What’s new? – September 2018

What’s new? – July 2018

My monthly overview of some of the papers from the literature I found interesting or important.

Your gut is talking, and your brain is listening

The fact that your digestive system communicates with your brain is nothing new. Your stomach tells your brain you’re full, your intestine might suggest it’s time to find a toilet soon. The gut has its own little brain, the enteric nervous system. Until recently, it was thought that the communication between the brain and the enteric nervous system was only indirect. The brain or the gut can secrete hormones and other signalling molecules, and these travel through the bloodstream to eventually have their effects.

Now, as reported in Science, Kaelberer et al show there is a far more direct route of communication. At least in the mouse, there is a direct nervous connection between the gut and the brain. The starting point was the observation that the signalling cells in the gut, the enteroendocrine cells, make peptides such as CCK and PYY which are normally released into the blood as hormones. However, these can also function as direct neurotransmitters at synapses.

Using a modified rabies virus, which only spreads through synaptic neuronal connections, they show these enteroendocrine cells do connect to a prominent nerve fibre called the vagus nerve, as well as the brainstem. The authors managed to recreate this system in a dish by culturing cells from the vagus nerve and this intestine, and not only showed that these wire up, but that the nerve cells respond to nutrients such as glucose. Through a series of experiments, they were able to confirm that it’s the enteroendocrine cells talking to the nerve cells causing this response.

Using optogenetics, a technique that allowed for cells to be turned on or off at will by exposing them to light, they show that activating or blocking the signalling from enteroendocrine cells modifies the firing rate of the vagus nerve. Doing this modifies the response to a glucose stimulus, and significantly affected the feeding behaviour of the mouse, showing this system has a real function. Far from just being an organ to absorb food, it seems more and more the case that the gut can have a real influence on our behaviour.


Microglia don’t like fat

Ok, I think we might be hitting peak microglia soon, they do seem to be involved in absolutely everything these days. This new study from Elisabeth Gould’s lab looks at the role of microglia in obesity. Something most people (including me!) might not have realised is that life-long obesity is associated with a decline in cognitive functioning, such as memory impairments.

In this study, mice were fed a high fat diet, leading to high levels of obesity (40 grams might not sound much, but it makes for a pretty chubby mouse….). These obese mice did perform worse on a number of cognitive tasks than the normal diet controls. Looking closely at the brains of these mice, they saw a decreased density of synaptic spines, or in other words, reduced numbers of connections between neurons.

As I’ve discussed before, one of the most prominent suggested non-immune functions of microglia is synaptic pruning, or the removal of weak neuronal connections. Could this process be going wrong here? Indeed, the authors saw increased activation of microglia in the obese animals, and more of them on or around synapses.

Genetically blocking microglial activation by knocking out the gene CXCR1 meant obese mice didn’t develop changes in neuronal connectivity or cognitive problems. Treating the mice with the anti-microglial drug minocyline, or inhibiting synaptic pruning with annexin-V for several weeks gave the same results, showing these deficits can be reversed.

So why would this be the case? It has been known for some time that chronic obesity can lead to low level inflammation. This can lead to higher levels of inflammatory proteins such as interleukin 6 and CRP. It is quite likely these inflammatory factors in the rest of the body turn on the microglia in the brain, which then in turn do neuronal damage. Would be a good hypothesis to test!


Hit the loop button to remember

As any student who has ever revised for an exam knows, repetition will help things stick. The brain knows this as well. There has been a lot of work in rodents where animals have been trained to run on a maze. This training is reflected by brain cells firing at specific places in a maze. When you record the activity of these cells when the animals sleep after the training, these exact same cells become active again, in the exact same order as if the animal was running on the maze again. If you disrupt these process, the animal won’t learn the maze as well. This phenomenon has also been seen in humans, brain areas that have been activated during a task also get activated in rest periods afterwards, and the hypothesis is that, as in rodents, this helps with consolidating memories.

In a cool study in Nature Communications, Shapiro et al present data that suggests this is in fact true. In the first session, volunteers were presented with a series of images of objects and asked to remember their specific features. Brain activity was measured by fMRI during the training and when subjects were tested on their memory of the objects. Afterwards, they were scanned while not seeing the subjects or being tested. Twelve hours later, this was repeated.

What they found was that interestingly, in the period after the testing, the brain activity patterns correlating to the objects that were remembered the worst were replayed by the brain the most. It is almost like the brain known which memories it needs more practice on. Evidently this practise works, as those memories which were replayed most often after session 1 were best remembered in the second session, 12 hours later.

However, this was only strongly the case in one situation; if the participants slept in between the sessions. If the two sessions were on the same day, there wasn’t anywhere near as strongly an effect of replay. So, all in all this would suggest there is a scientific reasoning for the old advise to keep revising and get a good night sleep before an exam.


Neurogenesis as a therapeutic mechanism? Hit the ground running

The formation of new neurons, or neurogenesis, in the adult brain is limited and restricted to certain areas such as the hippocampus – this is why losing neurons is such a big deal, most of the time, you can’t replace them. Hippocampal neurogenesis is required for a variety of memory processes and is disrupted in many diseases. There have been attempts to increase neurogenesis as a therapeutic strategy, mainly in depression, but so far this has not been successful.

Writing in Science earlier this month, Choi et al show an approach that might change this. Their study uses a transgenic mouse model of Alzheimer’s disease (how valid these models are is a good question, but that is a different debate). These animals start showing learning and memory problems as they age. The authors show that just increasing hippocampal neurogenesis with drugs either did not improve the performance of the animals in memory tasks, or showed at most a modest improvement, depending on the sex of the animals and the specific task.

However, if the treatment was combined with exercise, which is also known the stimulate neurogenesis, there was a much more robust increase in performance. On the other hand, exercise alone did not cause an improvement either, only the combination did. In the reverse experiment, they showed that blocking neurogenesis worsened task performance.

So why is this combination effective when the individual treatments aren’t? It is known that exercise increase the levels of BNDF, a factor which supports the survival of neurons. The authors showed that increasing BNDF levels mimicked the actions of exercise. Although they do not directly show it, the idea is that you require the beneficial effects of exercise, through increased BDNF levels to help the new neurons survive and give a functional improvement.

As good as that seems, the increases in test performance are still modest, and getting this to work in humans would be a challenge. Nevertheless, interesting data.


Stay tuned for more posts here on Neuroscience Ramblings, and in the mean time, follow me on Twitter: @DrNielsHaan

 

Fresh from the lab: our latest work on microglia and adult neurogenesis in schizophrenia

Our latest preprint has gone live on bioRxiv. This is some work we’re very excited about, so I thought I’d talk a bit about it here

You can find out latest preprint, “Haploinsufficiency of the schizophrenia risk gene Cyfip1 causes abnormal postnatal hippocampal neurogenesis through a novel microglia dependent mechanism” here. This work, which I did most, but certainly not all the work for, links three very different areas of research together, areas which have not been linked before. These are adult neurogenesis, genetic risk for schizophrenia (and other psychiatric diseases), and microglia.

Most of the brain can’t make any new cells in adulthood. However, the hippocampus is an exception to this rule. Here, in a structure called the subgranular zone of the dentate gyrus sit neural stem cells, which can make new neurons throughout life in a process called adult hippocampal neurogenesis. These adult born neurons are specifically used in several functions of the hippocampus, mostly to do with memory. Interestingly, there is some evidence hippocampal neurogenesis is disrupted is psychiatric patients, including in schizophrenia, and might be involved in some of the symptoms of these diseases.

Making new neurons in the adult brain broadly requires four phases. The first is cell division. This is when the stem cells that sit in the subgranular zone divide to generate new cells that will eventually become neurons. The second phase is differentiation. This is when a cells slowly change from a stem cell to something that will become a neuron. Call it neuronal puberty. In parallel with this, the third phase starts, which is cell migration. The developing neurons move from their birthplace into the adjacent granular zone to their eventual final location. This is where the last phase takes place, which is maturation. This is when the new neuron wires into the exiting circuitry and starts functioning. In rodents, this process takes up to eight weeks.

As a lab, we use a lot of genetic models of schizophrenia. Now, I’ve written about schizophrenia models before, so I’m not going to go on about their validity. What we used here was a mouse model for a human genetic risk factor called the 15q11.2(BP1-BP2) CNV. This means carriers have a small deletion in one copy of chromosome 15. Carrying this deletion doubles your risk for schizophrenia, as well as increasing risk for autism, epilepsy, and developmental delay amongst other things. One of the genes in this deletion is called Cyfip1. This gene is interesting because it has previously been shown to affect neuronal connectivity. For this and other reasons, we used a mouse model, which lacks one of the two copies of Cyfip1. In this mouse, we looked at adult hippocampal neurogenesis.

We looked at all phases of neurogenesis in these mice. We showed that there is no effect of the mutation on the rate of cell division, or the birth of the new neurons, either in the brain or when we grow the stem cells in a dish. However, what we do see in both conditions are larger numbers of immature neurons, which are in the process of differentiating, again both in the brain and in the dish. This difference stays when you look later on when the cells have migrated to their final positions and have matured.

neurogenesis
Neurogenesis in a dish. Stem cells isolated from mouse brain generating new neurons while we watch. This is a great model system for studying how neurogenesis is regulated

If more neurons aren’t being made, but you’re still seeing more neurons at the end, there is one obvious way to do this, that is to have more of them survive. In normal neurogenesis, well over half of all potential neurons die during the maturation process. If fewer die, you would end up with more neurons without having to make more at the start. Turns out this is exactly what is happening in our mice missing a copy of Cyfip1. Both in a dish and in the brain, there are fewer immature neurons dying.

Now, it was known that this cell death happens, but what causes it wasn’t well known yet. For this we looked at micorglia, the immune cells in the brain. These cells turn out to regulate many things in the brain, as I’ve talked about before here and here. We wondered if they could be the cells regulating the death of these new born neurons. First we looked at whether this was the case. Turns out that if you take out microglia from growing stem cells isolated from mouse brain, neurons survive better, and vice versa if you add more microglia, new neurons die more. So yes, microglia do regulated the survival of neurons at this stage.

So is this the mechanism through which loss of one copy of Cyfip1 affects neuronal survival? To start to work this out, we looked at the effects of the mutation on the functioning of microglia. Although microglia do make Cyfip1 (which nobody knew to start with), and their activation may be somewhat affected, overall the mutated microglia were pretty normal.

So are microglia not to blame? No, they are! The last set of experiments I did shows this clearly. If you grow cells in a dish, you do this in a nutrient solution called medium. While the cells are growing in this, the secret all sorts of factors into the media. Turns out that if you put medium in which microglia have grown on stem cell cultures, this can still cause the death of the new neurons (this is called a conditioned medium experiment). However, what happens when you put on medium in which Cyfip1 mutant microglia have grown on the stem cells? Nothing. Nada. Absolutely zilch.

So what do these results tell us? It tells us that in the normal situation, microglia regulate the numbers of adult born neurons by inducing cell death in some of them, which we didn’t know before. In the Cyfip1 mutant animals, microglia have somehow lost this ability, which means we get more surviving neurons than normal. (If you’re with me so far and have thought this through there could be another possibly, Cyfip1 mutant neurons can’t react to the signals from microglia. I tested this, and they can do this just fine. So it’s definitely the microglia)

Of course, there are still plenty of remaining questions. What do these excess neurons actually do in the brain? How exactly do microglia cause cell death in immature neurons? What does Cyfip1 actually do in microglia? We’re working hard on answering those questions right now, so all I can say have patience and you’ll hear about it here first.


Stay tuned for more posts here on Neuroscience Ramblings, and in the mean time, follow me on Twitter: @DrNielsHaan

PS: There seems to be something going on with cell migration in these animals as well, but you’ll have to wait for the next preprint to hear about that….

Anti-microglial treatments in schizophrenia – why aren’t they going anywhere?

There are multiple ongoing and recent trials aimed at inhibiting microglia, the immune cells of the brain, to help with schizophrenia treatment. So far, none have been particularly successful. Why were they tried and why aren’t they working?

Why do we need new treatments for schizophrenia?

A valid question. After all, we’ve had anti-psychotic drugs for decades, haloperidol (Haldol) has been around since the 60s, and second generation atypical anti-psychotics such as olanzapine (Zyprexa) and risperidone (Risperdal) came around in the 70s and 80s. Since then we’ve just been making variations on a theme, with no new classes of drug being developed so far.

The current drugs are pretty effective in treating the so-called positive symptoms (a spectacularly inappropriate term that somehow stuck) of hallucinations and delusions. They do this by blocking signalling of a neurotransmitter called dopamine, which is increased in schizophrenia.

However, they don’t do anything about the so-called negative symptoms (far more appropriate term), which include things like apathy, emotional blunting, social problems and memory issues. These things aren’t caused by dopamine. What are they caused by? Good question. We know there are differences in brain structure in schizophrenia patients compared to neurotypical people. Some people look towards the immune system to explain this.

What happening with the immune system in schizophrenia?

Let’s start at the beginning; why did people think targeting microglia, the immune cells of the brain, was a good idea? There is a long history of research into the role of the immune system in schizophrenia. We know a significant risk factor for in individual to develop schizophrenia is for their mother to contract an infection during pregnancy. The thinking is that the immune response by the mother affects brain development of the foetus.

Other risk factors include severe and chronic stress during childhood, for instance being exposed to abuse, famine or warfare. This chronic stress also leads to immune system activation. Lastly, we’ve now characterised well over 150 genetic risk factors which increase the risk for schizophrenia. Many of these are also involved in the immune response.

This isn’t just theorising; a common finding in the blood or cerebrospinal fluid of schizophrenia sufferers is elevated levels of immune factors, suggesting their immune system is somehow over-active.

Over-active microglia in schizophrenia?

Ok, so looks like there is involvement of the immune system in schizophrenia. As I described here, the immune system in the brain is different from the rest of the body, the brain has its own special immune cells, the microglia. Obviously, the next logical step would be to look at if microglia in schizophrenia patients are more active. People have done this using brain scans with a (mildy) radioactive probe for microglia and found that, indeed, this is the case (see for instance here).

Overzealous microglia are bad news, as I described in the second section here. It is a reasonable assumption that, if there is excess microglia activity, this leads to loss of neuronal connections and altered neuronal functioning, and that this could underlie some of the symptoms. So, the obvious next step is to calm down the microglia.

How can we hit microglia?

Ah, at least here there is a simple answer: minocycline. This was developed as an antibiotic, but along the line someone clever noticed it also inhibits the activity of microglia.

Minocycline
Minocycline, not just an antibiotic

Actually, minocyline is quite a ‘dirty’ drug, it is not very specific. It does other things in the brain as well, but for the purposes of the things we’re looking at today, the microglia effects are the most important.

Well? Does it work?

Between 2010 and 2015 the initial studies on minocyline in schizophrenia were reported. The tally? Four showing beneficial effects (1, 2, 3 and 4), two showing no change (1 and 2) in schizophrenia symptoms.

A recent meta-analysis (collating several of the earlier small studies) found small positive effects that were borderline significant. Promising, but nothing to write home about. These early trials were followed by larger trials trying to confirm these effects. These are now reporting their findings.

The results of the latest mincocycline trial (BeneMin, one of the largest yet) were presented by Bill Deakin at last month’s British Association for Psychopharmacology Summer Meeting, see my tweet with some of his results here. Long story short, absolutely nothing happened. No effects whatsoever.

This was in direct contradiction to one of the earlier positive studies, led by Bill Deakin as well. So, this leaves us with a net score of 3 vs 3, with the three “winners” generally being close calls.

So why isn’t minocycline the silver bullet for schizophrenia?

Pick your poison:

  • We’re not treating long enough
  • We’re not treating early enough
  • We’re not using the right drug
  • We aren’t treating the right patients
  • All microglia are not the same
  • Microglia really don’t have anything to do with the disease
  • All of the above (ie we have no idea what we’re doing)

The first two options are the most charitable interpretation of recent data. The reshaping of neuronal circuits and the other jobs they do can be slow processes, and it may take a long time for the drug to have enough of an effect in the brain to see a difference in symptoms.We would just need to treat for longer. It may also be that by the time symptoms are severe enough to need treatment, there are so many changes in the brain that just inhibiting microglia isn’t enough. You could think of treating people at high risk of developing the disease.

Are we using the right drug? Difficult question. Minocycline is just one option. People have tried other, more general, anti-inflammatory drugs such as NSAIDS, or immune suppressors like methotrexate, These drugs don’t target the microglia themselves, but the inflammatory process that activates them. So far, these trials have shown at most modest effects or less.

It may be that there are subtypes of schizophrenia and treating everyone in this way isn’t helpful. This concept is already being used in depression trials, where a distinction is being made between “inflammatory” and “non-inflammatory” patients. It might very well be the case that stratifying patients and targeting treatment that way could work in schizophrenia as well. I think this is likely (and also shows we still really don’t understand what is going on).

Maybe not all microglia are created equal. It’s known that there is a lot of diversity of microglia, in different brain regions, even between cells in the same region. Some may be more activated, and some may even be beneficial. Just shutting all of them down may be like taking a sledgehammer to a mosquito, and we should be targeting specific populations of cells. How that could be done is left as an exercise to the reader….

It could also be we’re barking up completely the wrong tree. Microglia are a logical and tempting target, given available data. But what about that data? For instance, the brain scans showing over-activation of microglia? Turns out the radioactive tracer used isn’t actually specific for microglia at all, and measures who knows what else as well. So are microglia actually more activated in schizophrenia sufferers? We don’t know for sure. The possibility still exists that microglia play no role at all, though I doubt that.

To be honest, the last option (“we have no idea what we’re doing”), is probably closest to the truth at the moment….

Where to go from here?

Well, walk before we run, I’d say. Scientists are people too, and we get excited as well. I think that when the data on raised inflammatory factors, and later the scans supposedly showing microglial over-activation, came through, people made the logical mental leap to start hitting microglia, without knowing what is actually going on (surprisingly common in trials, actually).

I think the (circumstantial) evidence that microglia are involved in schizophrenia is there, but we need to be cleverer in targeting them. Just hitting all of them clearly isn’t the answer.  What do we need to hit and how to do it? More research required! (Get back to me in five years time…..)


Stay tuned for more posts here on Neuroscience Ramblings, and in the mean time, follow me on Twitter: @DrNielsHaan

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