The etiology for late-onset Alzheimer’s disease (LOAD), which accounts for >95% of AD cases, is unknown.
Aging is the greatest risk factor for LOAD, whereas APOE4 is believed to be a major genetic risk factor in
acquiring LOAD, with female APOE4 carriers at the greatest risk. Yet, not all of APOE4 carriers, even older
female carriers, acquire AD, suggesting that other factors including environmental exposure must play a role.
Ozone (O3) is a highly reactive oxidant and one of the most abundant urban pollutants. Recent epidemiology
studies show that exposure to high levels of O3 is associated with an increased incidence of AD in the elderly and
that APOE4 carriers are more sensitive to O3-induced memory decline than non-APOE4 carriers are, although
no study has addressed sex-differences in response to O3. In an R21 project, we tested the hypothesis that O3
exposure synergies with aging and APOE4 leading to AD, using male apoE4 target replacement (TR) mice (only
male mice were proposed due to time and budget limitation). We found, surprisingly, that O3 exposure impaired
memory in old apoE3 (represents the majority of human population who carry the APOE3 allele) male mice,
while old apoE4 or young apoE3 and apoE4 male mice were spared 6. Associated with memory loss, old apoE3
male mice exhibit increased protein oxidative modifications (glutathionylation) and neuroinflammation,
compared to other groups6. Old apoE4 male mice, on the other hand, have significantly increased
expression/activities of several antioxidant enzymes and diminished protein oxidation as well as
neuroinflammation upon O3 exposure6. Our data suggest that an elevated antioxidant capacity may underlie the
increased resistance of old male apoE4 mice to O3-induced memory loss. Our data also suggest that APOE4
may affect the sensitivity to O3-induced memory loss in a sex-dependent manner, just as it does to the toxicities
of other toxicants. This R01 will continue our R21 project to further test sex-dependent effects of ApoE4 and
O3. As oxidative stress plays a critical role in AD pathophysiology and plasma level of estrogen, an inducer of
many antioxidant enzymes, decreases with age in females, our new data-supported hypothesis is that O3
exposure synergizes with aging and APOE4 leading to LOAD in sex-dependent manner, which is to
promote AD in females but not in males. We will test this hypothesis in two specific Aims, using apoE3 and
apoE4 TR mice and a cyclic O3 exposure protocol, which mimics human exposure scenarios. In Aim 1, we will
test the hypothesis that O3 exposure induces AD-like pathophysiology in female apoE4 TR mice compared to
their male counterparts and this is exacerbated by aging. In Aim 2, we will test the hypothesis that restoration of
brain antioxidant capacity with tert-butyl hydroquinone (TBHQ), a canonical activator of nuclear factor erythroid
2-related factor 2 (Nrf2), will eliminate sex-APOE genotype-aging-dependent sensitivity to O3-induced
neuropathophysiology. The results from these studies will not only shed new light on the etiology of LOAD but
may also lead to the development of new strategies for the prevention and treatment of this devastating disease.