A randomized controlled study to evaluate the effect of bexarotene on amyloid-β and apolipoprotein E metabolism in healthy subjects

Kaushik Ghosal, Michael Haag, Philip B. Verghese, Tim West, Tim Veenstra, Joel B. Braunstein, Randall J. Bateman, David M. Holtzman, Gary E. Landreth

Research output: Contribution to journalArticle

23 Scopus citations

Abstract

Introduction We conducted a phase Ib proof of mechanism trial to determine whether bexarotene (Targretin) increases central nervous system (CNS) apolipoprotein E (apoE) levels and alters Aβ metabolism in normal healthy individuals with the APOE ε3/ε3 genotype. Methods We used stable isotope labeling kinetics (SILK-ApoE and SILK-Aβ) to measure the effect of bexarotene on the turnover rate of apoE and Aβ peptides and stable isotope spike absolute quantitation (SISAQ) to quantitate their concentrations in the cerebrospinal fluid (CSF). Normal subjects were treated for 3 days with bexarotene (n = 3 women, 3 men, average 32 years old) or placebo (n = 6 women, average 30.2 years old) before administration of C13-leucine and collection of plasma and CSF over the next 48 hours. Bexarotene concentrations in plasma and CSF were also measured. Results Oral administration of bexarotene resulted in plasma levels of 1 to 2 μM; however, only low nM levels were found in CSF. Bexarotene increased CSF apoE by 25% but had no effect on metabolism of Aβ peptides. Discussion Bexarotene has poor CNS penetration in normal human subjects. Drug treatment resulted in a modest increase in CSF apoE levels. The absence of an effect on Aβ metabolism is likely reflective of the low CNS levels of bexarotene achieved. This study documents the utility of SILK-ApoE technology in measuring apoE kinetics in humans. Trial Registration This trial is registered at clinicaltrials.gov (NCT02061878).

Original languageEnglish
Pages (from-to)110-120
Number of pages11
JournalAlzheimer's and Dementia: Translational Research and Clinical Interventions
Volume2
Issue number2
DOIs
StatePublished - Jun 1 2016

Keywords

  • Alzheimer's disease
  • Apolipoprotein E
  • Bexarotene
  • Retinoid X receptor
  • β amyloid

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