Hydroxychloroquine lowers Alzheimer's disease and related dementias risk and rescues molecular phenotypes related to Alzheimer's disease.
Vijay R VarmaRishi J DesaiSheeja NavakkodeLik-Wei WongCarlos AnerillasTina LoefflerIrene SchilcherMufaddal MahesriKristyn ChinDaniel B HortonSeoyoung C KimTobias GerhardJodi B SegalSebastian SchneeweissMyriam GorospeSreedharan SajikumarMadhav ThambisettyPublished in: Molecular psychiatry (2022)
We recently nominated cytokine signaling through the Janus-kinase-signal transducer and activator of transcription (JAK/STAT) pathway as a potential AD drug target. As hydroxychloroquine (HCQ) has recently been shown to inactivate STAT3, we hypothesized that it may impact AD pathogenesis and risk. Among 109,124 rheumatoid arthritis patients from routine clinical care, HCQ initiation was associated with a lower risk of incident AD compared to methotrexate initiation across 4 alternative analyses schemes addressing specific types of biases including informative censoring, reverse causality, and outcome misclassification (hazard ratio [95% confidence interval] of 0.92 [0.83-1.00], 0.87 [0.81-0.93], 0.84 [0.76-0.93], and 0.87 [0.75-1.01]). We additionally show that HCQ exerts dose-dependent effects on late long-term potentiation (LTP) and rescues impaired hippocampal synaptic plasticity prior to significant accumulation of amyloid plaques and neurodegeneration in APP/PS1 mice. Additionally, HCQ treatment enhances microglial clearance of Aβ 1-42, lowers neuroinflammation, and reduces tau phosphorylation in cell culture-based phenotypic assays. Finally, we show that HCQ inactivates STAT3 in microglia, neurons, and astrocytes suggesting a plausible mechanism associated with its observed effects on AD pathogenesis. HCQ, a relatively safe and inexpensive drug in current use may be a promising disease-modifying AD treatment. This hypothesis merits testing through adequately powered clinical trials in at-risk individuals during preclinical stages of disease progression.
Keyphrases
- rheumatoid arthritis patients
- clinical trial
- cognitive decline
- inflammatory response
- cardiovascular disease
- healthcare
- mouse model
- traumatic brain injury
- lps induced
- emergency department
- palliative care
- type diabetes
- randomized controlled trial
- adipose tissue
- nuclear factor
- quality improvement
- cerebral ischemia
- cognitive impairment
- blood brain barrier
- protein kinase
- clinical practice
- skeletal muscle
- risk assessment
- mesenchymal stem cells
- spinal cord injury
- open label
- toll like receptor
- double blind
- single cell