Vaccination of Alzheimer's model mice with Aβ derivative in alum adjuvant reduces Aβ burden without microhemorrhages

Immunotherapy holds great promise for Alzheimer's disease (AD) and other conformational disorders but certain adverse reactions need to be overcome. The meningoencephalitis observed in the first AD vaccination trial was likely related to excessive cell-mediated immunity caused by the immunogen, amyloid-? (A?) 1–42, and the adjuvant, QS?21. To avoid this toxicity, we have been using A? derivatives in alum adjuvant that promotes humoral immunity. Other potential side effects of immunotherapy are increased vascular amyloid and associated microhemorrhages that may be related to rapid clearance of parenchymal amyloid. Here, we determined if our immunization strategy was associated with this form of toxicity, and if the therapeutic effect was age-dependent. Tg2576 mice and wild-type littermates were immunized from 11 or 19 months and their behaviour evaluated prior to killing at 24 months. Subsequently, plaque- and vascular-A? burden, A? levels and associated pathology was assessed. The therapy started at the cusp of amyloidosis reduced cortical A? deposit burden by 31% and A? levels by 30–37%, which was associated with cognitive improvements. In contrast, treatment from 19 months, when pathology is well established, was not immunogenic and therefore did not reduce A? burden or improve cognition. Significantly, the immunotherapy in the 11–24 months treatment group, that reduced A? burden, did not increase cerebral bleeding or vascular A? deposits in contrast to several A? antibody studies. These findings indicate that our approach age-dependently improves cognition and reduces A? burden when used with an adjuvant suitable for humans, without increasing vascular A? deposits or microhemorrhages.