Possible Therapeutic Targets in Microglia



Fig. 13.1
Possible therapeutic targets in microglia. Neurotransmitter receptors, neuropeptide receptors, neuromodulatory receptors, cytokine and chemokine receptors, transporters, and various factors affecting microglial function





13.2 Neurotransmitter Receptors


Microglia express various types of neurotransmitter receptors (Kettenmann et al. 2011; Verkhratsky and Butt 2013; Kettenmann and Ransom 2013; Lee 2013) , each of which can have a specific pathological role(s) which are discussed below .


13.2.1 Glutamate Receptors



13.2.1.1 AMPA Receptors


Microglia express functionally heterogeneous AMPA (α-amino-hydroxy-5-methyl-isoxazole-4-propionate)-type of receptors (Noda et al. 2000; Hagino et al. 2004) and contribute to glutamate (Glu)-mediated neuron-glia interaction (Bezzi et al. 2001) . Microglia express highly Ca2+ impermeable AMPA receptors due to the expression of GluA2 subunit . In addition, expression of plasmalemmal GluA2 subunits significantly increases upon activation of microglia, for example after treatment by lipopolysaccharide (LPS) (Beppu et al. 2013) . Since a decreased expression of GluA2 was reported in some of the neurodegenerative diseases such as AD and Creutzfeldt-Jakob disease (Ferrer and Puig 2003; Carter et al. 2004), functional change in GluA2-deficient microglia was investigated, showing higher Ca2+-permeability, consequently inducing significant increase in the release of pro-inflammatory cytokine, such as tumor necrosis factor-α (TNF-α). GluA2-deficient mouse brain also showed more neurotoxicity in response to kainic acid (Beppu et al. 2013) . Therefore, involvement of microglia in glutamatergic synaptic transmission may be also important to understand the mechanism of some neurodegeneration in which low GluA2 is suggested (Noda and Beppu 2013) .

In the hypothalamus and neurohypophysis of rats with streptozotocin (STZ)-induced diabetes, the expression of GluA2/3 was progressively down-regulated, being hardly detected at 4 months of STZ-diabetes, together with up-regulation of N-methyl D-aspartate receptor (NMDAR) subunit GluN1 and neuronal nitric oxide synthase (nNOS). In addition, both astrocytes and microglia appeared activated. Therefore, it was speculated that the glutamate receptors and NO are linked to overactivation of paraventricular and supraoptic nuclei leading ultimately to cell death (Luo et al. 2002) . The lack of GluA2/3 in microglia may also contribute to the cell death .


13.2.1.2 Kainate Receptors


Microglia express kainate (KA) receptor subunits (Yamada et al. 2006; Noda et al. 2000) and KA-induced current was affected by application of concanavalin A which is a positive modulator selective for KA-preferring receptors (subunits GluR5–GluR7 and KA-1 or KA-2) (Huettner 1990; Partin et al. 1993; Wong and Mayer 1993) , suggesting that only some of the KA-responsive cells express KA-preferring receptors and not only AMPA-preferring receptors (Noda et al. 2000). It was indicative of heterogeneous distribution of AMPA- and KA-preferring receptors among microglial cells; some cells express predominantly AMPA-preferring receptors, some cells express predominantly KA-preferring receptors, and some cells express both. The functional difference has not been identified yet .


13.2.1.3 NMDA Receptors


Although NMDA-induced membrane currents were not observed in primary cultured microglial cells (Noda et al. 2000), it was reported that cortical microglia express NMDAR subunits in vitro and in vivo and activation of the microglial NMDARs plays a pivotal role in neuronal cell death in the perinatal and adult brain (Kaindl et al. 2012) . Microglia have unique NMDAR subunit expression with a high level of the GluN2D subunit that is distinct from that found in neurons, indicating distinct NMDAR subunit assembly. The pathophysiologic relevance of microglial NMDARs is particularly high, as they confer sensitivity to excitotoxic cortical injury that is likely to be significant for a large variety of neurological diseases . For example, after stroke , glutamate released by damaged neurons in the infarct core can diffuse to nearby cells, and this can lead to an activation of microglia via their NMDARs and render them neurotoxic. Conversely, loss of function of the microglial NMDARs protects from gray matter damage .


13.2.1.4 Metabotropic Glutamate Receptors


Microglial cells also bear metabotropic glutamate receptors (mGluRs) (Biber et al. 1999; Farso et al. 2009; Taylor et al. 2002) ; mGluR1,5 (Group I) is linked to intracellular Ca2+ signaling, while mGluR2,3 (Group II) (Taylor et al. 2002) and mGluR4,6,8 (Group III) (Taylor et al. 2003) are coupled to adenosine 3′:5′ cyclic monophosphate (cAMP) and involved in regulation of TNF-α release and microglial cytotoxicity (Taylor et al. 2005). Since mGluRs is proposed as targets for multipotential treatment of neurological disorders (Byrnes et al. 2009) , microglial mGluRs may be critical regulators in neuron to glia transmissions especially under pathological state .


13.2.2 Purinergic Receptors


The most widespread and possibly most functionally important receptors for microglia are purinoceptors (Verkhratsky et al. 2009b) .


13.2.2.1 Ionotropic Purinoceptors (P2X Receptors)


The main type of ionotropic purinoceptors expressed in mature microglial cells areP2X4 and P2X7 receptors. The P2X4 receptors are also constitutively expressed in microglia and contribute to microglial activation in particular in the context of neuropathic pain . Increased levels of P2X4 receptors was found in activated microglia (Tsuda et al. 2003) , whereas intrathecal injection of cultured microglia bearing P2X4 receptors induced allodynia in the absence of peripheral nerve damage (Inoue and Tsuda 2009) . Involvement of P2X4 in KA-induced status epilepticus was also reported (Ulmann et al. 2013) .

The P2X7 receptors are involved in various neuropathologies (Franke et al. 2012) and contribute to various aspects of microglial reactions. P2X7 receptors are abundantly present in immune cells and mediate many immune reactions, including the processing and the release of various cytokines . Microglial cells constitutively express P2X7 receptors and various brain lesions and neuropathologies (such as, for example, MS, ALS and AD) induce substantial up-regulation of P2X7 receptors expression (Sperlagh et al. 2006; Verkhratsky et al. 2009a) . Activation of P2X7 receptors regulates multiple microglial processes from microglial activation to apoptotic death. Stimulation of P2X7 receptors was reported to be necessary for microglial activation by amyloid-β (Aβ) protein (Sanz et al. 2009) , and P2X7 receptors control microglial secretion of pro-inflammatory factors (see (Kettenmann et al. 2011) and references therein). Incidentally, over-expression of P2X7 receptors in microglia triggers their activation in the in vitro system in complete absence of any other exogenous factors (Monif et al. 2009) . Recently P2X7 receptor was reported to regulate microglial survival in living brain tissues (Eyo et al. 2013) . Removal of extracellular Ca2+ or application of a potent P2X7 receptor antagonist, protected microglial cell death. These pharmacological results were complemented by studies in tissue slices from P2X7 receptor null mice, in which oxygen-glucose deprivation (OGD)-induced microglial cell death was reduced by nearly half. These results indicate that stroke-like conditions induce Ca2+-dependent microglial cell death that is mediated in part by P2X7 receptor. Increased neocortical expression of the P2X7 receptor after status epilepticus and anticonvulsant effect of P2X7 receptor antagonist were also reported (Jimenez-Pacheco et al. 2013) . From a therapeutic standpoint, these findings could help direct novel approaches to enhance microglial survival and function following stroke and other neuropathological conditions .


13.2.2.2 Metabotropic Purinoceptors (P2Y Receptors)


Microglia express several metabotropic purinoceptors with predominant appearance of P2Y2, P2Y6, P2Y12, and P2Y13 receptors. Stimulation of these receptors as a rule triggers Ca2+ signals that often involve endoplasmic reticulum Ca2+release and store-operated Ca2+ influx; overstimulation of P2Y pathways can produce a long-lasting activation of the latter that can contribute to various aspects of microglial activation (Toescu et al. 1998) . The P2Y6 receptors, distinctively sensitive to UDP, regulate microglial phagocytosis (Koizumi et al. 2007) , whereas ADP-preferring P2Y12 receptors are fundamental for acute microglial responses to pathological insults, for morphological activation, membrane ruffling and chemotaxis (Verkhratsky et al. 2009a) . In addition P2Y12 receptors are linked to integrin-β1 signaling, which regulates extension of microglial processes (Ohsawa et al. 2010; Eyo and Wu 2013) . In the spinal cord P2Y12 receptors are involved in the genesis of neuropathic pain (Inoue and Tsuda 2009) .

As mentioned above, neuron-to-microglia purinergic signaling regulates microglial extension and retraction (see review (Eyo and Wu 2013)). In the event of neuronal injury, neurons release purines including ATP which can be degraded by endogenous enzymes into ADP and adenosine. Released purines diffuse in the extracellular space and activate P1 adenosine (A3) and P2Y (P2Y12) receptors on microglia that act in concert.

Recently, it was shown that soluble Aβ peptide 1–42 induced self-uptake in microglia through pinocytosis, a process involving activation of P2Y4 receptors by autocrine ATP signaling. It demonstrates a previously unknown function of ATP as a “drink me” signal for microglia and P2Y4 receptors as a potential therapeutic target for the treatment of AD (Li et al. 2013) .


13.2.2.3 Adenosine (P1) Receptors


Adenosine receptors of P1 type are represented by classical seven-transmembrane spanning G protein-coupled receptors and are subclassified into adenosine A1, A2A, A2B, and A3 receptors with distinct pharmacological and functional properties. All four types of adenosine receptors were identified at the mRNA level in cultured rat microglia (Fiebich et al. 1996b) . As mentioned above, purinergic activation leads to extension of microglial processes towards the injury site. Following microglial activation , adenosine can also activate A2A receptors that mediate microglial branch retraction. First, a role for the adenosine A2A receptor in microglial cytoskeletal rearrangements was suggested (Orr et al. 2009) . Adenosine A2B receptors mediate an increase in interleukin (IL)-6 in human astroglioma cells (Fiebich et al. 1996a) . Recently, there was a report that microglia also express A1 receptor which is up-regulated upon ATP treatment. Moreover, selective stimulation of A1 receptors inhibits morphological activation of microglia, possibly by suppressing the Ca2+ influx induced by ATP. Microglial cells, pretreated with the A1 receptor agonist, exhibit lower capability to facilitate the nociceptive neurons, as compared with the cells treated with ATP alone (Luongo et al. 2014) .


13.2.3 GABA (γ-Aminobutyric Acid) Receptors


Functional GABAB receptors were identified in a subpopulation of microglial cells in culture (Kuhn et al. 2004) . The physiological role of microglial GABAB receptors are described in Kettenmann et al. (2011) , but their pathophysiological role needs to be identified.


13.2.4 Cholinergic Receptors


The expression of neuronal α7 nicotinic receptors (nACh) was initially found in cultured mouse microglia (De Simone et al. 2005; Shytle et al. 2004) . The activation of nACh receptors generally inhibits the immune response of microglial cells, thus representing endogenous “cholinergic anti-inflammatory pathway” (Shytle et al. 2004). On example is that nicotine was shown to inhibit P2X7-mediated radical oxygen species (ROS) production in Aβ peptide 1–42 stimulated cultured microglial cells (Moon et al. 2008) . Also, long-term (15 days) incubation of corticostriatal organotypic slices with nicotine reduced the thrombin-dependent activation of microglia (Ohnishi et al. 2009) . More recently, the α7 nACh receptor ligands reduced LPS-induced TNF-α release from microglia (Thomsen and Mikkelsen 2012) .


13.2.5 Adrenergic Receptors


Accumulation of intracellular cAMP following stimulation of β2 receptors provided the first evidence for the expression of adrenergic receptors in microglia (Prinz et al. 2001) . While β2 receptor stimulation suppressed LPS-induced release of IL-12p40 in cultured microglia (Prinz et al. 2001), stimulation of β1 receptors increased expression of IL-1β mRNA (Tanaka et al. 2002) . Increasing intracellular cAMP suppressed proliferation of microglia (Fujita et al. 1998) , inhibited ATP-induced release of TNF-α (Morioka et al. 2009) and modulate microglial migration and phagocytosis. Micoglial adrenergic receptors could be relevant in pathogenesis of AD as early degeneration of locus coeruleus in AD and depletion of adrenergic input to the brain affects the ability of microglia to provide for effective clearance of Aβ (Heneka et al. 2010) . Recently, it became obvious that norepinephrine modulates the motility of resting and activated microglia via different adrenergic receptors; β2 receptors mediate microglial process dynamics in resting cells whereas α2A receptors do in activated cells. In addition, the presence of cross-talk between adrenergic and purinergic signaling in microglia was suggested (Gyoneva and Traynelis 2013) . These data show that norepinephrine can modulate microglial motility, which could affect microglial functions in pathogenic situations of either elevated or reduced norepinephrine levels.


13.2.6 Dopamine Receptors


The D1,2,3,4 (but not D5) receptors were identified on translational level in microglia in culture and visualized by immunostaining in substantia nigra from Parkinsonian brains, suggesting that activation of microglia in PD triggers expression of dopamine receptors, which may explain an increase in microglia-related toxicity towards dopamine-producing neurons (Mastroeni et al. 2009) . In PD, microglial cells in substantia nigra are activated and concentrated around dystrophic dopaminergic neurons (Rogers et al. 2007) ; the role of dopamine receptors in this specific activation and migration of microglia needs to be clarified further. The inhibition of D4 receptors by specific agonist suppressed microglial activation in the spinal cord of superoxide dismutase 1 transgenic animal model of ALS; this reduced microglial activation coincided with slowing down the disease progression (Tanaka et al. 2008) .


13.2.7 Serotonin Receptor


Microglia express 5-HT2 serotonin receptors (Kettenmann et al. 2011; Kato et al. 2013b) . There is a possibility that modulating microglia serotonin receptors may be a key target in the treatment of various psychiatric disorders , which likely will be a hot topic in the near future.


13.3 Neuropeptide Receptors


In addition to neurotransmitter receptors , microglia has receptors for a wide variety of neuropeptides, such as endothelin, bradykinin, angiotensin II, somatostatin,neurokinin-1, vasoactive intestinal peptide (VIP), neuropeptide Y (see (Kettenmann et al. 2011) (Kettenmann and Ransom 2013) for details). Bradykinin receptors, for example, have distinct effects on microglia from those on neurons. Inducible B1 receptor stimulate microglial migration (Ifuku et al. 2007) and have rather neuroprotective effects against LPS-induced activation and inflammatory responses (Noda et al. 2006, 2007) . Pituitary adenylate cyclase activating polypeptide (PACAP) activates a quinine-sensitive K+ outward current and modulates activities in microglia (Ichinose et al. 1998) , VIP and PACAP inhibit the MEKK1/MEK4/JNK signaling pathway (Delgado 2002b) and CREB binding protein (CBP)-nuclear factor (NF)-κB interaction (Delgado 2002a) in endotoxin-activated microglia. Neuropeptide receptors in microglia could become a strong therapeutic target, especially for AD.


13.4 Hormones and Hormone Receptors


It was indicated that glial cells may play a significant role in the link between the endocrine and nervous systems (Garcia-Segura et al. 1996; Chowen et al. 1996) . Glial cells express nuclear receptors for both thyroid and steroid hormones and participate in the metabolism of these hormones, resulting in the production of neuroactive metabolites. Furthermore, glial cells synthesize endogenous neuroactive steroids, including pregnenolone and progesterone, from cholesterol. It is known that thyroid hormones, glucocorticoids, gonadal steroids, and neurosteroids affect glial functions. Under physiological conditions, hormonal effects on glia may have important consequences for neuronal development, metabolism , and activity and for the formation and plasticity of synaptic connections. In addition, glucocorticoids, gonadal steroids, and neurosteroids may affect regenerative processes in neurons by modulating glial responses after injury. These effects include the activation of microglia, which is regulated by glucocorticoids. Therefore, endocrine impairments affect microglial function as well as other cell types in the CNS.


13.4.1 Sex Hormones


Estrogen has been shown to be neuroprotective in stroke and other neural injury models. The presence of estrogen receptor-β (ER-β) in rat microglial cells was reported a decade ago (Mor et al. 1999) . Estrogen-mediated neuroprotection is critically dependent on insulin-like growth factor (IGF)-1 signaling. Microglia appears as the source of IGF-1 and the locus of estrogen-IGF-1 interactions in stroke neuroprotection (Sohrabji and Williams 2013) .

Microglial cell line BV-2, responded to hypoxia by enhanced pro-inflammatory cytokine secretion and reduced phagocytic activity, which is prevented by sex steroids resulting in a switch of microglial cells from a pro-inflammatory to a more anti-inflammatory phenotype. Anti-inflammatory effects of gonadal steroids might directly be mediated through hormone-microglia interactions in addition to known effects via astroglial regulation (Habib et al. 2013a, 2013b) . Estrogen is also neuroprotective in the MS model (Wisdom et al. 2013) and encephalomyelitis (Spence et al. 2013; Wu et al. 2013) . Also, testosterone, being metabolized to estradiol and dihydrotestosterone, decreases reactive astroglia and reactive microglia after brain injury in male rats: role of its metabolites, estradiol and dihydrotestosterone (Barreto et al. 2007) .

Neuronal plasticity is regulated by the ovarian steroids estradiol and progesterone in many normal brain functions , as well as in acute response to injury and chronic neurodegenerative disease. In a female rat model of axotomy, the estradiol-dependent compensatory neuronal sprouting is antagonized by progesterone (Bali et al. 2013) .

In developing rat brain, microglia are essential to masculinization of brain and behavior (Lenz et al. 2013) . Estradiol up-regulates the synthesis of prostaglandin E2 (PGE2), originally in neurons, and then activate microglia and stimulates their own release of PGE2. This feed-forward loop of PGE2 production is required for the masculinization of the preoptic area and therefore of sexual behavior(Welberg 2013) . Microglial dysfunction may be also involved in abnormalities of brain development and sexual behavior.


13.4.2 Cortisol Receptor


Glucocorticoid- and mineralocorticoid receptors in microglia were reported (Tanaka et al. 1997) . Corticosterone suppresses the proliferation of BV2 microglia cells via glucocorticoid, but not mineralocorticoid receptor (Nakatani et al. 2012) . Dexamethasone inhibits the Nox-dependent ROS production via suppression of MKP-1-dependent MAPK pathways in activated microglia, suggesting down-regulation of Nox-2 and overexpression of MKP-1 that regulate ROS and NO may form the potential therapeutic strategy for the treatment of neuroinflammation in neurodegenerative diseases (Huo et al. 2011) .


13.4.3 Oxytocin Receptors


Oxytocin mediates social neuroprotection after cerebral ischemia. There is evidence for a direct suppressive action of oxytocin on cultured microglia, which is a key instigator in the development of neuroinflammation after cerebral ischemia (Karelina et al. 2011) . Since oxytocin is important for social behavior (Eckstein and Hurlemann 2013) , possible involvement of microglia via oxytocin needs to be investigated.

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Dec 11, 2016 | Posted by in NEUROLOGY | Comments Off on Possible Therapeutic Targets in Microglia

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