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The modulation of MAMs is an emerging area of research with potential implications for various disorders, including cancer, metabolic disorders, and neurodegenerative diseases13. Many pharmacological agents, including the dynein-antagonist LDC-3/Dynarrestin, antidiabetic drug metformin, and anti-cancer agent sulforaphane, disrupt MAMs and are currently under pre-clinical and clinical trials for cancer and metabolic disorders. These pharmacological agents modulate the ER-mitochondria contacts or MAM contact widths by regulating the interactions between MAM-tethering proteins such as PTPIP51, VAPB, VDAC1, PACS2, MFN2, VDAC1, and IP3R314,15,16,17,18,19,20. The sigma-1 receptor (S1R) antagonist (NE-100) downregulated MAMs and dramatically reduced axonal Aβ levels in a 3D neuronal model of AD21. A recent report demonstrated that the loss of S1R increased loose MAMs and decreased tight MAMs, suggesting S1R as a therapeutic target to modulate MAM tightness8,9.
Live FRET (fluorescence resonance energy transfer) imaging of neurons derived from Alzheimer's disease (AD) transgenic rats revealed a significant disruption in tight MAMs (<10 nm), with no observable change in loose MAMs (~20 nm), when compared to those in wild-type controls1. Inducible FRET/FLIM-based MAM stabilizers incorporating rapamycin (Rapa)/rapalog (Log)-inducible FRB and FKBP dimerization domains, expressed in N2AAPP cells, demonstrated that Rapa/Log treatment enhanced MAM tightness and increased Aβ40 production in a dose-dependent manner8,9. This provided the first proof of concept that narrowing the MAM gap width promotes amyloidogenic processing. The FDA-approved anti-amnestic drug rivastigmine, currently under preclinical investigation for mild to moderate AD22,23, significantly reduced Aβ40 levels (p < 0.001) without altering the expression of VDAC1 or BACE1, or affecting the colocalization frequency between CFP-ER and Mito-YFP8,9. Rivastigmine appears to influence MAM stabilization by modulating the levels of the MAM-anchoring protein mitofusin-2 (MFN2)24. This finding aligns with other studies reporting that rivastigmine reduces Aβ levels in cultured neurons and AD mouse models (3xTg)25,26. As MAM gap width regulates various cellular processes essential for cell survival27, targeted modulation of MAM stability may offer a more effective therapeutic strategy against Aβ accumulation than complete destabilization of MAMs, which could lead to unintended adverse effects.
A major limitation of the method is that the ratiometric FRET technique relies on the equimolar expression of the donor and the acceptor. Co-expression of the expression plasmids encoding the donor, or the acceptor will produce inconsistent results. Using a self-cleaving Tav2A connecting the donor and the acceptor biosensors ensures equimolar expression of the biosensors.However, the expression levels of the biosensors were checked using Western blot analysis prior to FRET analysis.
Rapamycin (Rapa) may not be ideal for assessing the effects of MAM tightening on Aβ production, as it inhibits the mammalian target of rapamycin (mTOR) signaling pathway, leading to downregulation of TREM2 (Triggering Receptor Expressed on Myeloid Cells 2) in microglia and consequently reducing Aβ plaque clearance in Alzheimer's disease (AD) mouse models (5XFAD)11. As an alternative, the rapamycin analog AP21967, commonly referred to as rapalog (Log), may be used. Log exhibits low binding affinity for mTOR, making it relatively non-toxic to cells. However, it retains the ability to bind the FRB domain with similar affinity to rapamycin, due to the introduction of a compensatory cavity-forming mutation (K2095P) in the FRB domain12.
The described method has high significance. Despite the evidence of several pre-clinical studies showing promising therapeutic effects of synthetic or natural small-molecule modulators of MAMs in cancer and metabolic disorders, no clinical trials have yet been undertaken. One of the primary reasons for this is the lack of a reliable method that can quantitatively measure MAM stability, a prerequisite for developing effective therapies. Quantification of MAM's structure-function relationship requires a complete view of the cell, which cannot be achieved for mature neurons by the traditional TEM or other high-resolution microscopies, but can be acquired with low magnification28. Thus, traditional techniques like TEM, cryo-TEM, or Scanning Electron Microscopies (SEM) may detect cellular structures at the nanoscale level but have limitations in measuring the degree of MAM stabilization because the highly dynamic nature of mitochondria29 and the ER30,31 makes MAM structures transient32,33,34. To investigate the MAM's structure function relationship, measuring the axonal velocity of mitochondria connected to the ER via tight or loose MAMs employing a live-cell imaging and kymography analysis has been proposed8,9.This is consistent with reports demonstrating decreased axonal transport of mitochondria in cortical neurons from AD brains35 and differentiated AD cybrid cells36. Despite the high quantitative accuracy, the live-cell imaging technique may not be useful for high-throughput drug screening. In contrast, FRET/FLIM analysis can be applied as a faster quantitative technique than the existing live-cell or high-resolution microscopy in the future to identify small-molecule therapeutics for AD.
The FRET protocol described here has been demonstrated to be applicable specifically in the context of artificially induced linkage between the ER and mitochondria. Its simplicity enables efficient assessment of ER-mitochondria contact stability and investigation of the resulting effects on amyloid pathology, which constitutes the primary objective of this approach. We aim to further utilize this method to screen a library of potential MAM-modulating small molecules within a recently developed three-dimensional (3D) AD drug screening platform37. The results will be immensely useful in selecting potential anti-Aβ small-molecule MAM modulators13 in vitro that can be extended to in vivo or clinical studies in the future.