Background
Materials and methods
Human brain tissue
Human blood collection and serum CARS level detection
Immunohistochemistry and immunofluorescence staining
Animals
Viral injection
Y-maze test
Novel object recognition (NOR) test
Open-field test (OFT)
Elevated plus maze (EPM) test
Rotarod locomotor test
Mouse brain collection
Cloning, expression, and purification of human CARS
Chemotaxis assay
Secretion test
RNA isolation, cDNA synthesis and quantitative real-time polymerase chain reaction (q-PCR)
Western blotting
Histology and three-dimensional (3D) reconstruction
Statistical analysis
Results
CARS expression levels in the temporal cortex increase with aging and in AD
Fig. 1 CARS protein level in the temporal cortex increases with aging and in AD. a Correlation between the CARS-ir intensity in the temporal cortex and age of the control subjects. b Representative images of CARS staining in the post-mortem temporal cortex of subjects with different Braak stages. Insets: Magnifications of the white dotted boxes. c Quantification of the CARS-ir intensity in panel b. d and e Representative images of western blotting (d) and quantification (e) of CARS protein level in the post-mortem temporal cortex of subjects with different Braak stages. f Representative images of neuronal CARS expression in the post-mortem temporal cortex of subjects with different Braak stages. White arrowheads denote the co-localization of CARS-ir and NeuN. g Quantification of the density of neurons. h Quantification of CARS-ir intensity per neuron in the temporal cortex of subjects with different Braak stages. Data are shown as mean ± SEM; *P < 0.05, ***P < 0.001, ****P < 0.0001 |
CARS overexpression in hippocampal neurons induces and aggravates memory impairment in C57BL/6J and APP/PS1 mice, respectively
Fig. 2 Overexpression of CARS in hippocampal neurons induces memory deficits in C57BL/6J mice. a Representative images showing CARS-ir neurons in the cortex and the hippocampus of C57BL/6J mice. White arrowheads denote neurons expressing CARS. b Percentages of neurons expressing CARS in the cortex and the hippocampus of C57BL/6J mice. c Schedule of viral injection and subsequent behavioral tests. d Left: Illustration of the injection sites. Right: Representative image of the infected hippocampus. e Immunostaining of NeuN in the hippocampus after the hSynapsin promoter-driven expression of CARS. f Left: Western blotting of CARS protein in the hippocampus of CARS-overexpressing and control mice. Right: Quantification of CARS protein level in the hippocampus. g Spontaneous alternation behavior in the Y-maze test (YMT). h-j Ratios of distance moved (h), as well as time spent (i) and entries (j) in the novel arm in the YMT. k Representative activity traces of the control and CARS-overexpressing mice in the YMT. l-n The exploration time on familiar and novel objects (l), discrimination index (m) and total distance moved (n) in the novel object recognition (NOR) test. o Representative activity traces of the control and the CARS-overexpressing mice in the NOR test. Data are shown as mean ± SEM; *P < 0.05, **P < 0.01, ***P < 0.001 |
Neuronal overexpression of CARS activates microglia and the TLR2/MyD88 pathway in the hippocampus
Fig. 3 Neuronal overexpression of CARS activates microglia and the TLR2/MyD88 pathway in the hippocampus. a Representative images of Iba1 immunostaining (red) and 3D reconstruction (gray) of microglia in the hippocampus of the naïve C57BL/6J mice treated with AAV-hSyn-CARS-EGFP (CARS-overexpression or overexpression) or AAV-hSyn-EGFP (control). The areas indicated with dotted lines are magnified and shown in the “Iba1: zoom” images. b Quantification of Iba1 fluorescence intensity in the hippocampus of the control and CARS-overexpressing mice. c-f Imaris-based automated quantification of Iba1+ microglial filament length (c), filament area (d), filament volume (e), and numbers of dendrite branch points (f) in the hippocampus of the control and the CARS-overexpressing mice. g Sholl analyses of microglial morphology in the control and the CARS-overexpressing mice. h Representative images of immunostaining for Iba1 (blue) and TLR2 (red) in the hippocampus of the control and the CARS-overexpressing mice. i, j Representative western blotting images (i) and quantification (j) of TLR2, MyD88 and p-NF-κB protein levels in the hippocampus of the control and the CARS-overexpressing mice. k, l Representative western blotting images of p-AKT, p-JNK, p-ERK and p-P38 proteins (k) and quantification (l) of the ratio of p-AKT/AKT, p-JNK/JNK, p-ERK/ERK and p-P38/P38 in the hippocampus. m, n Representative western blotting images (m) and quantification (n) of IL-6, TNF-α, IL-1β, and IL-10 protein levels in the hippocampus. Data are shown as mean ± SEM; *P < 0.05, **P < 0.01, ****P < 0.0001 |
CARS knockdown in the hippocampus has no significant effect on memory in C57BL/6J mice
CARS activates microglia and the TLR2/MyD88 signaling pathway in vitro
Fig. 4 CARS activates microglia and the TLR2/MyD88 pathway in vitro. a Representative images of adherent BV-2 cells stained with hematoxylin in the vehicle and CARS treatment groups. BV-2 cells were treated with CARS (100 μg/ml) for 12 h. Magnifications of the yellow boxes are shown in the lower panels. b Quantification of BV-2 cell density in the vehicle and CARS treatment (100 μg/ml, 12 h) groups. c-f Representative western blotting images (c-e) and quantification (f) of IL-6, IL-1β, IL-10, TLR2, TNF-α, p-NF-κB, and MyD88 protein levels in the BV-2 cells treated with CARS (10 μg/ml) for 24 h. g-i Representative western blotting images (g and h) and quantification (i) of p-AKT, p-JNK, p-ERK and p-P38 protein levels in BV-2 cells treated with CARS (10 μg/ml) for 24 h. Data are shown as mean ± SEM; *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 |
CARS accumulates within dense-core plaques along with the recruitment of ameboid microglia in the temporal cortex in AD
Fig. 5 CARS accumulates within dense-core Aβ plaques along with recruitment of ameboid microglia in the post-mortem temporal cortical tissues from AD patients. a Representative images showing CARS expression (green) within 4G8 (anti-β-amyloid antibody, red)-labeled diffusive Aβ plaques (upper panels) and dense-core Aβ plaques (lower panels) in the temporal cortical tissues from AD patients. The dashed lines indicate diffusive Aβ plaques (upper panels) and dense-core Aβ plaques (lower panels), and the magnifications are shown in the right panels. b Quantification of normalized CARS-ir intensity within the diffusive and the dense-core Aβ plaques in the temporal cortical tissues from three AD subjects. c Representative images showing Iba1-labeled microglia (red) within 4G8 (green)-labeled diffusive Aβ plaques (upper panels) and dense-core Aβ plaques (lower panels) in the temporal cortex of the AD subjects. d Quantification of microglia within the diffusive and the dense-core Aβ plaques in the temporal lobe cortex from three AD subjects. Data are shown as mean ± SEM; ****P < 0.0001 |
Discussion
Fig. 6 Proposed mechanisms underlying the CARS-induced chronic neuroinflammation in AD. Continuous accumulation of Aβ or other stresses such as oxidative stress can induce chronic neuroinflammation. The increased levels of pro-inflammatory cytokines such as TNF-α stimulate the release of CARS from neurons. Local elevation of CARS can induce additional microglial activation and the release of inflammatory cytokines, which further exacerbate the neuroinflammation cycle, aggravating cognitive impairment |

