Preventive methylene blue treatment preserves cognition in mice expressing full-length pro-aggregant human Tau

Introduction: Neurofibrillary tangles (NFT) composed of Tau are hallmarks of neurodegeneration in Alzheimer disease. Transgenic mice expressing full-length pro-aggregant human Tau (2N4R Tau-Delta K280, termed Tau(Delta K)) or its repeat domain (TauRD-Delta K280, TauRD(Delta K)) develop a progressive Tau pathology with missorting, phosphorylation, aggregation of Tau, loss of synapses and functional deficits. Whereas TauRD(Delta K) assembles into NFT concomitant with neuronal death, Tau(Delta K) accumulates into Tau pretangles without overt neuronal loss. Both forms cause a comparable cognitive decline (with onset at 10mo and 12mo, respectively), which is rescued upon switch-off of transgene expression. Since methylene blue (MB) is able to inhibit Tau aggregation in vitro, we investigated whether MB can prevent or rescue Tau-induced cognitive impairments in our mouse models. Both types of mice received MB orally using different preventive and therapeutic treatment protocols, initiated either before or after disease onset. The cognitive status of the mice was assessed by behavior tasks (open field, Morris water maze) to determine the most successful conditions for therapeutic intervention. Results: Preventive and therapeutic MB application failed to avert or recover learning and memory deficits of TauRD(Delta K) mice. Similarly, therapeutic MB treatment initiated after onset of cognitive impairments was ineffective in Tau(Delta K) mice. In contrast, preventive MB application starting before onset of functional deficits preserved cognition of Tau(Delta K) mice. Beside improved learning and memory, MB-treated Tau(Delta K) mice showed a strong decrease of insoluble Tau, a reduction of conformationally changed (MC1) and phosphorylated Tau species (AT180, PHF1) as well as an upregulation of protein degradation systems (autophagy and proteasome). This argues for additional pleiotropic effects of MB beyond its properties as Tau aggregation inhibitor. Conclusions: Our data support the use of Tau aggregation inhibitors as potential drugs for the treatment of AD and other tauopathies and highlights the need for preventive treatment before onset of cognitive impairments.