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Neurological Review |

Mechanisms of Protein Seeding in Neurodegenerative Diseases

Lary C. Walker, PhD; Marc I. Diamond, MD; Karen E. Duff, PhD; Bradley T. Hyman, MD, PhD
JAMA Neurol. 2013;70(3):304-310. doi:10.1001/jamaneurol.2013.1453.
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Most age-associated neurodegenerative diseases involve the aggregation of specific proteins within the nervous system. In Alzheimer disease, the insidious pathogenic process begins many years before the symptoms emerge, and the lesions that characterize the disease—senile plaques and neurofibrillary tangles—ramify systematically through the brain. We review evidence that the β-amyloid and tau proteins, which aggregate to form senile plaques and neurofibrillary tangles, respectively, are induced to misfold and self-assemble by a process of templated conformational change that amplifies a toxic species. Recent data also indicate that the spread of these lesions from one site to another is mediated by the cellular uptake, transport, and release of endogenous seeds formed by the cognate proteins. This simple pathogenic principle suggests that the formation, trafficking, and metabolism of pathogenic protein seeds are promising therapeutic targets for Alzheimer disease and other neurodegenerative disorders.

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Grahic Jump Location

Figure 1. Age-associated development of neurofibrillary lesions in the dentate gyrus of mice expressing human tau selectively in the entorhinal cortex. The dentate gyrus lacks Alz50 immunoreactivity at age 12 months (A), but by age 24 months, numerous granule cells are immunopositive (B). These lesions include human tau despite the fact that human tau messenger RNA was not detectable within the cells (scale bar = 100 μm).

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Grahic Jump Location

Figure 2. Monosynaptic and transsynaptic corticohippocampal and corticocortical connections radiating from the entorhinal cortex (EC) in young and old neuropsin-tTA-tau–transgenic mice. Young mice show accumulation of MC1-immunoreactive human tau in cell bodies and axonal tracts of the EC, the presubiculum, the parasubiculum, and projection areas (A), whereas old mice show relocation of tau to cell bodies and the appearance of human tau in synaptically connected areas in the hippocampus and neocortex (B) (scale bar = 500 μm). GC indicates granule cell layer of the dentate gyrus; H, hilus; I, inner molecular layer of the dentate gyrus; M, middle molecular layer of the dentate gyrus; O, outer molecular layer of the dentate gyrus; SLM, stratum lacunosum moleculare; SO, stratum oriens; SP, stratum pyramidale; and SR, stratum radiatum.

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Grahic Jump Location

Figure 3. Induction of intracellular aggregation by extracellular fibrils. The C17.2 neural cells expressing a tau–yellow fluorescent protein fusion (green) (A) were exposed to recombinant fibrils labeled with AlexaFluor 546 (red) (B); in the merged image, note the colocalization of externally derived fibrils with an intracellular tau–yellow fluorescent protein inclusion, representing the induction of intracellular aggregation (C) (scale bar = 10 μm) (image courtesy of Brandon B. Holmes, BS).

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