Theranostics 2021; 11(2):789-804. doi:10.7150/thno.50263 This issue

Research Paper

Enhanced neprilysin-mediated degradation of hippocampal Aβ42 with a somatostatin peptide that enters the brain

Fadi Rofo1, Canan Ugur Yilmaz1, Nicole Metzendorf1, Tobias Gustavsson2, Chiara Beretta2, Anna Erlandsson2, Dag Sehlin2, Stina Syvänen2, Per Nilsson3, Greta Hultqvist1✉

1. Department of Pharmaceutical Biosciences, Uppsala University, Uppsala, Sweden
2. Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
3. Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Rofo F, Ugur Yilmaz C, Metzendorf N, Gustavsson T, Beretta C, Erlandsson A, Sehlin D, Syvänen S, Nilsson P, Hultqvist G. Enhanced neprilysin-mediated degradation of hippocampal Aβ42 with a somatostatin peptide that enters the brain. Theranostics 2021; 11(2):789-804. doi:10.7150/thno.50263. Available from

File import instruction


Graphic abstract

Background: Aggregation of the amyloid-beta (Aβ) peptide is one of the main neuropathological events in Alzheimer's disease (AD). Neprilysin is the major enzyme degrading Aβ, with its activity enhanced by the neuropeptide somatostatin (SST). SST levels are decreased in the brains of AD patients. The poor delivery of SST over the blood-brain barrier (BBB) and its extremely short half-life of only 3 min limit its therapeutic significance.

Methods: We recombinantly fused SST to a BBB transporter binding to the transferrin receptor. Using primary neuronal cultures and neuroblastoma cell lines, the ability of the formed fusion protein to activate neprilysin was studied. SST-scFv8D3 was administered to mice overexpressing the Aβ-precursor protein (AβPP) with the Swedish mutation (APPswe) as a single injection or as a course of three injections over a 72 h period. Levels of neprilysin and Aβ were quantified using an Enzyme-linked immunosorbent assay (ELISA). Distribution of SST-scFv8D3 in the brain, blood and peripheral organs was studied by radiolabeling with iodine-125.

Results: The construct, SST-scFv8D3, exhibited 120 times longer half-life than SST alone, reached the brain in high amounts when injected intravenously and significantly increased the brain concentration of neprilysin in APPswe mice. A significant decrease in the levels of membrane-bound Aβ42 was detected in the hippocampus and the adjacent cortical area after only three injections.

Conclusion: With intravenous injections of our BBB permeable SST peptide, we were able to significantly increase the levels neprilysin, an effect that was followed by a significant and selective degradation of membrane-bound Aβ42 in the hippocampus. Being that membrane-bound Aβ triggers neuronal toxicity and the hippocampus is the central brain area in the progression of AD, the study has illuminated a new potential treatment paradigm with a promising safety profile targeting only the disease affected areas.

Keywords: Amyloid-β (Aβ) / blood-brain barrier (BBB) / neprilysin / somatostatin (SST) / transferrin receptor (TfR)