It has been suggested that, besides being most widely used to study atherosclerosis, ApoE-deficient mice could serve as a murine model for studying the progression of AD [16, 17]. ApoE is a ligand for lipoprotein receptors involved in lipoprotein recognition and clearance of chylomicrons, very-low-density lipoproteins, and their remnants [18]. Therefore, the lack of apoE leads to the delayed clearance of lipoproteins and severe hypercholesterolemia. ApoE-deficient mice showed high plasma cholesterol levels even on a chow diet, which increased after a Western-type diet [19, 20]. Since oxysterols increase in proportion to cholesterol levels [21], much higher amounts of 25OHChol and 27OHChol will be formed after consumption of a high-cholesterol diet, compared to the chow diet. Moreover, 27OHChol is able to cross the blood-brain barrier and flow into the brain; thus, it is possible that immunosterols accumulate in the brain of mice. ApoE is also primarily responsible for cholesterol transport in the CNS [22], thus, the lack of apoE leads to dysregulated cholesterol metabolism in the brain. Taken together, our results suggest that ApoE-deficient mice are an appropriate murine model for investigating the mechanisms of microglial activation and neuroinflammation caused by hypercholesterolemia.
Dysregulated cholesterol metabolism is associated with neurodegenerative diseases such as AD, Parkinson’s disease, and Huntington’s disease [23, 24]. High cholesterol is a risk factor for AD; elevated total cholesterol levels in middle age can raise late-life AD risk independent of the ApoE E4 allele and high systolic blood pressure [23, 25]. Although the exact mechanism is unknown, by using high fat/cholesterol dieted mice, hypercholesterolemia leads to neuroinflammation characterized by pro-inflammatory cytokine expression of TNF-α, IL-1β, and IL-6, as well as glial activation, which was determined by CD45 and GFAP immunostaining, in the hippocampus with loss of working memory [26]. Proinflammatory cytokines in microglia also induce amyloid precursor protein (APP) expression, which progresses to Aβ [27]. We also demonstrated microglial activation and IL-1β expression in the hippocampus of ApoE-deficient mice, which is in line with the idea that high cholesterol levels induce neuroinflammation [28]. Moreover, our in vitro results provide new evidence that oxidized cholesterol metabolites are responsible for the neuroinflammatory response under hypercholesterolemic conditions.
Previous studies have suggested that 24sOHChol, 25OHChol, and 27OHChol have distinct and overlapping roles in cholesterol metabolism. Therefore, we attempted to determine a novel pathophysiological role of oxysterols in the brain by investigating their effects on microglial activation. Excess cholesterol is oxidized to 24sOHChol by cholesterol 24-hydroxylase (CYP46A1) in neurons. 24sOHChol, the dominant oxysterol in the brain, inhibits cholesterol synthesis, promotes cholesterol efflux by activating LXRs in astrocytes, and is capable of crossing the blood–brain barrier to the bloodstream [29]. Almost all 27OHChol in the brain comes from the circulation that travels across the blood-brain barrier [30]. 27OHChol enhances cholesterol efflux from astrocytes by inducing expression of the cholesterol transporter ABCA1 [31]. It is converted to 7α-hydroxy-3-oxo-4-cholestenoic acid, which flows from the brain into the circulation via reactions catalyzed by 25-hydroxycholesterol 7-alpha-hydroxylase (CYP7B1) and 3 beta-hydroxysteroid dehydrogenase type 7 (HSD3B7) [32]. 25OHChol, which is mainly produced by macrophages including microglia, reduces cholesterol synthesis in astrocytes [33]. We demonstrated differential effects of side-chain oxysterols on microglial activation and IL-1β expression. As 24sOHChol did not activate microglia, we investigated whether it could regulate IL-1β expression. We observed that 24sOHChol did not impair IL-1β expression induced by 25OHChol and 27OHChol (data not shown), suggesting that 24sOHChol does not protect against neuroinflammation caused by the two oxysterols.
Microglia, resident macrophages in the CNS, mediate inflammatory processes in the brain. They become activated following exposure to pathogen-associated molecular patterns (PAMPs) and/or endogenous damage-associated molecular patterns (DAMPs) and removal of immune-suppressive signals [34]. Microglia respond to neuronal damage and damage cells by phagocytosis. However, chronic activation of microglia causes neuronal damage through the release of cytotoxic molecules such as pro-inflammatory cytokines, reactive oxygen intermediates, and proteinases [35]. Inflammatory cytokines secreted by activated microglia induce neuronal cell death [36, 37]. IL-1β, a pro-inflammatory cytokine released by activated microglia, which in turn mediates microglial activation and proliferation, is a key regulator of the local tissue response to injury and disease in the brain [38, 39]. We demonstrated that 25OHChol and 27OHChol induced the production of IL-1β as well as MHC II expression, which are features of activated microglia. Consistent with previous reports that over-expression of IL-1β induces chronic neuroinflammation and AD [40] and that microglial activation and IL-1β expression become almost synonymous with neuroinflammation [41], our results suggest that chronically accumulated extracellular 25OHChol and 27OHChol molecules are likely to function as DAMPs that induce neuroinflammation and are involved in disease progression.
MHC II, which is constitutively expressed on professional antigen-presenting cells, is critical for the initiation of antigen-specific immune responses and its main function is to present processed antigens to CD4+ T lymphocytes [42, 43]. Ligation of MHC II also activates intracellular signaling pathways, which cause apoptosis of dendritic cell [44]. The induction of MHC II expression is a common feature of microglial activation. Microglia lack MHC II or express low, if any, levels of MHC II protein in steady state, and its expression on the cell surface is induced under conditions of inflammation [45]. However, the functional significance of surface MHC II in microglia and its role in the neuroinflammatory response remain unclear [46]. We considered that protein markers, besides MHC II, expressed by microglia after activation in the presence of 25OHChol or 27OHChol would be useful for the early diagnosis of AD. Therefore, we attempted to identify other markers specifically expressed in oxysterol-activated microglia after confirming the expression of MHC II on the surface. We observed by RT-PCR that CD137 transcripts appeared to increase following treatment with 27OHChol (Supplementary Fig. 3). However, we were unable to obtain solid data on the increase in CD137 protein by microglia, as investigated by immunofluorescence and western blotting (data not shown).
Signaling pathways transduce extracellular stimuli into intracellular signals, thereby regulate gene expression. As signaling transduction pathways are involved in the production of cytokines by immune cells, they have become important and attractive targets for therapeutic intervention in inflammatory diseases [47, 48]. Microglia are also a source and target of cytokines including IL-β and IL-6 [49]. Aβ induces IL-β processing via ROS, while LPS induces neuroinflammation in microglia by activating the mTOR pathway [50, 51]. MAPKs (p38, ERK1/2, and JNK) are involved in IL-β expression induced by Aβ and LPS [52]. These previous studies suggest that various pathways mediate microglias’ production of cytokines. Our results also suggest that the PI3K, ERK, and Src pathways mediate 25OHChol- and 27OHChol-induced microglial activation and IL-1β expression, which is in line with a previous report on the involvement of multiple kinases in immune cell differentiation by oxysterol [53]. Since the PI3K, ERK, and Src pathways play important roles in cell growth, proliferation, survival, migration, secretion, and differentiation, the dysregulated activity of these kinases affects several cellular responses [54–56]. Therefore, it is imperative to identify the upstream signaling molecules responsible for immunosterol-induced activation of kinases to target neuroinflammation.
Elevated levels of oxidized cholesterol metabolites are associated with an increased risk of AD. Treatment of microglia with 25OHChol and 27OHChol, whose levels are elevated in AD, results in microglial activation and IL-1β expression, markers of the neuroinflammatory response. Since IL-1β is a key cytokine and chronic neuroinflammation plays an important role in the progression of AD, we suggest that the suppression of 25OHchol- and/or 27OHChol-induced IL-1β expression is a promising strategy for AD therapy.