Reduced Sulfotransferase SULT2A1 Activity in Patients with Alzheimer´S Disease
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Physiol. Res. 64 (Suppl. 2): S265-S273, 2015 https://doi.org/10.33549/physiolres.933160 Reduced Sulfotransferase SULT2A1 Activity in Patients With Alzheimer´s Disease M. VAŇKOVÁ1, M. HILL1, M. VELÍKOVÁ1, J. VČELÁK1, G. VACÍNOVÁ1, P. LUKÁŠOVÁ1, D. VEJRAŽKOVÁ1, K. DVOŘÁKOVÁ1, R. RUSINA2,4, I. HOLMEROVÁ3, E. JAROLÍMOVÁ3, H. VAŇKOVÁ3,5, B. BENDLOVÁ1 1Institute of Endocrinology, Prague, Czech Republic, 2Thomayer Hospital, Prague, Czech Republic, 3Faculty of Humanities, Charles University, Prague, Czech Republic, 4Department of Neurology and Center of Clinical Neuroscience, Charles University in Prague, First Faculty of Medicine and General University Hospital in Prague, Czech Republic, 5Third Faculty of Medicine, Charles University in Prague, Czech Republic Received August 2, 2015 Accepted August 18, 2015 Summary Introduction Steroids are important components in the pathophysiology of Alzheimer’s disease (AD). Although their role has been studied, Alzheimer’s disease (AD) represents more than the corresponding metabolomic data is limited. In the present one half of total dementias in seniors. The number of study we evaluate the role of steroid sulfotransferase SULT2A1 in people living with dementia worldwide today is estimated the pathophysiology of AD on the basis of circulating steroids at 44 million, set to almost double by 2030 and more than (measured by GC-MS), in which the sulfation catalyzed by triple by 2050 (Prince et al. 2014). SULT2A1 dominates over glucuronidation (pregnenolone/sulfate, AD is a neurodegenerative disease with DHEA/sulfate, androstenediol/sulfate and 5α-reduced pregnane progressive decline of episodic memory and impairment and androstane catabolites). To estimate a general trend of in other cognitive domains leading to dementia with loss SUL2A1 activity in AD patients we compared the ratios of steroid of autonomy. Definite diagnosis of AD requires conjugates to their unconjugated counterparts (C/U) in controls neuropathological confirmation from autopsy. Current (11 men and 22 women) and AD patients (18 men and diagnostic criteria for AD are mainly based on clinical 16 women) for individual circulating steroids after adjustment for and neuropsychological assessment (McKhann et al. age and BMI using ANCOVA model including the factors AD 2011). status and gender. Decreased C/U ratio for the C19 steroids There is increasing evidence that pathological demonstrate an association between attenuated sulfation of processes in the brain of AD patients may begin even C19 steroids in adrenal zona reticularis and the pathophysiology 10-20 years before the first symptoms appear (Holtzman of AD. et al. 2011), therefore, the need for early diagnosis is important and other biomarkers may be useful. Key words Various factors including altered steroid Alzheimer’s disease • SULT2A1 • GC-MS • Steroids biosynthesis may participate in the pathophysiology of AD. Steroid hormones are effective regulators of many Corresponding author physiological processes, including those in the brain M. Vaňková, Department of Molecular Endocrinology, Institute of (Hampl and Bicikova 2010). Steroid hormones active in Endocrinology, Národní 8, Prague, 116 94, Czech Republic. neural tissue are neuroactive steroids, which arise in the E-mail: [email protected] gonads (in women only in the reproductive period) and in the adrenal glands (the main source of postmenopausal women) and into the central nervous system are PHYSIOLOGICAL RESEARCH • ISSN 0862-8408 (print) • ISSN 1802-9973 (online) 2015 Institute of Physiology v.v.i., Academy of Sciences of the Czech Republic, Prague, Czech Republic Fax +420 241 062 164, e-mail: [email protected], www.biomed.cas.cz/physiolres S266 Vaňková et al. Vol. 64 transported across the blood-brain barrier directly or in pregnane steroids may also modulate the permeability of the form of precursors. However, a small portion of various ion channels such as excitatory glutamate steroids, called neurosteroids, are produced directly in receptors on one hand or inhibitory gamma-aminobutyric nervous tissue. The peripheral steroidogenesis may acid (GABA) receptors on the other hand (Bergeron et al. substantially influence neuronal activity in the brain. 1996, Majewska et al. 1990, Hill et al. 2015, Starka et al. Age-related deficit of sex steroid hormones 2015). increases the risk of dysfunction in hormone-responsive Steroid sulfates having distinct physiological tissues, including brain. Age-dependent hormone role compared with their unconjugated counterparts are depletion in the brain may result in diminished important precursors of further bioactive steroids (Strott neuroprotection, which increases a risk of 2002). The circulating levels of conjugated steroids are neurodegenerative diseases such as AD (Rosario and Pike usually much higher than in their non-conjugated forms. 2008). AD is more prevalent in women, which may be The steroid conjugates are frequently metabolic end- explained by differences in life expectancy in women products with excellent water solubility enabling their compared to men. However, incidence of AD is also uncomplicated excretion into the urine. The conjugation higher in women (Ruitenberg et al. 2001). Nevertheless, generally alters biological activity (Strott 1996) and may the basis of higher vulnerability for females to AD even convert the unconjugated steroids to their biological remains unclear. antagonists (Park-Chung et al. 1997, 1999). Even though From the menopause, dehydroepiandrosterone the sulfotransferase activity in primate brain is low (Kriz (DHEA) remains the exclusive and adrenal tissue-specific et al. 2005), the sulfation of brain neurosteroids might source of sex steroids in women while in (65-75 year-old) participate on the maintenance of brain function. Steroid men, the contribution of adrenal DHEA to the total sulfates are bound to serum proteins such as albumin, androgens is approximately 40 % (Labrie 2010). Sex corticosteroid binding globulin (CBG), and sex hormone steroid hormones derived from DHEA show a similar binding globulin (SHBG), and serve as circulating decline from the age of 30 years in both genders, but reservoir, while non-conjugated forms are more active at there is a continuous supply of testosterone, estrone and the tissue level. estradiol from testes in men. The ovarian estradiol Human SULT2A1 (sulfotransferase family 2A, secretion in women ends at the menopause. dehydroepiandrosterone-preferring, member 1) is enzyme Age-related loss of sex steroid hormones is strongly expressed in fetal zone of the fetal adrenal gland associated with numerous diseases such as tissue atrophy, (Barker et al. 1994), and in the zona reticularis of the bone loss, fat accumulation, type 2 diabetes mellitus, and mature adrenal gland. Besides the primary source of also with cognition problems, memory loss and perhaps steroid sulfotransferase activity in adrenal zona with AD (Labrie 2007). Alterations in steroid reticularis, also the kidneys and small intestine exhibit biosynthesis may contribute to the pathology of AD (Liu significant sulfotransferase activities (Barker et al. 1994, et al. 2013, Napolitano et al. 2014, Schumacher et al. Otterness et al. 1992). SULT2A1 expression is also 2014, Winkler and Fox 2013). detectable in ovary and prostate, in stomach and colon The endogenous sex steroids, estrogens, (Javitt et al. 2001), but these tissues produce the enzyme androgens, and progesterone, have effects on the brain, at a lower levels (Shimada et al. 2001). Besides the especially in perimenopausal and postmenopausal women DHEA, the SULT2A1 catalyzes the sulfation of further (Yaffe et al. 2000). DHEA, which may be converted to androgens, their 5α/β-reduced catabolites, pregnenolone, estrogens locally in the brain, have been shown to 5α/β-reduced pregnanolone isomers and pregnanediols, enhance memory and learning functions (Vallee et al. and also the bile acids. Whereas the lower ratio of 2001). Similarly, DHEA sulfate (DHEAS) influences circulating sulfates to unconjugated form of steroids may brain function and affects memory capacity (Hunt et al. indicate the lower overall SULT2A1 activity, we 2000). DHEA acting in the brain is either of peripheral attempted to investigate whether the reduced ratios of origin, or may be synthesized directly in the brain and steroid sulfates to their unconjugated counterparts are may be also converted into estrogens or androgens in consistently lower in the AD and if so, whether these brain tissues. Various brain areas express nuclear ratios may be used as markers of AD. receptors for estrogens, androgens and progesterone. Besides the nuclear receptors, both androstane and 2015 Reduced SULT2A1 Activity in Alzheimer´s Disease S267 Materials and Methods Cognitive Assessment, and Geriatric Depression Scale), biochemical examination of cerebrospinal fluid Subjects (β-amyloid peptides, total and phosphorylated τ-proteins) A total of 34 patients with AD (16 women and and magnetic resonance imaging of the brain. In our 18 men) fulfilling NINCDS-ADRDA criteria (National cohort of patients, 25 patients had AD, 3 patients had Institute of Neurological Communicative Disorders and possible dementia with Lewy bodies in comorbidity and Stroke – Alzheimer's disease and Related Disorders 6 patients had AD and significant subcortical ischemic Association) for probable Alzheimer´s disease and white matter lesions consistent with the diagnosis of 33 controls of similar age as the patients (22 women and mixed dementia. Controls were examined with the