Cytisine is neuroprotective in female but not male 6-hydroxydopamine lesioned parkinsonian mice and acts in combination with 17-β-estradiol to inhibit apoptotic endoplasmic reticulum stress in dopaminergic neurons

J Neurochem. 2021 May;157(3):710-726. doi: 10.1111/jnc.15282. Epub 2021 Jan 10.


Apoptotic endoplasmic reticulum (ER) stress is a major mechanism for dopaminergic (DA) loss in Parkinson's disease (PD). We assessed if low doses of the partial α4β2 nicotinic acetylcholine receptor agonist, cytisine attenuates apoptotic ER stress and exerts neuroprotection in substantia nigra pars compacta (SNc) DA neurons. Alternate day intraperitoneal injections of 0.2 mg/kg cytisine were administered to female and male mice with 6-hydroxydopamine (6-OHDA) lesions in the dorsolateral striatum, which caused unilateral degeneration of SNc DA neurons. Cytisine attenuated 6-OHDA-induced PD-related behaviors in female, but not in male mice. We also found significant reductions in tyrosine hydroxylase (TH) loss within the lesioned SNc of female, but not male mice. In contrast to female mice, DA neurons within the lesioned SNc of male mice showed a cytisine-induced pathological increase in the nuclear translocation of the pro-apoptotic ER stress protein, C/EBP homologous protein (CHOP). To assess the role of estrogen in cytisine neuroprotection in female mice, we exposed primary mouse DA cultures to either 10 nM 17-β-estradiol and 200 nM cytisine or 10 nM 17-β-estradiol alone. 17-β-estradiol reduced expression of CHOP, whereas cytisine exposure reduced 6-OHDA-mediated nuclear translocation of two other ER stress proteins, activating transcription factor 6 and x-box-binding protein 1, but not CHOP. Taken together, these data show that cytisine and 17-β-estradiol work in combination to inhibit all three arms (activating transcription factor 6, x-box-binding protein 1, and CHOP) of apoptotic ER stress signaling in DA neurons, which can explain the neuroprotective effect of low-dose cytisine in female mice.

Keywords: 6-OHDA; Parkinson's disease; cytisine; dopamine; endoplasmic reticulum stress; sex differences.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activating Transcription Factor 6 / drug effects
  • Alkaloids / pharmacology*
  • Animals
  • Apoptosis / drug effects*
  • Azocines / pharmacology
  • Behavior, Animal / drug effects
  • Dopaminergic Neurons / drug effects*
  • Endoplasmic Reticulum Stress / drug effects*
  • Estradiol / pharmacology*
  • Female
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Neuroprotective Agents / pharmacology*
  • Oxidopamine
  • Parkinsonian Disorders / chemically induced
  • Parkinsonian Disorders / drug therapy*
  • Parkinsonian Disorders / psychology
  • Primary Cell Culture
  • Quinolizines / pharmacology
  • Sex Characteristics
  • Substantia Nigra / drug effects
  • Sympatholytics
  • Transcription Factor CHOP / drug effects
  • Tyrosine 3-Monooxygenase / metabolism


  • Activating Transcription Factor 6
  • Alkaloids
  • Azocines
  • Ddit3 protein, mouse
  • Neuroprotective Agents
  • Quinolizines
  • Sympatholytics
  • Transcription Factor CHOP
  • Estradiol
  • cytisine
  • Oxidopamine
  • Tyrosine 3-Monooxygenase