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The Journal of Neuroscience, May 1, 1998, 18(9):3180-3185
Increased Synaptic Sprouting in Response to Estrogen via an
Apolipoprotein E-Dependent Mechanism: Implications for Alzheimer's
Disease
David J.
Stone,
Irina
Rozovsky,
Todd E.
Morgan,
Christopher P.
Anderson, and
Caleb E.
Finch
Andrus Gerontology Center and the Department of Biological
Sciences, University of Southern California, Los Angeles,
California 90089-0191
 |
ABSTRACT |
Estrogen replacement therapy appears to delay the onset of
Alzheimer's disease (AD), but the mechanisms for this action are incompletely known. We show how the enhancement of synaptic sprouting by estradiol (E2) in response to an entorhinal
cortex (EC) lesion model of AD may operate via an apolipoprotein E
(apoE)-dependent mechanism. In wild-type (WT) mice, ovariectomy
decreased commissural/associational sprouting to the inner molecular
layer of the dentate gyrus, with synaptophysin (SYN) as a marker.
E2 replacement returned SYN in the inner layer to levels of
EC-lesioned, ovary-bearing controls and increased the area of
compensatory synaptogenesis in the outer molecular layer. In
EC-lesioned apoE-knock-out (KO) mice, however, E2 did not
enhance sprouting. We also examined apoJ (clusterin) mRNA, which is
implicated in AD by its presence in senile plaques, its transport of
A across the blood-brain barrier, and its induction by
neurodegenerative lesioning. ApoJ mRNA levels were increased by
E2 replacement in EC-lesioned WT mice but not in apoE-KO
mice. These data suggest a mechanism for the protective effects of
estrogens on AD and provide a link between two important risk factors
in the etiology of AD, the apoE 4 genotype and an estrogen-deficient state. This is also the first evidence that SYN, a presynaptic protein
involved in neurotransmitter release, is regulated by E2 in
the adult brain, and that apoE is necessary for the induction of apoJ
mRNA by E2 in brain injury.
Key words:
Estrogen; apolipoprotein E; Alzheimer's disease; sprouting; synaptophysin; brain lesion; apolipoprotein J
 |
INTRODUCTION |
This study examines the interactions
of estradiol (E2) and ovariectomy (OVX) with
apolipoproteins E and J during reactive synaptogenesis in the
hippocampus. Estrogen replacement therapy reduces the risk of
Alzheimer's disease (AD) by incompletely known mechanisms. In the CA1
neuronal field of the hippocampus, which is devastated in AD (Simic et
al., 1997 ) E2 induces excitatory synapses and dendritic
spines (Woolley and McEwen, 1992 , 1993 ). E2 also enhances
compensatory sprouting in response to entorhinal cortex lesioning
(ECL), a model for the deafferenting aspect of AD (Geddes et al.,
1985 ). In the response to ECL, the molecular layer of the dentate gyrus
is reinnervated by sprouting from multiple pathways. The inner
molecular layer receives an increase in commissural/associational (C/A)
afferents, whereas the outer one-third receives afferents from the
septohippocampal pathways, contralateral entorhinal cortex, and local
interneurons (Steward and Loesche, 1977 ; Scheff, 1989 ). Ovariectomy
reduces and E2 replacement reinstates compensatory sprouting by C/A neurons to the inner molecular layer (Morse et al.,
1986 ). Effects of E2 on outer molecular layer sprouting
have not been reported.
We also considered two apolipoproteins in neuronal sprouting.
Apolipoprotein E (apoE) is a 37 kDa glycoprotein that mediates cholesterol transport in the CNS (Poirier et al., 1993a ) and peripheral circulation (Koo et al., 1985 ). ApoE is involved in the response to
neural injury (Boyles et al., 1990 ; Poirier et al., 1991 ; Poirier, 1994 ), maintenance of dendritic complexes (Masliah et al., 1995 ), and
neuronal remodeling in vitro (Nathan et al., 1994 ; Fagan et al., 1996 ) and in AD (Arendt et al., 1997 ). Because apoE mRNA levels in
the brain are induced by E2 (Srivastava et al., 1996 ; Stone
et al., 1997 ), we hypothesized that E2 supports synaptic sprouting via increased apoE production, possibly for the transport of
cholesterol and other hydrophobic membrane components. To test this
hypothesis we manipulated E2 levels in wild-type (WT) and apoE-knock-out (KO) mice via OVX and E2 replacement and
examined compensatory synaptic sprouting 2 weeks after entorhinal
cortex lesioning.
ApoJ also mediates cholesterol transport (Jordan-Stark et al., 1994 ).
Like apoE, apoJ mRNA is increased in experimental lesions and AD (May
et al., 1990 ) and is under steroidal control (Day et al., 1990 ). The
apoE 4 allele, the most general risk factor for AD currently
described, is associated with decreased apoE and increased apoJ in the
AD brain (Bertrand et al., 1995 ). We hypothesized that apoJ mRNA levels
would show a similar, brain-wide increase in apoE-KO mice, with apoJ
compensating for the reduction in brain apolipoproteins caused by the
removal of apoE.
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MATERIALS AND METHODS |
Surgery and estrogen replacement. Female mice
(C57Bl/6J and apoE-KO; The Jackson Laboratory, Bar Harbor, ME) were
maintained in a controlled light and temperature environment, with food
and water ad libitum. ApoE-KO mice were developed, verified
(by Southern blot and double immunodiffusion), and deposited at The
Jackson Laboratory by Piedrahita et al. (1992) . Animals underwent an
OVX or sham OVX under 2,2,2-tribromoethanol anesthesia (0.4 gm/kg). After 1 week, mice were lesioned by perforant path transection with a
stereotaxic retractable wire knife (Scouten wire knife; Kopf, Tujunga,
CA) under the same anesthesia. The retracted assembly is inserted into
the entorhinal cortex (0.5 mm anterior, 3.2 mm lateral of , and 1 mm
ventral from dura). The extended blade was then lowered 2 mm ventrally
twice at angles to avoid the hippocampus. For E2
replacement, OVX mice were given 17 -estradiol at a concentration of
440 ng/ml in acidified drinking water, which produces serum E2 levels of 8 pg/ml during the day (approximately estrus
or early diestrus levels) and 23 pg/ml at night (low proestrus levels) and was sufficient to suppress LH hypersecretion caused by OVX (Gordon
et al., 1986 ). Thus E2 levels in E2-replaced
mice did not exceed physiological levels. Control mice underwent
anesthesia and sham ovariectomy or ECL. In sham ovariectomies skin and
peritoneal wall incisions were made. In sham ECL scalps were
incised, and holes were drilled in the skull with a hand-held dental
drill; wire knife cuts were not made. Postoperative mortality was 60% higher in apoE-KO mice than in WT mice.
After 2 weeks the mice were anesthetized and perfusion-fixed in
phosphate buffer, pH 7.4, containing 4% paraformaldehyde. Brains
(n = 36, six per group) were immersion-fixed 1 d
at 4°C in buffered paraformaldehyde, immersed in 30% sucrose for
3 d (4°C), and sectioned by cryostat (25 µm).
Immunohistochemistry. Sections were treated with 1% BSA and
1% normal goat serum in PBS to block nonspecific binding and then treated with primary antibody (rabbit anti-human synaptophysin at 1.5 µg/ml; Dako, Carpenteria, CA) for 90 min at room temperature. After
washing in PBS, sections were exposed to biotinylated secondary antibody (goat anti-rabbit) for 1 hr and peroxidase-conjugated streptavidin for 30 min. (Vectastain; Vector Laboratories, Burlingame, CA). The reaction was completed with immunoperoxidase-DAB
visualization.
In situ hybridization. Sections were washed in PBS and
dehydrated in an ethyl alcohol series (30-100%). Sections were
prehybridized for 1 hr at 55°C (prehybridization buffer: 0.75 M NaCl, 50% formamide, 10% dextran sulfate, and 0.05 M phosphate, pH 7.4) and hybridized with a
35S-labeled cRNA probe. Sections were hybridized with
35S-labeled cRNA for 3 hr at 55°C. Sense cRNA probes
serve as controls for background signal. Slides were then covered with
NTB2 emulsion (Eastman Kodak, Rochester, NY) and exposed for 10 d
for cellular analysis. After development, slides were counter stained
with cresyl violet.
Image analysis and statistics. Molecular layer width and
optical density (OD) were measured with IPLab Spectrum image analysis software (Signal Analytics Corporation). To ensure that all
measurements were objective, light and optical density threshold levels
were established before measurement and were identical for each brain and treatment. Inner, middle, and outer molecular layers were distinguished as described previously (Masliah et al., 1991 ). Data were
analyzed by two-way ANOVA on SuperANOVA statistical software (Abacus
Concepts, Berkeley, CA). All statistical tests were run before data
normalization.
 |
RESULTS |
Synaptophysin immunoreactivity
To estimate synaptic density in the dentate gyrus, we examined the
immunoreactivity for the presynaptic protein synaptophysin (SYN) as
described by Masliah et al. (1991) . SYN immunoreactivity in the
molecular layer of the normal dentate gyrus (unlesioned mice) did not
differ between WT and apoE-KO mice (WT, 25.52 ± 2.1 OD units; KO,
29.6 ± 8.8 OD units, not significant). Fourteen days after EC
lesioning, both WT and apoE-KO mice (with ovaries) displayed the
expected laminated pattern of SYN immunoreactivity in the dentate gyrus
(Masliah et al., 1991 ), in which immunostaining was increased in the
inner and outer molecular layers but decreased in the middle molecular
layer (Fig. 1A,D).
Integrated density of the inner molecular layer was 15% lower in
apoE-KO mice than in wild-type mice (Fig.
2A).

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Figure 1.
Synaptophysin immunoreactivity in the dentate
gyrus of ECL wild-type and ApoE-KO mice. C57BL/6J mice
(A-C) and apoE-KO mice
(D-F) showed different responses to estradiol
after ECL. Two weeks after surgery, sham-OVX mice (A,
WT; D, apoE-KO) showed less immunoreactivity in the
middle molecular layer than in the inner or outer layer of the dentate
gyrus. In wild-type C57BL/6J mice, OVX causes a decrease in both the
relative thickness and OD of the inner layer (B),
whereas estradiol replacement brought inner layer thickness and OD back
to sham-OVX levels (C). In apoE-KO mice, OVX
(E) and estradiol replacement
(F) made no significant changes in inner
molecular layer thickness or OD. Width of the outer molecular layer was
also increased in the WT E2-replaced mice
(C). In apoE-KO mice, outer molecular layer width
was unaffected by estrogen treatment (D-F).
H, Hilus; G, granular layer;
O, outer; M, middle; I,
inner molecular layer.
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Figure 2.
Markers for sprouting in response to ECL show
E2-dependent effects in wild-type but not ApoE-KO mice.
A, The absolute width and OD of SYN immunoreactivity in
the inner molecular layer were measured with an image-processing
analysis system, and integrated density (thickness × optical
density) was calculated. The y-axis gives integrated
density as a percent of that for the WT, ovary-bearing (control) mice.
There was a decrease in both thickness (15%; p < 0.05) and OD (35%; p < 0.05) of the inner layer
of WT ovariectomized mice. E2 replacement returned inner
layer width, OD, and integrated density to control levels. ApoE-KO mice
did not show any significant changes in response to E2.
Ovary-bearing apoE-KO mice showed a reduced integrated density (15%;
NS) when compared with ovary-bearing controls. *Significantly different
from control; p < 0.05. B, The OD
of the outer molecular layer reached the threshold of image analysis
software; however, the width of the outer layer was measured. The
y-axis gives the width of the outer molecular layer,
expressed as a percent of the total molecular layer width. Although OVX
did not cause a significant decrease in outer layer width in WT mice,
E2-replaced mice showed a significant increase in outer
layer width. In contrast, no E2 effect on outer molecular
layer width was detected in aopE-KO mice. *Significantly different from
inner layer width; p < 0.05.
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OVX of WT mice decreased the C/A sprouting response to EC lesioning, as
shown by the thickness and intensity of the SYN immunoreactivity of the
inner molecular layer (Figs. 1B,
2A). E2 replacement in OVX-WT mice
restored expression of SYN to that of ovary-bearing, lesioned controls
(Figs. 1C, 2A). In contrast, apoE-KO mice
did not respond to manipulations of E2, as measured
by SYN immunoreactivity in the inner molecular layer (Figs.
1D-F,
2A).

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Figure 3.
ApoJ mRNA levels show E2-dependent
effects in wild-type but not ApoE-KO mice. A, At the
lesion site (entorhinal cortex), apoJ mRNA level shows a nonsignificant
decrease in response to OVX and a 1.7-fold increase with E2
replacement. No significant changes were observed in apoE-KO mice. The
y-axis gives in situ grain density as a
percent of WT, ovary-bearing (control) mice. B, In the
deafferented dentate gyrus (ipsilateral to lesion), apoJ mRNA levels
did not change in WT mice, whereas apoE-KO mice showed increased apoJ
mRNA levels in response to ovariectomy. E2 replacement did
not have an effect. Levels are given as a percent of contralateral
values. The y-axis gives in situ grain
density expressed as a percent of that in the contralateral
(unlesioned) dentate gyrus of the same brain. C, In the
unlesioned hippocampus (contralateral to lesion) of sham-ovariectomized
mice, apoE-KO mice showed a nonsignificant increase in apoJ mRNA,
suggesting a possible compensatory increase. This trend did not extend
to the apoJ responses to E2 or lesion. The
y-axis gives the in situ grain density in
the unlesioned dentate gyrus, expressed as a percent of that in WT
mice. *Significantly different from sham-OVX mice;
p < 0.05.
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Optical density for SYN in the outer molecular layer could not be
quantified because of a ceiling effect (i.e., staining too intense and
not linear). The width of the outer molecular layer, however, was
significantly increased in E2-replaced WT mice (Figs. 1C, 2B). ApoE-KO mice did not show any
difference in outer molecular layer width between groups (Figs.
1D-F, 2B).
Apolipoprotein J mRNA responses
ApoJ mRNA at the lesion site was increased threefold to fourfold
in all mice. However, OVX- and E2-treated WT mice showed a
twofold greater increase over sham-OVX and OVX-WT mice, whereas apoE-KO
mice did not show E2 influences (Fig. 3A). In
the molecular layer of the dentate gyrus of WT mice, apoJ mRNA levels
were unaffected by OVX and E2 replacement, whereas in
apoE-KO mice (Fig. 3B) OVX increased levels irrespective of
E2 replacement. In ovary-bearing apoE-KO mice, apoJ mRNA
levels in the deafferented dentate gyrus were not induced by ECL above
levels in the contralateral dentate gyrus. Ovariectomized apoE-KO mice,
with or without E2 replacement, had apoJ mRNA levels in the
molecular layer such as those of WT controls. Although the present
analysis at 2 weeks after ECL did not allow examination of the peak in
the apoE mRNA response (6 d after ECL; Poirier et al., 1991 ), apoE mRNA
levels still showed E2-dependent trends at both the lesion
site and in the deafferented dentate gyrus of WT mice (data not
shown).
The diminished responsiveness of apoE-KO mice to E2 during
sprouting responses to hippocampal deafferentation does not extend to
reproductive tract functions. ApoE-KO mice are indistinguishable from
WT mice in fecundity, e.g., number of corpus lutea or fetuses (Jablonka-Shariff et al., 1996 ) and estrogen-dependent uterine weights
(Table 1). Thus the congenital deficiency
of apoE does not impair some fundamental actions of E2
outside of the brain.
These experiments thus demonstrate two trends: apoE-dependent effects
of E2 in WT mice and E2-independent effects in
the outer molecular layer of the dentate gyrus of apoE-KO mice revealed by OVX. In the unlesioned hippocampus of sham-OVX mice, apoJ mRNA levels showed a nonsignificant 1.4-fold increase in apoE-KO mice over
WT (Fig. 3C). Because this effect did not extend to apoJ mRNA levels at the lesion site or in the deafferented hippocampus, loss
of the apoE gene may not cause a compensatory apoJ increase in
activated astrocytes.
 |
DISCUSSION |
Hormonal effects on synaptic sprouting
These studies show that SYN, a presynaptic protein that mediates
neurotransmitter release, is regulated by E2. The enhanced outgrowth of afferent fibers by E2 (Morse et al., 1986 ,
1992 ) is thus extended to presynaptic terminals. These findings also are consistent with the steroidal control of other mRNAs encoding presynaptic proteins (synaptosomal-associated protein 25) and growth
cones (GAP-43) during development (Lustig et al., 1993 ).
These data demonstrate that E2 influences synaptic
sprouting in response to injury via an apoE-dependent mechanism. In all brain parameters measured, apoE-KO mice did not respond to
E2. The present findings, in conjunction with the induction
of apoE by E2 (Srivastava et al., 1996 ; Stone et al.,
1997 ), suggest that E2 increases compensatory synaptic
sprouting by upregulating local transporters of cholesterol and other
hydrophobic membrane components. Thus E2 could increase
synaptic sprouting via increased production of apoE protein or
increased uptake of apoE-containing lipoproteins.
Sprouting to the outer molecular layer of the dentate gyrus has been
attributed to the septohippocampal pathway, because these fibers are
acetylcholinesterase (AChE)-positive (Scheff, 1989 ). However, various
markers associated with cholinergic neurons do not increase in
accordance with AChE in the outer molecular layer of the dentate gyrus
after ECL; thus the neurochemistry of the compensatory synapses in
question is not fully characterized (Aubert et al., 1994 ). Because
AChE-positive, noncholinergic interneurons are present in the
hippocampus, it is possible that much of the reafferentation to the
outer molecular layer is from a local source (Shute and Lewis, 1966 ).
Unlike C/A sprouting, sprouting in the outer molecular layer was not
decreased in WT mice by OVX (although E2 replacement caused
an increase). The increased sprouting in the E2-replaced
mice may be caused by the actions of estrogen when not interacting with
progesterone or may be a result of exposure to high-physiological
(proestrus) levels of estrogen on a daily basis, rather than once every
4 d as in normally cycling mice.
Both the E2-induced increase in apoJ mRNA at the lesion
site (Fig. 3A) and the lesion-induced apoJ mRNA increase in
the deafferented dentate gyrus (Fig. 3B, sham-OVX mice)
appear to be apoE-dependent. A possible explanation is that the
production of the two proteins is linked. In the optic tract
cholesterol transport involves lipoprotein particles with both apoE and
apoJ components (Shanmugaratnam et al., 1997 ). This finding predicts
that production of apoE and apoJ in the CNS will be closely
coregulated. The removal of apoE could thus alter production of these
particles, resulting in changes in apoJ expression. Examples of this
alteration would be the loss of both the estrogen effect at the lesion
site and the lesion-induced increase in the deafferented dentate gyrus
observed in the present study. The small, possibly compensatory
increase in apoJ mRNA in apoE-KO mice over WT is only observed in the
unlesioned dentate gyrus and does not apply to glia responding to
steroids or damage.
Estrogen, apoE, ECL, and Alzheimer's disease
ECL is used as a model of the deafferenting aspects of AD (see
introductory remarks). In ECL, the outer and middle molecular layers of
the dentate gyrus are deafferented by transection or ablation of the
perforant path. The outer two-thirds of the molecular layer of the
dentate gyrus receive the majority of their input from the stellate
neurons from layer 2 of the entorhinal cortex, which make up the
majority of the perforant path (Amaral and Witter, 1995 ). Likewise, one
aspect of AD is the death of entorhinal cortex neurons and the loss of
input to the dentate gyrus. As in ECL, the AD brain responds to the
deafferentation with an increase in the C/A pathway and AChE-positive
fibers in the outer molecular layer (Geddes et al., 1985 ).
These results thus pertain to the etiology and treatment of AD. The
apoE 4 allele is a risk factor for AD (Corder et al., 1993 ; Poirier
et al., 1993b ), and AD patients with the 4 allele have less neuronal
remodeling than those without the 4 allele (Arendt et al., 1997 ). In
cultured neurons, addition of the human apoE 4 isoform also inhibits
neurite outgrowth relative to 3 (Nathan et al., 1994 ). Thus the 4
allele may increase AD risk by impairing neuronal sprouting (Poirier et
al., 1993a ). Evidence that 4 carriers with AD have less hippocampal
apoE than noncarriers (Bertrand et al., 1995 ) supports this theory.
Estrogen increases activity of choline acetyltransferase (ChAT) and
AChE (Luine and McEwen, 1983 ; Liune et al., 1986 ), high-affinity choline uptake (Singh et al., 1994 ), and ChAT mRNA levels (Gibbs et
al., 1994 ; McMillan et al., 1996 ). Because cholinergic deficits are a
hallmark of AD (Whitehouse et al., 1982 ), estrogen may slow the
progress of AD by cholinergic upregulation. In AD patients, an allele
dose of apoE 4 is inversely correlated with ChAT activity, clinical
responses to tacrine (a cholinomimetic drug), and the density of
cholinergic forebrain neurons (Poirier et al., 1995 ). It has been
hypothesized that the decreased apoE protein levels associated with the
4 genotype (Bertrand et al., 1995 ) inhibit transport of
phospholipids necessary for the production of choline (Poirier et al.,
1995 ). Growing evidence suggests that estrogen replacement therapy
slows the progression and delays the onset of AD (Simpkins et al.,
1994 ; Paganini-Hill and Henderson, 1996 ; Tang et al., 1996 ). Increased
apoE production or uptake in response to estrogen could ameliorate the
effects of AD through two pathways: increased compensatory synaptic
sprouting and increased ChAT activity.
The present data suggest a mechanism for this neuroprotective effect
and a link between two important risk factors in AD. Moreover, the
apparently greater risk of AD in female carriers of 4 than in males
(Poirier et al., 1993b ; Payami et al., 1996 ; Rao et al., 1996 ) could be
attributed to the combined effects of an estrogen-deficient state and
the 4 genotype on the ability for neuronal reorganization and ChAT
activity. These data further suggest that estrogen replacement therapy
might be less effective against AD in rare humans who have hereditary
apoE deficiencies (Schaefer et al., 1986 ) and those with the apoE 4
genotype.
 |
FOOTNOTES |
Received Dec. 16, 1997; revised Feb. 4, 1998; accepted Feb. 18, 1998.
This work was supported by National Institutes of Health Grants
AG05766-0151 (D.J.S.) and AG-13499 (C.E.F.) and Alzheimer's Association/Estate of Ann Clark Hobson Grant FSA 95033 (T.E.M.).
Correspondence should be addressed to David J. Stone, Andrus
Gerontology Center and the Department of Biological Sciences, University of Southern California, 3715 McClintock Avenue, Los Angeles,
CA 90089-0191.
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