lysosomal function and prevent autophagy flux, the detailed mechanism leading to autophagy dysfunction in AD remains to be elucidated. The resemblance between pathological hallmarks of AD and Niemann-Pick Type C disease, including endosome-lysosome abnormalities and impaired autophagy, suggests cholesterol accumulation as a common link. Using a mouse model of AD (APP-PSEN1-SREBF2mice), expressing chimeric mouse-humanamyloid precursor protein with the familial Alzheimer Swedish mutation (APP695swe) and mutant presenilin 1 (PSEN1-dE9), together with a dominant-positive, truncated and active form of SREBF2/SREBP2 (sterol regulatory element binding factor 2), we demonstrated that high brain cholesterol enhanced autophagosome formation, but disrupted its fusion with endosomal-lysosomal vesicles. The combination of these alterations resulted in impaired degradation of Aβ and endogenous MAPT (microtubule associated protein tau), and stimulated autophagy-dependent Aβ secretion. Exacerbated Aβ-induced oxidative stress in APP-PSEN1-SREBF2mice, due to cholesterol-mediated depletion of mitochondrial glutathione/mGSH, is critical for autophagy induction. In agreement, in vivo mitochondrial GSH recovery with GSH ethyl ester, inhibited autophagosome synthesis by preventing the oxidative inhibition of ATG4B deconjugation activity exerted by Aβ. Moreover, cholesterol-enrichment within the endosomes-lysosomes modified the levels and membrane distribution of RAB7A and SNAP receptors (SNAREs), which affected its fusogenic ability. Accordingly, in vivo treatment with 2-hydroxypropyl-β-cyclodextrin completely rescued these alterations, making it a potential therapeutic tool for AD.
Alzheimer diseaseamyloid betaAMP-activated protein kinaseamyloid beta (A4) precursor proteinautophagy relatedATPase, H+ transporting, lysosomal V0 subunit A1Beclin 1, autophagy relatedcathepsin D2’,7’-dichlorofluorescin diacetatedetergent-resistant membraneearly endosome antigen 1flotillin 1gamma-aminobutyric acid (GABA) A receptor-associated protein-like 2glutathioneglutathione ethyl esterhexafluoroisopropanol2-hydroxypropyl-β-cyclodextrininsulin-like growth factor 2 receptorlysosomal-associated membrane proteinlysosomal storage disordersmicrotubule-associated protein 1 light chain 3 betamicrotubule-associated protein taumitofusin 2membrane lightmechanistic target of rapamycin (serine/threonine kinase)mitochondrial-derived vesiclesNiemann-Pick type C diseaseParkinson disease (autosomal recessive, juvenile) 2, parkinPTEN induced putative kinase 1parkin RBR E3 ubiquitin protein ligasepresenilin 1phosphatidylinositol 3-kinasequantitative reverse transcriptase-polymerase chain reactionmember RAS oncogene familyreactive oxygen speciesribosomal protein S6 kinase polypeptide 1soluble NSF attachment proteinSNAP receptorsequestosome 1sterol regulatory element binding factor 2syntaxinunc-51 like kinasevesicle-associated membrane proteinvesicle transport through interaction with t-SNAREs 1B
Introduction
The toxic accumulation of amyloid beta (Aβ) peptide and neurofibrillary tangles of hyperphosphorylated MAPT (microtubule associated protein tau) are the defining pathological hallmarks of Alzheimer disease (AD). The majority of mutations that cause early-onset familial AD increase the ratio of fibrillogenic Aβ, which indicates that the peptide is a primary neuropathological insult in AD progression, preceding MAPT pathology [1].Aβ is derived from the sequential processing of APP (amyloid beta precursor protein) by BACE1/β-secretase 1, followed by the γ-secretase complex with PSEN1 (presenilin 1) and PSEN2 in the active site. At homeostasis, the level of Aβ is tightly regulated through its elimination, via several processes that operate in parallel [2]. However, when Aβ production exceeds clearance, it accumulates to above optimal concentrations, which subsequently leads to its self-association into neurotoxic aggregations. Remarkably, by quantifying the rates of Aβ degradation vs. synthesis, within the cerebrospinal fluid, it has been shown that late-onset sporadic AD, which accounts for more than 98% of AD cases, exhibited significant defects in the clearance of Aβ peptides [3].Basal macroautophagy, the major intracellular degradation and recycling system, which will hereafter be referred to as autophagy, is responsible for the clearance of misfolded and aggregated proteins in the nervous system. Deficiencies in this system can lead to neurodegeneration [4]. In particular, the heterozygous deletion of Becn1/Beclin 1, whose expression is decreased during the early stages of AD, increases intracellular and extracellular Aβ deposition [5]. In contrast, the reduction of the Aβ load is associated with improved cognitive function in ADmouse models, following the induction of MTOR (mechanistic target of rapamycin [serine/threonine kinase])-dependent autophagy [6,7]. Remarkably, the beneficial effects of rapamycin are observed exclusively in young animals. In the AD brain, abnormalities of the endosomal-lysosomal system are early pathological features, along with the progressive buildup of autophagic intermediates, which indicate impaired autophagic flux [8,9]. Several studies using PSEN1 knockout cells or cells expressing PSEN1 with familial AD-linked point mutations, have described that PSEN deficiency impairs lysosomal function, either by affecting its proteolytic efficiency or fusion ability [10-12]. However, defective PSEN1 would only account for disruption of autophagy flux in cases of early-onset familial AD that carry these specific genetic mutations; hence, it is likely that other factors contribute to autophagy impairment in AD.A close connection between impaired lysosomal clearance and neurodegeneration has also been illustrated by lysosomal storage disorders (LSD) [13]. Results from Niemann-Pick type C disease (NPC) research, in which intracellular Aβ and neurofibrillary tangles are present despite absence of mutations in AD-related genes, are particularly interesting [14]. These studies show that defective trafficking of cholesterol due to mutations in Npc1 and Npc2 genes leads to altered endocytic trafficking and accumulation of autophagic vesicles, that like in AD precede neuronal loss [15,16]. Cholesterol load inhibits endosome-lysosome trafficking [17] and reduces the ability of lysosomes to fuse with endocytic and autophagic vesicles [18,19]. Moreover, the compound 2-hydroxypropyl-β-cyclodextrin (HP-β-CD), which stimulates cholesterol egress from endosome-lysosome compartments [20] and whose therapeutic effect has been probed in animal models of NPC [21,22], also exerts a protective effect in ADmouse models [23]. Taken together, and notwithstanding the differences, the striking parallels that exist between both these neurodegenerative disorders strongly suggest that a pathological mechanism involving abnormal cholesterol may explain autophagy impairment in AD.Cholesterol has been consistently linked to AD. Despite decrease in cholesterol levels in healthy aging brains [24], lipid analysis of the brains of patients with AD reveals increased levels of the sterol in vulnerable regions, including the cortex [25,26], basal ganglia [27], and middle frontal gyrus [28]. Cholesterol accumulation has been described in tangle-bearing and Aβ-immunopositive neurons [25,29,30]. In addition, retrospective epidemiological studies show that hypercholesterolemia in middle age is a risk factor for AD [31]. Further, despite conflicting observations from reports examining statin usage [32,33], a growing number of studies demonstrates that changes in cholesterol homeostasis regulate amyloidogenic processing of APP and Aβ aggregation [34]. In addition, using genetic mouse models of cholesterol loading, we previously show that excess cholesterol in brain mitochondria depletes glutathione/GSH, rendering cells more vulnerable to Aβ cytotoxicity [35,36]. Later, we demonstrate that overexpression of the dominant-positive truncated form of SREBF2 (sterol regulatory element binding factor 2) in APP-PSEN1mice accelerates and worsens diverse pathological AD hallmarks, including Aβ depositions, oxidative damage, neuroinflammation and the presence of neurofibrillary tangles of hyperphosphorylated MAPT, which are associated with cognitive deficits [37]. Importantly, treatment with GSH ethyl ester (GSHee), a cell-permeable form of GSH, recovers the pool of mitochondrial GSH/mGSH and prevents Aβ-induced oxidative damage, which significantly reduces MAPT aggregates and amyloid plaques without affecting APP processing [37]. This suggests that cholesterol may also regulate Aβ disposal. Faster delivery of Aβ to lysosomes and enhanced degradation has been described in microglia after reducing cellular cholesterol levels [38]; however, the molecular mechanisms by which cholesterol may contribute to the endosomal-lysosomal disturbances described in AD are still to be fully elucidated. Using APP-PSEN1-SREBF2mice we examined the regulatory role of cholesterol on Aβ-induced autophagy and further analyzed the impact of these alterations on Aβ and MAPT metabolism. Our data demonstrate that cholesterol exerts a dual effect on autophagy. Specifically, high intracellular cholesterol enhances Aβ-induced autophagosome formation, but impairs lysosomal fusion ability by altering RAB7A and SNAP receptors (SNAREs) content and distribution, which results in decreased Aβ and MAPT lysosomal clearance. Moreover, induction of autophagy in conjunction with inhibition of degradative autophagic flux stimulates secretory autophagy of Aβ, which may eventually contribute to extracellular Aβ deposition.
Results
Overexpression of SREBF2 in APP-PSEN1 mice enhances autophagosome formation that is associated with reduced levels of BECN1 and impaired SQSTM1 clearance
To explore whether cholesterol can regulate autophagy in AD we first monitored the presence of autophagy markers in the brains of wild-type (WT) and APP-PSEN1mice, with and without SREBF2 overexpression, at different ages. The longitudinal analysis of APP-PSEN1mice showed an increase in the expression levels of lipidated MAP1LC3B/LC3B (microtubule-associated protein 1 light chain 3 beta), hereafter referred to as LC3B-II, and BECN1 at 10 mo of age (Figure 1A and D). It is noteworthy that LC3B was analyzed using an antibody with stronger reactivity for the type II (lipidated) form of the protein in the membrane light (ML) fraction, which displays higher LC3B-II enrichment when autophagy is engaged (). We assessed the levels of SQSTM1/p62 (sequestosome 1) protein, a ubiquitin-binding protein that acts as a scaffold for protein aggregates and triggers their autophagic degradation, as an indicator of autophagic resolution. The increase in LC3B-II levels in 10-mo-old APP-PSEN1mice was associated with a significant reduction in SQSTM1 levels, consistent with proper autophagic induction and subsequent cargo degradation (Figure 1A and D). In APP-PSEN1-SREBF2mice, the accumulation of LC3B-positive structures was already evident in hippocampal slices at the age of 7 mo (Figure 1B). Further, the rise in lipidated LC3B was accompanied by high levels of SQSTM1 protein (Figure 1C and D). Given that the SQSTM1 protein abundance did not correlate with the corresponding mRNA expression levels (), the observed increase most likely reflected defective autophagic degradation.
Figure 1.
APP-PSEN1 mice overexpressing SREBF2 show an early accumulation of autophagosomes associated with decreased levels of BECN1 and impaired SQSTM1 clearance. Equal amounts of lysates from ML fractions (for LC3 analysis) or brain homogenates were subjected to SDS-PAGE and western blot analysis with the corresponding antibodies. (A) Representative immunoblots showing levels of lipidated LC3B (LC3B-II), BECN1 and SQSTM1 in brains from 10-mo-old WT mice and APP-PSEN1 mice at the indicated ages (mth, month). (B) Representative photomicrographs of hippocampus from 7-mo-old mice labeled with anti-LC3B and counterstained with DRAQ5 (blue) showing increased presence of LC3B puncta in APP-PSEN1-SREBF2 mice. Scale bar: 50 µm. Graph depicts quantification of the average number of LC3B puncta per cell (40 to 50 cells analyzed per genotype from a pool of at least 4 images). (C and D) Immunoblots of lipidated LC3B (LC3B-II), BECN1, SQSTM1, and PARK2 in soluble (sol., detergent-treated) and insoluble (insol., urea-treated) protein fractions of brains from 7-mo-old mice (C), and from mice at the indicated ages (mth, month) (D). (E) Western blot analysis of lipidated LC3B (LC3B-II), BECN1, and SQSTM1 in brains from 15-mo-old WT and APP-PSEN1 mice. In western blot analyses, densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding ACTB/actin β bands and expressed as relative intensity values. *P< 0.05 and **P< 0.01; n≥3. See for uncropped blots.
APP-PSEN1mice overexpressing SREBF2 show an early accumulation of autophagosomes associated with decreased levels of BECN1 and impaired SQSTM1 clearance. Equal amounts of lysates from ML fractions (for LC3 analysis) or brain homogenates were subjected to SDS-PAGE and western blot analysis with the corresponding antibodies. (A) Representative immunoblots showing levels of lipidated LC3B (LC3B-II), BECN1 and SQSTM1 in brains from 10-mo-old WT mice and APP-PSEN1mice at the indicated ages (mth, month). (B) Representative photomicrographs of hippocampus from 7-mo-old mice labeled with anti-LC3B and counterstained with DRAQ5 (blue) showing increased presence of LC3B puncta in APP-PSEN1-SREBF2mice. Scale bar: 50 µm. Graph depicts quantification of the average number of LC3B puncta per cell (40 to 50 cells analyzed per genotype from a pool of at least 4 images). (C and D) Immunoblots of lipidated LC3B (LC3B-II), BECN1, SQSTM1, and PARK2 in soluble (sol., detergent-treated) and insoluble (insol., urea-treated) protein fractions of brains from 7-mo-old mice (C), and from mice at the indicated ages (mth, month) (D). (E) Western blot analysis of lipidated LC3B (LC3B-II), BECN1, and SQSTM1 in brains from 15-mo-old WT and APP-PSEN1mice. In western blot analyses, densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding ACTB/actin β bands and expressed as relative intensity values. *P< 0.05 and **P< 0.01; n≥3. See for uncropped blots.The protein level of BECN1 was significantly reduced in the brains of APP-PSEN1-SREBF2mice at 7 and 10 mo, but not in APP-PSEN1mice (Figure 1C and D). Quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) analysis showed unchanged mRNA levels of Becn1 in all genotypes (), indicating again that changes at the protein level were not elicited by transcriptional regulation. Interestingly, 15-mo-old APP-PSEN1mice, in which we have previously described an age-dependent induction of brain cholesterol synthesis [39], reproduced the pattern of altered expression of BECN1 and the accumulation of SQSTM1 that was displayed by young APP-PSEN1-SREBF2mice (Figure 1E). Thus, these observations provide evidence for the link between disturbances in autophagy and changes in cholesterol homeostasis.Recent studies suggest that PRKN (parkin RBR E3 ubiquitin protein ligase), a key player in mitophagy, can also trigger autophagic removal of Aβ by interacting with BECN1 [40]. A decrease in PRKN solubility impairs this interaction and compromises Aβ clearance [40]. We analyzed PARK2 expression levels in soluble and insoluble protein fractions from brain of WT and mutant mice. The immunoblots revealed similar detergent-soluble PARK2 levels with almost negligible presence of the protein in the insoluble fraction regardless of mouse genotype (Figure 1C), suggesting that the autophagic defects in APP-PSEN1-SREBF2mice were not related to PARK2 solubility. However, further studies would be needed to evaluate whether changes in brain cholesterol can regulate mitophagy mediated by the PARK2-PINK1 (PTEN induced putative kinase 1) axis.
Expression levels of core autophagy proteins and MTOR signaling pathway remain unchanged in APP-PSEN1-SREBF2 mice
Autophagosome biogenesis requires the cooperation between the autophagy-related ATG12–ATG5-ATG16L1 conjugation complex and the processed form of mammalian orthologs of yeastAtg8, which includes the LC3 and the GABARAP (gamma-aminobutyric acid receptor associated protein) subfamilies [41]. We analyzed the expression levels of ATG12, ATG5, and 2 enzymes, ATG7 and ATG10, involved in the conjugation process, by qRT-PCR (Figure 2A) and western blot (Figure 2B). There were no changes in any of the components in the brains of 7-mo-old APP-PSEN1mice, with or without SREBF2 overexpression. In addition, we assessed the expression levels and activity of ULK1 (unc-51 like kinase 1) and ULK2, which are serine-threonine kinases that integrate upstream nutrient and energy signals to coordinate the induction of autophagy. Activity of ULK1 (and ULK2) is oppositely regulated by MTORC1 (MTOR complex 1) and AMPK (AMP-activated protein kinase) [42]. Interestingly, the activity of both enzymatic complexes, as well as the expression levels of ULK1, are altered in response to oxidative stress [43,44]. Nonetheless, although brains from APP-PSEN1-SREBF2mice displayed exacerbated oxidative damage compared to APP-PSEN1mice [37], qRT-PCR analysis did not show significant changes in Ulk1 and Ulk2 mRNA levels between both genotypes in the current study (Figure 2A). Further, ULK1 activation, which was assessed by the level of AMPK-mediated phosphorylation at Ser317, was undetectable in brain extracts from 7-mo-old mice, irrespective of genotype (Figure 2C). The unchanged levels of phosphorylated RPS6KB1 (ribosomal protein S6 kinase, polypeptide 1) (Figure 2D), further proved that autophagy in APP-PSEN1-SREBF2mice was independent of the MTOR signaling pathway. Altogether, these results were consistent with the accumulation of autophagosomes in the triple transgenic mice due to a blockage that occurs late in the autophagic flux pathway.
Figure 2.
Expression levels of the ATG12–ATG5 ubiquitin-like conjugation system and activity of the MTOR-dependent pathway remained unchanged in APP-PSEN1-SREBF2 mice. (A) mRNA levels of the indicated autophagy-related proteins in brains from 7-mo-old WT and mutant mice analyzed by qRT-PCR. Absolute mRNA values were determined, normalized to Rn18s ribosomal RNA, and reported as relative levels referred to the expression in WT mice. (B) Protein expression levels were assessed in brain homogenates from 7-mo-old WT and mutant mice. Shown are representative immunoblots for ATG12–ATG5 conjugate, ATG7, and ATG5. (C) Western blot analysis of AMPK-dependent phosphorylation of ULK1 at Ser317. Cellular lysates from SH-SY5Y cells starved in FBS-depleted medium for 24 h were used as positive control (SC). (D) Representative immunoblots showing the MTOR-dependent phosphorylation status of RPS6KB1. In western blot analyses, densitometric values of the bands representing the specific protein immunoreactivity were normalized to the values of the corresponding ACTB bands and expressed as relative intensity values. n=3.
Expression levels of the ATG12–ATG5 ubiquitin-like conjugation system and activity of the MTOR-dependent pathway remained unchanged in APP-PSEN1-SREBF2mice. (A) mRNA levels of the indicated autophagy-related proteins in brains from 7-mo-old WT and mutant mice analyzed by qRT-PCR. Absolute mRNA values were determined, normalized to Rn18s ribosomal RNA, and reported as relative levels referred to the expression in WT mice. (B) Protein expression levels were assessed in brain homogenates from 7-mo-old WT and mutant mice. Shown are representative immunoblots for ATG12–ATG5 conjugate, ATG7, and ATG5. (C) Western blot analysis of AMPK-dependent phosphorylation of ULK1 at Ser317. Cellular lysates from SH-SY5Y cells starved in FBS-depleted medium for 24 h were used as positive control (SC). (D) Representative immunoblots showing the MTOR-dependent phosphorylation status of RPS6KB1. In western blot analyses, densitometric values of the bands representing the specific protein immunoreactivity were normalized to the values of the corresponding ACTB bands and expressed as relative intensity values. n=3.
Cholesterol impairs autophagic flux induced by rapamycin treatment and Aβ exposure
To further explore the role of cholesterol homeostasis on autophagic flux we used both primary neuronal cultures and mice overexpressing SREBF2. First, WT and SREBF2mice were treated with the MTOR inhibitor rapamycin (5 mg/kg), and the expression of autophagy markers in the brain was evaluated. Inhibition of MTOR activity was confirmed by western blot analysis of phosphorylated RPS6KB1 levels (). After 24 h of treatment, only the brain extracts from SREBF2mice showed significant inhibition of MTOR (), which was associated with increased levels of lipidated LC3B (Figure 3A). The buildup of autophagosomes after treatment in the hippocampus of SREBF2mice was also assessed by immunofluorescence (Figure 3B). This accumulation was accompanied with an elevation of BECN1 levels (Figure 3C). Moreover, consistent with the inhibition of autophagic flux, both western blot (Figure 3D) and immunofluorescence (Figure 3E) analyses demonstrated the marked accumulation of SQSTM1 in SREBF2mice treated with the MTOR inhibitor. Autophagy induction was also observed in WT mice by increasing the dose and time of rapamycin treatment. Rapamycin injection at 10 mg/kg for 2 d significantly reduced the levels of phosphorylated RPS6KB1 in brain homogenates from WT and SREBF2mice (). Inhibition of MTOR raised the levels of LC3B-II in WT brain extracts to the same extent than in extracts from SREBF2mice (). However, in contrast to SREBF2 samples, levels of SQSTM1 in brain extracts of WT mice significantly decreased after rapamycin treatment (). As expected, after cotreatment with rapamycin and the lysosomotropic agent chloroquine (50 mg/kg), brains from WT mice displayed a stepwise increase in the LC3B-II:LC3B-I ratio (Figure 3F). In contrast, the brains of the rapamycin-treated SREBF2mice showed high LC3B-II:LC3B-I ratio at all time-points that were analyzed, regardless of chloroquine cotreatment (Figure 3F), which strongly reinforced the evidence for cholesterol-induced impairment of autophagy resolution.
Figure 3.
Impaired autophagic flux in SREBF2 mice after in vivo treatment with rapamycin. 7-mo-old WT and SREBF2 mice were treated with the MTOR inhibitor rapamycin (RM) at 5 mg/kg for 24 h. Equal amounts of lysates from ML fractions (for LC3 analysis) or brain homogenates were subjected to SDS-PAGE and western blot analysis with the corresponding antibodies. (A) Representative immunoblots showing levels of lipidated LC3B (LC3B-II). (B) Representative photomicrographs of hippocampus from WT and SREBF2 mice labeled with anti-LC3B and counterstained with DRAQ5 (blue). Scale bar: 50 μm. Graph depicts quantification of the average number of LC3B puncta per cell (80 to 90 cells analyzed per genotype and experimental condition from a pool of at least 4 images). (C and D) Western blot analysis of BECN1 (C), and SQSTM1 (D). (E) Representative photomicrographs of hippocampus from WT and SREBF2 mice labeled with anti-SQSTM1 and counterstained with DRAQ5 (blue). Scale bar: 50 μm. Graph depicts quantification of the average number of SQSTM1 puncta per cell (80 to 90 cells analyzed per genotype and experimental condition from a pool of at least 4 images). (F) To assess changes in autophagic flux mice were cotreated with rapamycin (RM, 5 mg/kg) and chloroquine (CQ, 50 mg/kg) for the indicated times. A representative western blot for LC3B and the corresponding quantification of the LC3B-II:LC3B-I ratio in total brain homogenates are shown. In all western blot analyses, densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding ACTB bands and expressed as relative intensity values. **P< 0.01; n≥3. See for uncropped blots.
Impaired autophagic flux in SREBF2mice after in vivo treatment with rapamycin. 7-mo-old WT and SREBF2mice were treated with the MTOR inhibitor rapamycin (RM) at 5 mg/kg for 24 h. Equal amounts of lysates from ML fractions (for LC3 analysis) or brain homogenates were subjected to SDS-PAGE and western blot analysis with the corresponding antibodies. (A) Representative immunoblots showing levels of lipidated LC3B (LC3B-II). (B) Representative photomicrographs of hippocampus from WT and SREBF2mice labeled with anti-LC3B and counterstained with DRAQ5 (blue). Scale bar: 50 μm. Graph depicts quantification of the average number of LC3B puncta per cell (80 to 90 cells analyzed per genotype and experimental condition from a pool of at least 4 images). (C and D) Western blot analysis of BECN1 (C), and SQSTM1 (D). (E) Representative photomicrographs of hippocampus from WT and SREBF2mice labeled with anti-SQSTM1 and counterstained with DRAQ5 (blue). Scale bar: 50 μm. Graph depicts quantification of the average number of SQSTM1 puncta per cell (80 to 90 cells analyzed per genotype and experimental condition from a pool of at least 4 images). (F) To assess changes in autophagic flux mice were cotreated with rapamycin (RM, 5 mg/kg) and chloroquine (CQ, 50 mg/kg) for the indicated times. A representative western blot for LC3B and the corresponding quantification of the LC3B-II:LC3B-I ratio in total brain homogenates are shown. In all western blot analyses, densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding ACTB bands and expressed as relative intensity values. **P< 0.01; n≥3. See for uncropped blots.These in vivo studies were complemented with data from primary neuronal cultures. Embryonic cortical and hippocampal neurons from WT and SREBF2mice were incubated with Aβ at 5 μM for 24 h and double-immunostained with anti-LC3B or anti-SQSTM1 and anti-LAMP2 (lysosomal associated membrane protein 2) antibodies. Confocal images showed a higher accumulation of LC3B-positive structures in the soma of SREBF2 neurons after Aβ treatment, which, unlike WT cells, showed almost no colocalization between LC3B and LAMP2 (Figure 4A). Similarly, a low degree of colocalization was observed in cells that were incubated with rapamycin at 10 nM (Figure 4A). SQSTM1 was mainly localized inside lysosomes in WT cells after Aβ incubation (see insets in Figure 4B). In contrast, the exposure of SREBF2 neurons to Aβ resulted in the accumulation of SQSTM1 in the soma of the cell, which, like LC3B, did not show overt signs of colocalization with the lysosomal marker LAMP2 (Figure 4B). These results, therefore, recapitulated the autophagic flux defect observed in SREBF2mice after in vivo treatment with rapamycin. Autophagosome formation in neurons from WT and SREBF2mice induced by Aβ, was completely abolished by preincubation with the phosphatidylinositol 3-kinase (PtdIns3K) inhibitor wortmannin (Figure 4C), which meant that class III PtdIns3K complex was involved in Aβ-induced autophagy. Similar results were obtained when cells were preincubated with GSHee. The recovery of the depleted pool of mGSH by GSHee treatment in SREBF2 cells () paralleled a significantly reduction of reactive oxygen species (ROS) generation after Aβ exposure () and totally prevented the formation of LC3B-positive vesicles in Aβ-incubated neurons from WT and SREBF2mice (Figure 4C), which suggested that mitochondrial oxidative stress is a key player in Aβ-induced autophagy.
Figure 4.
SREBF2 overexpression enhances autophagosome accumulation but inhibits autophagy clearance. (A and B) Embryonic cortical and hippocampal neurons isolated from WT and SREBF2 mice were treated with 10 nM rapamycin (RM) or 5 μM Aβ for 24 h. Shown are representative confocal images of neuronal-enriched cultures double immunostained for LC3B (red) and LAMP2 (green) (A) and for SQSTM1 (red) and LAMP2 (green) (B). Insets show a 3-fold magnification of the indicated region. (C) Neurons were pretreated with 5 μM wortmannin or 0.5 mM GSHee for 30 min prior autophagy induction with 5 μM Aβ for 24 h. Shown are representative confocal images of double immunolabeling with antibodies against to LC3B (red) and LAMP2 (green). Nuclei were stained by DRAQ5 (blue fluorescence). Scale bars: 50 μm. Quantification of the average number of LC3B or SQSTM1 puncta per cell was assessed using ImageJ software and depicted in the corresponding graphs (15 to 20 cells analyzed per genotype and experimental condition from a pool of at least 4 images). The Pearson correlation coefficient was used as a measure of colocalization of Alexa fluor 488 signals (LC3B) with Alexa fluor 555 signals (LAMP2). **P< 0.01.
SREBF2 overexpression enhances autophagosome accumulation but inhibits autophagy clearance. (A and B) Embryonic cortical and hippocampal neurons isolated from WT and SREBF2mice were treated with 10 nM rapamycin (RM) or 5 μM Aβ for 24 h. Shown are representative confocal images of neuronal-enriched cultures double immunostained for LC3B (red) and LAMP2 (green) (A) and for SQSTM1 (red) and LAMP2 (green) (B). Insets show a 3-fold magnification of the indicated region. (C) Neurons were pretreated with 5 μM wortmannin or 0.5 mM GSHee for 30 min prior autophagy induction with 5 μM Aβ for 24 h. Shown are representative confocal images of double immunolabeling with antibodies against to LC3B (red) and LAMP2 (green). Nuclei were stained by DRAQ5 (blue fluorescence). Scale bars: 50 μm. Quantification of the average number of LC3B or SQSTM1 puncta per cell was assessed using ImageJ software and depicted in the corresponding graphs (15 to 20 cells analyzed per genotype and experimental condition from a pool of at least 4 images). The Pearson correlation coefficient was used as a measure of colocalization of Alexa fluor 488 signals (LC3B) with Alexa fluor 555 signals (LAMP2). **P< 0.01.
Cholesterol-induced mGSH depletion in APP-PSEN1-SREBF2 mice controls autophagosome formation through regulating the Aβ inhibitory effect on ATG4B
Accumulating evidence supports the idea that a redox imbalance can regulate autophagy, especially during phagophore elongation [45]. Intriguingly, the chemically-induced oxidation of GSH by itself, is able to trigger autophagy, even in the absence of other autophagic stimuli [46]. These data prompted us to analyze whether the depleted mGSH levels can regulate Aβ-induced autophagy in APP-PSEN1-SREBF2mice. Mice were administered GSHee (1.25 mmol/kg/day) for 2 wk, which recovers the mGSH content [37]. After treatment, APP-PSEN1-SREBF2mice showed significantly lower levels of lipidated LC3B (Figure 5A). The decreased autophagosome formation was further confirmed by immunofluorescence and confocal microscopy, which demonstrated reduced LC3B puncta in the hippocampus of APP-PSEN1-SREBF2mice after GSHee administration (Figure 5B). In contrast, impaired autophagic degradation of SQSTM1 in the triple transgenic mice did not improve following mGSH recovery (Figure 5A), which suggested that the regulatory role of mGSH in autophagy is confined to the first steps of the process.
Figure 5.
Mitochondrial GSH depletion in APP-PSEN1-SREBF2 mice stimulates autophagosome formation via enhancing the inhibitory effect of Aβ on ATG4B. WT and APP-PSEN1-SREBF2 mice (7-mo-old) were treated with GSHee at 1.25 mmol/kg/d every 12 h for 2 wk. Lysates from ML fractions (for LC3 analysis) or brain homogenates were subjected to western blot analysis. (A) Representative immunoblots showing levels of lipidated LC3B (LC3B-II) and SQSTM1. (B) Representative photomicrographs of hippocampal sections labeled with anti-LC3B and counterstained with DRAQ5 (blue). Scale bar: 50 μm. Graph depicts quantification of the average number of LC3B puncta per cell measured using ImageJ software (80 to 90 cells analyzed per genotype and experimental condition from a pool of at least 4 images). (C) ATG4B activity of brain homogenates from 7-mo-old WT and mutant mice. Lysates were incubated with recombinant HA-GABARAPL2 AMC at 37ºC for 45 min and ATG4B activity was assessed by means of AMC fluorescence. (D) Western blot analysis of ATG4B expression in brain homogenates from 7-mo-old WT and mutant mice. (E) ATG4B activity of neuronal-enriched cultures incubated with 5 μM Aβ for 24 h with or without 30 min preincubation with 2 mM GSHee. Cell lysates were incubated with HA-GABARAPL2 AMC as in C and AMC fluorescence was analyzed. DTT (1 mM) was added to the reaction buffer to assess ATG4B maximum activity. In western blot analyses densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding ACTB bands and expressed as relative intensity values. *P< 0.05 and **P< 0.01; n=3. See for uncropped blots.
Mitochondrial GSH depletion in APP-PSEN1-SREBF2mice stimulates autophagosome formation via enhancing the inhibitory effect of Aβ on ATG4B. WT and APP-PSEN1-SREBF2mice (7-mo-old) were treated with GSHee at 1.25 mmol/kg/d every 12 h for 2 wk. Lysates from ML fractions (for LC3 analysis) or brain homogenates were subjected to western blot analysis. (A) Representative immunoblots showing levels of lipidated LC3B (LC3B-II) and SQSTM1. (B) Representative photomicrographs of hippocampal sections labeled with anti-LC3B and counterstained with DRAQ5 (blue). Scale bar: 50 μm. Graph depicts quantification of the average number of LC3B puncta per cell measured using ImageJ software (80 to 90 cells analyzed per genotype and experimental condition from a pool of at least 4 images). (C) ATG4B activity of brain homogenates from 7-mo-old WT and mutant mice. Lysates were incubated with recombinant HA-GABARAPL2AMC at 37ºC for 45 min and ATG4B activity was assessed by means of AMC fluorescence. (D) Western blot analysis of ATG4B expression in brain homogenates from 7-mo-old WT and mutant mice. (E) ATG4B activity of neuronal-enriched cultures incubated with 5 μM Aβ for 24 h with or without 30 min preincubation with 2 mM GSHee. Cell lysates were incubated with HA-GABARAPL2AMC as in C and AMC fluorescence was analyzed. DTT (1 mM) was added to the reaction buffer to assess ATG4B maximum activity. In western blot analyses densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding ACTB bands and expressed as relative intensity values. *P< 0.05 and **P< 0.01; n=3. See for uncropped blots.The cysteine protease ATG4B activates Atg8-family proteins by proteolytic clipping, which is a requirement for its subsequent conjugation with phospholipids, during the formation of nascent autophagosomes [41]. ATG4B also exerts an esterase activity that hydrolyzes the link between Atg8-family proteins and phospholipids. Scherz-Shouval et al. describe a local rise in H2O2, upon starvation-induced autophagy, which transiently oxidizes and inactivates ATG4B allowing the conjugation of lipidated Atg8-family proteins to the phagophore membranes [47]. At later stages, ATG4B is reactivated to delipidate and release Atg8-family proteins from the outer membrane of autophagosomes, which facilitates its fusogenic capability [48]. Given the brain oxidative damage displayed by APP-PSEN1-SREBF2mice [37] together with increased ROS levels in primary neuronal cultures exacerbated by the mitochondrial respiration inhibitor antimycin A (), we hypothesized an enhanced inhibitory effect on the ATG4B activity. Using a fluorescence-based assay and the Atg8-family member GABARAPL2/GATE-16 (gamma-aminobutyric acid (GABA) A receptor-associated protein-like 2) as a substrate, we measured the ATG4B activity in brain extracts from 7-mo-old WT and transgenic mice. Enzymatic activity was significantly reduced in the APP-PSEN1mice compared to WT mice, and overexpression of SREBF2 in the APP-PSEN1mice further enhanced this inhibition (Figure 5C). Western blot analysis revealed identical levels of ATG4B protein, which meant that changes in activity were not related to protein expression levels (Figure 5D). We also assessed the activity of the enzyme in primary neurons from WT and SREBF2 embryos that were exposed to 5 μM Aβ for 24 h (Figure 5E). In WT neurons, Aβ incubation significantly reduced the cleavage activity of ATG4B. Compared to WT cells, untreated SREBF2 neurons exhibited lower ATG4B activity and exposure to Aβ increased this inhibitory effect (Figure 5E). Conversely, pretreatment with 2 mM GSHee prevented the Aβ-induced inhibition of ATG4B in both WT and SREBF2 cells (Figure 5E). Thus, our findings suggest that Aβ promotes autophagosome formation by inhibiting the cleavage activity of ATG4B. The cholesterol-induced depletion of mGSH levels, through stimulating mitochondrial ROS generation triggered by Aβ, increases ATG4B inhibition and subsequent autophagosome formation.Mitochondrial ROS has also been implicated as a signal for PINK1-PRKN-mediated mitophagy, an event regulated by mitochondrial dynamics [49]. Dysfunctional and depolarized mitochondria lose their fusion capacity, which prevents damaged organelles from incorporating back to the mitochondrial network, targeting them for autophagy clearance. Impaired balance of mitochondrial dynamics has been described in AD, associated with increased mitochondrial fragmentation and reduced mitochondrial density in neuronal processes [50]. In line with these data, confocal analysis of the mitochondrial network in neurons from APP-PSEN1-SREBF2mice revealed an abnormal mitochondrial distribution pattern and increased mitochondrial fragmentation in neurites, compared to the elongated mitochondria observed in neurons from WT and APP-PSEN1mice (). Moreover, previous studies in neuronal cells treated with the mitochondrial respiration inhibitor rotenone describe the translocation of cardiolipin to the mitochondrial outer membrane as a key elimination signal for mitophagy [51]. To evaluate cardiolipin externalization, isolated mitochondria from WT and mutant mice were incubated with fluorescently labeled ANXA5/annexin V, which at μM calcium concentrations specifically binds cardiolipin among other anionic phospholipids [51]. The analysis by flow cytometry showed an increased percentage of ANXA5+ events in samples from APP-PSEN1mice compared to untreated samples from WT mice, which further increased in mitochondria from APP-PSEN1-SREBF2mice (). Thus, cholesterol likely through regulating Aβ-induced mitochondrial ROS affects mitochondrial dynamics and stimulates cardiolipin externalization, which may prime mitochondria for autophagy.
Loss of autophagic degradation capacity due to high cholesterol levels alters intracellular and extracellular Aβ levels
Once the impact of cholesterol on Aβ-induced autophagy was established, we analyzed whether these alterations in turn regulated Aβ metabolism. Autophagy has been described to influence intracellular Aβ accumulation and plaque formation by regulating the secretion of the peptide to the extracellular space [52]. Using cortical and hippocampal neurons, we determined the levels of Aβ in medium conditioned for 48 h (Figure 6A). Neurons from APP-PSEN1mice that overexpressed SREBF2 showed an approximate 2.5-fold increase of extracellular Aβ concentration in comparison with cells from APP-PSEN1mice (Figure 6A). Preincubation with wortmannin significantly reduced the extracellular Aβ levels in both APP-PSEN1 and APP-PSEN1-SREBF2 cells, compared to untreated cells (Figure 6B). However, since the effect was most robust (i.e., close to 60% reduction) in cells that overexpressed SREBF2 (Figure 6B), the higher Aβ secretion in these cells could be attributed to enhanced autophagy. Intriguingly, an even greater reduction in Aβ extracellular levels was observed on pretreatment with GSHee (Figure 6B). This decrease in extracellular Aβ levels, which paralleled the reduction of autophagosomes observed after GSHee treatment, underscores a cholesterol-regulated connection between ROS, autophagy and Aβ secretion.
Figure 6.
SREBF2 overexpression in APP-PSEN1 mice results in intracellular Aβ accumulation associated with stimulated Aβ secretion. (A and B) Quantitative assessment of extracellular Aβ secretion analyzed in medium conditioned for 48 h of neuronal-enriched cultures isolated from APP-PSEN1 and APP-PSEN1-SREBF2 mice, untreated (A) and treated with 0.2 μM wortmannin (WM) or 4 mM GSHee and expressed as percentage of untreated controls (B). *P< 0.05; n=3. (C and D) Confocal colocalization analysis of Aβ and LC3B (C) or Aβ and LAMP2 (D) in hippocampal slices from 7-mo-old APP-PSEN1 and APP-PSEN1-SREBF2 mice with or without in vivo GSHee treatment. Insets show a 3-fold magnification of the indicated region. Graphs represent fluorescence intensity profiles of Aβ (green) and LC3B or LAMP2 (red) in the regions delineated by a white line. Nuclei were stained with DRAQ5 (blue). Scale bar: 50 μm.
SREBF2 overexpression in APP-PSEN1mice results in intracellular Aβ accumulation associated with stimulated Aβ secretion. (A and B) Quantitative assessment of extracellular Aβ secretion analyzed in medium conditioned for 48 h of neuronal-enriched cultures isolated from APP-PSEN1 and APP-PSEN1-SREBF2mice, untreated (A) and treated with 0.2 μM wortmannin (WM) or 4 mM GSHee and expressed as percentage of untreated controls (B). *P< 0.05; n=3. (C and D) Confocal colocalization analysis of Aβ and LC3B (C) or Aβ and LAMP2 (D) in hippocampal slices from 7-mo-old APP-PSEN1 and APP-PSEN1-SREBF2mice with or without in vivo GSHee treatment. Insets show a 3-fold magnification of the indicated region. Graphs represent fluorescence intensity profiles of Aβ (green) and LC3B or LAMP2 (red) in the regions delineated by a white line. Nuclei were stained with DRAQ5 (blue). Scale bar: 50 μm.To assess the intracellular localization of Aβ and its relationship with the autophagic system we next performed double immunostaining with antibodies against Aβ and LC3B or LAMP2 (Figure 6C and D). As expected, confocal microscopy revealed higher presence of intracellular Aβ and autophagosomes (LC3B puncta) in the hippocampus from 7-mo-old APP-PSEN1-SREBF2mice, in comparison to APP-PSEN1mice (Figure 6C). However, while almost all Aβ colocalized with LC3B+ vesicles in hippocampus from APP-PSEN1mice (Figure 6C), only a partial colocalization was observed in samples from mice overexpressing SREBF2 (Figure 6C), which meant that Aβ was located in different intracellular compartments apart from autophagosomes. In vivo GSHee treatment of APP-PSEN1-SREBF2mice markedly reduced the levels of LC3B puncta; however, it did not ameliorate the degree of colocalization with Aβ that was observed in samples from untreated animals (Figure 6C). Histological slices from APP-PSEN1mice showed a high degree of colocalization between Aβ and LAMP2 in lysosomes (Figure 6D). Conversely, however, almost none of the Aβ+ granules in samples from triple transgenic mice colocalized with the lysosomal marker (Figure 6D). Further, GSHee treatment did not improve the low levels of colocalization (Figure 6D). Altogether these findings suggest that the effect of cholesterol on autophagy modifies both intracellular and extracellular Aβ levels. High cholesterol levels impair Aβ lysosomal clearance, which results in intracellular accumulation of the toxic peptide, and via regulation of the mGSH and Aβ-induced ROS axis, cholesterol enhances autophagosome formation that ultimately favors Aβ secretion.Autophagosomes can be formed de novo or arise from pre-existing membranes derived from different organelles [53]. Autophagosome biogenesis has been described in ZFYVE1 (zinc finger FYVE-type containing 1) positive subdomains of the endoplasmic reticulum (ER). In recent reports, mitochondria and the ER-mitochondrial contact sites have also been proposed as membrane suppliers, showing that disruption of these contact sites by silencing of PACS2 (phosphofurin acidic cluster sorting protein 2) or MFN2 (mitofusin 2), prevents autophagosome synthesis induced by starvation [54]. To analyze the contribution of these ER-mitochondrial contact sites to cholesterol-regulated autophagosome formation in APP-PSEN1-SREBF2mice we knocked down the expression of MFN2, a protein that tethers the ER to mitochondria (). Mouse embryonic fibroblasts were transfected with Mfn2 siRNA or control siRNA for 48 h. Western blot analysis confirmed a marked downregulation of MFN2 in cells derived from APP-PSEN1 and APP-PSEN1-SREBF2mice after Mfn2 siRNA incubation (). Knockdown of MFN2 expression resulted in a significant reduction of LC3B puncta in cells from APP-PSEN1-SREBF2mice (). Similarly, the increased presence of LC3B-positive vesicles in cells from SREBF2mice induced by Aβ was prevented by pretreatment with Mfn2 siRNA (). Furthermore, the quantitative analysis of Aβ levels in conditioned media showed that Mfn2 silencing affected Aβ secretion in both APP-PSEN1 and APP-PSEN1-SREBF2 cells (). These results demonstrate that a correct interplay between ER and mitochondria is required for cholesterol-enhanced autophagosome biogenesis and may play a critical role in regulating Aβ metabolism and secretion.
APP-PSEN1-SREBF2 mice show an enlarged endosomal-lysosomal system with high cholesterol levels but preserved functionality
To gain insight into the mechanistic link between high cholesterol levels and the autophagy deficiency observed in the APP-PSEN1-SREBF2mice we analyzed the endosomal-lysosomal system. Enlarged endosomes in the brain have been reported in patients with sporadic AD at preclinical stages of the disease [9]. This phenotype, which is particularly exacerbated in patients carrying the ε4 allele of the APOE gene, has been also observed in neurons and AD animal models after cholesterol loading [17,55-57]. In line with these data, brain homogenates from mice overexpressing SREBF2 showed increased levels of EEA1 (early endosome antigen 1) and the GTPase RAB5A, which has been proposed to be a master regulator of endosome biogenesis [58] (Figure 7A). In APP-PSEN1-SREBF2mice, the increased levels of endosomal markers were associated with the high expression of LAMP2, suggesting the synergistic effect between cholesterol and Aβ on the regulation of the endosomal-lysosomal system.
Figure 7.
APP-PSEN1-SREBF2 mice show an enlarged endosomal-lysosomal system with high cholesterol levels but preserved functionality. (A) Expression levels of the indicated proteins in brain homogenates from 7-mo-old WT and mutant mice. Densitometric values of the bands representing specific protein immunoreactivity were normalized with the values of the corresponding ACTB bands and expressed as relative intensity values. *P < 0.05 and **P < 0.01; n = 3. (B) Cholesterol levels of endosomes-lysosomes isolated from brain homogenates of the indicated mice at 7 mo of age and expressed as μg of product per ACP (acid phosphatase) activity. *P< 0.05; n=3. (C and D) Hippocampal slices from 7-mo-old WT and transgenic mice. Shown are confocal photomicrographs of CTSD and LAMP2 immunoreactivity (C) or IGF2R and LAMP2 immunoreactivity (D). Scale bar: 50 μm. (G) Embryonic cortical and hyppocampal neurons isolated from WT and APP-PSEN1-SREBF2 mice. Shown are representative confocal images of double immunolabeling with antibodies against LAMP2 (green) and CTSD (red) or IGF2R (red), as indicated. Nuclei were stained with DRAQ5 (blue). Scale bar: 50 μm. The Pearson correlation coefficient was calculated in all the confocal microscopy analysis for quantifying colocalization (15 to 20 cells were analyzed per genotype and experimental condition from a pool of at least 3 images).
APP-PSEN1-SREBF2mice show an enlarged endosomal-lysosomal system with high cholesterol levels but preserved functionality. (A) Expression levels of the indicated proteins in brain homogenates from 7-mo-old WT and mutant mice. Densitometric values of the bands representing specific protein immunoreactivity were normalized with the values of the corresponding ACTB bands and expressed as relative intensity values. *P < 0.05 and **P < 0.01; n = 3. (B) Cholesterol levels of endosomes-lysosomes isolated from brain homogenates of the indicated mice at 7 mo of age and expressed as μg of product per ACP (acid phosphatase) activity. *P< 0.05; n=3. (C and D) Hippocampal slices from 7-mo-old WT and transgenic mice. Shown are confocal photomicrographs of CTSD and LAMP2 immunoreactivity (C) or IGF2R and LAMP2 immunoreactivity (D). Scale bar: 50 μm. (G) Embryonic cortical and hyppocampal neurons isolated from WT and APP-PSEN1-SREBF2mice. Shown are representative confocal images of double immunolabeling with antibodies against LAMP2 (green) and CTSD (red) or IGF2R (red), as indicated. Nuclei were stained with DRAQ5 (blue). Scale bar: 50 μm. The Pearson correlation coefficient was calculated in all the confocal microscopy analysis for quantifying colocalization (15 to 20 cells were analyzed per genotype and experimental condition from a pool of at least 3 images).Next, we confirmed that the increased cholesterol levels shown in total brain homogenates of mice overexpressing SREBF2 [35,37], resulted in cholesterol-enrichment of the endosomal-lysosomal compartments (Figure 7B). A similar increase of cholesterol content was observed in endosomes-lysosomes isolated from brains of APP-PSEN1mice from the age of 10 mo onward (, which also paralleled the rise in cholesterol previously reported in total brain extracts [35]. The lack of cross-contamination in the endosomal-lysosomal fraction by other cellular membranes was estimated from western blot analysis of CALR (calreticulin; marker of endoplasmic reticulum), ATP1A1 (ATPase Na+/K+ transporting, alpha 1 polypeptide; marker of plasma membrane), MAP1LC3B/LC3B (marker of autophagosomes in its LC3B-II lipidated form) and COX4 (cytochrome c oxidase subunit 4; marker of mitochondria) ().PSEN1 knockdown or defective PSEN1 with AD-linked point mutations such as A246E, M233T, H163Y, M146L, and L392V, have been suggested to inhibit autophagosome clearance by affecting the proteolytic activity of lysosomes [10,11]. However, APP-PSEN1-SREBF2mice, despite harboring the most severe mutation in PSEN1 that causes 2 amino-acid substitutions and an in-frame deletion of exon 9, did not show signs of impaired lysosomal function. We previously described the unaltered activity of the lysosomal hydrolase CTSD (cathepsin D) in brain homogenates of APP-PSEN1-SREBF2mice compared with WT counterparts [37]. In addition, and in line with studies showing higher lysosomal membrane stability after cholesterol enrichment [59], confocal analysis of hippocampal slices from transgenic mice revealed a lack of lysosomal leakage (Figure 7C), with an equal degree of colocalization between CTSD and LAMP2 and total absence of diffuse cytosolic CTSD, in comparison with histological samples from WT mice. In parallel, we evaluated changes in lysosomal acidification. Luminal acidification was assessed by analyzing the degree of colocalization between LAMP2 and the IGF2R/CI-MPR (insulin-like growth factor 2 receptor), taking advantage of the fact that dissociation of IGF2R from cathepsins after their delivery to late endosomes required proper lysosomal acidification. Most LAMP2-positive vesicles were negative for IGF2R in histological samples from both WT and APP-PSEN1-SREBF2mice (Figure 7D), which indicated that the dissociation of IGF2R from cathepsins was unaffected. Confocal microscopy analysis of primary neuronal cultures also showed that almost all LAMP2+ vesicles, regardless of cell genotype, were positive for CTSD and negative for IGF2R (Figure 7E), confirming the lack of lysosomal dysfunction.
Impaired fusion between autophagosomes and lysosomes by high cholesterol levels disrupts Aβ and MAPT autophagic clearance
Fraldi et al [18]. demonstrate that cholesterol accumulation reduces the ability of lysosomes to fuse with endocytic and autophagic vesicles in mouse embryonic fibroblasts derived from 2 different LSD mouse models. In line with this study, impaired autophagy in NPC has been related to defective autophagosome-late endosome fusion, whereas lysosomal proteolytic function remains unaffected [15]. We assessed the fusogenic capability between autophagosomes and lysosomes isolated from brains of 10-mo-old APP-PSEN1mice, with or without SREBF2 overexpression, and from the brains of rapamycin-primed SREBF2 and WT mice. To characterize whether high cholesterol levels affected fusion dynamics independently of vesicular trafficking, we used an in vitro image-based assay, which has been previously described in detail [19]. Briefly, 3 different fractions corresponding to autophagosomes (F1), autolysosomes (F2), and lysosomes (F3) were isolated from brain homogenates by a discontinuous density Nycodenz gradient. Western blot analysis confirmed marked enrichment of the autophagosome marker LC3B in fraction F1, while CTSD, which was detected in low levels in F1, was mostly enriched in fraction F3 (). Autophagosomes (F1) immunolabeled with anti-LC3B antibody, and lysosomes (F3) stained with the fluorescent acidotropic dye LysoTracker Red were incubated together and fusion events were monitored using immunofluorescence microscopy (Figure 8A). Double labeling of F1 and F3 and the subsequent analysis of individual fluorescence images showed <6% of cross-contamination between fractions (). Fusion was calculated as the percentage of total vesicles positive for both fluorophores. Overexpression of SREBF2 significantly impaired the fusogenic capability of vesicles isolated from APP-PSEN1-SREBF2mice, compared to vesicles from APP-PSEN1mice (36.0% vs. 64.7%, respectively) (Table 1). Fluorescence images from homotypic fusion between autophagosomes and lysosomes from APP-PSEN1-SREBF2mice displayed differentially labeled vesicles in close proximity but without fusion, unlike samples from APP-PSEN1mice (Figure 8A). A similar reduction in the percentage of fusion was observed when the assays were performed using autophagosomes and lysosomes from SREBF2mice treated with rapamycin, compared with fusion assays of vesicles from WT mice (26.4% vs. 63%, respectively) (Table 2). Interestingly, heterotypic fusion assays revealed a comparable decrease in colocalization frequencies regardless of whether the cholesterol-enriched particles were autophagosomes or lysosomes (Table 2).
Figure 8.
APP-PSEN1 mice overexpressing SREBF2 show impaired autophagosome and endosome-lysosome fusion associated with an accumulation of Aβ and endogenous MAPT in autophagosomes. (A) Autophagosomes (F1) immunolabeled with anti-LC3B antibody and lysosomes (F3) stained with LysoTracker Red were incubated together and fusion events were monitored by immunofluorescence microscopy. Insets show a 3-fold magnification. In inset 2, differentially labeled vesicles in close proximity are indicated by white arrows. Scale bar: 50 μm. (B) Expression levels of Aβ and MAPT in autophagosomes (AP) and endosomes-lysosomes (EL). LC3B and CTSD (intermediate, 45 kDa; and mature form, 34 kDa) were used as markers of AP and lysosomes, respectively. All densitometric values were first normalized to Ponceau S staining to adjust for protein loading. MAPT values were normalized to the corresponding LC3B (I and II) and CTSD (mature form) bands. *P< 0.05 and **P< 0.01; n=3. (C) Proteinase K protection assay. Autophagosomes from APP-PSEN1-SREBF2 mice were exposed to proteinase K (Prot K) with or without Triton X-100 for 30 min. After inhibition of protease activity, levels of Aβ were quantified. To evaluate the presence of Aβ aggregates the same autophagosomal fraction was incubated with HFIP. Disruption of the aggregated forms significantly increased Aβ values, presumably by favoring antibody recognition. *P< 0.05 and **P< 0.01; n=3.
Table 1.
Decreased fusion of autophagosomes with endosomes-lysosomes isolated from APP-PSEN1-SREBF2 mice compared to APP-PSEN1 mice.
homotypic fusion
N COUNT
% FUSION
APP-PSEN1
1712
64.7%
APP-PSEN1-SREBF2
3656
36.0%***
Table summarizes particle counting and percentages of autophagosomes fused to endosomes-lysosomes after homotypic incubation of isolated fractions. *** P<0.001 vs APP-PSEN1 values by analysis of proportions with Chi-squared (χ2) test. Counts are from 10 different fields from 3 independent experiments.
Table 2.
Decreased fusion of autophagosomes with endosomes-lysosomes isolated from SREBF2 mice compared to WT mice.
N COUNT
% FUSION
WT homotypic fusion
1432
63.0%
SREBF2 homotypic fusion
2298
26.4% ***
Heterotypic fusion 1: (WT APs + SREBF2 EL)
1716
28.7% ***
Heterotypic fusion 2: (SREBF2 APs + WT EL)
1472
29.8% ***,*
Table summarizes particle counting and percentages of autophagosomes (APs) fused to endosomes-lysosomes (EL) after homotypic and heterotypic incubation of isolated fractions. *** P<0.001 vs WT homotypic values, * P<0.05 vs SREBF2 homotypic values by analysis of proportions with the Chi-squared (χ2) test. Counts are from 10 different fields from 3 independent experiments.
APP-PSEN1mice overexpressing SREBF2 show impaired autophagosome and endosome-lysosome fusion associated with an accumulation of Aβ and endogenous MAPT in autophagosomes. (A) Autophagosomes (F1) immunolabeled with anti-LC3B antibody and lysosomes (F3) stained with LysoTracker Red were incubated together and fusion events were monitored by immunofluorescence microscopy. Insets show a 3-fold magnification. In inset 2, differentially labeled vesicles in close proximity are indicated by white arrows. Scale bar: 50 μm. (B) Expression levels of Aβ and MAPT in autophagosomes (AP) and endosomes-lysosomes (EL). LC3B and CTSD (intermediate, 45 kDa; and mature form, 34 kDa) were used as markers of AP and lysosomes, respectively. All densitometric values were first normalized to Ponceau S staining to adjust for protein loading. MAPT values were normalized to the corresponding LC3B (I and II) and CTSD (mature form) bands. *P< 0.05 and **P< 0.01; n=3. (C) Proteinase K protection assay. Autophagosomes from APP-PSEN1-SREBF2mice were exposed to proteinase K (Prot K) with or without Triton X-100 for 30 min. After inhibition of protease activity, levels of Aβ were quantified. To evaluate the presence of Aβ aggregates the same autophagosomal fraction was incubated with HFIP. Disruption of the aggregated forms significantly increased Aβ values, presumably by favoring antibody recognition. *P< 0.05 and **P< 0.01; n=3.Decreased fusion of autophagosomes with endosomes-lysosomes isolated from APP-PSEN1-SREBF2mice compared to APP-PSEN1mice.Table summarizes particle counting and percentages of autophagosomes fused to endosomes-lysosomes after homotypic incubation of isolated fractions. *** P<0.001 vs APP-PSEN1 values by analysis of proportions with Chi-squared (χ2) test. Counts are from 10 different fields from 3 independent experiments.Decreased fusion of autophagosomes with endosomes-lysosomes isolated from SREBF2mice compared to WT mice.Table summarizes particle counting and percentages of autophagosomes (APs) fused to endosomes-lysosomes (EL) after homotypic and heterotypic incubation of isolated fractions. *** P<0.001 vs WT homotypic values, * P<0.05 vs SREBF2 homotypic values by analysis of proportions with the Chi-squared (χ2) test. Counts are from 10 different fields from 3 independent experiments.Next, we analyzed whether cholesterol-impaired fusogenic ability affected the presence of Aβ and MAPT in autophagic vesicles. There was no overt presence of Aβ in lysosomes, regardless of genotype, whereas the toxic peptide accumulated in autophagosomes in 10-mo-old APP-PSEN1-SREBF2mice (Figure 8B). Aβ in the autophagosomal fraction was resistant to proteinase K degradation, but it became sensitive when autophagosome membranes were permeabilized by Triton X-100, which indicated that Aβ was completely enclosed by the autophagosome membranes (Figure 8C). Interestingly, treatment of autophagosomes with HFIP (hexafluoroisopropanol), a compound widely used to break down β-sheet structure, resulted in 3-fold increased Aβ quantification compared with untreated samples (Figure 8C). This outcome would be consistent with a prominent presence of Aβ aggregates in autophagosomes, whose epitopes became unmasked after HFIP treatment.Previous studies indicated that autophagy can also enhance the clearance of pathological or total endogenous MAPT [60-63]. Furthermore, it has been shown that coincubation of CTSD and MAPT results in the loss of intact MAPT proteins and production of a 28-kDa fragment [64]. Consistent with an impaired autophagy-mediated MAPT clearance, immunoblotting using an antibody against pan-MAPT (anti-TAU-5) revealed substantially reduced levels of the 28 kDa fragment in lysosomal compartments, accompanied with an accumulation of intact MAPT (55 to 65 kDa) in autophagosomes from mice overexpressing SREBF2 (Figure 8B).
Mice overexpressing SREBF2 show changes in the expression levels and membrane distribution of key proteins involved in the fusion of autophagosomes and endosomes-lysosomes
The membrane fusion process requires conserved machinery that consists of RAB GTPases, membrane-tethering effectors that mediate the first contact, and SNAREs. SNAREs are membrane-anchored proteins that interact with each other to form a trans-SNARE complex that consists of R-SNAREs (with an arginine [R] residue in the SNARE motif) on the donor membrane and Q-SNAREs (with a glutamine [Q] residue in the SNARE motif) on the acceptor membrane [65]. From the 38 SNAREs identified in humans [65], the Q-SNAREs including STX7 (syntaxin 7), SXT8 (syntaxin 8), STX17(syntaxin 17) and VTI1B (vesicle transport through interaction with t-SNAREs 1B), along with the R-SNAREs VAMP7 (vesicle-associated membrane protein 7) and VAMP8, have been directly or indirectly implicated in the autophagosome and endosome-lysosome fusion process [66]. Remarkably, cholesterol-binding motifs have been identified in some of them [67]. In addition, changes in cellular cholesterol levels have been described to affect the dynamics of SNAREs assembly and disassembly in intracellular membranes, by regulating their location and fusogenic functions [15,18,68]. Based on these data we investigated whether accumulation of cholesterol can modulate the content and distribution of VAMP7, VTI1B and STX7 in endosomes-lysosomes isolated from the brain of mice that overexpress SREBF2. Compared to WT mice, the level of VAMP7, VTI1B, and STX7 were markedly increased in the endosome-lysosome membranes of APP-PSEN1-SREBF2mice (Figure 9A). VTI1B was also significantly high in samples from SREBF2mice. Additionally, as previously reported [69], cholesterol enrichment increased the content of small GTPase RAB7A, while the levels of both the ATP6V0A1 (ATPase, H+ transporting, lysosomal V0 subunit A1), responsible for lysosome acidification, and the lipid raft marker FLOT1 (flotillin 1), remain unaltered (Figure 9A).
Figure 9.
Changes in levels and membrane distribution of key autophagosome and endosome-lysosome fusion proteins in mice overexpressing SREBF2 are prevented by in vivo treatment with 2-hydroxypropyl-β-cyclodextrin resulting in improved MAPT and Aβ clearance. (A) Western blot analysis of the indicated proteins in endosomes-lysosomes isolated from 7-mo-old WT and transgenic mice. (B) Immunoblot analysis of VAMP7 and VTI1B distribution into soluble fractions and DRMs isolated from endosomes-lysosomes of 7-mo-old WT and the indicated transgenic mice. Immunoblots with FLOT1 identified DRMs mainly in fractions 1 and 2. Int-I and Int-II: intermediate fraction I and II, Sol.: soluble fraction. (C) Expression levels of ATG14 and STX17 in autophagosomes isolated from 7-mo-old WT and the indicated mutant mice. To induce autophagy WT and SREBF2 mice were treated with rapamycin (RM, 5 mg/kg) for 24 h. LC3B protein levels were analyzed as a marker of autophagosomes. ATG14 and STX17 were normalized to the corresponding LC3B (I and II) bands. (D to H) Mice were treatment with HP-β-CD (4 g/kg) for 10 wk. To induce autophagy WT and SREBF2 mice were treated with rapamycin (RM, 5 mg/kg) 24 h prior sacrifice. (D) Expression levels of RAB7A and the indicated SNARE proteins in endosomes-lysosomes. LAMP1 was used as a marker of lysosomes. Densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding LAMP1 bands. (E) Immunoblot analysis of VAMP7 and VTI1B distribution into soluble fractions and DRMs isolated from endosomes-lysosomes (EL). Immunoblots with FLOT1 identified DRMs mainly in fractions 1 and 2. Int-I and Int-II: intermediate fractions I and II, Sol.: soluble fraction. (F) Expression levels of ATG14 and STX17 in autophagosomes. LC3B was used as a marker of autophagosomes. ATG14 and STX17 were normalized to the corresponding LC3B (I and II) bands. (G) Expression levels of endogenous MAPT in autophagosomes (AP) and endosomes-lysosomes (EL). LC3B and CTSD (intermediate, 45 kDa; and mature form, 34 kDa) levels were used as autophagosome and lysosome markers, respectively. MAPT values were normalized to the corresponding LC3B (I and II) and CTSD (mature form) bands. (H) Representative immunoblot showing that HP-β-CD treatment prevents the accumulation of Aβ in autophagosomes isolated from APP-PSEN1-SREBF2 mice. In all western blots, densitometric values of the bands representing specific protein immunoreactivity were first normalized to Ponceau S staining to adjust for protein loading. *P< 0.05 and **P< 0.01; n=3. See for uncropped blots.
Changes in levels and membrane distribution of key autophagosome and endosome-lysosome fusion proteins in mice overexpressing SREBF2 are prevented by in vivo treatment with 2-hydroxypropyl-β-cyclodextrin resulting in improved MAPT and Aβ clearance. (A) Western blot analysis of the indicated proteins in endosomes-lysosomes isolated from 7-mo-old WT and transgenic mice. (B) Immunoblot analysis of VAMP7 and VTI1B distribution into soluble fractions and DRMs isolated from endosomes-lysosomes of 7-mo-old WT and the indicated transgenic mice. Immunoblots with FLOT1 identified DRMs mainly in fractions 1 and 2. Int-I and Int-II: intermediate fraction I and II, Sol.: soluble fraction. (C) Expression levels of ATG14 and STX17 in autophagosomes isolated from 7-mo-old WT and the indicated mutant mice. To induce autophagy WT and SREBF2mice were treated with rapamycin (RM, 5 mg/kg) for 24 h. LC3B protein levels were analyzed as a marker of autophagosomes. ATG14 and STX17 were normalized to the corresponding LC3B (I and II) bands. (D to H) Mice were treatment with HP-β-CD (4 g/kg) for 10 wk. To induce autophagy WT and SREBF2mice were treated with rapamycin (RM, 5 mg/kg) 24 h prior sacrifice. (D) Expression levels of RAB7A and the indicated SNARE proteins in endosomes-lysosomes. LAMP1 was used as a marker of lysosomes. Densitometric values of the bands representing the specific protein immunoreactivity were normalized with the values of the corresponding LAMP1 bands. (E) Immunoblot analysis of VAMP7 and VTI1B distribution into soluble fractions and DRMs isolated from endosomes-lysosomes (EL). Immunoblots with FLOT1 identified DRMs mainly in fractions 1 and 2. Int-I and Int-II: intermediate fractions I and II, Sol.: soluble fraction. (F) Expression levels of ATG14 and STX17 in autophagosomes. LC3B was used as a marker of autophagosomes. ATG14 and STX17 were normalized to the corresponding LC3B (I and II) bands. (G) Expression levels of endogenous MAPT in autophagosomes (AP) and endosomes-lysosomes (EL). LC3B and CTSD (intermediate, 45 kDa; and mature form, 34 kDa) levels were used as autophagosome and lysosome markers, respectively. MAPT values were normalized to the corresponding LC3B (I and II) and CTSD (mature form) bands. (H) Representative immunoblot showing that HP-β-CD treatment prevents the accumulation of Aβ in autophagosomes isolated from APP-PSEN1-SREBF2mice. In all western blots, densitometric values of the bands representing specific protein immunoreactivity were first normalized to Ponceau S staining to adjust for protein loading. *P< 0.05 and **P< 0.01; n=3. See for uncropped blots.We next analyzed the compartmentalization of SNAREs in endosome-lysosome detergent-resistant membranes (DRMs), cholesterol-enriched domains, which can be isolated through a sucrose-gradient centrifugation and identified by FLOT1 immunostaining [70]. In agreement with previous data from LSD cell models [18], high cholesterol levels in endosome-lysosome membranes from mice overexpressing SREBF2 correlated with an increased presence of VAMP7 and VTI1B in DRMs at the expense of lower amounts of both in the soluble region of the gradient (Figure 9B). The aberrant sequestration of SNAREs in cholesterol-enriched regions was not observed in samples from WT and APP-PSEN1mice (Figure 9B).ATG14 has been identified as a key player in autophagosome and lysosome fusion, through its binding and subsequent stabilization of the STX17-SNAP28 complex on the autophagosome membranes [71]. Interestingly, our western blot analysis showed increased levels of ATG14 and STX17 in autophagosomes from rapamycin-treated SREBF2mice and APP-PSEN1-SREBF2mice (Figure 9C). The increase in protein expression in both cases was not due to upregulated transcription as qRT-PCR analysis displayed similar Atg14 and Stx17 mRNA levels regardless of mouse genotype (). Moreover, the accumulation of ATG14 and STX17 in autophagosomes in SREBF2mice was not observed unless autophagy was induced (). Further, the inhibition of the lysosomal function by chloroquine was not sufficient to promote the accumulation of both proteins in rapamycin-primed WT cells (), meaning that ATG14 and STX17 enrichment in samples from SREBF2mice was not due to the impaired autophagy clearance.
In vivo treatment with 2-hydroxypropyl-β-cyclodextrin in mice overexpressing SREBF2 reduces the endosome-lysosome cholesterol levels, recovering impaired autophagosome-lysosome fusion and restoring Aβ and MAPT autophagy degradation
In npc1 knockout mice, a single brain injection of the hydroxypropyl form of β-cyclodextrin (HP-β-CD), a cyclic polysaccharide compound that modulates the cellular cholesterol content [20], is sufficient to promote cholesterol export from lysosomes [21]. In these mice chronic administration of the drug for 28 d (either by continuous brain infusion or systemically administrated) prevents most of the pathological hallmarks of NPC. Later studies from mice overexpressing mutant App transgenes indicate that HP-β-CD can also be beneficial for AD [23,72]. In these studies, cognitive improvement after chronic HP-β-CD administration is associated with lower phosphorylated MAPT and reduced Aβ burden, suggesting that the therapeutic effect of the drug may in part be mediated by enhanced clearance of Aβ. [23] To analyze the impact of a chronic HP-β-CD treatment on autophagy, mice were administered with the compound (4 g/kg/day) for 10 wk. Compared to WT levels, the treatment significantly reduced the cholesterol content of endosomes-lysosomes of SREBF2 and APP-PSEN1-SREBF2mice (). The reversal of cholesterol accretion by HP-β-CD prevented the accumulation of RAB7A and SNAREs in endosomes-lysosomes of APP-PSEN1-SREBF2 and rapamycin-primed SREBF2mice (Figure 9D). Further, the wrong compartmentalization of SNAREs, which was displayed in the endosomes-lysosomes of mice overexpressing SREBF2, was corrected after HP-β-CD treatment, showing the translocation of VAMP7 and VTI1B from DRMs to more soluble areas of the endosome-lysosome membranes (Figure 9E). In contrast, the high content of ATG14 and STX17 in autophagosomes from APP-PSEN1-SREBF2 and rapamycin-primed SREBF2mice remained unchanged, regardless of whether or not the mice were administered the cholesterol-lowering agent (Figure 9F), indicating that the abnormalities in autophagosome membranes are not recovered by the treatment.Next, we investigated whether HP-β-CD-induced changes in SNAREs levels and distribution in endosome-lysosome membranes were sufficient to correct the impaired autophagosome-lysosome fusion. Fluorescence images of homotypic incubation of autophagosomes (LC3B+ vesicles) and lysosomes (LysoTracker Red+ vesicles), which were isolated from rapamycin-primed SREBF2mice, revealed a dramatic increase in the number of colocalization events when mice were previously treated with HP-β-CD (70.3% vs. 31.9%, respectively) (Table 3 and ). It is noteworthy that the recovery of the fusogenic properties was associated with improved Aβ and MAPT metabolism. SREBF2mice treated with HP-β-CD showed reduced levels of full-length MAPT in autophagosomes associated with the increased presence of 28-kDa fragments in lysosomes (Figure 9G), which was indicative of autophagic flux recovery. Similarly, the Aβ accumulation in the autophagosomes of 10-mo-old APP-PSEN1-SREBF2mice was totally prevented by HP-β-CD treatment (Figure 9H). Overall, our data demonstrate a dual role of cholesterol in Aβ-induced autophagy, stimulating autophagosomes formation but impairing autophagosome-lysosome fusion, which ultimately reverberates on Aβ and MAPT metabolism (Figure 10).
Table 3.
In vivo treatment with 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) recovers the fusogenic properties of autophagic vesicles isolated from SREBF2 mice.
N COUNT
% FUSION
WT + RM
1239
70.3%
SREBF2 + RM
888
31.9% ***
WT + HP-β-CD + RM
509
82.0%
SREBF2 + HP-β-CD + RM
476
70.3% ###
Table summarizes particle counting and percentages of autophagosomes fused to endosomes-lysosomes after homotypic incubation of isolated fractions. RM, rapamycin. *** P<0.001 vs WT values, ### P<0.001 vs SREBF2 values by analysis of proportions with the Chi-squared (χ2) test. Counts are from 10 different fields from 3 independent experiments.
Figure 10.
Schema illustrating our proposed model by which high cholesterol levels regulate Aβ-induced autophagy. In mitochondria (A), cholesterol-enrichment enhances ROS generation triggered by Aβ. The increased oxidative stress inhibits the delipidation activity of ATG4B on LC3B, and therefore, favors autophagosome synthesis. ER-mitochondria contact sites contribute to the biogenesis of these vesicles, which mainly enclose Aβ aggregates together with other more soluble forms of the peptide. In contrast, the accumulation of cholesterol in lysosomes (B) affects the levels and distribution of RAB7A and SNARE proteins, which ultimately impairs the ability of lysosomes to fuse with autophagosomes and/or amphisomes. Inhibition of the autophagy flux by high cholesterol levels reduces MAPT and Aβ clearance and stimulates Aβ secretion. DRMs, detergent-resistant membranes; mGSH, mitochondrial glutathione; LE, late endosome; MVB, multivesicular body; ROS, reactive oxygen species.
In vivo treatment with 2-hydroxypropyl-β-cyclodextrin (HP-β-CD) recovers the fusogenic properties of autophagic vesicles isolated from SREBF2mice.Table summarizes particle counting and percentages of autophagosomes fused to endosomes-lysosomes after homotypic incubation of isolated fractions. RM, rapamycin. *** P<0.001 vs WT values, ### P<0.001 vs SREBF2 values by analysis of proportions with the Chi-squared (χ2) test. Counts are from 10 different fields from 3 independent experiments.Schema illustrating our proposed model by which high cholesterol levels regulate Aβ-induced autophagy. In mitochondria (A), cholesterol-enrichment enhances ROS generation triggered by Aβ. The increased oxidative stress inhibits the delipidation activity of ATG4B on LC3B, and therefore, favors autophagosome synthesis. ER-mitochondria contact sites contribute to the biogenesis of these vesicles, which mainly enclose Aβ aggregates together with other more soluble forms of the peptide. In contrast, the accumulation of cholesterol in lysosomes (B) affects the levels and distribution of RAB7A and SNARE proteins, which ultimately impairs the ability of lysosomes to fuse with autophagosomes and/or amphisomes. Inhibition of the autophagy flux by high cholesterol levels reduces MAPT and Aβ clearance and stimulates Aβ secretion. DRMs, detergent-resistant membranes; mGSH, mitochondrial glutathione; LE, late endosome; MVB, multivesicular body; ROS, reactive oxygen species.
Discussion
In the present study, we advance the knowledge of the role of cholesterol in AD. We demonstrate that brain cholesterol homeostasis can affect MAPT and Aβ clearance by impairing autophagy. Importantly, according to our findings, the critical factor by which cholesterol influences the metabolism of these 2 key players in AD is most related to increases of the sterol levels in specific compartments within the cell, rather than changes in the total levels (Figure 10). In mitochondria, cholesterol-mediated depletion of GSH stimulates Aβ-induced oxidative inhibition of ATG4B resulting in increased autophagosome formation. The rise of cholesterol in endosome-lysosome membranes, however, impairs autophagosome and lysosome fusion ability. It is interesting to note that impaired endocytic trafficking of cholesterol and accumulation of the lipid in endosomes-lysosomes have been linked to the apolipoprotein E4 variant, the most prevalent genetic risk factor of sporadic AD [73]. Similarly, in hippocampal neurons of normal mice the knockdown of CYP46A1/cholesterol 24-hydroxylase, i.e., the enzyme that controls cholesterol efflux from the brain, resulted in cognitive deficits and hippocampal atrophy associated with the accumulation of cholesterol and modifications of the endosomal compartment [57]. The affected neurons showed high cholesterol in DRMs, increased levels of RAB5A indicative of early endosomal enlargement, and upregulation of Abca1 and Npc2 mRNA, which could be explained as a compensatory response to the lipidjam in the endosomal-lysosomal system.In contrast to what was expected, the accumulation of lipidated LC3 in APP-PSEN1-SREBF2mice was accompanied by a reduction in the levels of BECN1. A similar outcome has been previously reported in the brains of patients with AD and mouse models of the disease [5]. The exact mechanism leading to this alteration, however, still remains unknown. In line with our observations, previous studies demonstrate that APP overexpression alone does not lead to BECN1 decrease unless autophagosomal-lysosomal fusion is inhibited by bafilomycin A1 [74]. In addition, we have found that the cholesterol-enhanced reduction of BECN1 was not observed in SREBF2mice when autophagy was induced by rapamycin, which indicated that the impairment of autophagy resolution was necessary, but not sufficient to regulate the levels of BECN1. It is known that the translocation of the PtdIns3K complex to autophagic or endocytic membranes is dependent on the interaction between the coiled-coil domain of BECN1 with either ATG14 (complex I) or UVRAG (UV radiation resistance associated) (complex II), thereby specifying its participation in autophagosome formation or endocytic trafficking, as well as autophagosome and endosome-lysosome fusion [75]. It would be worth exploring whether the changes of BECN1 levels may affect these interactions. Furthermore, given the high levels of ATG14 observed in the autophagosomes of APP-PSEN1-SREBF2mice, it would be also interesting to know whether this enrichment can influence PtdIns3K complex recruitment, favoring the balance towards autophagosome formation.Alterations in the autophagic flux were also observed in 15-mo-old APP-PSEN1mice, although this occurred with a temporary lag regarding endosomal-lysosomal cholesterol rise. Differences in the onset of these alterations can be explained by the existence of compensatory systems, which may eventually be affected. Using the same transgenicADmouse model, a longitudinal analysis of autophagy shows that accumulation of autophagosomes and decreased BECN1 levels correlate with the rise of neuroinflammatory cytokines at 12 mo of age [76], suggesting a link between autophagy impairment and neuroinflammation.We have found that treatment with GSHee completely prevented the accumulation of LC3-labeled autophagosomes that was induced by Aβ, in both SREBF2 and WT cells, indicating that a certain degree of oxidative stress is required for Aβ-induced autophagy. A similar inhibitory effect has been shown with antioxidants like N-acetyl-L-cysteine and CAT (catalase) under starving conditions [47]. These studies identified the transient oxidative inactivation of ATG4B as the molecular mechanism for redox regulation of the starvation-induced autophagy [47]. More recently, a redox control of ATG4B activity has been reported in response to hypoxia and energy stress via the induction of the pro-oxidant complex REDD1-TXNIP, in which redd1 knockout mice show deregulated ATG4B, impaired autophagic flux, and accumulation of defective mitochondria [77]. Our observations demonstrate the inhibitory effect of Aβ on ATG4B activity for the first time. Furthermore, the fact that the loss of activity was amplified in mice and cells overexpressing SREBF2 (with depleted mGSH), and was prevented by GSHee treatment, which reduces Aβ-induced mitochondrial ROS, strongly suggest the mitochondrial redox control of ATG4B activity. Further, since ATG4B acts as both a conjugating and deconjugating enzyme, although evidence is currently lacking, it would be reasonable to envision a subcellular spatial regulation of ATG4B activity, where a mitochondrial ROS burst would inactivate ATG4B at the site of autophagosome formation. Further work, however, is required to investigate this possibility.In neurons from APP-PSEN1-SREBF2mice enhanced ROS generation correlated with increased mitochondrial fragmentation and cardiolipin externalization, both events involved in mitophagy induction. Mitochondrial ROS has been reported as a trigger for PINK1-PRKN-dependent mitophagy [49]. A tight control of ROS homeostasis, by oxidative sensors such as PARK7 or the antioxidant enzyme PRDX6 (peroxiredoxin 6) [78,79], has been shown necessary to promote autophagic mitochondrial clearance and prevent ROS-induced cell death. Oxidative stress has also been linked to cardiolipin function [80]. Whereas externalization of nonoxidized cardiolipin acts as a mitophagy receptor, the presence of peroxidized cardiolipin in the outer mitochondrial membrane potentiates BAX (BCL2 associated X, apoptosis regulator)-mediated mitochondrial apoptosis [80,81]. Previously, we have shown that mGSH depletion in hepatocytes stimulates cardiolipin oxidation, sensitizing cells to tumor necrosis factor-induced apoptosis [82]. Therefore, one would expect that externalized cardiolipin in mitochondria of APP-PSEN1-SREBF2mice encloses a predominant presence of the oxidized forms, which initially may be more prone to induce apoptosis. Further research would be needed to decipher whether cholesterol by regulating Aβ-induced mitochondrial ROS can modulate the balance between mitophagy (PINK1-PRKN-dependent or -independent) and the mitochondrial apoptotic pathway. Recently, a novel mechanistic pathway for mitochondrial quality control under conditions of oxidative stress has been described, involving the formation of mitochondrial-derived vesicles (MDVs) [83]. PINK1-PRKN-dependent vesicles bud off of damaged mitochondria and are delivered to the endosomal-lysosomal system by a STX17-driven mechanism [84]. Whether MDVs are generated by Aβ-induced mitochondrial ROS is unknown. Studies in that direction might uncover MDVs as a new pathway for targeting mitochondrial Aβ to lysosomal degradation.A key feature of our findings is that cholesterol-induced changes in autophagy regulate both intracellular and extracellular Aβ levels. Our results suggest that intracellular accumulation of the toxic peptide in brain from APP-PSEN1-SREBF2mice can be attributed to the enhanced formation of autophagosomes, which have been identified as amyloidogenic sites [85], combined with the disruption of autophagosome-lysosome fusion that is elicited by high endosomal-lysosomal cholesterol levels. Remarkably, treatment with GSHee that failed to restore autophagy clearance (as seen by high SQSTM1 levels) did not normalize the intracellular accumulation of Aβ. Furthermore, confocal analysis only showed a partial colocalization of Aβ with autophagosomes, in line with recent studies that link the sequestration of cholesterol in endosomes-lysosomes with Aβ accumulation mostly in early and late endosomes [86,87]. Moreover, consistent with evidence linking autophagy with Aβ secretion [52], conditioned media from APP-PSEN1-SREBF2 cells displayed increased Aβ levels. The marked reduction of extracellular Aβ levels following wortmannin and GSHee treatment is further evidence for the role that autophagosomes play on Aβ secretion. The induction of autophagy in conjunction with the inhibition of degradative autophagic flux has been also described to induce secretory autophagy of α-synuclein [88]. The mechanisms that drive this unconventional secretory pathway are largely unknown, although the exocytosis of the amphisome and late endosome has been proposed to play a role [89].The metabolism of MAPT can also be influenced by cholesterol. MAPT is processed by both autophagy and the proteasome; however, unlike proteasomes, autophagy has been described to clear both soluble and insoluble MAPT, regardless of its phosphorylation state [61,62]. Consistent with these reports, activation of autophagy reduces MAPT levels in cultured cells and ameliorates MAPT pathology in MAPT-overexpressing mice [60,63], while the perturbation of lysosomal function induced aggregation of MAPT into tangle-like structures [62]. Once autophagy was engaged in the brains of mice overexpressing SREBF2, full-length MAPT accumulated in autophagosomes, with low amount of cleaved fragments in lysosomal compartments. The reversal effect observed after HP-β-CD treatment highlighted that cholesterol enrichment of endosomes-lysosomes was responsible for the impaired autophagic degradation of endogenous MAPT. Similarly, a buildup of MAPT in autophagic vesicles has been described in the muscles from rats following long-term administration of chloroquine [90]. Therefore, based on these findings it is reasonable to assume that the impaired autophagic clearance may contribute to the full tauopathy observed in APP-PSEN1-SREBF2mice [37]. Moreover, the induction of autophagy by nutrient deprivation, combined with lysosomal dysfunction has been described to increase MAPT secretion, which has been linked to the propagation of MAPT pathology in the brain [91]. The effect of cholesterol on MAPT secretion has not yet been analyzed; however, given the increase of Aβ secretion in SREBF2 cells, it is likely that a parallel release of MAPT is occurring.In nerve cells, most autophagosomes are formed distally in the neuritic network. Following their fusion with late endosomes the resulting amphisomes are transported retrogradely along microtubuli toward the centrosome, where most lysosomes reside. Mobility on microtubule tracks is regulated by the late endosomal GTPase RAB7A, which in combination with SNAREs, also plays a central role in the fusion of autophagosomes with endosomes-lysosomes. The cholesterol enrichment of endosome-lysosome membranes has been shown to affect proper sorting and recycling of RAB7A and SNAREs, leading to the inhibition of plus-end motility (anterograde traffic), which impairs the fusogenic properties of endosomes-lysosomes [18,69]. Accordingly, once autophagy is engaged, APP-PSEN1-SREBF2mice and SREBF2mice showed perinuclear accumulation of autophagosomes and impaired fusion, which was associated with high levels of RAB7A and aberrant buildup of different SNAREs in DRMs of endosomes-lysosomes. The recovery of the fusion events paralleled the restoration of RAB7A and SNAREs levels in endosome-lysosome membranes after HP-β-CD treatment, which further reinforces the mechanistic link between both alterations. It is noteworthy that VAMP7, VTI1B, and STX7 have been proposed to mediate autophagosome biogenesis by promoting the homotypic fusion of autophagic precursor vesicles [66]. However, whether changes in cholesterol can regulate these events is still unknown. Recently, the RAB7A effector, known as ORP1L, the N-terminally (950 amino acids) longer form of OSBPL1A (oxysterol binding protein-like 1A), has been identified as a cholesterol sensor on mature autophagosomes, which regulates their position and fusion capability [92]. Future studies will be required to evaluate its contribution to cholesterol-mediated autophagy impairment.The current in vivo studies demonstrate that HP-β-CD treatment significantly reduces Aβ and MAPT accumulation in autophagosomes by recovering the fusion abilities of autophagic vesicles, which indicates the proper clearance of both peptides. HP-β-CD does not cross the blood-brain barrier efficiently; however, given its efficacy in animal models of NPC, the molecule is currently being assayed in different clinical trials for NPC, via intrathecal and i.v. administration. Its exact mechanism of action is unknown. However, in neurons, in contrast to the neurotoxic effect displayed by high HP-β-CD concentrations (> 5 mM), small amounts of the drug are endocytosed and unclog the endosomal-lysosomal system by clearing lipids without significantly affecting total cholesterol levels [21,93]. This has established an important difference regarding other cholesterol-lowering agent such as statins, whose therapeutic use in AD up to date has provided mixed outcomes [32,33]. Overall, our results show that cholesterol exacerbates the pathological potential of Aβ by stimulating autophagy, paradoxically this results in reduced Aβ degradation and increased Aβ secretion due to impaired autolysosome formation. The results further highlight the relevance of specific brain-cholesterol-lowering strategies. Together with former studies showing neuroprotective effects of HP-β-CD in ADmouse model [23,72], and the current use in clinical trials for NPC, HP-β-CD exemplifies the potential for therapeutic approaches in AD, especially in conjunction with autophagy inducers.
Materials and methods
Mice
Breeding pairs of B6C3-Tg(APPswe,PSEN1dE9)85Dbo/J (APP-PSEN1; MMRRC stock 34829) [94] and B6;SJL-Tg(rPEPCKSREBF2)788Reh/J (SREBF2; JAX stock 003311) [95] mice were purchased from The Jackson Laboratory. APP-PSEN1mice express a chimeric mouse/humanamyloid precursor protein (isoform 695) with the Swedish mutation (Mo/HuAPP695swe) and mutant humanpresenilin 1 (PSEN1dE9), both directed to neurons by the mousePRNP (prion protein) promoter. Both mutations are associated with early-onset Alzheimer disease. The Swedish mutation is actually a double mutation (K595N/M596L) located immediately before the N terminus of the Aβ domain, which results in 3 to 6 times more Aβ production. Affected individuals meet diagnostic criteria for Alzheimer disease [96]. The PSEN1 sequence encodes humanpresenilin-1, which models AD-associated mutations in PSEN1 resulting in exclusion of exon 9 (dE9). This domain contains the cleavage site for proteolytic processing, and therefore, PSEN1dE9 accumulates as an uncleaved protein with a specific gain of toxic function for APP processing [94]. In turn, SREBF2mice express a transgenic construct containing a humanSREBF2 cDNA fragment (amino acids 1-468) under the control of the ratPEPCK (phosphoenolpyruvate carboxykinase) promoter. Former studies describe high circulating cholesterol levels and increased cholesterol synthetic rates in liver and adipose tissue of SREBF2mice [95]. APP-PSEN1-SREBF2mice were generated from crossbreeding APP-PSEN1 and SREBF2mice, which were first back-crossed more than 5 generations into the B6SJL background and characterized as previously described [37]. At the time of weaning (21 d), mice were genetically identified by PCR using DNA from ear-tips and following the genotyping protocols provided by the supplier. All procedures involving animals and their care were approved by the animal care committee of the Universitat de Barcelona and were conducted in accordance with institutional guidelines in compliance with national and international laws and policies. Because APP-PSEN1-SREBF2mice show sex-related differences in brain cholesterol levels, we only used male mice. Autophagy was induced in vivo by intraperitoneal (i.p.) injection of rapamycin (5 mg/kg; Santa Cruz Biotechnology, sc-3504). Rapamycin was reconstituted in DMSO at 25 mg/ml and diluted in phosphate-buffered saline (PBS; Sigma-Aldrich, P3813) containing 5% Tween-80 (Sigma-Aldrich, P4780) and 5% PEG-400 (polyethylene glycol 400; Sigma-Aldrich, 202398). In some cases, autophagic flux was blocked by i.p. administration of chloroquine (50 mg/kg; Sigma-Aldrich, C6628). In mice that overexpress SREBF2, the recovery of mGSH content was accomplished by treatment with GSH ethyl ester (1.25 mmol/kg/d; Sigma-Aldrich, G1404), i.p. injected every 12 h for 2 wk as described before [35]. To reduce brain cholesterol levels, mice were treated with 2-hydroxypropyl-β-cyclodextrin (4 g/kg) (Santa Cruz Biotechnology, sc-203461), subcutaneously injected at the scruff of the neck, twice weekly for 10 wk [23].
Cell culture and treatments
Neuron-rich primary cultures were obtained from cerebral cortex and hippocampus of embryos (d 16) using standard techniques. Dissociated cells were suspended in Neurobasal™ medium (Thermo Fisher Sci., 21103-049) with 2.5% (v:v) B27 supplement (Thermo Fisher Sci., 17504-001), 0.5 mM L-glutamine (Thermo Fisher Sci., 25030-081) and 5 μg/ml plasmocin™ (InvivoGen, ant-mpt), and plated onto poly-D-lysine (Sigma-Aldrich, P6407) and laminin (Sigma-Aldrich, L2020)-coated plates at a density of 2 x 105 cells/cm2. Half of the culture medium was changed every 3 or 4 d. Experiments were performed at 10 to 12 d in vitro (DIV). The cellular composition of the cultures was evaluated at that time by immunocytochemistry using antibodies to neuron- and glial-specific markers and was found to consist of >95% neurons.Cells were treated with 10 nM rapamycin (Santa Cruz Biotechnology, sc-3504) and 5 μM oligomeric human Aβ (Bachem, H-6466) for 24 h. In some cases, 30 min prior to the treatment, autophagic flux was inhibited by adding 5 μM wortmannin (Sigma-Aldrich, W1628). The recovery of the mGSH content was assessed by preincubation with GSH ethyl ester (from 0.5 mM to 4 mM). To determine the mGSH levels, cells were fractionated into cytosol and mitochondria by digitonin (Santa Cruz Biotechnology, sc-280675) permeabilization and GSH levels were analyzed in the mitochondrial fraction as described previously [35]. ROS generation was monitored fluorometrically using 2′,7′-dichlorofluorescin diacetate (DCF; Sigma-Aldrich, D6883). Cells were incubated with 10 μM DCF for 30 min at 37ºC prior to Aβ or antimycin A exposure. Fluorescence was measured in a SPECTRAmax Gemini XS microplate reader (Molecular Devices LLC., Sunnyvale, CA, USA) at Ex 495 nm and Em 525 nm. In some cases, DCF values were normalized to the fluorescence intensity of the mitochondrial probe MitoTracker® Deep Red FM (5 μM; Invitrogen, M22426), incubated for 30 min at 37ºC (Ex 644 nm and Em 665 nm).Aβ secretion was analyzed in 48 h media from cultured APP-PSEN1 and APP-PSEN1-SREBF2 neurons using the Aβ42 human ELISA kit (Thermo Fisher Sci., KHB3544). Cells were centrifuged at 600 g for 1 min and supernatants, after adding the protease inhibitor AEBSF (1 mM; Sigma-Aldrich, A8456) were stored at -80ºC until use.
Preparation of Aβ peptides
Human Aβ42 hydrochloride salt (Bachem, H-6466) was dissolved to 1 mM in hexafluoroisopropanol (HFIP; Sigma-Aldrich, 10,522-8) and aliquoted into microcentrifuge tubes, then the HFIP was evaporated and the peptides were stored at -20ºC until use. For oligomeric assembly, concentrated peptides were resuspended by sonication in DMSO at 5 mM concentration and then diluted to 100 μM in phenol red free medium and incubated at 4ºC for 24 h. Oligomeric forms of Aβ were confirmed by western blot as previously described [35,37].
Western blot analysis
Cell or tissue lysates were prepared in RIPA buffer (Sigma-Aldrich, R0278). Samples (30 to 80 μg of protein/lane) were resolved by SDS-PAGE and transferred to nitrocellulose membranes. Blots were probed with the antibodies listed in Table 4. After overnight incubation at 4ºC, bound antibodies were visualized using anti-rabbit, mouse or rat IgG horseradish peroxidase-coupled secondary antibodies (Sigma-Aldrich, GENA934, GENA931, GENA935, respectively) and the Pierce ECL western blotting substrate (Thermo Fisher Sci., 32106). Uncropped scans of representative western blots from Figures 1, 3, 5 and 9 are shown in . PARK2 levels were analyzed in both soluble and insoluble protein fractions. To extract the soluble fraction, brain tissues were homogenized in 50 mM Tris pH 7.6, 150 mM NaCl, 2 mM EDTA, 0.2% NP-40 (Sigma-Aldrich, NP40), 0.2% BSA (Sigma-Aldrich, A4503), 20 mM PMSF (Sigma-Aldrich, P7626), and complete EDTA-free protease inhibitor cocktail tablets (Sigma-Aldrich, 11873580001), centrifuged at 10,000 g for 20 min at 4ºC, and the supernatants containing the soluble fraction of proteins were collected. To extract the insoluble fraction the pellet was resuspended in 4 M urea and adjusted to pH 7.0 with 1 N NaOH and centrifuged at 10,000 g for 20 min at 4ºC, and the supernatant containing the insoluble fraction was collected.
Table 4.
Details of the primary antibodies used in the current study.
Antibody
Company
Cat. No.
WB/IF dilution
ACTB/actin
Sigma-Aldrich
A3853
1:10,000
Aβ (6E10)
BioLegend
803001
1:1000/1:200
ATG4B
Biorbyt
orb126738
1:1000
ATG5
Cell Signaling Technology
12994
1:1000
ATG7
Cell Signaling Technology
8558
1:1000
ATG12
Cell Signaling Technology
4180
1:1000
ATG14
MLB Int. Corp.
PD026
1:500
ATP6V0A1/V-ATPase A1
Santa Cruz Biotech.
sc-28801
1:200
BECN1/beclin 1
Cell Signaling Technology
3495
1:1000
CTSD/cathepsin D
Santa Cruz Biotech.
sc-6486
1:200
EEA1
Santa Cruz Biotech.
sc-6414
1:200
FLOT1/flotillin 1
Santa Cruz Biotech.
sc-25506
1:500
IGF2R
Abcam
ab2733
1:500
LAMP1
Santa Cruz Biotech.
sc-17768
1:200
LAMP2
Abcam
ab13524
1:1000/1:200
LC3B
Cell Signaling Technology
2775
1:1000/1:200
MAPT/TAU-5
Thermo Fisher Sci.
AHB0042
1:1000
MFN2/mitofusin 2
Santa Cruz Biotech.
sc-50331
1:500
PRKN/parkin
Abcam
ab15954
1:1000
RAB5A
Santa Cruz Biotech.
sc-515401
1:100
RAB7A
Santa Cruz Biotech.
sc-10767
1:200
p-RPS6KB1/phospho-p70S6K
Cell Signaling Technology
9205
1:1000
RPS6KB1/p70S6K
Cell Signaling Technology
9202
1:1000
SQSTM1/p62
Abcam
ab91526
1:1000/1:200
STX7/syntaxin 7
Sigma-Aldrich
S4819
1:1000
STX17/syntaxin 17
Sigma-Aldrich
HPA001204
1:500
TOMM20
Santa Cruz Biotech.
sc-11415
1:200
VAMP7/TI-VAMP
Santa Cruz Biotech.
sc-67060
1:200
VTI1B
Abcam
ab184170
1:1000
Details of the primary antibodies used in the current study.
Immunofluorescence and laser confocal imaging
Paraffin-embedded blocks were prepared by sequential dehydration in graded ethanol and infiltration in paraffin before embedding. Blocks were serially sectioned between –1.2 mm and –2.4 mm from Bregma at a thickness of 5 μm. Dewaxed and rehydrated hippocampal sections were first boiled in Tris-EDTA buffer, pH 9.0, and incubated with 0.1 M glycine in PBS for 20 min to reduce autofluorescence. Tissues processed for Aβ staining were pretreated with 99% formic acid for 7 min. Sections were then incubated overnight at 4°C with the antibodies listed in Table 4. After washing in PBS, the immunoreaction was visualized using Alexa Fluor 488, 555, and 594 conjugated secondary antibodies (1:400; Thermo Fisher Sci., A27012, A27017, A11005, respectively). Nuclei were stained with DRAQ5 fluorescent probe solution (Thermo Fisher Sci., 62251). Neurons were fixed for 15 min with 4% paraformaldehyde (Thermo Fisher Sci., 28908) and permeabilized with 0.1% saponin (Sigma-Aldrich, 47036) in blocking buffer (1% BSA + 20 mM glycine in PBS) for 15 min before proceeding with the immunostaining. Confocal images were collected with a Leica TCS SPE confocal laser scanning microscope (Leica Microsystems, Barcelona, Spain) using a 63x/1.32-0.60 oil PH3CS objective and a confocal pinhole set at 1 Airy unit. All confocal images shown are single optical sections.
Quantitative RT-PCR
qRT-PCR amplification was carried out using the MyiQ Single-Color RT-PCR detection system (Bio-Rad, 170-9770, Barcelona, Spain) and the iScript one-step RT-PCR kit with SYBR Green (Bio-Rad, 170-8893). The primer sequences used are listed in Table 5. PCRs were run in duplicates for each sample. Relative gene expression was quantified by the delta-delta Ct method.
Table 5.
Primer sequences used for qRT-PCR.
Name
Forward sequence
Reverse sequence
Atg5
5’- ACAGCTTCTGGATGAAAGGC-3’
5’- TGGGACTGCAGAATGACAGA-3’
Atg7
5’- GCCAGGTACTCCTGAGCTGT-3’
5’- ACTTGACCGGTCTTACCCTG-3’
Atg10
5’- TGATGGCTACATGTGCAAAA-3
5’- TGCAGGTCTCGTCACTTCAG-3’
Atg12
5’- CCACAGCCCATTTCTTTGTT-3’
5’- GAAACAGCCACCCCAGAG-3’
Atg14
5’-TGCATTGGGAAAGCTGCAAC-3’
5’-TCTGTGTGATCAACCTGACCTG-3’
Becn1
5’-CTGCACAGGGAACACAGCAA-3’
5’-GCCAGCGGCTATGAGAGAAG-3’
Sqstm1
5’- TCTGGGGTAGTGGGTGTCAG-3’
5’- AGAATGTGGGGGAGAGTGTG-3’
Stx17
5’-TGAAGTTACGCAGGCTTGAG-3’
5’-TGTGCTCTTCGTGCAACTTG-3’
Ulk1
5’- TAGTCAGCCAGGTCTCCACC-3’
5’- CTGCTGGGAAAGGAAATCAA-3’
Ulk2
5’- TAATCTGCCAGGTCTCCACC-3’
5’- CAAATTCTGCTTGGAAAGGAA-3’
Primer sequences used for qRT-PCR.
Cholesterol measurements
Cholesterol levels in lysosomes were determined fluorimetrically using the Amplex Red Cholesterol Assay kit (Thermo Fisher Sci., A12216). Samples (0.02 mg/ml) were extracted with chloroform:isopropanol:IGEPAL CA-630 (Sigma-Aldrich, I8896) (7:11:0.1) and centrifuged at 13,000 g for 10 min to remove insoluble material. Then, the organic phase was transferred to a new tube and dried under vacuum for 30 min. The lipids were dissolved with 120 μl of 1x cholesterol reaction buffer, and vortex until mixture was homogenous. Amount of cholesterol in lysosomes was calculated from the standard curve and expressed as μg of product per acid phosphatase activity.
Acid phosphatase assay
Acid phosphatase activity was determined by using p-nitrophenyl phosphate as a substrate. Briefly, 50 μl of the lysosomal fraction (20 μg protein) were incubated in 200 μl of assay solution (300 mg of 4-nitrophenyl phosphate disodium salt hexahydrate [Sigma-Aldrich, N2765] in 90 mM NaOAc) for 30 min at 37ºC. Then, 0.6 ml of 0.25 M NaOH was added to stop the reaction and samples were microcentrifuged 2 min at 21,000 g. Absorbances were measured at 410 nm against the appropriate blank.
ATG4B activity
Brain homogenates and cells were lysed in 0.05% NP-40, 10 mM HEPES, 10 mM KCl, 1.5 mM MgCl2, pH 8.0. Lysates (10 μg) were incubated with 210 nM of recombinant human HA-GABARAPL2/GATE16AMC (Boston Biochem, UL-445) in reaction buffer (50 mM Tris-HCl, pH 8.1, 2 M sodium citrate) at 37ºC for 45 min. Release of AMC fluorescence was monitored at Ex 380 nm and Em 460 nm.
Isolation of detergent-resistant membrane (DRM) microdomains
Lysosomal membranes (100 mg of protein) were incubated with 1% of Triton X-114 (Sigma-Aldrich, X114) in 150 mM NaCl, 50 mM Tris-HCl, 5 mM EDTA, pH 7.4, on ice for 30 min [70]. At the end of the incubation, samples were adjusted to 40% sucrose (Sigma-Aldrich, S0389), and loaded at the bottom of a 9 ml step-wise discontinuous sucrose gradient (40, 35, 30, 25, 20, 15, 10 and 5%) and centrifuged at 200,000 g for 19 h. Then, 6 aliquots of 1.5 ml were collected from the top of the gradient corresponding to DRMs (aliquot 1 and 2), intermediate-I (aliquot 3), intermediate-II (aliquot 4) and soluble (aliquot 5 and 6) fractions, and were subjected to acid precipitation with 10% trichloroacetic acid. Precipitates were washed with acetone, resuspended in 2x electrophoresis sample buffer, and subjected to SDS-PAGE and immunoblot.
Endosome-lysosome and autophagosome fractionation
Endosomes-lysosomes were prepared by a discontinuous OptiPrep gradient [97]. Brains were removed of olfactory bulbs, midbrain and cerebellum, and were homogenized in 5 mM Tris-HCl, pH 7.5, 320 mM sucrose, 1 mM MgCl2, 1 mM CaCl2, 1 mM NaHCO3 plus complete EDTA-free protease inhibitor cocktail tablets (Sigma-Aldrich, 11873580001). Homogenates were centrifuged at 1,000 g for 10 min. The supernatant was kept and the pellet was homogenized and centrifuged again. The 2 supernatants were centrifuged at 20,000 g for 20 min. The pellet was designated ML fraction and resuspended in dilution buffer (5 mM MOPS [Sigma-Aldrich, M3183], pH 8.0, 1 mM EDTA and 0.1% ethanol). The ML suspension was further diluted (10 mg of protein/ml) to a solution containing 19% OptiPrep density gradient medium (Sigma-Aldrich, D1556) and osmotically balanced with 2.3 M sucrose (290 mOsm). Different OptiPrep density gradient medium solutions were prepared with dilution buffer, balanced with sucrose, and loaded from bottom to top as follows: 27%, 22.5%, 19% or ML suspension, 16%, 12% and 8%. After ultracentrifugation at 155,500 g for 4 h in an SW40Ti rotor (Beckman Coulter, Barcelona, Spain), 0.5 ml fractions were collected and analyzed for lysosomal markers and total protein. The fraction at the interphase between 8% and 12% of the OptiPrep gradient was taken as endosomes-lysosomes.Autophagosomes were isolated by centrifugation in a discontinuous Nycodenz gradient, as described previously [98]. The corresponding ML fraction resulting from 5 brains was resuspended in 1ml of 50% Nycodenz and loaded onto 3.5 ml of 26% Nycodenz placed at the bottom of the tubes. Density gradient separation of autophagic vacuoles was achieved after layering above the sample with 1.5 ml of each 24%, 20% and 10% Nycondenz, and ultracentrifugation at 120,000 g for 4 h in a SW40Ti rotor (Beckman Coulter, Barcelona, Spain). The bands were collected from the gradient, diluted 5 times with 0.3 M sucrose and sedimented at 37,000 g for 10 min. Autophagosomes were recovered in the 20% to 10% interface and lysosomes in the 26 to 24% interface.
In vitro vesicular fusion assay
Isolated autophagosomes and lysosomes were carefully resuspended in fusion buffer (10 mM HEPES pH 7.0, 10 mM KCl, 1.5 mM MgCl2, 1 mM DTT, 0.25 M sucrose, and complete EDTA-free protease inhibitor cocktail tablets [Sigma-Aldrich, 11873580001]), and protein content of samples was balanced to 15 mg/ml [98]. Prior to fusion reaction, lysosomes were stained with LysoTracker Red (1 μM; Thermo Fisher Sci., L7528) for 10 min at 37ºC. Labeled lysosomes were then recovered by centrifuging at 21,000 g for 15 min and incubated with autophagosomes at 37ºC for 30 min in the reaction buffer containing 3 mM ATP (Sigma-Aldrich, A2383), 2 mM GTP (Sigma-Aldrich, G8877), 2 mM CaCl2, 8 mM phosphocreatine (Sigma-Aldrich, P6502), 0.16 mg/ml of creatine phosphokinase (Sigma-Aldrich, C7886), and protease inhibitors. To stop the reaction 8% of formaldehyde was added to the suspension. After 10 min fixation at room temperature, samples were rinsed with PBS and immunostained for autophagosomes overnight at 4°C using the anti-LC3B antibody listed in Table 4. Finally, the mixture was spotted on a glass slide and visualized under the fluorescence microscope. Images were acquired with a Zeiss Axioplan microscope (Carl Zeiss, Oberkochen, Germany) equipped with a Nikon digital camera DXM1200F (Nikon, Amsterdam, The Netherlands) using a 100x/1.3 N.A. objective. Quantification was performed using ImageJ software [99].
Proteinase K protection assay
Isolated autophagosomal fraction was suspended in 10 mM HEPES pH 7.0, 10 mM KCl, 1.5 mM MgCl2, 0.25 M sucrose and incubated for 30 min on ice with or without 10 μg/ml proteinase K (Sigma-Aldrich, P2308) and 0.5% Triton X-100 (Sigma-Aldrich, X100). Protease activity was stopped by adding 1 mM AEBSF (Sigma-Aldrich, 76307). Samples were stored at −80°C until Aβ quantification. In some cases, samples were evaporated and redissolved in 50 μl of HFIP and incubated for 30 min at room temperature. After treatment, HFIP was removed by vacuum evaporation.
Statistical analysis
Results are expressed as means ± SD. Statistical significance was performed using an analysis of variance (ANOVA) followed by the unpaired 2-tailed Student t test with Tukey post hoc multiple comparison test when required. The Chi-square test of independence was used to test for equality of proportions between populations. All analyses were performed using GraphPad Prism. A P< 0.05 value was considered statistically significant.
Authors: Anja Zeigerer; Jerome Gilleron; Roman L Bogorad; Giovanni Marsico; Hidenori Nonaka; Sarah Seifert; Hila Epstein-Barash; Satya Kuchimanchi; Chang Geng Peng; Vera M Ruda; Perla Del Conte-Zerial; Jan G Hengstler; Yannis Kalaidzidis; Victor Koteliansky; Marino Zerial Journal: Nature Date: 2012-05-23 Impact factor: 49.962
Authors: J C Fernández-Checa; A Fernández; A Morales; M Marí; C García-Ruiz; A Colell Journal: CNS Neurol Disord Drug Targets Date: 2010-08 Impact factor: 4.388
Authors: Elisabet Barbero-Camps; Anna Fernández; Anna Baulies; Laura Martinez; Jose C Fernández-Checa; Anna Colell Journal: Am J Pathol Date: 2014-05-09 Impact factor: 4.307
Authors: Montserrat Marí; Anna Colell; Albert Morales; Francisco Caballero; Anna Moles; Anna Fernández; Oihana Terrones; Gorka Basañez; Bruno Antonsson; Carmen García-Ruiz; José C Fernández-Checa Journal: Gastroenterology Date: 2008-01-31 Impact factor: 22.682
Authors: Huaqi Xiong; Debbie Callaghan; Aimee Jones; Douglas G Walker; Lih-Fen Lue; Thomas G Beach; Lucia I Sue; John Woulfe; Huaxi Xu; Danica B Stanimirovic; Wandong Zhang Journal: Neurobiol Dis Date: 2007-11-04 Impact factor: 5.996
Authors: Komla Sobo; Isabelle Le Blanc; Pierre-Philippe Luyet; Marc Fivaz; Charles Ferguson; Robert G Parton; Jean Gruenberg; F Gisou van der Goot Journal: PLoS One Date: 2007-09-05 Impact factor: 3.240
Authors: Daniel J Klionsky; Amal Kamal Abdel-Aziz; Sara Abdelfatah; Mahmoud Abdellatif; Asghar Abdoli; Steffen Abel; Hagai Abeliovich; Marie H Abildgaard; Yakubu Princely Abudu; Abraham Acevedo-Arozena; Iannis E Adamopoulos; Khosrow Adeli; Timon E Adolph; Annagrazia Adornetto; Elma Aflaki; Galila Agam; Anupam Agarwal; Bharat B Aggarwal; Maria Agnello; Patrizia Agostinis; Javed N Agrewala; Alexander Agrotis; Patricia V Aguilar; S Tariq Ahmad; Zubair M Ahmed; Ulises Ahumada-Castro; Sonja Aits; Shu Aizawa; Yunus Akkoc; Tonia Akoumianaki; Hafize Aysin Akpinar; Ahmed M Al-Abd; Lina Al-Akra; Abeer Al-Gharaibeh; Moulay A Alaoui-Jamali; Simon Alberti; Elísabet Alcocer-Gómez; Cristiano Alessandri; Muhammad Ali; M Abdul Alim Al-Bari; Saeb Aliwaini; Javad Alizadeh; Eugènia Almacellas; Alexandru Almasan; Alicia Alonso; Guillermo D Alonso; Nihal Altan-Bonnet; Dario C Altieri; Élida M C Álvarez; Sara Alves; Cristine Alves da Costa; Mazen M Alzaharna; Marialaura Amadio; Consuelo Amantini; Cristina Amaral; Susanna Ambrosio; Amal O Amer; Veena Ammanathan; Zhenyi An; Stig U Andersen; Shaida A Andrabi; Magaiver Andrade-Silva; Allen M Andres; Sabrina Angelini; David Ann; Uche C Anozie; Mohammad Y Ansari; Pedro Antas; Adam Antebi; Zuriñe Antón; Tahira Anwar; Lionel Apetoh; Nadezda Apostolova; Toshiyuki Araki; Yasuhiro Araki; Kohei Arasaki; Wagner L Araújo; Jun Araya; Catherine Arden; Maria-Angeles Arévalo; Sandro Arguelles; Esperanza Arias; Jyothi Arikkath; Hirokazu Arimoto; Aileen R Ariosa; Darius Armstrong-James; Laetitia Arnauné-Pelloquin; Angeles Aroca; Daniela S Arroyo; Ivica Arsov; Rubén Artero; Dalia Maria Lucia Asaro; Michael Aschner; Milad Ashrafizadeh; Osnat Ashur-Fabian; Atanas G Atanasov; Alicia K Au; Patrick Auberger; Holger W Auner; Laure Aurelian; Riccardo Autelli; Laura Avagliano; Yenniffer Ávalos; Sanja Aveic; Célia Alexandra Aveleira; Tamar Avin-Wittenberg; Yucel Aydin; Scott Ayton; Srinivas Ayyadevara; Maria Azzopardi; Misuzu Baba; Jonathan M Backer; Steven K Backues; Dong-Hun Bae; Ok-Nam Bae; Soo Han Bae; Eric H Baehrecke; Ahruem Baek; Seung-Hoon Baek; Sung Hee Baek; Giacinto Bagetta; Agnieszka Bagniewska-Zadworna; Hua Bai; Jie Bai; Xiyuan Bai; Yidong Bai; Nandadulal Bairagi; Shounak Baksi; Teresa Balbi; Cosima T Baldari; Walter Balduini; Andrea Ballabio; Maria Ballester; Salma Balazadeh; Rena Balzan; Rina Bandopadhyay; Sreeparna Banerjee; Sulagna Banerjee; Ágnes Bánréti; Yan Bao; Mauricio S Baptista; Alessandra Baracca; Cristiana Barbati; Ariadna Bargiela; Daniela Barilà; Peter G Barlow; Sami J Barmada; Esther Barreiro; George E Barreto; Jiri Bartek; Bonnie Bartel; Alberto Bartolome; Gaurav R Barve; Suresh H Basagoudanavar; Diane C Bassham; Robert C Bast; Alakananda Basu; Henri Batoko; Isabella Batten; Etienne E Baulieu; Bradley L Baumgarner; Jagadeesh Bayry; Rupert Beale; Isabelle Beau; Florian Beaumatin; Luiz R G Bechara; George R Beck; Michael F Beers; Jakob Begun; Christian Behrends; Georg M N Behrens; Roberto Bei; Eloy Bejarano; Shai Bel; Christian Behl; Amine Belaid; Naïma Belgareh-Touzé; Cristina Bellarosa; Francesca Belleudi; Melissa Belló Pérez; Raquel Bello-Morales; Jackeline Soares de Oliveira Beltran; Sebastián Beltran; Doris Mangiaracina Benbrook; Mykolas Bendorius; Bruno A Benitez; Irene Benito-Cuesta; Julien Bensalem; Martin W Berchtold; Sabina Berezowska; Daniele Bergamaschi; Matteo Bergami; Andreas Bergmann; Laura Berliocchi; Clarisse Berlioz-Torrent; Amélie Bernard; Lionel Berthoux; Cagri G Besirli; Sebastien Besteiro; Virginie M Betin; Rudi Beyaert; Jelena S Bezbradica; Kiran Bhaskar; Ingrid Bhatia-Kissova; Resham Bhattacharya; Sujoy Bhattacharya; Shalmoli Bhattacharyya; Md Shenuarin Bhuiyan; Sujit Kumar Bhutia; Lanrong Bi; Xiaolin Bi; Trevor J Biden; Krikor Bijian; Viktor A Billes; Nadine Binart; Claudia Bincoletto; Asa B Birgisdottir; Geir Bjorkoy; Gonzalo Blanco; Ana Blas-Garcia; Janusz Blasiak; Robert Blomgran; Klas Blomgren; Janice S Blum; Emilio Boada-Romero; Mirta Boban; Kathleen Boesze-Battaglia; Philippe Boeuf; Barry Boland; Pascale Bomont; Paolo Bonaldo; Srinivasa Reddy Bonam; Laura Bonfili; Juan S Bonifacino; Brian A Boone; Martin D Bootman; Matteo Bordi; Christoph Borner; Beat C Bornhauser; Gautam Borthakur; Jürgen Bosch; Santanu Bose; Luis M Botana; Juan Botas; Chantal M Boulanger; Michael E Boulton; Mathieu Bourdenx; Benjamin Bourgeois; Nollaig M Bourke; Guilhem Bousquet; Patricia Boya; Peter V Bozhkov; Luiz H M Bozi; Tolga O Bozkurt; Doug E Brackney; Christian H Brandts; Ralf J Braun; Gerhard H Braus; Roberto Bravo-Sagua; José M Bravo-San Pedro; Patrick Brest; Marie-Agnès Bringer; Alfredo Briones-Herrera; V Courtney Broaddus; Peter Brodersen; Jeffrey L Brodsky; Steven L Brody; Paola G Bronson; Jeff M Bronstein; Carolyn N Brown; Rhoderick E Brown; Patricia C Brum; John H Brumell; Nicola Brunetti-Pierri; Daniele Bruno; Robert J Bryson-Richardson; Cecilia Bucci; Carmen Buchrieser; Marta Bueno; Laura Elisa Buitrago-Molina; Simone Buraschi; Shilpa Buch; J Ross Buchan; Erin M Buckingham; Hikmet Budak; Mauricio Budini; Geert Bultynck; Florin Burada; Joseph R Burgoyne; M Isabel Burón; Victor Bustos; Sabrina Büttner; Elena Butturini; Aaron Byrd; Isabel Cabas; Sandra Cabrera-Benitez; Ken Cadwell; Jingjing Cai; Lu Cai; Qian Cai; Montserrat Cairó; Jose A Calbet; Guy A Caldwell; Kim A Caldwell; Jarrod A Call; Riccardo Calvani; Ana C Calvo; Miguel Calvo-Rubio Barrera; Niels Os Camara; Jacques H Camonis; Nadine Camougrand; Michelangelo Campanella; Edward M Campbell; François-Xavier Campbell-Valois; Silvia Campello; Ilaria Campesi; Juliane C Campos; Olivier Camuzard; Jorge Cancino; Danilo Candido de Almeida; Laura Canesi; Isabella Caniggia; Barbara Canonico; Carles Cantí; Bin Cao; Michele Caraglia; Beatriz Caramés; Evie H Carchman; Elena Cardenal-Muñoz; Cesar Cardenas; Luis Cardenas; Sandra M Cardoso; Jennifer S Carew; Georges F Carle; Gillian Carleton; Silvia Carloni; Didac Carmona-Gutierrez; Leticia A Carneiro; Oliana Carnevali; Julian M Carosi; Serena Carra; Alice Carrier; Lucie Carrier; Bernadette Carroll; A Brent Carter; Andreia Neves Carvalho; Magali Casanova; Caty Casas; Josefina Casas; Chiara Cassioli; Eliseo F Castillo; Karen Castillo; Sonia Castillo-Lluva; Francesca Castoldi; Marco Castori; Ariel F Castro; Margarida Castro-Caldas; Javier Castro-Hernandez; Susana Castro-Obregon; Sergio D Catz; Claudia Cavadas; Federica Cavaliere; Gabriella Cavallini; Maria Cavinato; Maria L Cayuela; Paula Cebollada Rica; Valentina Cecarini; Francesco Cecconi; Marzanna Cechowska-Pasko; Simone Cenci; Victòria Ceperuelo-Mallafré; João J Cerqueira; Janete M Cerutti; Davide Cervia; Vildan Bozok Cetintas; Silvia Cetrullo; Han-Jung Chae; Andrei S Chagin; Chee-Yin Chai; Gopal Chakrabarti; Oishee Chakrabarti; Tapas Chakraborty; Trinad Chakraborty; Mounia Chami; Georgios Chamilos; David W Chan; Edmond Y W Chan; Edward D Chan; H Y Edwin Chan; Helen H Chan; Hung Chan; Matthew T V Chan; Yau Sang Chan; Partha K Chandra; Chih-Peng Chang; Chunmei Chang; Hao-Chun Chang; Kai Chang; Jie Chao; Tracey Chapman; Nicolas Charlet-Berguerand; Samrat Chatterjee; Shail K Chaube; Anu Chaudhary; Santosh Chauhan; Edward Chaum; Frédéric Checler; Michael E Cheetham; Chang-Shi Chen; Guang-Chao Chen; Jian-Fu Chen; Liam L Chen; Leilei Chen; Lin Chen; Mingliang Chen; Mu-Kuan Chen; Ning Chen; Quan Chen; Ruey-Hwa Chen; Shi Chen; Wei Chen; Weiqiang Chen; Xin-Ming Chen; Xiong-Wen Chen; Xu Chen; Yan Chen; Ye-Guang Chen; Yingyu Chen; Yongqiang Chen; Yu-Jen Chen; Yue-Qin Chen; Zhefan Stephen Chen; Zhi Chen; Zhi-Hua Chen; Zhijian J Chen; Zhixiang Chen; Hanhua Cheng; Jun Cheng; Shi-Yuan Cheng; Wei Cheng; Xiaodong Cheng; Xiu-Tang Cheng; Yiyun Cheng; Zhiyong Cheng; Zhong Chen; Heesun Cheong; Jit Kong Cheong; Boris V Chernyak; Sara Cherry; Chi Fai Randy Cheung; Chun Hei Antonio Cheung; King-Ho Cheung; Eric Chevet; Richard J Chi; Alan Kwok Shing Chiang; Ferdinando Chiaradonna; Roberto Chiarelli; Mario Chiariello; Nathalia Chica; Susanna Chiocca; Mario Chiong; Shih-Hwa Chiou; Abhilash I Chiramel; Valerio Chiurchiù; Dong-Hyung Cho; Seong-Kyu Choe; Augustine M K Choi; Mary E Choi; Kamalika Roy Choudhury; Norman S Chow; Charleen T Chu; Jason P Chua; John Jia En Chua; Hyewon Chung; Kin Pan Chung; Seockhoon Chung; So-Hyang Chung; Yuen-Li Chung; Valentina Cianfanelli; Iwona A Ciechomska; Mariana Cifuentes; Laura Cinque; Sebahattin Cirak; Mara Cirone; Michael J Clague; Robert Clarke; Emilio Clementi; Eliana M Coccia; Patrice Codogno; Ehud Cohen; Mickael M Cohen; Tania Colasanti; Fiorella Colasuonno; Robert A Colbert; Anna Colell; Miodrag Čolić; Nuria S Coll; Mark O Collins; María I Colombo; Daniel A Colón-Ramos; Lydie Combaret; Sergio Comincini; Márcia R Cominetti; Antonella Consiglio; Andrea Conte; Fabrizio Conti; Viorica Raluca Contu; Mark R Cookson; Kevin M Coombs; Isabelle Coppens; Maria Tiziana Corasaniti; Dale P Corkery; Nils Cordes; Katia Cortese; Maria do Carmo Costa; Sarah Costantino; Paola Costelli; Ana Coto-Montes; Peter J Crack; Jose L Crespo; Alfredo Criollo; Valeria Crippa; Riccardo Cristofani; Tamas Csizmadia; Antonio Cuadrado; Bing Cui; Jun Cui; Yixian Cui; Yong Cui; Emmanuel Culetto; Andrea C Cumino; Andrey V Cybulsky; Mark J Czaja; Stanislaw J Czuczwar; Stefania D'Adamo; Marcello D'Amelio; Daniela D'Arcangelo; Andrew C D'Lugos; Gabriella D'Orazi; James A da Silva; Hormos Salimi Dafsari; Ruben K Dagda; Yasin Dagdas; Maria Daglia; Xiaoxia Dai; Yun Dai; Yuyuan Dai; Jessica Dal Col; Paul Dalhaimer; Luisa Dalla Valle; Tobias Dallenga; Guillaume Dalmasso; Markus Damme; Ilaria Dando; Nico P Dantuma; April L Darling; Hiranmoy Das; Srinivasan Dasarathy; Santosh K Dasari; Srikanta Dash; Oliver Daumke; Adrian N Dauphinee; Jeffrey S Davies; Valeria A Dávila; Roger J Davis; Tanja Davis; Sharadha Dayalan Naidu; Francesca De Amicis; Karolien De Bosscher; Francesca De Felice; Lucia De Franceschi; Chiara De Leonibus; Mayara G de Mattos Barbosa; Guido R Y De Meyer; Angelo De Milito; Cosimo De Nunzio; Clara De Palma; Mauro De Santi; Claudio De Virgilio; Daniela De Zio; Jayanta Debnath; Brian J DeBosch; Jean-Paul Decuypere; Mark A Deehan; Gianluca Deflorian; James DeGregori; Benjamin Dehay; Gabriel Del Rio; Joe R Delaney; Lea M D Delbridge; Elizabeth Delorme-Axford; M Victoria Delpino; Francesca Demarchi; Vilma Dembitz; Nicholas D Demers; Hongbin Deng; Zhiqiang Deng; Joern Dengjel; Paul Dent; Donna Denton; Melvin L DePamphilis; Channing J Der; Vojo Deretic; Albert Descoteaux; Laura Devis; Sushil Devkota; Olivier Devuyst; Grant Dewson; Mahendiran Dharmasivam; Rohan Dhiman; Diego di Bernardo; Manlio Di Cristina; Fabio Di Domenico; Pietro Di Fazio; Alessio Di Fonzo; Giovanni Di Guardo; Gianni M Di Guglielmo; Luca Di Leo; Chiara Di Malta; Alessia Di Nardo; Martina Di Rienzo; Federica Di Sano; George Diallinas; Jiajie Diao; Guillermo Diaz-Araya; Inés Díaz-Laviada; Jared M Dickinson; Marc Diederich; Mélanie Dieudé; Ivan Dikic; Shiping Ding; Wen-Xing Ding; Luciana Dini; Jelena Dinić; Miroslav Dinic; Albena T Dinkova-Kostova; Marc S Dionne; Jörg H W Distler; Abhinav Diwan; Ian M C Dixon; Mojgan Djavaheri-Mergny; Ina Dobrinski; Oxana Dobrovinskaya; Radek Dobrowolski; Renwick C J Dobson; Jelena Đokić; Serap Dokmeci Emre; Massimo Donadelli; Bo Dong; Xiaonan Dong; Zhiwu Dong; Gerald W Dorn Ii; Volker Dotsch; Huan Dou; Juan Dou; Moataz Dowaidar; Sami Dridi; Liat Drucker; Ailian Du; Caigan Du; Guangwei Du; Hai-Ning Du; Li-Lin Du; André du Toit; Shao-Bin Duan; Xiaoqiong Duan; Sónia P Duarte; Anna Dubrovska; Elaine A Dunlop; Nicolas Dupont; Raúl V Durán; Bilikere S Dwarakanath; Sergey A Dyshlovoy; Darius Ebrahimi-Fakhari; Leopold Eckhart; Charles L Edelstein; Thomas Efferth; Eftekhar Eftekharpour; Ludwig Eichinger; Nabil Eid; Tobias Eisenberg; N Tony Eissa; Sanaa Eissa; Miriam Ejarque; Abdeljabar El Andaloussi; Nazira El-Hage; Shahenda El-Naggar; Anna Maria Eleuteri; Eman S El-Shafey; Mohamed Elgendy; Aristides G Eliopoulos; María M Elizalde; Philip M Elks; Hans-Peter Elsasser; Eslam S Elsherbiny; Brooke M Emerling; N C Tolga Emre; Christina H Eng; Nikolai Engedal; Anna-Mart Engelbrecht; Agnete S T Engelsen; Jorrit M Enserink; Ricardo Escalante; Audrey Esclatine; Mafalda Escobar-Henriques; Eeva-Liisa Eskelinen; Lucile Espert; Makandjou-Ola Eusebio; Gemma Fabrias; Cinzia Fabrizi; Antonio Facchiano; Francesco Facchiano; Bengt Fadeel; Claudio Fader; Alex C Faesen; W Douglas Fairlie; Alberto Falcó; Bjorn H Falkenburger; Daping Fan; Jie Fan; Yanbo Fan; Evandro F Fang; Yanshan Fang; Yognqi Fang; Manolis Fanto; Tamar Farfel-Becker; Mathias Faure; Gholamreza Fazeli; Anthony O Fedele; Arthur M Feldman; Du Feng; Jiachun Feng; Lifeng Feng; Yibin Feng; Yuchen Feng; Wei Feng; Thais Fenz Araujo; Thomas A Ferguson; Álvaro F Fernández; Jose C Fernandez-Checa; Sonia Fernández-Veledo; Alisdair R Fernie; Anthony W Ferrante; Alessandra Ferraresi; Merari F Ferrari; Julio C B Ferreira; Susan Ferro-Novick; Antonio Figueras; Riccardo Filadi; Nicoletta Filigheddu; Eduardo Filippi-Chiela; Giuseppe Filomeni; Gian Maria Fimia; Vittorio Fineschi; Francesca Finetti; Steven Finkbeiner; Edward A Fisher; Paul B Fisher; Flavio Flamigni; Steven J Fliesler; Trude H Flo; Ida Florance; Oliver Florey; Tullio Florio; Erika Fodor; Carlo Follo; Edward A Fon; Antonella Forlino; Francesco Fornai; Paola Fortini; Anna Fracassi; Alessandro Fraldi; Brunella Franco; Rodrigo Franco; Flavia Franconi; Lisa B Frankel; Scott L Friedman; Leopold F Fröhlich; Gema Frühbeck; Jose M Fuentes; Yukio Fujiki; Naonobu Fujita; Yuuki Fujiwara; Mitsunori Fukuda; Simone Fulda; Luc Furic; Norihiko Furuya; Carmela Fusco; Michaela U Gack; Lidia Gaffke; Sehamuddin Galadari; Alessia Galasso; Maria F Galindo; Sachith Gallolu Kankanamalage; Lorenzo Galluzzi; Vincent Galy; Noor Gammoh; Boyi Gan; Ian G Ganley; Feng Gao; Hui Gao; Minghui Gao; Ping Gao; Shou-Jiang Gao; Wentao Gao; Xiaobo Gao; Ana Garcera; Maria Noé Garcia; Verónica E Garcia; Francisco García-Del Portillo; Vega Garcia-Escudero; Aracely Garcia-Garcia; Marina Garcia-Macia; Diana García-Moreno; Carmen Garcia-Ruiz; Patricia García-Sanz; Abhishek D Garg; Ricardo Gargini; Tina Garofalo; Robert F Garry; Nils C Gassen; Damian Gatica; Liang Ge; Wanzhong Ge; Ruth Geiss-Friedlander; Cecilia Gelfi; Pascal Genschik; Ian E Gentle; Valeria Gerbino; Christoph Gerhardt; Kyla Germain; Marc Germain; David A Gewirtz; Elham Ghasemipour Afshar; Saeid Ghavami; Alessandra Ghigo; Manosij Ghosh; Georgios Giamas; Claudia Giampietri; Alexandra Giatromanolaki; Gary E Gibson; Spencer B Gibson; Vanessa Ginet; Edward Giniger; Carlotta Giorgi; Henrique Girao; Stephen E Girardin; Mridhula Giridharan; Sandy Giuliano; Cecilia Giulivi; Sylvie Giuriato; Julien Giustiniani; Alexander Gluschko; Veit Goder; Alexander Goginashvili; Jakub Golab; David C Goldstone; Anna Golebiewska; Luciana R Gomes; Rodrigo Gomez; Rubén Gómez-Sánchez; Maria Catalina Gomez-Puerto; Raquel Gomez-Sintes; Qingqiu Gong; Felix M Goni; Javier González-Gallego; Tomas Gonzalez-Hernandez; Rosa A Gonzalez-Polo; Jose A Gonzalez-Reyes; Patricia González-Rodríguez; Ing Swie Goping; Marina S Gorbatyuk; Nikolai V Gorbunov; Kıvanç Görgülü; Roxana M Gorojod; Sharon M Gorski; Sandro Goruppi; Cecilia Gotor; Roberta A Gottlieb; Illana Gozes; Devrim Gozuacik; Martin Graef; Markus H Gräler; Veronica Granatiero; Daniel Grasso; Joshua P Gray; Douglas R Green; Alexander Greenhough; Stephen L Gregory; Edward F Griffin; Mark W Grinstaff; Frederic Gros; Charles Grose; Angelina S Gross; Florian Gruber; Paolo Grumati; Tilman Grune; Xueyan Gu; Jun-Lin Guan; Carlos M Guardia; Kishore Guda; Flora Guerra; Consuelo Guerri; Prasun Guha; Carlos Guillén; Shashi Gujar; Anna Gukovskaya; Ilya Gukovsky; Jan Gunst; Andreas Günther; Anyonya R Guntur; Chuanyong Guo; Chun Guo; Hongqing Guo; Lian-Wang Guo; Ming Guo; Pawan Gupta; Shashi Kumar Gupta; Swapnil Gupta; Veer Bala Gupta; Vivek Gupta; Asa B Gustafsson; David D Gutterman; Ranjitha H B; Annakaisa Haapasalo; James E Haber; Aleksandra Hać; Shinji Hadano; Anders J Hafrén; Mansour Haidar; Belinda S Hall; Gunnel Halldén; Anne Hamacher-Brady; Andrea Hamann; Maho Hamasaki; Weidong Han; Malene Hansen; Phyllis I Hanson; Zijian Hao; Masaru Harada; Ljubica Harhaji-Trajkovic; Nirmala Hariharan; Nigil Haroon; James Harris; Takafumi Hasegawa; Noor Hasima Nagoor; Jeffrey A Haspel; Volker Haucke; Wayne D Hawkins; Bruce A Hay; Cole M Haynes; Soren B Hayrabedyan; Thomas S Hays; Congcong He; Qin He; Rong-Rong He; You-Wen He; Yu-Ying He; Yasser Heakal; Alexander M Heberle; J Fielding Hejtmancik; Gudmundur Vignir Helgason; Vanessa Henkel; Marc Herb; Alexander Hergovich; Anna Herman-Antosiewicz; Agustín Hernández; Carlos Hernandez; Sergio Hernandez-Diaz; Virginia Hernandez-Gea; Amaury Herpin; Judit Herreros; Javier H Hervás; Daniel Hesselson; Claudio Hetz; Volker T Heussler; Yujiro Higuchi; Sabine Hilfiker; Joseph A Hill; William S Hlavacek; Emmanuel A Ho; Idy H T Ho; Philip Wing-Lok Ho; Shu-Leong Ho; Wan Yun Ho; G Aaron Hobbs; Mark Hochstrasser; Peter H M Hoet; Daniel Hofius; Paul Hofman; Annika Höhn; Carina I Holmberg; Jose R Hombrebueno; Chang-Won Hong Yi-Ren Hong; Lora V Hooper; Thorsten Hoppe; Rastislav Horos; Yujin Hoshida; I-Lun Hsin; Hsin-Yun Hsu; Bing Hu; Dong Hu; Li-Fang Hu; Ming Chang Hu; Ronggui Hu; Wei Hu; Yu-Chen Hu; Zhuo-Wei Hu; Fang Hua; Jinlian Hua; Yingqi Hua; Chongmin Huan; Canhua Huang; Chuanshu Huang; Chuanxin Huang; Chunling Huang; Haishan Huang; Kun Huang; Michael L H Huang; Rui Huang; Shan Huang; Tianzhi Huang; Xing Huang; Yuxiang Jack Huang; Tobias B Huber; Virginie Hubert; Christian A Hubner; Stephanie M Hughes; William E Hughes; Magali Humbert; Gerhard Hummer; James H Hurley; Sabah Hussain; Salik Hussain; Patrick J Hussey; Martina Hutabarat; Hui-Yun Hwang; Seungmin Hwang; Antonio Ieni; Fumiyo Ikeda; Yusuke Imagawa; Yuzuru Imai; Carol Imbriano; Masaya Imoto; Denise M Inman; Ken Inoki; Juan Iovanna; Renato V Iozzo; Giuseppe Ippolito; Javier E Irazoqui; Pablo Iribarren; Mohd Ishaq; Makoto Ishikawa; Nestor Ishimwe; Ciro Isidoro; Nahed Ismail; Shohreh Issazadeh-Navikas; Eisuke Itakura; Daisuke Ito; Davor Ivankovic; Saška Ivanova; Anand Krishnan V Iyer; José M Izquierdo; Masanori Izumi; Marja Jäättelä; Majid Sakhi Jabir; William T Jackson; Nadia Jacobo-Herrera; Anne-Claire Jacomin; Elise Jacquin; Pooja Jadiya; Hartmut Jaeschke; Chinnaswamy Jagannath; Arjen J Jakobi; Johan Jakobsson; Bassam Janji; Pidder Jansen-Dürr; Patric J Jansson; Jonathan Jantsch; Sławomir Januszewski; Alagie Jassey; Steve Jean; Hélène Jeltsch-David; Pavla Jendelova; Andreas Jenny; Thomas E Jensen; Niels Jessen; Jenna L Jewell; Jing Ji; Lijun Jia; Rui Jia; Liwen Jiang; Qing Jiang; Richeng Jiang; Teng Jiang; Xuejun Jiang; Yu Jiang; Maria Jimenez-Sanchez; Eun-Jung Jin; Fengyan Jin; Hongchuan Jin; Li Jin; Luqi Jin; Meiyan Jin; Si Jin; Eun-Kyeong Jo; Carine Joffre; Terje Johansen; Gail V W Johnson; Simon A Johnston; Eija Jokitalo; Mohit Kumar Jolly; Leo A B Joosten; Joaquin Jordan; Bertrand Joseph; Dianwen Ju; Jeong-Sun Ju; Jingfang Ju; Esmeralda Juárez; Delphine Judith; Gábor Juhász; Youngsoo Jun; Chang Hwa Jung; Sung-Chul Jung; Yong Keun Jung; Heinz Jungbluth; Johannes Jungverdorben; Steffen Just; Kai Kaarniranta; Allen Kaasik; Tomohiro Kabuta; Daniel Kaganovich; Alon Kahana; Renate Kain; Shinjo Kajimura; Maria Kalamvoki; Manjula Kalia; Danuta S Kalinowski; Nina Kaludercic; Ioanna Kalvari; Joanna Kaminska; Vitaliy O Kaminskyy; Hiromitsu Kanamori; Keizo Kanasaki; Chanhee Kang; Rui Kang; Sang Sun Kang; Senthilvelrajan Kaniyappan; Tomotake Kanki; Thirumala-Devi Kanneganti; Anumantha G Kanthasamy; Arthi Kanthasamy; Marc Kantorow; Orsolya Kapuy; Michalis V Karamouzis; Md Razaul Karim; Parimal Karmakar; Rajesh G Katare; Masaru Kato; Stefan H E Kaufmann; Anu Kauppinen; Gur P Kaushal; Susmita Kaushik; Kiyoshi Kawasaki; Kemal Kazan; Po-Yuan Ke; Damien J Keating; Ursula Keber; John H Kehrl; Kate E Keller; Christian W Keller; Jongsook Kim Kemper; Candia M Kenific; Oliver Kepp; Stephanie Kermorgant; Andreas Kern; Robin Ketteler; Tom G Keulers; Boris Khalfin; Hany Khalil; Bilon Khambu; Shahid Y Khan; Vinoth Kumar Megraj Khandelwal; Rekha Khandia; Widuri Kho; Noopur V Khobrekar; Sataree Khuansuwan; Mukhran Khundadze; Samuel A Killackey; Dasol Kim; Deok Ryong Kim; Do-Hyung Kim; Dong-Eun Kim; Eun Young Kim; Eun-Kyoung Kim; Hak-Rim Kim; Hee-Sik Kim; Jeong Hun Kim; Jin Kyung Kim; Jin-Hoi Kim; Joungmok Kim; Ju Hwan Kim; Keun Il Kim; Peter K Kim; Seong-Jun Kim; Scot R Kimball; Adi Kimchi; Alec C Kimmelman; Tomonori Kimura; Matthew A King; Kerri J Kinghorn; Conan G Kinsey; Vladimir Kirkin; Lorrie A Kirshenbaum; Sergey L Kiselev; Shuji Kishi; Katsuhiko Kitamoto; Yasushi Kitaoka; Kaio Kitazato; Richard N Kitsis; Josef T Kittler; Ole Kjaerulff; Peter S Klein; Thomas Klopstock; Jochen Klucken; Helene Knævelsrud; Roland L Knorr; Ben C B Ko; Fred Ko; Jiunn-Liang Ko; Hotaka Kobayashi; Satoru Kobayashi; Ina Koch; Jan C Koch; Ulrich Koenig; Donat Kögel; Young Ho Koh; Masato Koike; Sepp D Kohlwein; Nur M Kocaturk; Masaaki Komatsu; Jeannette König; Toru Kono; Benjamin T Kopp; Tamas Korcsmaros; Gözde Korkmaz; Viktor I Korolchuk; Mónica Suárez Korsnes; Ali Koskela; Janaiah Kota; Yaichiro Kotake; Monica L Kotler; Yanjun Kou; Michael I Koukourakis; Evangelos Koustas; Attila L Kovacs; Tibor Kovács; Daisuke Koya; Tomohiro Kozako; Claudine Kraft; Dimitri Krainc; Helmut Krämer; Anna D Krasnodembskaya; Carole Kretz-Remy; Guido Kroemer; Nicholas T Ktistakis; Kazuyuki Kuchitsu; Sabine Kuenen; Lars Kuerschner; Thomas Kukar; Ajay Kumar; Ashok Kumar; Deepak Kumar; Dhiraj Kumar; Sharad Kumar; Shinji Kume; Caroline Kumsta; Chanakya N Kundu; Mondira Kundu; Ajaikumar B Kunnumakkara; Lukasz Kurgan; Tatiana G Kutateladze; Ozlem Kutlu; SeongAe Kwak; Ho Jeong Kwon; Taeg Kyu Kwon; Yong Tae Kwon; Irene Kyrmizi; Albert La Spada; Patrick Labonté; Sylvain Ladoire; Ilaria Laface; Frank Lafont; Diane C Lagace; Vikramjit Lahiri; Zhibing Lai; Angela S Laird; Aparna Lakkaraju; Trond Lamark; Sheng-Hui Lan; Ane Landajuela; Darius J R Lane; Jon D Lane; Charles H Lang; Carsten Lange; Ülo Langel; Rupert Langer; Pierre Lapaquette; Jocelyn Laporte; Nicholas F LaRusso; Isabel Lastres-Becker; Wilson Chun Yu Lau; Gordon W Laurie; Sergio Lavandero; Betty Yuen Kwan Law; Helen Ka-Wai Law; Rob Layfield; Weidong Le; Herve Le Stunff; Alexandre Y Leary; Jean-Jacques Lebrun; Lionel Y W Leck; Jean-Philippe Leduc-Gaudet; Changwook Lee; Chung-Pei Lee; Da-Hye Lee; Edward B Lee; Erinna F Lee; Gyun Min Lee; He-Jin Lee; Heung Kyu Lee; Jae Man Lee; Jason S Lee; Jin-A Lee; Joo-Yong Lee; Jun Hee Lee; Michael Lee; Min Goo Lee; Min Jae Lee; Myung-Shik Lee; Sang Yoon Lee; Seung-Jae Lee; Stella Y Lee; Sung Bae Lee; Won Hee Lee; Ying-Ray Lee; Yong-Ho Lee; Youngil Lee; Christophe Lefebvre; Renaud Legouis; Yu L Lei; Yuchen Lei; Sergey Leikin; Gerd Leitinger; Leticia Lemus; Shuilong Leng; Olivia Lenoir; Guido Lenz; Heinz Josef Lenz; Paola Lenzi; Yolanda León; Andréia M Leopoldino; Christoph Leschczyk; Stina Leskelä; Elisabeth Letellier; Chi-Ting Leung; Po Sing Leung; Jeremy S Leventhal; Beth Levine; Patrick A Lewis; Klaus Ley; Bin Li; Da-Qiang Li; Jianming Li; Jing Li; Jiong Li; Ke Li; Liwu Li; Mei Li; Min Li; Min Li; Ming Li; Mingchuan Li; Pin-Lan Li; Ming-Qing Li; Qing Li; Sheng Li; Tiangang Li; Wei Li; Wenming Li; Xue Li; Yi-Ping Li; Yuan Li; Zhiqiang Li; Zhiyong Li; Zhiyuan Li; Jiqin Lian; Chengyu Liang; Qiangrong Liang; Weicheng Liang; Yongheng Liang; YongTian Liang; Guanghong Liao; Lujian Liao; Mingzhi Liao; Yung-Feng Liao; Mariangela Librizzi; Pearl P Y Lie; Mary A Lilly; Hyunjung J Lim; Thania R R Lima; Federica Limana; Chao Lin; Chih-Wen Lin; Dar-Shong Lin; Fu-Cheng Lin; Jiandie D Lin; Kurt M Lin; Kwang-Huei Lin; Liang-Tzung Lin; Pei-Hui Lin; Qiong Lin; Shaofeng Lin; Su-Ju Lin; Wenyu Lin; Xueying Lin; Yao-Xin Lin; Yee-Shin Lin; Rafael Linden; Paula Lindner; Shuo-Chien Ling; Paul Lingor; Amelia K Linnemann; Yih-Cherng Liou; Marta M Lipinski; Saška Lipovšek; Vitor A Lira; Natalia Lisiak; Paloma B Liton; Chao Liu; Ching-Hsuan Liu; Chun-Feng Liu; Cui Hua Liu; Fang Liu; Hao Liu; Hsiao-Sheng Liu; Hua-Feng Liu; Huifang Liu; Jia Liu; Jing Liu; Julia Liu; Leyuan Liu; Longhua Liu; Meilian Liu; Qin Liu; Wei Liu; Wende Liu; Xiao-Hong Liu; Xiaodong Liu; Xingguo Liu; Xu Liu; Xuedong Liu; Yanfen Liu; Yang Liu; Yang Liu; Yueyang Liu; Yule Liu; J Andrew Livingston; Gerard Lizard; Jose M Lizcano; Senka Ljubojevic-Holzer; Matilde E LLeonart; David Llobet-Navàs; Alicia Llorente; Chih Hung Lo; Damián Lobato-Márquez; Qi Long; Yun Chau Long; Ben Loos; Julia A Loos; Manuela G López; Guillermo López-Doménech; José Antonio López-Guerrero; Ana T López-Jiménez; Óscar López-Pérez; Israel López-Valero; Magdalena J Lorenowicz; Mar Lorente; Peter Lorincz; Laura Lossi; Sophie Lotersztajn; Penny E Lovat; Jonathan F Lovell; Alenka Lovy; Péter Lőw; Guang Lu; Haocheng Lu; Jia-Hong Lu; Jin-Jian Lu; Mengji Lu; Shuyan Lu; Alessandro Luciani; John M Lucocq; Paula Ludovico; Micah A Luftig; Morten Luhr; Diego Luis-Ravelo; Julian J Lum; Liany Luna-Dulcey; Anders H Lund; Viktor K Lund; Jan D Lünemann; Patrick Lüningschrör; Honglin Luo; Rongcan Luo; Shouqing Luo; Zhi Luo; Claudio Luparello; Bernhard Lüscher; Luan Luu; Alex Lyakhovich; Konstantin G Lyamzaev; Alf Håkon Lystad; Lyubomyr Lytvynchuk; Alvin C Ma; Changle Ma; Mengxiao Ma; Ning-Fang Ma; Quan-Hong Ma; Xinliang Ma; Yueyun Ma; Zhenyi Ma; Ormond A MacDougald; Fernando Macian; Gustavo C MacIntosh; Jeffrey P MacKeigan; Kay F Macleod; Sandra Maday; Frank Madeo; Muniswamy Madesh; Tobias Madl; Julio Madrigal-Matute; Akiko Maeda; Yasuhiro Maejima; Marta Magarinos; Poornima Mahavadi; Emiliano Maiani; Kenneth Maiese; Panchanan Maiti; Maria Chiara Maiuri; Barbara Majello; Michael B Major; Elena Makareeva; Fayaz Malik; Karthik Mallilankaraman; Walter Malorni; Alina Maloyan; Najiba Mammadova; Gene Chi Wai Man; Federico Manai; Joseph D Mancias; Eva-Maria Mandelkow; Michael A Mandell; Angelo A Manfredi; Masoud H Manjili; Ravi Manjithaya; Patricio Manque; Bella B Manshian; Raquel Manzano; Claudia Manzoni; Kai Mao; Cinzia Marchese; Sandrine Marchetti; Anna Maria Marconi; Fabrizio Marcucci; Stefania Mardente; Olga A Mareninova; Marta Margeta; Muriel Mari; Sara Marinelli; Oliviero Marinelli; Guillermo Mariño; Sofia Mariotto; Richard S Marshall; Mark R Marten; Sascha Martens; Alexandre P J Martin; Katie R Martin; Sara Martin; Shaun Martin; Adrián Martín-Segura; Miguel A Martín-Acebes; Inmaculada Martin-Burriel; Marcos Martin-Rincon; Paloma Martin-Sanz; José A Martina; Wim Martinet; Aitor Martinez; Ana Martinez; Jennifer Martinez; Moises Martinez Velazquez; Nuria Martinez-Lopez; Marta Martinez-Vicente; Daniel O Martins; Joilson O Martins; Waleska K Martins; Tania Martins-Marques; Emanuele Marzetti; Shashank Masaldan; Celine Masclaux-Daubresse; Douglas G Mashek; Valentina Massa; Lourdes Massieu; Glenn R Masson; Laura Masuelli; Anatoliy I Masyuk; Tetyana V Masyuk; Paola Matarrese; Ander Matheu; Satoaki Matoba; Sachiko Matsuzaki; Pamela Mattar; Alessandro Matte; Domenico Mattoscio; José L Mauriz; Mario Mauthe; Caroline Mauvezin; Emanual Maverakis; Paola Maycotte; Johanna Mayer; Gianluigi Mazzoccoli; Cristina Mazzoni; Joseph R Mazzulli; Nami McCarty; Christine McDonald; Mitchell R McGill; Sharon L McKenna; BethAnn McLaughlin; Fionn McLoughlin; Mark A McNiven; Thomas G McWilliams; Fatima Mechta-Grigoriou; Tania Catarina Medeiros; Diego L Medina; Lynn A Megeney; Klara Megyeri; Maryam Mehrpour; Jawahar L Mehta; Alfred J Meijer; Annemarie H Meijer; Jakob Mejlvang; Alicia Meléndez; Annette Melk; Gonen Memisoglu; Alexandrina F Mendes; Delong Meng; Fei Meng; Tian Meng; Rubem Menna-Barreto; Manoj B Menon; Carol Mercer; Anne E Mercier; Jean-Louis Mergny; Adalberto Merighi; Seth D Merkley; Giuseppe Merla; Volker Meske; Ana Cecilia Mestre; Shree Padma Metur; Christian Meyer; Hemmo Meyer; Wenyi Mi; Jeanne Mialet-Perez; Junying Miao; Lucia Micale; Yasuo Miki; Enrico Milan; Małgorzata Milczarek; Dana L Miller; Samuel I Miller; Silke Miller; Steven W Millward; Ira Milosevic; Elena A Minina; Hamed Mirzaei; Hamid Reza Mirzaei; Mehdi Mirzaei; Amit Mishra; Nandita Mishra; Paras Kumar Mishra; Maja Misirkic Marjanovic; Roberta Misasi; Amit Misra; Gabriella Misso; Claire Mitchell; Geraldine Mitou; Tetsuji Miura; Shigeki Miyamoto; Makoto Miyazaki; Mitsunori Miyazaki; Taiga Miyazaki; Keisuke Miyazawa; Noboru Mizushima; Trine H Mogensen; Baharia Mograbi; Reza Mohammadinejad; Yasir Mohamud; Abhishek Mohanty; Sipra Mohapatra; Torsten Möhlmann; Asif Mohmmed; Anna Moles; Kelle H Moley; Maurizio Molinari; Vincenzo Mollace; Andreas Buch Møller; Bertrand Mollereau; Faustino Mollinedo; Costanza Montagna; Mervyn J Monteiro; Andrea Montella; L Ruth Montes; Barbara Montico; Vinod K Mony; Giacomo Monzio Compagnoni; Michael N Moore; Mohammad A Moosavi; Ana L Mora; Marina Mora; David Morales-Alamo; Rosario Moratalla; Paula I Moreira; Elena Morelli; Sandra Moreno; Daniel Moreno-Blas; Viviana Moresi; Benjamin Morga; Alwena H Morgan; Fabrice Morin; Hideaki Morishita; Orson L Moritz; Mariko Moriyama; Yuji Moriyasu; Manuela Morleo; Eugenia Morselli; Jose F Moruno-Manchon; Jorge Moscat; Serge Mostowy; Elisa Motori; Andrea Felinto Moura; Naima Moustaid-Moussa; Maria Mrakovcic; Gabriel Muciño-Hernández; Anupam Mukherjee; Subhadip Mukhopadhyay; Jean M Mulcahy Levy; Victoriano Mulero; Sylviane Muller; Christian Münch; Ashok Munjal; Pura Munoz-Canoves; Teresa Muñoz-Galdeano; Christian Münz; Tomokazu Murakawa; Claudia Muratori; Brona M Murphy; J Patrick Murphy; Aditya Murthy; Timo T Myöhänen; Indira U Mysorekar; Jennifer Mytych; Seyed Mohammad Nabavi; Massimo Nabissi; Péter Nagy; Jihoon Nah; Aimable Nahimana; Ichiro Nakagawa; Ken Nakamura; Hitoshi Nakatogawa; Shyam S Nandi; Meera Nanjundan; Monica Nanni; Gennaro Napolitano; Roberta Nardacci; Masashi Narita; Melissa Nassif; Ilana Nathan; Manabu Natsumeda; Ryno J Naude; Christin Naumann; Olaia Naveiras; Fatemeh Navid; Steffan T Nawrocki; Taras Y Nazarko; Francesca Nazio; Florentina Negoita; Thomas Neill; Amanda L Neisch; Luca M Neri; Mihai G Netea; Patrick Neubert; Thomas P Neufeld; Dietbert Neumann; Albert Neutzner; Phillip T Newton; Paul A Ney; Ioannis P Nezis; Charlene C W Ng; Tzi Bun Ng; Hang T T Nguyen; Long T Nguyen; Hong-Min Ni; Clíona Ní Cheallaigh; Zhenhong Ni; M Celeste Nicolao; Francesco Nicoli; Manuel Nieto-Diaz; Per Nilsson; Shunbin Ning; Rituraj Niranjan; Hiroshi Nishimune; Mireia Niso-Santano; Ralph A Nixon; Annalisa Nobili; Clevio Nobrega; Takeshi Noda; Uxía Nogueira-Recalde; Trevor M Nolan; Ivan Nombela; Ivana Novak; Beatriz Novoa; Takashi Nozawa; Nobuyuki Nukina; Carmen Nussbaum-Krammer; Jesper Nylandsted; Tracey R O'Donovan; Seónadh M O'Leary; Eyleen J O'Rourke; Mary P O'Sullivan; Timothy E O'Sullivan; Salvatore Oddo; Ina Oehme; Michinaga Ogawa; Eric Ogier-Denis; Margret H Ogmundsdottir; Besim Ogretmen; Goo Taeg Oh; Seon-Hee Oh; Young J Oh; Takashi Ohama; Yohei Ohashi; Masaki Ohmuraya; Vasileios Oikonomou; Rani Ojha; Koji Okamoto; Hitoshi Okazawa; Masahide Oku; Sara Oliván; Jorge M A Oliveira; Michael Ollmann; James A Olzmann; Shakib Omari; M Bishr Omary; Gizem Önal; Martin Ondrej; Sang-Bing Ong; Sang-Ging Ong; Anna Onnis; Juan A Orellana; Sara Orellana-Muñoz; Maria Del Mar Ortega-Villaizan; Xilma R Ortiz-Gonzalez; Elena Ortona; Heinz D Osiewacz; Abdel-Hamid K Osman; Rosario Osta; Marisa S Otegui; Kinya Otsu; Christiane Ott; Luisa Ottobrini; Jing-Hsiung James Ou; Tiago F Outeiro; Inger Oynebraten; Melek Ozturk; Gilles Pagès; Susanta Pahari; Marta Pajares; Utpal B Pajvani; Rituraj Pal; Simona Paladino; Nicolas Pallet; Michela Palmieri; Giuseppe Palmisano; Camilla Palumbo; Francesco Pampaloni; Lifeng Pan; Qingjun Pan; Wenliang Pan; Xin Pan; Ganna Panasyuk; Rahul Pandey; Udai B Pandey; Vrajesh Pandya; Francesco Paneni; Shirley Y Pang; Elisa Panzarini; Daniela L Papademetrio; Elena Papaleo; Daniel Papinski; Diana Papp; Eun Chan Park; Hwan Tae Park; Ji-Man Park; Jong-In Park; Joon Tae Park; Junsoo Park; Sang Chul Park; Sang-Youel Park; Abraham H Parola; Jan B Parys; Adrien Pasquier; Benoit Pasquier; João F Passos; Nunzia Pastore; Hemal H Patel; Daniel Patschan; Sophie Pattingre; Gustavo Pedraza-Alva; Jose Pedraza-Chaverri; Zully Pedrozo; Gang Pei; Jianming Pei; Hadas Peled-Zehavi; Joaquín M Pellegrini; Joffrey Pelletier; Miguel A Peñalva; Di Peng; Ying Peng; Fabio Penna; Maria Pennuto; Francesca Pentimalli; Cláudia Mf Pereira; Gustavo J S Pereira; Lilian C Pereira; Luis Pereira de Almeida; Nirma D Perera; Ángel Pérez-Lara; Ana B Perez-Oliva; María Esther Pérez-Pérez; Palsamy Periyasamy; Andras Perl; Cristiana Perrotta; Ida Perrotta; Richard G Pestell; Morten Petersen; Irina Petrache; Goran Petrovski; Thorsten Pfirrmann; Astrid S Pfister; Jennifer A Philips; Huifeng Pi; Anna Picca; Alicia M Pickrell; Sandy Picot; Giovanna M Pierantoni; Marina Pierdominici; Philippe Pierre; Valérie Pierrefite-Carle; Karolina Pierzynowska; Federico Pietrocola; Miroslawa Pietruczuk; Claudio Pignata; Felipe X Pimentel-Muiños; Mario Pinar; Roberta O Pinheiro; Ronit Pinkas-Kramarski; Paolo Pinton; Karolina Pircs; Sujan Piya; Paola Pizzo; Theo S Plantinga; Harald W Platta; Ainhoa Plaza-Zabala; Markus Plomann; Egor Y Plotnikov; Helene Plun-Favreau; Ryszard Pluta; Roger Pocock; Stefanie Pöggeler; Christian Pohl; Marc Poirot; Angelo Poletti; Marisa Ponpuak; Hana Popelka; Blagovesta Popova; Helena Porta; Soledad Porte Alcon; Eliana Portilla-Fernandez; Martin Post; Malia B Potts; Joanna Poulton; Ted Powers; Veena Prahlad; Tomasz K Prajsnar; Domenico Praticò; Rosaria Prencipe; Muriel Priault; Tassula Proikas-Cezanne; Vasilis J Promponas; Christopher G Proud; Rosa Puertollano; Luigi Puglielli; Thomas Pulinilkunnil; Deepika Puri; Rajat Puri; Julien Puyal; Xiaopeng Qi; Yongmei Qi; Wenbin Qian; Lei Qiang; Yu Qiu; Joe Quadrilatero; Jorge Quarleri; Nina Raben; Hannah Rabinowich; Debora Ragona; Michael J Ragusa; Nader Rahimi; Marveh Rahmati; Valeria Raia; Nuno Raimundo; Namakkal-Soorappan Rajasekaran; Sriganesh Ramachandra Rao; Abdelhaq Rami; Ignacio Ramírez-Pardo; David B Ramsden; Felix Randow; Pundi N Rangarajan; Danilo Ranieri; Hai Rao; Lang Rao; Rekha Rao; Sumit Rathore; J Arjuna Ratnayaka; Edward A Ratovitski; Palaniyandi Ravanan; Gloria Ravegnini; Swapan K Ray; Babak Razani; Vito Rebecca; Fulvio Reggiori; Anne Régnier-Vigouroux; Andreas S Reichert; David Reigada; Jan H Reiling; Theo Rein; Siegfried Reipert; Rokeya Sultana Rekha; Hongmei Ren; Jun Ren; Weichao Ren; Tristan Renault; Giorgia Renga; Karen Reue; Kim Rewitz; Bruna Ribeiro de Andrade Ramos; S Amer Riazuddin; Teresa M Ribeiro-Rodrigues; Jean-Ehrland Ricci; Romeo Ricci; Victoria Riccio; Des R Richardson; Yasuko Rikihisa; Makarand V Risbud; Ruth M Risueño; Konstantinos Ritis; Salvatore Rizza; Rosario Rizzuto; Helen C Roberts; Luke D Roberts; Katherine J Robinson; Maria Carmela Roccheri; Stephane Rocchi; George G Rodney; Tiago Rodrigues; Vagner Ramon Rodrigues Silva; Amaia Rodriguez; Ruth Rodriguez-Barrueco; Nieves Rodriguez-Henche; Humberto Rodriguez-Rocha; Jeroen Roelofs; Robert S Rogers; Vladimir V Rogov; Ana I Rojo; Krzysztof Rolka; Vanina Romanello; Luigina Romani; Alessandra Romano; Patricia S Romano; David Romeo-Guitart; Luis C Romero; Montserrat Romero; Joseph C Roney; Christopher Rongo; Sante Roperto; Mathias T Rosenfeldt; Philip Rosenstiel; Anne G Rosenwald; Kevin A Roth; Lynn Roth; Steven Roth; Kasper M A Rouschop; Benoit D Roussel; Sophie Roux; Patrizia Rovere-Querini; Ajit Roy; Aurore Rozieres; Diego Ruano; David C Rubinsztein; Maria P Rubtsova; Klaus Ruckdeschel; Christoph Ruckenstuhl; Emil Rudolf; Rüdiger Rudolf; Alessandra Ruggieri; Avnika Ashok Ruparelia; Paola Rusmini; Ryan R Russell; Gian Luigi Russo; Maria Russo; Rossella Russo; Oxana O Ryabaya; Kevin M Ryan; Kwon-Yul Ryu; Maria Sabater-Arcis; Ulka Sachdev; Michael Sacher; Carsten Sachse; Abhishek Sadhu; Junichi Sadoshima; Nathaniel Safren; Paul Saftig; Antonia P Sagona; Gaurav Sahay; Amirhossein Sahebkar; Mustafa Sahin; Ozgur Sahin; Sumit Sahni; Nayuta Saito; Shigeru Saito; Tsunenori Saito; Ryohei Sakai; Yasuyoshi Sakai; Jun-Ichi Sakamaki; Kalle Saksela; Gloria Salazar; Anna Salazar-Degracia; Ghasem H Salekdeh; Ashok K Saluja; Belém Sampaio-Marques; Maria Cecilia Sanchez; Jose A Sanchez-Alcazar; Victoria Sanchez-Vera; Vanessa Sancho-Shimizu; J Thomas Sanderson; Marco Sandri; Stefano Santaguida; Laura Santambrogio; Magda M Santana; Giorgio Santoni; Alberto Sanz; Pascual Sanz; Shweta Saran; Marco Sardiello; Timothy J Sargeant; Apurva Sarin; Chinmoy Sarkar; Sovan Sarkar; Maria-Rosa Sarrias; Surajit Sarkar; Dipanka Tanu Sarmah; Jaakko Sarparanta; Aishwarya Sathyanarayan; Ranganayaki Sathyanarayanan; K Matthew Scaglione; Francesca Scatozza; Liliana Schaefer; Zachary T Schafer; Ulrich E Schaible; Anthony H V Schapira; Michael Scharl; Hermann M Schatzl; Catherine H Schein; Wiep Scheper; David Scheuring; Maria Vittoria Schiaffino; Monica Schiappacassi; Rainer Schindl; Uwe Schlattner; Oliver Schmidt; Roland Schmitt; Stephen D Schmidt; Ingo Schmitz; Eran Schmukler; Anja Schneider; Bianca E Schneider; Romana Schober; Alejandra C Schoijet; Micah B Schott; Michael Schramm; Bernd Schröder; Kai Schuh; Christoph Schüller; Ryan J Schulze; Lea Schürmanns; Jens C Schwamborn; Melanie Schwarten; Filippo Scialo; Sebastiano Sciarretta; Melanie J Scott; Kathleen W Scotto; A Ivana Scovassi; Andrea Scrima; Aurora Scrivo; David Sebastian; Salwa Sebti; Simon Sedej; Laura Segatori; Nava Segev; Per O Seglen; Iban Seiliez; Ekihiro Seki; Scott B Selleck; Frank W Sellke; Joshua T Selsby; Michael Sendtner; Serif Senturk; Elena Seranova; Consolato Sergi; Ruth Serra-Moreno; Hiromi Sesaki; Carmine Settembre; Subba Rao Gangi Setty; Gianluca Sgarbi; Ou Sha; John J Shacka; Javeed A Shah; Dantong Shang; Changshun Shao; Feng Shao; Soroush Sharbati; Lisa M Sharkey; Dipali Sharma; Gaurav Sharma; Kulbhushan Sharma; Pawan Sharma; Surendra Sharma; Han-Ming Shen; Hongtao Shen; Jiangang Shen; Ming Shen; Weili Shen; Zheni Shen; Rui Sheng; Zhi Sheng; Zu-Hang Sheng; Jianjian Shi; Xiaobing Shi; Ying-Hong Shi; Kahori Shiba-Fukushima; Jeng-Jer Shieh; Yohta Shimada; Shigeomi Shimizu; Makoto Shimozawa; Takahiro Shintani; Christopher J Shoemaker; Shahla Shojaei; Ikuo Shoji; Bhupendra V Shravage; Viji Shridhar; Chih-Wen Shu; Hong-Bing Shu; Ke Shui; Arvind K Shukla; Timothy E Shutt; Valentina Sica; Aleem Siddiqui; Amanda Sierra; Virginia Sierra-Torre; Santiago Signorelli; Payel Sil; Bruno J de Andrade Silva; Johnatas D Silva; Eduardo Silva-Pavez; Sandrine Silvente-Poirot; Rachel E Simmonds; Anna Katharina Simon; Hans-Uwe Simon; Matias Simons; Anurag Singh; Lalit P Singh; Rajat Singh; Shivendra V Singh; Shrawan K Singh; Sudha B Singh; Sunaina Singh; Surinder Pal Singh; Debasish Sinha; Rohit Anthony Sinha; Sangita Sinha; Agnieszka Sirko; Kapil Sirohi; Efthimios L Sivridis; Panagiotis Skendros; Aleksandra Skirycz; Iva Slaninová; Soraya S Smaili; Andrei Smertenko; Matthew D Smith; Stefaan J Soenen; Eun Jung Sohn; Sophia P M Sok; Giancarlo Solaini; Thierry Soldati; Scott A Soleimanpour; Rosa M Soler; Alexei Solovchenko; Jason A Somarelli; Avinash Sonawane; Fuyong Song; Hyun Kyu Song; Ju-Xian Song; Kunhua Song; Zhiyin Song; Leandro R Soria; Maurizio Sorice; Alexander A Soukas; Sandra-Fausia Soukup; Diana Sousa; Nadia Sousa; Paul A Spagnuolo; Stephen A Spector; M M Srinivas Bharath; Daret St Clair; Venturina Stagni; Leopoldo Staiano; Clint A Stalnecker; Metodi V Stankov; Peter B Stathopulos; Katja Stefan; Sven Marcel Stefan; Leonidas Stefanis; Joan S Steffan; Alexander Steinkasserer; Harald Stenmark; Jared Sterneckert; Craig Stevens; Veronika Stoka; Stephan Storch; Björn Stork; Flavie Strappazzon; Anne Marie Strohecker; Dwayne G Stupack; Huanxing Su; Ling-Yan Su; Longxiang Su; Ana M Suarez-Fontes; Carlos S Subauste; Selvakumar Subbian; Paula V Subirada; Ganapasam Sudhandiran; Carolyn M Sue; Xinbing Sui; Corey Summers; Guangchao Sun; Jun Sun; Kang Sun; Meng-Xiang Sun; Qiming Sun; Yi Sun; Zhongjie Sun; Karen K S Sunahara; Eva Sundberg; Katalin Susztak; Peter Sutovsky; Hidekazu Suzuki; Gary Sweeney; J David Symons; Stephen Cho Wing Sze; Nathaniel J Szewczyk; Anna Tabęcka-Łonczynska; Claudio Tabolacci; Frank Tacke; Heinrich Taegtmeyer; Marco Tafani; Mitsuo Tagaya; Haoran Tai; Stephen W G Tait; Yoshinori Takahashi; Szabolcs Takats; Priti Talwar; Chit Tam; Shing Yau Tam; Davide Tampellini; Atsushi Tamura; Chong Teik Tan; Eng-King Tan; Ya-Qin Tan; Masaki Tanaka; Motomasa Tanaka; Daolin Tang; Jingfeng Tang; Tie-Shan Tang; Isei Tanida; Zhipeng Tao; Mohammed Taouis; Lars Tatenhorst; Nektarios Tavernarakis; Allen Taylor; Gregory A Taylor; Joan M Taylor; Elena Tchetina; Andrew R Tee; Irmgard Tegeder; David Teis; Natercia Teixeira; Fatima Teixeira-Clerc; Kumsal A Tekirdag; Tewin Tencomnao; Sandra Tenreiro; Alexei V Tepikin; Pilar S Testillano; Gianluca Tettamanti; Pierre-Louis Tharaux; Kathrin Thedieck; Arvind A Thekkinghat; Stefano Thellung; Josephine W Thinwa; V P Thirumalaikumar; Sufi Mary Thomas; Paul G Thomes; Andrew Thorburn; Lipi Thukral; Thomas Thum; Michael Thumm; Ling Tian; Ales Tichy; Andreas Till; Vincent Timmerman; Vladimir I Titorenko; Sokol V Todi; Krassimira Todorova; Janne M Toivonen; Luana Tomaipitinca; Dhanendra Tomar; Cristina Tomas-Zapico; Sergej Tomić; Benjamin Chun-Kit Tong; Chao Tong; Xin Tong; Sharon A Tooze; Maria L Torgersen; Satoru Torii; Liliana Torres-López; Alicia Torriglia; Christina G Towers; Roberto Towns; Shinya Toyokuni; Vladimir Trajkovic; Donatella Tramontano; Quynh-Giao Tran; Leonardo H Travassos; Charles B Trelford; Shirley Tremel; Ioannis P Trougakos; Betty P Tsao; Mario P Tschan; Hung-Fat Tse; Tak Fu Tse; Hitoshi Tsugawa; Andrey S Tsvetkov; David A Tumbarello; Yasin Tumtas; María J Tuñón; Sandra Turcotte; Boris Turk; Vito Turk; Bradley J Turner; Richard I Tuxworth; Jessica K Tyler; Elena V Tyutereva; Yasuo Uchiyama; Aslihan Ugun-Klusek; Holm H Uhlig; Marzena Ułamek-Kozioł; Ilya V Ulasov; Midori Umekawa; Christian Ungermann; Rei Unno; Sylvie Urbe; Elisabet Uribe-Carretero; Suayib Üstün; Vladimir N Uversky; Thomas Vaccari; Maria I Vaccaro; Björn F Vahsen; Helin Vakifahmetoglu-Norberg; Rut Valdor; Maria J Valente; Ayelén Valko; Richard B Vallee; Angela M Valverde; Greet Van den Berghe; Stijn van der Veen; Luc Van Kaer; Jorg van Loosdregt; Sjoerd J L van Wijk; Wim Vandenberghe; Ilse Vanhorebeek; Marcos A Vannier-Santos; Nicola Vannini; M Cristina Vanrell; Chiara Vantaggiato; Gabriele Varano; Isabel Varela-Nieto; Máté Varga; M Helena Vasconcelos; Somya Vats; Demetrios G Vavvas; Ignacio Vega-Naredo; Silvia Vega-Rubin-de-Celis; Guillermo Velasco; Ariadna P Velázquez; Tibor Vellai; Edo Vellenga; Francesca Velotti; Mireille Verdier; Panayotis Verginis; Isabelle Vergne; Paul Verkade; Manish Verma; Patrik Verstreken; Tim Vervliet; Jörg Vervoorts; Alexandre T Vessoni; Victor M Victor; Michel Vidal; Chiara Vidoni; Otilia V Vieira; Richard D Vierstra; Sonia Viganó; Helena Vihinen; Vinoy Vijayan; Miquel Vila; Marçal Vilar; José M Villalba; Antonio Villalobo; Beatriz Villarejo-Zori; Francesc Villarroya; Joan Villarroya; Olivier Vincent; Cecile Vindis; Christophe Viret; Maria Teresa Viscomi; Dora Visnjic; Ilio Vitale; David J Vocadlo; Olga V Voitsekhovskaja; Cinzia Volonté; Mattia Volta; Marta Vomero; Clarissa Von Haefen; Marc A Vooijs; Wolfgang Voos; Ljubica Vucicevic; Richard Wade-Martins; Satoshi Waguri; Kenrick A Waite; Shuji Wakatsuki; David W Walker; Mark J Walker; Simon A Walker; Jochen Walter; Francisco G Wandosell; Bo Wang; Chao-Yung Wang; Chen Wang; Chenran Wang; Chenwei Wang; Cun-Yu Wang; Dong Wang; Fangyang Wang; Feng Wang; Fengming Wang; Guansong Wang; Han Wang; Hao Wang; Hexiang Wang; Hong-Gang Wang; Jianrong Wang; Jigang Wang; Jiou Wang; Jundong Wang; Kui Wang; Lianrong Wang; Liming Wang; Maggie Haitian Wang; Meiqing Wang; Nanbu Wang; Pengwei Wang; Peipei Wang; Ping Wang; Ping Wang; Qing Jun Wang; Qing Wang; Qing Kenneth Wang; Qiong A Wang; Wen-Tao Wang; Wuyang Wang; Xinnan Wang; Xuejun Wang; Yan Wang; Yanchang Wang; Yanzhuang Wang; Yen-Yun Wang; Yihua Wang; Yipeng Wang; Yu Wang; Yuqi Wang; Zhe Wang; Zhenyu Wang; Zhouguang Wang; Gary Warnes; Verena Warnsmann; Hirotaka Watada; Eizo Watanabe; Maxinne Watchon; Anna Wawrzyńska; Timothy E Weaver; Grzegorz Wegrzyn; Ann M Wehman; Huafeng Wei; Lei Wei; Taotao Wei; Yongjie Wei; Oliver H Weiergräber; Conrad C Weihl; Günther Weindl; Ralf Weiskirchen; Alan Wells; Runxia H Wen; Xin Wen; Antonia Werner; Beatrice Weykopf; Sally P Wheatley; J Lindsay Whitton; Alexander J Whitworth; Katarzyna Wiktorska; Manon E Wildenberg; Tom Wileman; Simon Wilkinson; Dieter Willbold; Brett Williams; Robin S B Williams; Roger L Williams; Peter R Williamson; Richard A Wilson; Beate Winner; Nathaniel J Winsor; Steven S Witkin; Harald Wodrich; Ute Woehlbier; Thomas Wollert; Esther Wong; Jack Ho Wong; Richard W Wong; Vincent Kam Wai Wong; W Wei-Lynn Wong; An-Guo Wu; Chengbiao Wu; Jian Wu; Junfang Wu; Kenneth K Wu; Min Wu; Shan-Ying Wu; Shengzhou Wu; Shu-Yan Wu; Shufang Wu; William K K Wu; Xiaohong Wu; Xiaoqing Wu; Yao-Wen Wu; Yihua Wu; Ramnik J Xavier; Hongguang Xia; Lixin Xia; Zhengyuan Xia; Ge Xiang; Jin Xiang; Mingliang Xiang; Wei Xiang; Bin Xiao; Guozhi Xiao; Hengyi Xiao; Hong-Tao Xiao; Jian Xiao; Lan Xiao; Shi Xiao; Yin Xiao; Baoming Xie; Chuan-Ming Xie; Min Xie; Yuxiang Xie; Zhiping Xie; Zhonglin Xie; Maria Xilouri; Congfeng Xu; En Xu; Haoxing Xu; Jing Xu; JinRong Xu; Liang Xu; Wen Wen Xu; Xiulong Xu; Yu Xue; Sokhna M S Yakhine-Diop; Masamitsu Yamaguchi; Osamu Yamaguchi; Ai Yamamoto; Shunhei Yamashina; Shengmin Yan; Shian-Jang Yan; Zhen Yan; Yasuo Yanagi; Chuanbin Yang; Dun-Sheng Yang; Huan Yang; Huang-Tian Yang; Hui Yang; Jin-Ming Yang; Jing Yang; Jingyu Yang; Ling Yang; Liu Yang; Ming Yang; Pei-Ming Yang; Qian Yang; Seungwon Yang; Shu Yang; Shun-Fa Yang; Wannian Yang; Wei Yuan Yang; Xiaoyong Yang; Xuesong Yang; Yi Yang; Ying Yang; Honghong Yao; Shenggen Yao; Xiaoqiang Yao; Yong-Gang Yao; Yong-Ming Yao; Takahiro Yasui; Meysam Yazdankhah; Paul M Yen; Cong Yi; Xiao-Ming Yin; Yanhai Yin; Zhangyuan Yin; Ziyi Yin; Meidan Ying; Zheng Ying; Calvin K Yip; Stephanie Pei Tung Yiu; Young H Yoo; Kiyotsugu Yoshida; Saori R Yoshii; Tamotsu Yoshimori; Bahman Yousefi; Boxuan Yu; Haiyang Yu; Jun Yu; Jun Yu; Li Yu; Ming-Lung Yu; Seong-Woon Yu; Victor C Yu; W Haung Yu; Zhengping Yu; Zhou Yu; Junying Yuan; Ling-Qing Yuan; Shilin Yuan; Shyng-Shiou F Yuan; Yanggang Yuan; Zengqiang Yuan; Jianbo Yue; Zhenyu Yue; Jeanho Yun; Raymond L Yung; David N Zacks; Gabriele Zaffagnini; Vanessa O Zambelli; Isabella Zanella; Qun S Zang; Sara Zanivan; Silvia Zappavigna; Pilar Zaragoza; Konstantinos S Zarbalis; Amir Zarebkohan; Amira Zarrouk; Scott O Zeitlin; Jialiu Zeng; Ju-Deng Zeng; Eva Žerovnik; Lixuan Zhan; Bin Zhang; Donna D Zhang; Hanlin Zhang; Hong Zhang; Hong Zhang; Honghe Zhang; Huafeng Zhang; Huaye Zhang; Hui Zhang; Hui-Ling Zhang; Jianbin Zhang; Jianhua Zhang; Jing-Pu Zhang; Kalin Y B Zhang; Leshuai W Zhang; Lin Zhang; Lisheng Zhang; Lu Zhang; Luoying Zhang; Menghuan Zhang; Peng Zhang; Sheng Zhang; Wei Zhang; Xiangnan Zhang; Xiao-Wei Zhang; Xiaolei Zhang; Xiaoyan Zhang; Xin Zhang; Xinxin Zhang; Xu Dong Zhang; Yang Zhang; Yanjin Zhang; Yi Zhang; Ying-Dong Zhang; Yingmei Zhang; Yuan-Yuan Zhang; Yuchen Zhang; Zhe Zhang; Zhengguang Zhang; Zhibing Zhang; Zhihai Zhang; Zhiyong Zhang; Zili Zhang; Haobin Zhao; Lei Zhao; Shuang Zhao; Tongbiao Zhao; Xiao-Fan Zhao; Ying Zhao; Yongchao Zhao; Yongliang Zhao; Yuting Zhao; Guoping Zheng; Kai Zheng; Ling Zheng; Shizhong Zheng; Xi-Long Zheng; Yi Zheng; Zu-Guo Zheng; Boris Zhivotovsky; Qing Zhong; Ao Zhou; Ben Zhou; Cefan Zhou; Gang Zhou; Hao Zhou; Hong Zhou; Hongbo Zhou; Jie Zhou; Jing Zhou; Jing Zhou; Jiyong Zhou; Kailiang Zhou; Rongjia Zhou; Xu-Jie Zhou; Yanshuang Zhou; Yinghong Zhou; Yubin Zhou; Zheng-Yu Zhou; Zhou Zhou; Binglin Zhu; Changlian Zhu; Guo-Qing Zhu; Haining Zhu; Hongxin Zhu; Hua Zhu; Wei-Guo Zhu; Yanping Zhu; Yushan Zhu; Haixia Zhuang; Xiaohong Zhuang; Katarzyna Zientara-Rytter; Christine M Zimmermann; Elena Ziviani; Teresa Zoladek; Wei-Xing Zong; Dmitry B Zorov; Antonio Zorzano; Weiping Zou; Zhen Zou; Zhengzhi Zou; Steven Zuryn; Werner Zwerschke; Beate Brand-Saberi; X Charlie Dong; Chandra Shekar Kenchappa; Zuguo Li; Yong Lin; Shigeru Oshima; Yueguang Rong; Judith C Sluimer; Christina L Stallings; Chun-Kit Tong Journal: Autophagy Date: 2021-02-08 Impact factor: 13.391