K_ATP channels are necessary for glucose-dependent increases in amyloid-β and Alzheimer’s disease–related pathology

Elevated blood glucose levels, or hyperglycemia, can increase brain excitability and amyloid-β (Aβ) release, offering a mechanistic link between type 2 diabetes and Alzheimer’s disease (AD). Since the cellular mechanisms governing this relationship are poorly understood, we explored whether ATP-sensitive potassium (K_ATP) channels, which couple changes in energy availability with cellular excitability, play a role in AD pathogenesis. First, we demonstrate that K_ATP channel subunits Kir6.2/KCNJ11 and SUR1/ABCC8 were expressed on excitatory and inhibitory neurons in the human brain, and cortical expression of KCNJ11 and ABCC8 changed with AD pathology in humans and mice. Next, we explored whether eliminating neuronal K_ATP channel activity uncoupled the relationship between metabolism, excitability, and Aβ pathology in a potentially novel mouse model of cerebral amyloidosis and neuronal K_ATP channel ablation (i.e., amyloid precursor protein [APP]/PS1 Kir6.2^–/–mouse). Using both acute and chronic paradigms, we demonstrate that Kir6.2-K_ATP channels are metabolic sensors that regulate hyperglycemia-dependent increases in interstitial fluid levels of Aβ, amyloidogenic processing of APP, and amyloid plaque formation, which may be dependent on lactate release. These studies identify a potentially new role for Kir6.2-K_ATP channels in AD and suggest that pharmacological manipulation of Kir6.2-K_ATP channels holds therapeutic promise in reducing Aβ pathology in patients with diabetes or prediabetes.