#303 - A breakthrough in Alzheimer’s disease: the promising potential of klotho for brain health, cognitive decline, and as a therapeutic tool for Alzheimer's disease | Dena Dubal, M.D., Ph.D.
The Peter Attia DriveSun May 26 2024
Klotho Protein and Brain Health:
- Klotho, a protein associated with longevity, decreases by half during aging, with levels peaking upon waking due to a circadian rhythm.
- Chronic stress is linked to lower klotho levels, while exercise significantly boosts klotho levels by about 30% after 12 weeks.
- Methylation around the clotho promoter inhibits its transcription and translation as individuals age, impacting klotho production.
- Studies show a direct correlation between shorter telomeres and lower klotho levels, suggesting an interplay in aging processes.
- Klotho enhances cognition in mice across different ages and disease models like Alzheimer's and Parkinson's diseases.
Discovery of Clotho Gene:
- The clotho gene was serendipitously discovered in 1997 by Makoto Kuroo during hypertension studies in mice.
- Clotho codes for a transmembrane protein primarily produced in the kidney before being released as soluble clotho into the blood or cerebrospinal fluid.
Mechanism of Action - GluN2B Receptors:
- Clotho enhances cognition through NMDA receptors' subunit GluN2B at synapses, promoting memory formation and synaptic plasticity.
- Overexpression of GluN2B improves neural connections and memory efficiency, indicating their role in brain function.
- Blocking GluN2B inhibits clotho's ability to enhance cognition, highlighting their interplay in brain health.
Peripheral Administration of Clothoprotein:
- Despite not crossing the blood-brain barrier, peripheral administration of clothoprotein results in cognitive enhancement within hours lasting for weeks.
- Studies suggest that clothoprotein may act through messengers sent from the blood into the brain to enhance cognitive functions.
Klotho's Impact on Brain Health in Mice:
- Klotho was found to enhance cognition in mice, with a single klotho injection leading to long-lasting effects.
- The study showed that platelet factor four (PF4) released by activated platelets enhanced cognition in both young and aging mice.
- Clotho stimulated platelets to release PF4, which improved cognitive function in mouse models of Parkinson's and Alzheimer's diseases.
- In the experiments conducted, clotho demonstrated the ability to activate platelets, leading to the release of PF4, ultimately enhancing brain health and cognitive functions in mice.
Clotho's Cognitive Enhancement in Primates:
- Rhesus macaques were used as a model system due to their genetic diversity and anatomical complexity similar to humans.
- Monkeys treated with klotho demonstrated better performance than those receiving a placebo in spatial memory tasks.
- A low physiologic dose of clotho immediately enhanced cognition in monkeys, lasting for at least three weeks.
- The study design involved rigorous testing methodologies such as spatial delayed response tasks to assess cognitive improvements accurately.
Dosing Strategies and Efficacy Across Species:
- In mice, very low doses of clotho significantly enhanced cognition, even more so than higher supraphysiologic doses.
- Dosing strategies aimed to stay within physiological levels while also testing higher doses up to 10-20 times the natural level.
- The minimum effective dose in mice was more than five times less than the peak physiologic dose.
- Researchers carefully considered dosing regimens across species, ensuring that the dosages remained within physiological ranges while exploring potential therapeutic benefits.
Longevity Factor Klotho's Potential Therapeutic Role:
- Clotho treatment extended lifespan and normalized cognition across the lifespan of APP mutant mice overexpressing clotho.
- Clotho provided resilience against Alzheimer's toxins without reducing amyloid beta or tau levels in the brain.
- The potential use of clotho as a therapeutic agent for neurodegenerative diseases like Alzheimer’s and Parkinson’s is being explored.
- Studies have shown promising results indicating that clotho could potentially serve as a protective agent against neurodegenerative conditions through its positive impact on neural circuits associated with memory and cognitive functions.
Implications for Human Clinical Trials:
- There is interest in moving towards human clinical trials with clotho as a potential therapy for cognitive decline associated with neurodegenerative diseases like Alzheimer’s disease.
- Clotho may offer protective benefits by enhancing brain health through its impact on neural circuits involved in memory and cognitive functions.
Klotho Protein and Cognitive Function:
- Klotho, a protein associated with longevity, plays a vital role in brain health and cognitive function, offering protection against neurodegenerative diseases like Alzheimer's and Parkinson's.
- Testing different doses of klotho in monkeys showed that high doses did not harm cognition but also did not enhance it compared to low doses.
- In mice, continuous cognitive improvement was observed with klotho, indicating the necessity of determining the optimal therapeutic dose before human trials.
Potential Longevity Effects of Klotho Injection:
- The long-lasting effects of a single klotho injection are intriguing due to its potential organizational impact on synaptic plasticity and cognitive function over time rather than just immediate enhancements.
- Speculation exists around the idea that klotho may have an extended effect beyond acute improvements seen with interventions like exercise boosts.
Genetic Variant KLVS Associated with Cloth O Gene:
- KLVS refers to two specific genetic variations affecting clotho protein levels in individuals.
- Heterozygotes carrying one copy of KLVS exhibit better cognition across aging studies compared to non-carriers or homozygotes.
Association Between KLVS and APOE4 Genes:
- Individuals carrying both KLVS and APOE4 genes demonstrated decreased risk for developing Alzheimer's disease and lower amyloid beta deposition.
- The protective effect of KLVS seemed consistent regardless of APOE4 status, potentially mitigating the negative impact of APOE4 on Alzheimer's risk.
Impact of Homozygosity for KLVS:
- Homozygotes for KLVS produce lower levels of clotho compared to non-carriers or heterozygotes, showing about a 30% decrease in clotho levels.
- Studies indicate that homozygosity leads to decreased clotho levels by approximately 30% compared to non-carriers.