3.1. Transcellular Mitochondrial Transfer in Nervous Cells
In the central nervous system (CNS), mitochondrial transfer constitutes an important form of intercellular crosstalk contributing to the homeostasis and neuroprotection of CNS
[45]. The transfer of mitochondria among nervous cells participates in the cellular and tissue defense against CNS damage, performing a relevant function in recovery after injury
[45]. In the CNS, astrocytes perform a wide range of functions, including the regulation of neurodevelopment, neurotransmission and metabolism (reviewed in
[14]). Emerging studies show that the neuroprotective functions of astrocytes may comprise the transfer of mitochondria from these cells to damaged neurons
[45,55,56][45][55][56]. Under physiological conditions, astrocytes defend neurons, counteracting oxidative stress and excitotoxicity and ensuring neurotrophic support
[57,58][57][58]. In the context of injury, astrocytes can transfer healthy mitochondria to axons
[45,59][45][59]. Recently, a study of Cheng et al. in co-culture systems of human-induced pluripotent stem cells (iPSC) showed that iPSC-derived astrocytes can transfer mitochondria to neurons, recovering dopaminergic neuronal toxicity
[60]. The neuroprotective function of astrocyte-derived mitochondria transfer to neurons has been highlighted in other studies of neurotoxicity; for instance, English et al. demonstrated, in their in vitro work on a co-culture of cisplatin-treated neurons with astrocytes, that neurons that had received mitochondria from astrocytes showed improved neuronal survival, reinstated neuronal mitochondrial membrane potential and normalized neuronal calcium dynamics, underlining the relevance of transcellular mitochondrial transfer
[61]. Notably, under stress conditions, astrocytes may interrupt their protective function and release danger signaling factors, such as inflammatory cytokines, thus damaging neurons (reviewed in
[14]).
In broader terms, there is growing evidence revealing that like in the whole CNS, transcellular transfer of mitochondria can have significant relevance and multifunctional roles in various physio-pathological contexts:
-
The transfer of mitochondria from neurons to astrocytes can activate a process known as trans-mitophagy, allowing cells to degrade dysfunctional mitochondria
[45];
-
The transfer of astrocytic mitochondria to injured neurons can lead neuroprotective benefits
[45,55,56][45][55][56];
-
The transfer of active mitochondria from endothelial progenitor cells to brain endothelial cells can enhance cell viability and improve their function of defensive barrier
[62,63][62][63];
-
The transfer of mitochondria from hematopoietic stem and progenitor cells to neurons can improve their mitochondrial functional efficiency
[14].
3.2. Mitochondrial Transfer in Dysfunctional Mitochondria-Related Neurodegenerative Disorders: Therapeutic Use of Exogenous Mitochondria for Alzheimer’s and Parkinson’s Diseases
Pathogenesis of neurodegenerative disorders, such as Alzheimer’s and Parkinson’s diseases, involves dysfunction of mitochondria
[64,65][64][65].
Alzheimer’s disease (AD) is the most common neurodegenerative disorder, characterized by a progressive failure in cognitive function due to progressive loss of neurons in forebrain and other brain areas
[66]. Mitochondrial dysfunction has been established as an early and prominent feature of the disease
[67]. The multiform, and even opposed, modes involving mitochondrial dysfunction in AD pathophysiology and their complex regulation make the aim of targeting mitochondrial deficits very difficult. Nitzan and coworker’s experimental strategy aimed at overcoming this limitation by using active and functional mitochondria, thereby allowing mitochondria to act as whole organelles rather than targeting only one of their dysfunctional tasks. The results of their analysis suggest that transfer of functionally active mitochondria, aimed at efficiently mimicking mitochondrial function, is beneficial to treat AD deficits, correcting cognitive deficits, brain pathology and mitochondrial defects in an AD mouse model
[68]. In this recent in vivo study, the effect of transferring active intact mitochondria was investigated, by treating AD-mice (amyloid, intracerebroventricularly injected) intravenously (IV) with fresh human isolated mitochondria. Fourteen days after mitochondrial transplantation, AD-mice treated with exogenous mitochondria showed significantly improved cognitive performances almost comparable to those of untreated control mice
[68]. A significant recovery in neuronal loss and reduced gliosis were also detected in the hippocampus of treated mice respect to untreated AD-mice. Increased citrate synthase and cytochrome
c oxidase activities were measured in mitochondria-treated AD-mice, reaching activity values close to untreated control mice
[68]. Increased mitochondrial activity was also detected in the liver of mitochondria-treated mice. No toxicity associated with the treatment was detected. Therefore, mitochondrial transfer could offer a novel therapeutic approach for AD treatment.
Parkinson’s disease (PD) is the second most common neurodegenerative disorder, characterized by the selective loss of dopaminergic neurons of the substantia nigra pars compacta (SNc) with motor and nonmotor symptoms
[69]. The main histopathological marker of PD is the presence in neurons of α-synuclein (α-syn) protein aggregates forming in inclusion bodies, indicated as Lewy bodies
[70]. α-Syn is principally expressed pre-synaptically and there is evidence of the existence of α-syn transfer from neurons to neuronal and non-neuronal cells in vitro, indicating that α-syn pathology propagates between anatomically adjacent brain regions by an intercellular transfer mode
[71]. Mitochondrial dysfunction is widely recognized as a common central pathway involved in the pathogenetic processes of sporadic and genetic PD (reviewed in
[72]). Dysfunctional mitochondria are constant presences in PD
[73]; moreover, α-syn can be located at mitochondrial membranes and its aggregation can be related to mitochondrial dysfunction in PD
[74]. Increased ROS levels resulting from reduced efficiency in the electron transport chain activity are involved in the formation of α-syn aggregates and neuronal loss
[75].
Increasing evidence suggests that astrocytes have a relevant part in the progression of PD (reviewed in
[72]). A recent work presented clear evidence that transneuronal mitophagy occurs in vivo in PD models
[76]. In PD models, astrocytes are primarily responsible for clearance of damaged mitochondria—a functional role of considerable relevance in the context of PD associated to mutations of Parkin and PINK1
[72]. Notably, PINK1 activity was recently predominantly found in astrocytes while almost absent in neurons
[77]. Exogenous supplementation of mitochondria to damaged regions may be a potential and innovative therapeutic strategy for the treatment of PD, as shown in the in vivo work of Chang et al., demonstrating that injection of mitochondria into medical forebrain bundle (MFB) of 6-hydroxydopamine-unilaterally infused PD rats enhanced the survival of dopaminergic neurons and improved mitochondrial functions by recovering normal levels of mitochondrial complex I-IV and reducing mitochondrial oxidative stress in vivo
[78].
Remarkably, the translational application of mitochondrial transfer should be further evaluated and its therapeutic potential exploited for the treatment of neurodegenerative diseases, such as AD and PD.
3.3. Mitochondrial Transfer in Neurodevelopmental Diseases: Extracellular Mitochondrial Release Reflecting Mitochondrial Dysfunction in Down Syndrome and Fragile X Syndrome
Mitochondrial dysfunction is a critical player contributing to the pathogenesis of several neurodevelopmental diseases, including Down syndrome (DS), the most common genetic defect leading to intellectual disability and caused by the trisomy of human chromosome 21. DS is characterized by neuropathological changes occurring already in fetal and neonatal life, leading to alterations in brain development
[79].
Defective mitochondrial bioenergetics negatively compromise neuronal development and represent an early event in developing the neurobiological alterations characterizing the syndrome
[80,81,82][80][81][82]. Although DS is a multi-genic disorder and many pathways are affected, oxidative phosphorylation (OXPHOS) dysfunction was found ubiquitously present in any tissue or cell type, regardless of age, including fetal one, so that DS is now regarded as an OXPHOS disorder
[83].
In a very recent study, a new population of extracellular vesicles containing mitochondrial proteins, named “mitovesicles”, were identified and found altered in Down syndrome
[84]. D’Acunzo et al. have shown that brain-derived mitochondria contain a specific subset of mitochondrial components and that their levels and cargo are aberrant in DS
[84]. Comparative analysis of EVs derived from brains of Ts2 mouse model of DS and obtained from post-mortem human brains of individuals with DS showed higher numbers of mitovesicles with altered composition in the DS brain parenchyma, in both murine and human post-mortem brains
[84] (
Figure 2A). These data indicate that mitochondrial damage directly affects mitochondrial biology, either by activating the release of these vesicles or by regulating the mitochondrial cargo in the single extracellular vesicle.
Figure 2. EVs of mitochondrial origin reflect mitochondrial dysfunction in DS and FXS. (
A) Mitovesicles are a novel population of extracellular vesicles of mitochondrial origin altered in DS. Comparative analysis of EVs obtained from individuals with DS and Ts2 mouse model of DS showed higher numbers of mitovesicles with altered composition in the cerebral parenchyma, in both DS murine and human post-mortem brains
[84]. (
B) Depletion of mitochondrial components from extracellular vesicles secreted from astrocytes in a mouse model of FXS. Mitochondrial components contained in EVs derived from both cerebral cortices and astrocytes of
Fmr1 KO mice were found reduced
[85].
Taken together, these data show that mitochondrial levels and composition of mitovesicles mirror mitochondrial alterations within the cell of origin and could be used as biomarkers for assessing mitochondrial brain dysfunctions in neurological disorders.
Mitochondrial dysfunction contributes to the pathogenesis of another neurodevelopmental disease, the Fragile X syndrome (FXS). FXS is an inherited disorder characterized by mental retardation, caused by silencing of the
fmr1 gene, encoding the Fragile X mental retardation protein (FMRP)
[86], an RNA-binding protein expressed mainly in neurons and astrocytes of the brain and associated with approximately 4% of transcripts, including those for mitochondrial proteins
[87]. Neuronal development in
Fmr1 knock-out (KO) mice exhibited impaired dendritic maturation, altered expression of mitochondrial genes, fragmented mitochondria, impaired mitochondrial function and increased oxidative stress
[88].
D’Antoni et al. provided the first evidence of a compromised and inefficient mitochondrial bioenergetics in the brain cortex of
Fmr1 KO mice, a model of FXS, supporting the idea that mitochondrial dysfunctions may play a critical role in pathogenesis of the syndrome
[89].
In a recent study, the ability of EVs to transfer mitochondrial components and their role in mitochondrial dysfunction was assessed in astrocytes and brain cortices from
Fmr1 KO mice FLX model
[85]. The mitochondrial protein levels of the transcription factor NRF-1 (nuclear respirator factor 1), the subunits ATP5A and ATPB of ATP synthase and the mitochondrial membrane protein VDAC1 in EVs were found drastically reduced in cerebral cortex and astrocyte samples from
Fmr1 KO mice compared to euploid mice. These reductions are related to a reduction in mitochondrial biogenesis in the
Fmr1 KO brain, associated with decreased mitochondrial membrane potential in
Fmr1 KO astrocytes. Mitochondrial components were found reduced in both EVs derived from cerebral cortices and those secreted from astrocytes of
Fmr1 KO mice (
Figure 2B). The depletion of mitochondrial proteins contributes to mitochondrial dysfunction in astrocytes
[85]. This study indicates that mitochondrial dysfunction in astrocytes is related to the pathogenesis of FXS and can be monitored by depletion of EV mitochondrial components.
These findings may improve the ability to diagnose neurodevelopmental diseases associated with mitochondrial dysfunction. However, this kind of study is nascent and further investigations are needed to define the exact mechanisms responsible for the observed decrease in mitochondrial proteins, which could mirror a deficit in intracellular transferring from mitochondria to EVs or a compromised EVs formation.
Furthermore, to better understand the complex physiological functions of astrocyte-derived EVs, it will be crucial to determine which components of EVs critically impact the progression of FXS disease and its regulatory mechanism.