Roya Varmazyar1, Ali Noori-Zadeh2, Farzad Rajaei3, Shahram Darabi4, Salar Bakhtiyari5. 1. Student Research Committee, Qazvin University of Medical Sciences, Qazvin, Iran. 2. Department of Clinical Biochemistry, Faculty of Allied Medical Sciences, Ilam University of Medical Sciences, Ilam, Iran. 3. Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. 4. Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. Electronic Address: shahram2005d@yahoo.com. 5. Department of Clinical Biochemistry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran.
Parkinson’s disease (PD) is a neurodegenerative
motor disorder that affects 50% of elderly people
over 85 years old (1). Although the etiology of PD is
mainly unknown, some factors such as oxidative stress-
induced mitochondrial damage, which in turn, increases
the protein aggregations, is the molecular and cellular
characterization of the disease. Moreover, several studies
have indicated the relationship between autophagy
deficiency and neurodegenerative diseases such as PD. In
this regard, autophagy regulation has been considered a
strategy for the treatment of neurodegenerative diseases.Autophagy is the primary cellular catabolic program
in response to cellular starvation and degradation of
the damaged organelles. It is well accepted that 17
ß-estradiol (E2) has neuroprotective effects in many
neurodegenerative diseases (2). E2 also plays a
significant role in regulating the MAPK/ERK pathway
(3). Epidemiological studies have demonstrated
that men are more prone to PD by a ratio of 3:2 in
comparison with women and estrogen affects the
disease onset and the severity of the symptoms
associated with the disease (4). In addition, it acts
through the antioxidant system by increasing the brain
blood flow (5). Some actions of estrogen such as the
regulation of neurotransmitter function are mediated
through genomic and non-genomic pathways (6).In PD, the degeneration of dopaminergic neurons
results from the accumulation of aggregated proteins
caused by oxidative stress in the cell. In fact, autophagy
mediated degradation of aggregated proteins and
damaged organelles are disrupted, therefore, autophagy
may be considered a therapeutic target. As the age
increases, changes in the lysosomal activity can reduce
the rate of autophagy in the neurodegenerative diseases
(7, 8). However, the mechanism of its protective
actions is still largely unknown, particularly in PD. In
the present study, the mechanism of E2 in autophagymediated
neuroprotection has been investigated in the
rat model of PD.
Materials and Methods
Animals
In this experimental study, rats (female, Wistar) were
maintained under a 12-12 hours light-dark condition
at a controlled temperature of the animal laboratory.
Water and food were available ad libitum for all of
the animals. All ethical guidelines were followed in
order to reduce the animal suffering. The study was
conducted in accordance with the guidelines for
working with experimental animals set by the Ethics
Committee (Ethics code: IR.QUMS.REC.1395.67) of
Qazvin University of Medical Sciences.
Ovariectomy of animals
In order to remove E2-producing gonads and hormonal
cycle, the ovaries were both removed under sterile and
aseptic conditions in all of the animals. After anesthetizing
with a mixture of ketamine (100 mgkg-1, Sigma-Aldrich,
Germany) and xylazine (5 mgkg-1, Sigma-Aldrich,
Germany), the ovaries were removed after 1 cm cutting in
the skin of the animal. Then, the skin of the ovariectomized
rats was sutured.
Development of Parkinson’s disease in ovariectomized
rats
For the development of Parkinson’s disease in
the animal model, the ovariectomized rats were
anesthetized by intraperitoneal injection of a mixture
of Ketamine (100 mgkg-1) and Xylazine (5 mgkg-1).
Their heads were then fixed in a stereotaxic device
in accordance with the coordinates. The coordinates
were set to 3 mm lateral to the left to cause a lesion,
4.5 mm abdominal from dura mater and +9.2 anterior-
posterior to the interaural line. Incisor bar was also
located 3.3 mm below the horizontal line. After fixing
the animals’ head on the device, the skin can be
exposed by removing hairs from the head using regular
razors and scissors. After disinfecting the surgical
site using Betadine, an incision was created parallel
to the sagittal plane from a distance between the eyes
to between the ears, and the scalp was sheared from
the skull. After finding the coordinates, the bone for
injection was drilled at low speed in order to protect
the brain tissue from an injury. In the ovariectomized
control group (OCG), stereotaxic surgery was
performed on the rats and 5 µL of saline containing
0.2 % of ascorbate was injected into the left corpus
striatum. In the ovariectomized degeneration group
(ODG), 5 µL saline ascorbate 0.2% contained 25 µg
of 6-OHDA was injected into the left corpus striatum
of rats. The rats in ovariectomized E2 pretreatment
group (OE2PTG) were pretreated with 0.1 mgkg-1 of
17 ß-estradiol (E8875, Sigma-Aldrich, Germany) for
three days prior to the destruction of corpus striatum.
After E2 pretreatment, the dura mater was exposed
and 5 µL of saline ascorbate 0.2% contained 25 µg of
6-OHDA was injected into the left corpus striatum of
rats using a 5-µl Hamilton syringe.
Behavioral tests
The behavioral test was performed on the rats in the
three experimental groups before the surgery and four
weeks afterward. Behavioral tests were carried out by
intraperitoneal injection of apomorphine hydrochloride
(Sigma-Aldrich, Germany) with a dose of 2.5 mgkg-1.
Ten minutes before the surgery (baseline) rats were
kept in a cylindrical transparent chamber made of
glass with the diameter of 33 cm and the height of 35
cm. After injecting medication, the total 360-degree
rotation was measured manually for 60 minutes at the
intervals of 10 minutes. The number of contralateral
(opposite the lesion site or to the right) and the number
of ipsilateral rotations (toward the lesion site or to the
left side) were considered the positive and negative
numbers, respectively. The net number of the rotations
was calculated after subtracting rotations from two
directions.
Nissl staining in experimental groups
By intraperitoneal injection of a mixture of ketamine
(100 mgkg-1) and xylazine (5 mgkg-1), rats were
anesthetized at the fourth week, i.e. after performing
the behavioral tests. The rats were perfused using
normal saline and formalin. After perfusion, the brain
was removed from the skull. For neuronal counts,
tissue blocks were provided from animals’ substantia
nigra. Tissue sections with the diameter of 10 µm
were made from the midbrain at intervals of 2.4 to 2.9
mm from the interaural point in accordance with the
Paxinos atlas. The tissue sections were Nissl-stained
with Cresyl violet solution (0.1%). The neurons in
the dense part of substantia nigra were counted in
sections aligned with 4 levels of Paxinos atlas (i.e.,
2.96, 3.2, 3.8, and 4.2) as compared to the center of
interaural line with the magnification of (×200, ×100).
At each level, at least two sections were counted and
the neurons with the cytoplasmic domain were also
counted.
Gene expression analysis
The total RNA was isolated from the striatum of each
animal using Ambion kit (Invitrogen, USA) following
the manufacturer’s instructions. Each sample of
the isolated RNA was further treated with DNase I
enzyme (Invitrogen, USA). The yield and quality of
the total RNA were assessed using absorbance ratio
at (260 nm/280 nm) using spectrophotometry and
denaturing agarose gel electrophoresis. The reverse
transcription-polymerase chain reaction (RT-PCR)
was performed using the RevertAid first strand
cDNA synthesis kit (Fermentas, Lithuania) according
to the manufacturer’s instructions. Meanwhile,
glyceraldehyde-3-phosphate dehydrogenase (Gapdh)
was used as an internal control gene. The primers have
been shown in Table 1.The sequence of the primer pairs and corresponding amplicon sizes that have been used in this study
Statistical analysis
All data were expressed as mean ± SEM (any exception
is mentioned). Moreover, one-way ANOVA was used
for the results obtained from investigating apomorphineinduced
rotational behavior in two periods (i.e., before
and 4 weeks after surgery). One-way ANOVA was used to
evaluate the mean neurons in the dense part of substantia
nigra and multiple post-hoc comparisons were performed
by Tukey’s test between the groups. In addition, Microsoft
Excel (2017) was used in order to draw the diagrams.
P<0.05 was considered as a significant statistical
difference.
Results
Apomorphine-induced rotational behavior test
The behavioral test was performed at the 1st and 4th
weeks of the surgery. The results indicated that the
rotations before the surgery were 5 ± 0.36, 3 ± 0.39,
and 4 ± 0.42 (mean ± SEM) meanwhile at 4 weeks
post-surgery the rotations were 4 ± 0.44, 73.53 ± 1,
and 183 ± 4.78 for the OCG, OE2PTG and, ODG
groups, respectively. The rotation results in the ODG
group suggested the verification of substantia nigra
degradation in the animal model. Moreover, E2 reduced
the damage to the dopaminergic neurons of substantia
nigra which was characterized by improving the
motor behavior and reducing rotations in the OE2PTG
group in comparison with ODG group. There was a
significant difference (P<0.05) of rotations between
the OCG and ODG groups (Fig .1). Before the surgery,
there was no significant difference among the OCG,
ODG, and OE2PTG groups in the rotations (Fig .1).
Fig.1
Before the surgery, there was no significant difference among the
OCG, ODG, and OE2PTG groups in the rotations (P<0.05).
OCG; Ovariectomized control group, ODG; Ovariectomized degeneration
group, OE2PTG; Ovariectomized E2 pretreatment group, and *; Indicates
a significant difference between each experimental group with the OCG
group.
Before the surgery, there was no significant difference among the
OCG, ODG, and OE2PTG groups in the rotations (P<0.05).OCG; Ovariectomized control group, ODG; Ovariectomized degeneration
group, OE2PTG; Ovariectomized E2 pretreatment group, and *; Indicates
a significant difference between each experimental group with the OCG
group.
Nissl staining of substantia nigra
The midbrain was separated and after preparing the
tissue block, neuronal counts were done using Nissl
staining. The results indicated that the means ± SEM
for the neurons in the right (normal area) substantia
nigra for the OCG, OE2PTG, and ODG groups were
126 ± 3.18, 128 ± 2.73, and 129 ± 2.64, respectively;
suggesting that there were no significant differences
among the groups. Moreover, the means ± SEM for
neurons in the left (degenerated area) substantia
nigra for the OCG, OE2PTG, and ODG groups were
120 ± 2.19, 89 ± 1.68, and 49 ± 1.67, respectively
suggesting a significant (P<0.05) reduction of neurons
in the groups as compared to control group (Fig .2).
Progressive degeneration of the nigral dopaminergic
neurons after 6-OHDA administration was observed
in ODG group (Fig .2A). In ODG group, the number
of neurons was statistically less than OCG group
suggesting the degeneration of neurons in substantia
nigra by 6-OHDA (Fig .2). In OE2PTG group (Fig .2B),
17 ß-estradiol prevented the neuronal degeneration of
substantia nigra in OE2PTG group and fewer neurons
degenerated in comparison with the OCG group
(Fig .2C).
Fig.2
Neuronal counts in the substantia nigra. A. The means of nigral
neurons in the left and right sides of the three experimental groups have
been shown. On the right side, there were no significant differences
among the groups. However, for the left side, a significant difference
was observed for all groups (P<0.05). Neurons in substantia nigra in the
left side of the experimental groups with Nissl staining for B. OCG group,
C. OE2PTG group, and D. ODG group. Abundant neurons existed in the
substantia nigra and ventral tegmental area of OCG and OE2PTG groups.
In contrast, the number of neurons was progressively decreased in
substantia nigra ipsilateral to 6-OHDA injection in ODG group. OCG, ODG,
ovariectomized E2 pretreatment group (OE2PTG), substantia nigra pars
compacta (SNc), ventral tegmentum area (VTA) (scale bars: 200 µm).
OCG; Ovariectomized control group, ODG; Ovariectomized degeneration
group, and *; Shows the statistically significant difference in OCG group
(P<0.05).
The results of P62, Ulk1, and Lc3 gene expression
analyses in the three experimental groups indicated
that P62 and Lc3 genes expressed in all groups while
Ulk1 was only expressed in ODG group. In OE2PTG
group after receiving E2, Ulk1 was overexpressed (Fig .3). Gapdh was used as an internal control expressed in
all groups.
Fig.3
Gene expression results. The P62 and Lc3 expressed in all groups,
while Ulk1 was expressed only in ovariectomized degeneration (ODG)
group. In ovariectomized rats pretreated with 17 ß-estradiol before
6-hydroxydopamine injection (OE2PTG), Ulk1 was overexpressed. Gapdh was used as an internal control which was expressed in all groups. OCG;
Ovariectomized control group.
Neuronal counts in the substantia nigra. A. The means of nigral
neurons in the left and right sides of the three experimental groups have
been shown. On the right side, there were no significant differences
among the groups. However, for the left side, a significant difference
was observed for all groups (P<0.05). Neurons in substantia nigra in the
left side of the experimental groups with Nissl staining for B. OCG group,
C. OE2PTG group, and D. ODG group. Abundant neurons existed in the
substantia nigra and ventral tegmental area of OCG and OE2PTG groups.
In contrast, the number of neurons was progressively decreased in
substantia nigra ipsilateral to 6-OHDA injection in ODG group. OCG, ODG,
ovariectomized E2 pretreatment group (OE2PTG), substantia nigra pars
compacta (SNc), ventral tegmentum area (VTA) (scale bars: 200 µm).
OCG; Ovariectomized control group, ODG; Ovariectomized degeneration
group, and *; Shows the statistically significant difference in OCG group
(P<0.05).Gene expression results. The P62 and Lc3 expressed in all groups,
while Ulk1 was expressed only in ovariectomized degeneration (ODG)
group. In ovariectomized rats pretreated with 17 ß-estradiol before
6-hydroxydopamine injection (OE2PTG), Ulk1 was overexpressed. Gapdh was used as an internal control which was expressed in all groups. OCG;
Ovariectomized control group.
Discussion
In the present experimental study, 17 ß-estradiol i.
Improved the motor behavior and reduced apomorphineinduced
rotational behavior, ii. Reduced the degeneration
of substantia nigra neurons which was induced by the
neurotoxic effects of 6-OHDA, and iii. Overexpression
of ULK1 inhibited by 6-OHDA. In this study, 6-OHDA
injections caused behavioral and tissue changes in
accordance with PD model development. This model
for PD is the most common pre-clinical model that has
been well known due to its effects on the nigrostriatal
dopaminergic system. 6-OHDA model caused molecular
changes in the substantia nigra, which is most similar to
PD characteristics in humans. The biological functions of
estrogen are mediated by binding to the estrogen receptor
-a and estrogen receptor-ß; by which estrogen has a
slow genomic mechanism that protects the cells against
apoptosis and inflammatory reactions and regulates the
growth factors and neurotrophins and contributes to the
formation of synapses.Studies have also suggested that ovarian removal can
cause significant behavioral changes in apomorphineinduced
in animals (9). Such changes can be due to the
reduced number of dopaminergic neurons in substantia
nigra (10). In addition, these neurotransmitter changes
following the removal of the gonads can justify the
nervous system disorder in women after the menopause.
Another study in ovariectomized rats indicated the
ability of estrogen to increase the dopamine absorption
in the nigrostriatal dopaminergic system (11). In a study
conducted in monkeys, it was observed that more than
30% of dopaminergic neurons in substantia nigra were
disappeared 30 days after ovariectomy and estrogen
prevented the degeneration of neurons within 10 days (12),
however, they did not explore the underlying mechanism.
In a study conducted in vitro model of PD, it was observed
that estrogen is able to prevent the cell apoptosis against
6-OHDA toxicity by activating anti-apoptotic proteins
and inhibiting pro-apoptotic proteins (13). Yet, they did
not investigate the other estrogen pleiotropic effects.
Studies have shown that 17ß-estradiol mediates its effect
through the dopamine receptors (14). For the treatment of
neurological diseases, cell and gene therapy along with
various methods for the differentiation of mesenchymal
stem cell and their differentiation into the neurons
have been widely used (15-18). Moreover, epigenetic
alteration and sex hormone therapy may be the other
available treatment options as well. Indeed, studies have
also indicated that the sex hormones are effective in
the treatment of other neurodegenerative diseases (19)
as we showed earlier. Consistent with our study, it has
been recently shown that 17 ß-estradiol can regulate
autophagy (20).Macroautophagy is a conserved protein degradation
mechanism in which the cargo is surrounded by
autophagosome and then fused with the lysosome. In the
initiation phase of autophagy, the first step is the formation
of autophagosome. ULK1 as an upstream protein starts
the process of autophagy and is regulated by signals such
as mTOR, AMP-activated protein kinase (AMPK), and
glycogen synthase kinase 3 (GSK3) (21). Under the normal
conditions, mTOR is phosphorylated and negatively
regulates the complexes such as ULK1, ULK2, ATG101,
ATG13, and FIP200. As mTOR is inhibited, ULK1
activation results in activation of ATG13 and FIP200 upon
the initiation of autophagy. The deficiency in autophagy
can cause neurodegenerative diseases such as Alzheimer’s
disease, Parkinson’s disease, and amyotrophic lateral
sclerosis (22, 23). In PD, phosphorylated a-synuclein is
fibrillated and accumulated known as Lewy bodies (24).
The ULK1 has been observed in Lewy bodies. Evidence
suggests that the downstream protein, LC3, contributes
to Lewy body formation. Phosphatidyl ethanolamineconjugated
form of LC3 (LC3II) is bound to the internal
surface of autophagosome and acts as a clasp for the cargo
receptors such as P62 (25). These results indicate that
autophagy-lysosome system plays a significant role in
the pathogenesis of PD and Lewy body formation. In the
present study, 17 ß-estradiol increased the expression of
ULK1 in animals with PD. In another study, 17 ß -estradiol
prevented osteoblast cell death by activating autophagy
and ER-ERK-mTOR and expressing ULK1 and Beclin-1
(20). ULK1 plays a significant role in the bingeing of the
autophagy process. The deficiency in autophagy can also
cause the abnormal protein accumulations and damage
to the organelles in neurodegeneration. Since some PD
models can impair mitochondrial functions, deficiency
in controlling the mitochondrial quality plays a crucial
role in the pathogenesis of PD. The studies have shown
that selective degradation of damaged mitochondria is a
part of an important homeostasis pathway for controlling
the organelles quality and mitophagy (mitochondrial
autophagy) playing a vital role in mitochondrial
decomposition and maintaining dopaminergic neurons.On the other hand, protein accumulation as a cellular
pathology has been observed in many neurodegenerative
diseases including PD. In this context, autophagy is
considered one of the major proteolytic systems which
can maintain the homeostasis of the cellular proteins.
ULK1 is required to form autophagosomes in mammalian
cells. It has been proven that ULK1 and 2 are necessary
for autophagy. LC3 is one of the autophagic genes that
its product accumulates in the autophagosome membrane
and is considered an autophagy marker (25). ATG101 is a
binding protein for ATG13 which is a part of ATG1/ULK1
serine-threonine kinase and is required for autophagy
induction. The ULK1 complex contains ATG13 and
FIP200 which are required for autophagy initiation. The
interaction between ATG101 and ATG13 is important for
the stability and phosphorylation of ATG13 and ULK1.
Therefore, the lack of ULK1 expression leads to the
disturbance in the initiation of autophagy.
Conclusion
In this study, the administration of 17 ß-estradiol
led to Ulk1 overexpression and regulating autophagy
accompanied by the improvement in behavioral and tissue
of animal model of PD.
Table 1
The sequence of the primer pairs and corresponding amplicon sizes that have been used in this study
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