Methylene blue upregulates Nrf2/ARE genes and prevents tau-related neurotoxicity

Cliona Stack, Shari Jainuddin, Ceyhan Elipenahli, Meri Gerges, Natalia Starkova, Anatoly A. Starkov, Mariona Jové, Manuel Portero-Otin, Nathalie Launay, Aurora Pujol, Navneet Ammal Kaidery, Bobby Thomas, Davide Tampellini, M. Flint Beal, Magali Dumont

Research output: Contribution to journalArticlepeer-review

109 Scopus citations


Methylene blue (MB, methylthioninium chloride) is a phenothiazine that crosses the blood brain barrier and acts as a redox cycler. Among its beneficial properties are its abilities to act as an antioxidant, to reduce tau protein aggregation and to improve energy metabolism. These actions are of particular interest for the treatment of neurodegenerative diseases with tau protein aggregates known as tauopathies. The present study examined the effects of MB in the P301S mouse model of tauopathy. Both 4 mg/kg MB (low dose) and 40 mg/kg MB (high dose) were administered in the diet ad libitum from 1 to 10months of age.Weassessed behavior, tau pathology, oxidative damage, inflammation and numbers of mitochondria. MB improved the behavioral abnormalities and reduced tau pathology, inflammation and oxidative damage in the P301S mice. These beneficial effects were associated with increased expression of genes regulated by NF-E2-related factor 2 (Nrf2)/antioxidant response element (ARE), which play an important role in antioxidant defenses, preventing protein aggregation, and reducing inflammation. The activation of Nrf2/ARE genes is neuroprotective in other transgenic mouse models of neurodegenerative diseases and it appears to be an important mediator of the neuroprotective effects of MB in P301S mice. Moreover, we used Nrf2 knock out fibroblasts to show that the upregulation of Nrf2/ARE genes by MB is Nrf2 dependent and not due to secondary effects of the compound. These findings provide further evidence that MB has important neuroprotective effects that may be beneficial in the treatment of human neurodegenerative diseases with tau pathology.

Original languageEnglish (US)
Article numberddu080
Pages (from-to)3716-3732
Number of pages17
JournalHuman Molecular Genetics
Issue number14
StatePublished - Jul 2014
Externally publishedYes

ASJC Scopus subject areas

  • Molecular Biology
  • Genetics
  • Genetics(clinical)


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