Abstract
The biological fates of the key initiator of Alzheimer’s disease (AD), the amyloid precursor protein (APP), and a family of lipoprotein receptors, the low-density lipoprotein (LDL) receptor-related proteins (LRPs) and their molecular roles in the neurodegenerative disease process are inseparably interwoven. Not only does APP bind tightly to the extracellular domains (ECDs) of several members of the LRP group, their intracellular portions are also connected through scaffolds like the one established by FE65 proteins and through interactions with adaptor proteins such as X11/Mint and Dab1. Moreover, the ECDs of APP and LRPs share common ligands, most notably Reelin, a regulator of neuronal migration during embryonic development and modulator of synaptic transmission in the adult brain, and Agrin, another signaling protein which is essential for the formation and maintenance of the neuromuscular junction (NMJ) and which likely also has critical, though at this time less well defined, roles for the regulation of central synapses. Furthermore, the major independent risk factors for AD, Apolipoprotein (Apo) E and ApoJ/Clusterin, are lipoprotein ligands for LRPs. Receptors and ligands mutually influence their intracellular trafficking and thereby the functions and abilities of neurons and the blood-brain-barrier to turn over and remove the pathological product of APP, the amyloid-β peptide. This article will review and summarize the molecular mechanisms that are shared by APP and LRPs and discuss their relative contributions to AD.
Lipoprotein Receptors
Structure and General Physiological Properties
Besides the important role in lipid metabolism, members of the low-density lipoprotein (LDL) receptor family take part in a broad range of pre- and post-developmental functions in brain and play key roles in the pathogenesis of Alzheimer’s disease (AD). Much like the amyloid precursor protein (APP), members of the LDL receptor family are type-I membrane receptors with single-pass transmembrane (TM) domains that can be endocytosed, proteolytically processed and participate in a variety of protein interactions both inside and outside of the cell, including direct interactions with APP (May et al., 2005; Dieckmann et al., ). Lipoprotein receptors are involved in various mechanisms of APP-processing and Aβ-clearance in several cell types including neurons, astrocytes, endothelial cells of the blood brain barrier (BBB), and ependymal cells of the blood cerebrospinal fluid (CSF) barrier (BCSFB; reviewed by Hoe and Rebeck, 2008; Marzolo and Bu, 2009; Wagner and Pietrzik, 2012; Lane-Donovan et al., 2014).
In the peripheral and central nervous system, lipoprotein receptors and APP interact to control developmental processes and synaptic function. These lipoprotein receptors are highly conserved—at least as far back in evolution as C. elegans (Yochem and Greenwald, 1993)—and are related by both structure and function (Krieger and Herz, 1994; Figure 1). The seven core members of this receptor family are the LDL receptor (Ldlr), Apolipoprotein E (ApoE) receptor 2 (Apoer2/Lrp8), very-LDL receptor (Vldlr), LDL receptor-related protein 1 (Lrp1), Lrp1b, Lrp2/Megalin and multiple epidermal growth factor (EGF) repeat containing protein 7 (Megf7/Lrp4; Dieckmann et al., ). Structurally, the extracellular domain (ECD) of each of the core LDL receptor family members is composed of a combination of two types of conserved domains: (1) ligand binding-type repeat domains (LBDs); and (2) EGF-precursor homology domains. The amino-terminal LBD domain confers ligand specificity, consisting of cysteine-rich complement-type ligand binding-type repeats (LBRs, sometimes called type A repeats). The EGF-precursor domains participate in the pH-dependent release of bound ligands after endocytosis and contain a mixture of EGF receptor-like repeats (EGF-repeats) and YWTD (Tyr-Trp-Thr-Asp) β-propeller repeats (Beglova and Blacklow, ; Andersen et al., ; reviewed in Li et al., 2001). The intracellular domain is less conserved between the family members, but each of the core members contain at least one NPxY (Asn-Pro-X-Tyr) motif that functions in protein interaction/signal transduction (Trommsdorff et al., 1998; Howell et al., 1999; Gotthardt et al., 2000) and endocytosis (Chen et al., ).
Figure 1
The smaller receptors within the LDL receptor family, Ldlr, Vldlr and Apoer2, contain only one EGF-precursor domain and have a juxtamembraneous domain rich in serine and threonine residues, which serve as sites for O-linked glycosylation (Kingsley et al., 1986; Sakai et al., 1994; Christie et al.,
Additional somewhat distant members are Lrp5 and Lrp6 as well as the Sortilin-related receptor with LDLR class A repeats (SorLA; Figure 1). Lrp5 and Lrp6 (called arrow in D. melanogaster) encode four EGF-precursor domains but lack N-terminal LBDs and intracellular NPxY-motifs (Brown et al.,
Genetics
Despite the high degree of homology between the receptors and the overlapping expression pattern and function, the majority of these receptors are indispensable for survival or proper brain function. In fact, deletion of Lrp1 (Herz et al., 1992), Lrp1b (Dietrich et al.,
Lipoprotein Metabolism and Alzheimer’S Disease
One percent of all AD cases are early onset (EOAD) generally manifesting from mutations in APP or APP processing genes and leading to increased production of the toxic APP cleavage product, amyloid β (Aβ). The other 99% of cases are late-onset AD (LOAD) with increased Aβ-levels and deposition that are apparently independent from EOAD-like mutations in APP/APP processing genes. Instead, the leading cause in LOAD appears to be an imbalance between Aβ production and clearance from the brain (Weller et al., 2008; Mawuenyega et al., 2010). Thus, it is important to understand the various mechanisms by which LDL receptor family members and their ligands clear Aβ.
Aside from age, the most important risk modifier for developing LOAD is ApoE (Corder et al.,
The brain is the most cholesterol-rich organ, containing approximately 25%–30% of the body’s total cholesterol (Dietschy and Turley,
The cholesterol metabolism link to AD pathogenesis is further supported by additional genome-wide association studies that implicate other apolipoproteins and their receptors as AD risk factors. In addition to ApoE, a variety of SNPs in ApoJ/Clusterin from several populations are associated with LOAD (Harold et al., 2009; Bagyinszky et al.,
With diverse functions including gathering nutrients and clearing toxic, useless debris from the extracellular space, as well as mediating intracellular trafficking/signaling and even transcription, the indispensable nature of many of the lipoprotein receptors is not surprising. Most of these receptors play some part in APP processing or clearance of Aβ, affecting the balance between Aβ-production and clearance. Understanding how these lipoprotein receptors and their ligands influence the homeostasis of Aβ production/clearance individually, as well as in unison, will prove crucial for not only elucidating mechanisms of AD pathogenesis, but also the design of potential therapeutic interventions to counteract the disease. In this chapter, we will focus on lipoprotein receptors and their role in AD pathogenesis through regulating APP processing and Aβ clearance.
Ldlr
Structure and General Physiological Properties
Ldlr, the founding member of the LDL receptor family, is ubiquitously expressed throughout the body, where it plays a key role in regulating cholesterol homeostasis (reviewed in Go and Mani, 2012). The receptor clusters after binding cholesterol-rich LDL particles and mediates cholesterol uptake through clathrin-mediated endocytosis of the lipoprotein-bound receptor (reviewed in Brown and Goldstein,
Genetics
While impaired Ldlr function in humans leads to elevated plasma cholesterol and premature cardiovascular disease due to reduced uptake of cholesterol-rich LDLs (Hobbs et al., 1990; Fass et al.,
Biochemistry and Cellular Function
As cholesterol metabolism is linked to AD and regulated by Ldlr, Ldlr knockout mice have been used as a model organism to study the interplay between cholesterol and Aβ-deposition in several studies. While Ldlr has no known direct or indirect interaction with APP or APP processing, Ldlr binds to Aβ and mediates its clearance by degradation in astrocytes, but does not alter APP processing (Kim et al., 2009). Ldlr knockout mice are more susceptible to Aβ-induced neurotoxicity, when Aβ is injected into the hippocampus (de Oliveira et al.,
Lrp1
Structure and General Physiological Properties
The second receptor identified in the LDL receptor family, Lrp1 (Herz et al., 1988) is one of the largest (~600 kDa) and most versatile members as it is known to bind over 100 different ligands (Herz and Strickland, 2001; Gonias and Campana, 2014). Lrp1 can be processed by the same enzymes as APP: ADAM10 (Nakajima et al., 2013), BACE1 (von Arnim et al., 2005) and γ-secretase (May et al., 2002; May and Herz, 2003; Zurhove et al., 2008). The sequential processing of Lrp1 first produces a soluble Lrp1-ECD, followed by a γ-secretase-mediated release of the Lrp1-ICD (May et al., 2002). The Lrp-ECD is capable of binding Lrp1 ligands (Quinn et al., 1997), and the Lrp1-ICD can translocate to the nucleus and regulate gene transcription (Zurhove et al., 2008). Of note, this Lrp1-ICD-mediated transcriptional regulation might be relevant to neuroinflammation (Zurhove et al., 2008), which is emerging as a common factor in many neuropathological conditions including AD (Heneka et al., 2015; Chen et al.,
Genetics
Global Lrp1 knockout mice are embryonically lethal (Herz et al., 1992, 1993). Lrp1 gene polymorphisms have been associated with a premature risk of cardiovascular disease in patients with familial hypercholesterolemia/FH (Aledo et al.,
Biochemistry and Cellular Function
Lrp1 directly interacts with APP extracellularly and regulates the localization and processing of APP (Kounnas et al., 1995). In several cell lines, depletion of the rapidly recycling Lrp1 reduced Aβ production (Ulery et al., 2000; Pietrzik et al., 2002). In vivo, overexpression of a minireceptor of Lrp1 (EGF-precursor domain-II, TM-domain, and ICD-domain) in an AD mouse model (PDAPP) increased soluble brain Aβ (Zerbinatti et al., 2004); however, reduced levels of Lrp1 in hippocampal neurons of another AD mouse model (APP/PS1) had no effect on Aβ production (Xu et al., 2012).
The extracellular interaction of Lrp1 and APP only occurs with APP isoforms containing the Kunitz protease inhibitor (KPI) domain and promotes the internalization of APP (Kounnas et al., 1995; Billnitzer et al.,
Intracellular interactions with APP and Lrp1 also appear important in modulating the amyloidogenic processing of APP. Both Fe65 and Dab1 interact with Lrp1 NPxY motifs and modify intracellular signal transduction (Trommsdorff et al., 1998; Gotthardt et al., 2000; Kinoshita et al., 2001; Pietrzik et al., 2004). These adaptors also bind APP (Fiore et al.,
Despite promoting neuronal Aβ production, Lrp1 participates in Aβ clearance (reviewed in Kanekiyo and Bu, 2014). Lrp1 binds Aβ, with higher affinity for Aβ40 than Aβ42 (Shibata et al., 2000; Storck et al., 2016). Within the brain, Lrp1 endocytoses Aβ from the extracellular space and directs it to the lysosome for degradation (Kanekiyo et al., 2013). Lrp1 is also expressed in astrocytes and microglia where it is involved in Aβ-clearance (reviewed in Ries and Sastre, 2016). Another major Aβ clearance mechanism involves the transcytosis of Aβ from the brain to the circulation via the BBB (Marques et al., 2013). Lrp1 gene silencing reduced the clearance of intracerebroventricularly-injected Aβ across the BBB in wildtype mice (Jaeger et al., 2009). Furthermore, an endothelial (brain and choroid plexus)-specific Lrp1 knockout revealed that Lrp1 preferentially clears Aβ40, as these mice accumulated Aβ40 faster and demonstrated reduced spatial memory (Storck et al., 2016), which is a common phenotype observed with high levels of Aβ. Moreover, Lrp1 cleavage by ADAM10 has opposing effects as well; whereas soluble Lrp1 in the brain inhibits Aβ clearance, in the periphery it could provide a sink for Aβ monomers. Inhibition of ADAM10 reduces Lrp1 ectodomain shedding, thereby promoting Aβ-clearance across the BBB, especially Aβ40 (Shackleton et al., 2016); however, ADAM10 cleavage of Lrp1 also leads to the segregation of soluble Lrp1 into the periphery where it has been described to prevent the reentering of Aβ monomers into the brain (Sagare et al., 2007). Recently it was found that another AD risk gene, PICALM, plays a central role in BBB transcytosis of Aβ, and it has been reported that extracellular binding of Aβ to Lrp1 induces an intracellular conformational change allowing for PICALM binding and endocytosis of the entire complex (Zhao et al., 2015).
Importantly, both the Vldlr- and Lrp1-mediated Aβ clearance mechanisms via the BBB are differentially slowed down by ApoE-isoforms: ApoE4 > ApoE2 or ApoE3 (Deane et al.,
Figure 2

Lipoprotein receptors modulate amyloid precursor protein (APP) trafficking and processing in neurons. Neurons are the major source of Aβ (depicted as green droplets) in the brain. APP (green), all core LDL receptor family members as well as the more distant member SorLA contains at least one NPxY-motif, which acts as a docking site for PTB-domains of intracellular adaptor/scaffold proteins. Both Fe65 and Dab1 bind APP, as well as a number of LDL receptor family members (red and orange), via their PTB-domains. The simultaneous binding of these intracellular adaptor/scaffolding proteins to the NPxY motifs of APP and LDL receptors coordinate their intracellular trafficking, thus regulating APP localization and processing. The adapter/scaffold proteins control the speed of endocytosis of the receptors in that Fe65 and Dab1 binding to APP masks the endocytosis signal of APP, resulting in the surface retention of APP. This increases the exposure of APP to α-secretase (α), which cleaves APP inside the Aβ region (dark green) to release a soluble APPα (sAPPα) fragment and ultimately preventing the production of Aβ. Importantly, Lrp1 and Lrp1b (both orange in the diagram) have drastically different rates of endocytosis, with the internalization rate of Lrp1 exceeding that of Lrp1b by many-fold. Both bind Fe65, connecting them in a complex APP, and have opposite effects on APP processing. The fast endocytosis rate of Lrp1 increases the exposure of APP to the endosomal β- (BACE1, β) and γ-secretase (γ), producing Aβ (green tears) and soluble APPβ (sAPPβ) fragment. Another intraendosomal sorting receptor of the LDL receptor family, SorLA, can bind and reroute receptors from the endosome back to the trans-Golgi network (TGN), where it is either sequestered, sorted back to the cell surface, or sent to the lysosome for degradation. Apoer2, which also recycles slowly, binds Fe65 via its NPxY-motif, promoting APP surface stability and decrease amyloidogenic processing. Additionally, simultaneous binding of the secreted, extracellular ligand, F-spondin, to the ECDs of APP and Apoer2 also promotes APP stability at the surface.
Figure 3

Lrp2 mediates Aβ-clearance via the blood cerebrospinal fluid (CSF) barrier (BCSFB). Diagram depicting the Lrp2-mediated clearance of interstitial Aβ through the cerebral spinal fluid (CSF) into the blood. In addition to direct astrocytic Lrp2 clearance of Aβ, Lrp2 expressed in the ependymal cells of the choroid plexus also facilitate Aβ removal. The choroid plexus functions to produce and filter CSF. This filtration removes metabolic waste, excess neurotransmitters and foreign/toxic particles, such as Aβ, which is mainly produced by neurons (see Figure 2). Apolipoproteins, such as ApoE and ApoJ/Clusterin (yellow dots), mainly secreted from astrocytes (“Astro”), bind circulating interstitial Aβ. These Aβ-laden apolipoproteins then bind lipoprotein receptors (red) and mediate their cellular uptake. ApoJ/Clusterin is eliminated rapidly across the BCSFB by ependymal Lrp2 (light red), facilitating the clearance of Aβ via lysosomal degradation in ependymal cells and subsequent exocytosis into the CSF, where soluble Lrp2 (sLrp2) has been detected (Spuch et al., 2015). BACE1 is the enzyme that processes Lrp2 and Lrp1 to release sLrp2 and sLrp1, respectively. BACE1 is also found in the choroid plexus (Crossgrove et al.,
Lrp1b (LRP-DIT)
Structure and General Physiological Properties
Lrp1b is very similar to Lrp1 in overall structure and sequence (~59% identical). Where Lrp1b differs most from Lrp1 is an extra LBR in the ECD and a 33 amino acid insert in the ICD (Liu et al., 2000). Lrp1b was first associated with tumorigenesis, but is also highly expressed in the adult brain (Liu et al., 2000; Haas et al., 2011) and retains APP at the cell surface reducing Aβ production (Cam et al.,
Genetics
Mutations in Lrp1b are associated with multiple different types of cancer (Liu et al., 2000; Langbein et al., 2002; Sonoda et al., 2004), including gliomas (Roversi et al., 2006). Lrp1b-deficiency leads to embryonal lethality (Dietrich et al.,
Biochemistry and Cellular Function
Lrp1b binds to fibrinogen and ApoE carrying proteins (Haas et al., 2011). In total, Lrp1 and Lrp1b share numerous ligands. Lrp1b also binds APP at the extracellular KPI-containing domain (Cam et al.,
Apoer2 (Lrp8) and Vldlr
Structure, General Physiological Properties and Genetics
Both Apoer2 and Vldlr are quite similar in size and domain composition to Ldlr (Figure 1; Kim et al., 1996). The sequence identity between Vldlr and Apoer2 is approximately 50% (Kim et al., 1996 and reviewed in Reddy et al., 2011). Apoer2 has seven ligand-binding repeats, one less than Vldr, and contains a unique alternatively-spliced proline-rich domain not found in Vldlr (Kim et al., 1997; Clatworthy et al.,
Apoer2 and Vldlr are almost exclusively expressed in the brain where they act as receptors not only for ApoE but also for the neuromodulator Reelin (D’Arcangelo et al.,
The signaling initiated by Reelin binding to Apoer2 and Vldlr plays essential roles during the development of the CNS and neuronal function through adulthood (Förster et al.,
Apoer2 and Vldlr double knockout leads to a phenotype comparable to Reelin or Dab1 deficiency: mice develop strong ataxia, a smaller cerebellum, and defective lamination of cerebellum, cortex and hippocampus (Trommsdorff et al., 1999).
Cortical Cajal-Retzius cells die out after birth and the amount of hippocampal Cajal-Retzius cells dramatically thins out later during postnatal hippocampal maturation (Chowdhury et al.,
Apoer2 and Vldlr bind Reelin and cluster together resulting in the phosphorylation of Dab1 and Src-kinase-mediated phosphorylation of NR2 subunits of the NMDA receptor (Hiesberger et al., 1999; Arnaud et al.,
There are several lines of evidence that implicate Reelin signaling as protective against AD pathogenesis. First, Reelin-signaling can counteract Aβ-induced synaptic suppression (Durakoglugil et al.,
Biochemistry and Cellular Function
Both Apoer2 and Vldlr interact with APP-binding proteins and influence the amyloidogenic processing of APP (reviewed Hoe and Rebeck, 2008; Marzolo and Bu, 2009; Wagner and Pietrzik, 2012; Lane-Donovan et al., 2014). Of the two receptors, Apoer2 interacts with a larger number of APP-binding proteins. Both APP and Apoer2 bind F-spondin (Ho and Südhof, 2004; Hoe et al., 2005) and Reelin (Hoe et al., 2009) extracellularly, as well as the intracellular adaptor proteins X11α/β (Borg et al.,
Ligand binding to Apoer2 induces homotypic clustering as well as clustering with other receptors, including APP (Divekar et al.,
F-spondin is an extracellular ligand for both Apoer2 (Hoe et al., 2005) and APP (Ho and Südhof, 2004). This secreted extracellular protein, F-spondin, is composed of an amino-terminal Reelin and F-spondin domains followed by a thrombospondin domain, which contains six thrombospondin repeats (TSRs; reviewed in Feinstein and Klar,
Like Lrp1, the NPxY domain of Apoer2 binds the cytosolic adaptor protein Fe65. While Lrp1 and Fe65 enhance Aβ production, Fe65 increases the interaction of APP and Apoer2 and decreases APP processing by stabilizing them at the cell surface (Hoe et al., 2006a). As Apoer2 and Lrp1 interact within the same region of Fe65, these two receptors may compete with each other for Fe65 binding and differentially influence APP processing (Hoe et al., 2006a). Dab1 also binds the NPxY motifs of Apoer2 and APP, and Aβ is decreased with Dab1 overexpression and increased in Dab1-deficient primary neurons (Hoe et al., 2006c).
Apoer2 directly interacts with APP extracellularly (Fuentealba et al.,
Lrp2 (Megalin/gp330)
Structure and General Physiological Properties
Lrp2 is structurally very similar to Lrp1b and one of the most studied lipoprotein receptors in conjunction with AD. Similar to Lrp1, Lrp2 undergoes proteolytic processing to release the ECD followed by γ-secretase cleavage to release the ICD (Zou et al., 2004; Biemesderfer,
During neural tube formation and forebrain development Lrp2 is required for the dorsal to ventral gradient of the bone morphogenic protein 4 (BMP4) and sonic hedgehog (Shh). Lrp2 mediates endocytosis of Bmp4 for degradation and Bmp4 levels are increased in Lrp2-deficient mice (Spoelgen et al., 2005). Lrp2 is also a required co-receptor for Shh, ligand-binding induces a positive feedback loop and increased Shh-expression, thus Lrp2-deficiency leads to the loss of Shh expression in the ventral neuroepithelium (Christ et al.,
Genetics
Lrp2-deficient mice die shortly after birth due to respiratory insufficiency. Lrp2 function is critical during neural tube formation, as it acts to organize Shh-mediated forebrain development during neurulation (Christ et al.,
Biochemistry and Cellular Function
In the adult brain, Lrp2, facilitated by its ligand ApoJ/Clusterin, mediates Aβ clearance from the CSF (Hammad et al., 1997; Bell et al.,
Lrp2 expression decreases with age, which goes along with a reduced clearance rate of Aβ (Carro et al.,
Lrp4 (Megf7)
Structure and General Physiological Properties
One of the shorter members of the LDL receptor family, Lrp4, is critical for survival in that LRP4 knockout mice die after birth due to defects in the neuromuscular junction (NMJ; Weatherbee et al., 2006). Lrp4 is also involved in the development of both the kidneys and limbs as Lrp4 knockout mice display abnormal limb morphology and renal agenesis (Johnson et al., 2005; Simon-Chazottes et al., 2006; Karner et al., 2010; Tanahashi et al., 2016). Additionally, Lrp4 regulates chondrocyte and osteoblast homeostasis during cartilage and bone growth (respectively) through binding the ligands Wise/Sostdc1, Dickkopf and Sclerostin (Choi et al.,
Genetics
Deficiency in Lrp4, MuSK, Agrin, APP and APLP2, or the intracellular scaffold Rapsyn lead to neonatal lethality, due to failure to form NMJs (Gautam et al.,
Studies at the NMJ also revealed important insights how different members of the APP-family interact (Choi et al.,
Biochemistry and Cell Biology
On the muscle fiber membrane, MuSK and Lrp4 form a functional receptor complex for Agrin. Upon Agrin binding to Lrp4, MuSK is phosphorylated resulting in Rapsyn-dependent focal clustering of nAChR (Shen et al., 2014). APP, and presumably APLP2, present on the muscle fiber surface and along with APLP1 on the neuron, also binds to Lrp4 and Agrin, which is required for the localized clustering of AChR on the muscle fiber where nerves terminate to allow a functional NMJ to form (Kim et al., 2008; Choi et al.,
Figure 4

Lrp4 and APP interaction during neuromuscular junction (NMJ) formation. Illustration depicting the interaction of Lrp4, MuSK, Agrin and APP/APLP1/APLP2 in the formation of the NMJ. Agrin binds Lrp4 resulting in phosphorylation (P) of MuSK, which leads to the recruitment and clustering of acetylcholine receptors (AchRs). The recruitment of AChR to the NMJ depends on all components of the complex. Knockouts of Lrp4, MuSK, Agrin, or APP/APLP1/APLP2 result in defective NMJ formation and perinatal lethality. APP and its family members (APLP1 and APLP2) have redundant functions, allowing them to compensate if one is knocked out. APLP1 is expressed on the presynaptic motor neuron, whereas APLP2 and APP are expressed by both nerve cells and muscle cells. Double knockouts lacking both APP and APLP1 form functional NMJs and are viable, whereas APP−/−/APLP2−/− and APLP1−/−/APLP2−/− mice have severely defective neuromuscular synapses and high postnatal lethality, indicating that APLP2 is an essential component in NMJ formation, but APP and APLP1 together can partially compensate in the absence of APLP2. Agrin is expressed in both neurons and muscle cells, but each express different isoforms. Isoforms expressed by neurons differ from muscular Agrin by the Z+ splice insert (yellow star), required for Lrp4 binding (Zong et al., 2012) and NMJ-formation (Burgess et al.,
Similar to the lipoprotein receptor ligand Reelin, multiple functions have been described for Agrin in shaping and maintaining neuronal activity in the brain. Agrin stimulates filopodia formation to allow structural plasticity (McCroskery et al., 2009) and inhibits astrocytic ATP release resulting in enhanced synaptic glutamate release (Sun et al., 2016). Agrin also regulates the strength of GABAergic synapses during network inactivation (Pribiag et al., 2014), reduces Aβ-levels (Rauch et al., 2011), and contributes to acetylcholine receptor clustering (Rauch et al., 2011). However, as of now, it is unknown if these functions require Lrp4-mediated endocytosis and trafficking. For example, Lrp4 does not require endocytic activity to promote NMJ formation (Willnow et al., 2012). Agrin binds not only Lrp4 but also to multiple other receptors and ligands such as heparin (Wallace, 1990), NCAM (Storms et al., 1996), Integrins (Martin and Sanes, 1997), α-dystroglycan (Bowe et al.,
Lrp4 also contributes to synaptic plasticity. Mice lacking Lrp4 or expressing a truncated Lrp4 retaining the ECD (Lrp4-ECD) in the brain have impaired hippocampal LTP and impaired memory (Gomez et al., 2014; Pohlkamp et al., 2015). Importantly, Sun et al. (2016) showed that the astrocyte-specific knockout of Lrp4 (using GFAP-Cre) extinguishes all brain Lrp4 expression and enhances the release of ATP from astrocytes, which may be causative for the described impairment in LTP. Of note, GFAP-Cre expression is not restricted to astrocytes and found in some neuronal populations as well. However, the authors also demonstrated that Agrin, by binding to Lrp4 and activating MuSK, controls the ATP release from astrocytes (Sun et al., 2016). The impaired LTP in Lrp4-ECD mice (Pohlkamp et al., 2015) suggests that anchoring of Lrp4 to the astrocytic membrane is required for normal synaptic potentiation. Neurons exclusively express the TM-Agrin (Neumann et al., 2001) that contains the alternatively spliced Z+ insert required for Lrp4 binding. TM-Agrin, by binding to Lrp4 could mediate a direct interaction of astrocytes and neurons. Furthermore, activity-driven neurotrypsin cleavage would allow the release of the Agrin C-terminal Lrp4-binding domain, which then can diffuse and bind to Lrp4/MuSK complexes on the astrocytic surface to control ATP release. It needs to be determined if this pathway requires APP or APLP1/2 in the complex, which are mainly/exclusively expressed by neurons. The astrocytic Agrin/Lrp4/MuSK complex together with APP or APLP2 on the neuronal surface might also be relevant for astrocyte-neuron interactions.
In the hippocampus, besides neurons, astrocytes express functional α7-type AchRs (Shen and Yakel, 2012), which is increased in the brain of AD-patients (Yu et al., 2005). Importantly Aβ binds to hippocampal α7AchR expressed on astrocytes, resulting in increased Ca2+ permeability (Pirttimaki et al., 2013). Activation of α7AchR on astrocytes triggers AMPA receptor recruitment to glutamatergic synapses, a mechanism also involved in converting silent synapses to functional ones (Wang et al., 2013a). At the NMJ Agrin/Lrp4/MuSK/APP complex formation appears to be required to effectively cluster AchRs. So far, however, astrocytic α7AchR function has not been shown to require the formation of an Agrin/Lrp4/MuSK/APP-complex. However, total AChR clustering in TM-Agrin knockout mouse brains, expressing only 20% of the Lrp4-binding Z+ Agrin form, is 4- to 5-fold reduced (Rauch et al., 2011).
Heparan sulfate proteoglycans (HSPG) inhibit BACE1 mediated APP cleavage (Scholefield et al., 2003). Thus, Agrin, as the major HSPG accumulating in plaques of AD-brains (Verbeek et al., 1999) might be a relevant inhibitor of BACE1. Agrin has also been described to be relevant for the function of the BBB (Rauch et al., 2011; Steiner et al., 2014). However, Aβ-clearance via Agrin and Lrp4 in astrocytes is unlikely, since in the neuron-specific TM-Agrin knockout, which expresses only 20% of Z+ Lrp4-interacting Agrin, Aβ clearance is not affected. By contrast, endothelial-specific knockout of Agrin does reduce Aβ-clearance (Rauch et al., 2011).
Lrp5/6
Structure and General Physiological Properties
Lrp5 and Lrp6 share 71% homology and are more distantly related members of the family. Despite encoding three LBRs and four EGF-precursor homology domains, compared to the core members, the domains appear in an inverse order with the ligand-binding domains adjacent to the TM segment rather than at the N-terminus. Additionally, their ICDs lack NPxY motifs. Both receptors have important functions in Wnt/β-catenin signaling, whereby Wnt and the Frizzled-receptors, mediate intracellular β-catenin translocation to the nucleus for transcriptional control of target gene expression (reviewed by Joiner et al., 2013). Similar to Lrp4, Lrp5 and Lrp6 are involved in bone growth (Lara-Castillo and Johnson, 2015), recently Lrp6 has also been suggested to have a role in AD and APP processing (De Ferrari et al.,
Genetics
Lrp5 deficiency causes osteoporosis and bone fracture in mice due to reduced osteoblast proliferation and low bone mass (Kato et al., 2002), and point mutations have been found in human patients with altered bone mass. Lrp5 knockout also leads to defects in cholesterol and glucose metabolism. Lrp5 and ApoE double knockout mice suffer from hypercholesterolemia, fat intolerance, and atherosclerosis (Fujino et al.,
Biochemistry and Cellular Function
Wnt signaling via Lrp6 has been implicated in neuronal differentiation (Jeong et al., 2014), commissural axon guidance (Avilés and Stoeckli,
SorLA (Sorl1/LR11/LRP11)
Structure and General Physiological Properties
SorLA is a hybrid-type receptor, as the only member of the LDL receptor family with a Vps10p (yeast vacuolar protein sorting 10 protein) domain and six Fibronectin repeats (Figure 1). SorLA is predominantly expressed in the brain, especially in neurons (Jacobsen et al., 1996; Yamazaki et al., 1996), where it acts as an intracellular sorting receptor transporting cargo, including APP, between different intracellular compartments in the cell (Andersen et al.,
Genetics
Defective homeostasis of SorLA and its cargo disrupts cellular function and causes AD, atherosclerosis and obesity (Caglayan et al.,
Biochemistry and Cellular Function
The ICD of SorLA is important for retrograde trafficking from endosomes to the trans-Golgi network (TGN) by binding to the retromer complex and anterograde trafficking by interacting with clathrin-adaptors (Jacobsen et al., 2002; Seaman, 2007; Fjorback et al.,
Very Distinct and Short Receptors Containing LBRs
Lrp3, Lrp10 (murine Lrp9) and Lrp12 (ST7/Mig13) share high homology (Battle et al.,
Lrp3, discovered in 1998 is expressed in a wide range of human tissues, including the brain, with the highest expression in skeletal muscle and ovary. Interestingly, in contrast to other LDL receptor family members, Lrp3 does not seem to bind to RAP (Ishii et al., 1998).
Lrp10 (murine Lrp9) is expressed in various tissues, including the brain. Little is known about its function; only one publication describes its involvement in APP processing. Lrp10 is located in endosomes and in the TGN (Sugiyama et al., 2000). The cytoplasmic tail interacts with clathrin adaptors that coordinate shuttling between endosomes and TGN (Boucher et al.,
Lrp12 (ST7/MG13) has been annotated as a member of the LDL receptor family in 2003 (Battle et al.,
Lrad3 has the shortest ECD of all receptors (Figure 1), with only three LBRs. Lrad3 is found in the brain and is expressed in microvascular endothelial cells and neurons (Otsuki et al., 2005; Ranganathan et al., 2011). In cell culture, the results of Lrad3 overexpression were similar to those of Lrp1: Lrad3 promoted the pathogenic proteolytic pathway of APP, shifting it away from the α-secretase pathway towards the endosome, resulting in enhanced Aβ production. While Lrad3 does not interact with Aβ, the receptor does interact with the central APP fragment (C99) that contains the ICD, the TM-domain, and a short ECD (Ranganathan et al., 2011). The Lrad3-ICD contains two PPxY motifs to which WW-domain containing proteins, e.g., ubiquitin ligases, bind (Ingham et al., 2004). More recently, it was found that Lrad3 is a component of the ubiquitin proteasome system by activating the E3 ubiquitin ligases Itch and Nedd4 (Noyes et al., 2016). However, a direct role of Lrad3 regulation of ubiquitination to APP processing has not been established.
Lipoprotein Receptors and APP Beyond Alzheimer’S
The function of APP and Aβ beyond AD is not well understood and understudied, especially in conjunction with lipoprotein receptors. Different chapters of this series discuss the physiological role of APP and its cleavage products from various physiological perspectives. APP and its trafficking and processing plays a role in neurite outgrowth and synaptogenesis, APP-deficiency decreases dendritic spine numbers and impairs LTP, which can be rescued by sAPPα but not sAPPβ (Tyan et al., 2012). APP function is largely occluded in single APP mutants, since its paralogs APLP1 and APLP2 can partially compensate for APP-loss. Characterization of combined knockouts of APP and its close relatives APLP1 and APLP2 provides additional insights into the trophic functions of APP: whereas single knockouts and APLP1/APP double knockouts are viable and fertile, combined APLP2/APP or APLP1/APLP2 knockouts display reduced viability (Heber et al., 2000). This suggests that APLP2 carries the most essential physiological functions that can be partially compensated by redundancy in the other family members. APP and APLP2 are expressed ubiquitously, while APLP1 expression is restricted to the nervous system (Lorent et al., 1995). Lrp4, MuSK, Agrin and APP/APLP2 are essential components of a functional complex that recruits and clusters acetylcholine receptors at the NMJ (reviewed in the “Lrp4” Section). Additionally, Lrp4 does not require the KPI domain to bind APP (Choi et al.,
APP trafficking and processing is controlled by a large variety of proteins, but little is known about their physiological relevance. APP interacts with numerous type-I TM receptors, many of which are lipoprotein receptors, and several other ligands, adaptor and scaffolding proteins, which together provide a protein-protein network involved in signaling, processing of various receptors, partially through endocytic pathways.
Concluding Remarks
APP processing to Aβ and in particular the accumulation of the amyloidogenic Aβ42 product, either from increased production or impaired clearance, are initiating events in AD, and ApoE genotype is the most important late onset risk factor for AD. Both APP and ApoE interact with LDL receptor family members to regulate APP trafficking, processing and elimination. Therefore, it is all but certain, that LDL receptor family members play a pivotal role in the pathogenesis of AD.
As a result of the work reviewed in this article, we have learned much about the potential molecular mechanisms that these lipoprotein receptors play in AD pathogenesis, yet the relative importance of each individual event is still unclear. Continuing work on the biology of LDL receptor related genes and their ligands on the physiology of the APP processing machinery holds great promise not only to greater understanding of the disease process but also for the identification of novel and effective therapeutic approaches.
Statements
Author contributions
TP and CRW jointly wrote the article and designed the figures under JH guidance and JH edited the manuscript.
Acknowledgments
This work was supported by grants from the NHLBI (R37 HL063762), the NIA (RF AG053391), the NINDS and NIA (RO1 NS093382), as well as, the Consortium for Frontotemporal Dementia Research (A108400), and the Brightfocus Foundation (A2016396S). We would like to thank Nancy Heard and Barbara Dacus for their help in preparing the figures.
Conflict of interest
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
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Summary
Keywords
LRP, APOE, LDL receptor gene family, neuromuscular junction, synapse, glutamate receptors, trafficking, amyloid beta
Citation
Pohlkamp T, Wasser CR and Herz J (2017) Functional Roles of the Interaction of APP and Lipoprotein Receptors. Front. Mol. Neurosci. 10:54. doi: 10.3389/fnmol.2017.00054
Received
04 January 2017
Accepted
16 February 2017
Published
01 March 2017
Volume
10 - 2017
Edited by
Thomas Deller, Goethe-University, Germany
Reviewed by
Eckart Förster, Ruhr University Bochum, Germany; Claus Pietrzik, University of Mainz, Germany
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© 2017 Pohlkamp, Wasser and Herz.
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution and reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Joachim Herz joachim.herz@utsouthwestern.edu
†These authors have contributed equally to this work.
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