Abstract
Accumulation of pathological tau is the hallmark of Alzheimer’s disease and other tauopathies and is closely correlated with cognitive decline. Clearance of pathological tau from the brain is a major therapeutic strategy for tauopathies. The physiological capacity of the periphery to clear brain-derived tau and its therapeutic potential remain largely unknown. Here, we found that cisterna magna injected 131I-labelled synthetic tau dynamically effluxed from the brain and was mainly cleared from the kidney, blood, and liver in mice; we also found that plasma tau levels in inferior vena cava were lower than those in femoral artery in humans. These findings suggest that tau proteins can efflux out of the brain and be cleared in the periphery under physiological conditions. Next, we showed that lowering blood tau levels via peritoneal dialysis could reduce interstitial fluid (ISF) tau levels in the brain, and tau levels in the blood and ISF were dynamically correlated; furthermore, tau efflux from the brain was accelerated after the addition of another set of peripheral system in a parabiosis model. Finally, we established parabiosis mouse models using tau transgenic mice and their wild-type littermates and found that brain tau levels and related pathologies in parabiotic transgenic mice were significantly reduced after parabiosis, suggesting that chronic enhancement of peripheral tau clearance alleviates pathological tau accumulation and neurodegeneration in the brain. Our study provides the first evidence of physiological clearance of brain-derived pathological tau in the periphery, suggesting that enhancing peripheral tau clearance is a potential therapeutic strategy for tauopathies.
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Acknowledgements
This study was supported by the National Natural Science Foundation of China (NSFC) through Grants 81625007, 91749206, and 81600949. The authors would like to thank the following for aid in radiolabelling of 131I-tau: Professor Ding-De Huang from Department of Nuclear Medicine, Southwest Hospital of Third Military Medical University, and Professor Zhi-Ping Peng from Department of Radiological Medicine, College of Basic Medical, Chongqing Medical University. The authors would also like to thank professor Shi-Fei Tong from The Third Affiliated Hospital of Chongqing Medical University for collecting blood samples from patients.
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Wang, J., Jin, WS., Bu, XL. et al. Physiological clearance of tau in the periphery and its therapeutic potential for tauopathies. Acta Neuropathol 136, 525–536 (2018). https://doi.org/10.1007/s00401-018-1891-2
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DOI: https://doi.org/10.1007/s00401-018-1891-2