The principal pathological features of Alzheimer's disease (AD) are extracellular amyloid plaques and intracellular neurofibrillary tangles, the latter composed of the microtubule-binding protein tau assembled into paired helical and straight filaments. Recent studies suggest that these pathological entities may be functionally linked, although the mechanisms by which amyloid deposition promotes pathological tau filament assembly are poorly understood. Here, we report that tau is proteolyzed by multiple caspases at a highly conserved aspartate residue (Asp 421 ) in its C terminus in vitro and in neurons treated with amyloid-␤ (A␤) (1-42) peptide. Tau is rapidly cleaved at Asp 421 in A␤-treated neurons (within 2 h), and its proteolysis appears to precede the nuclear events of apoptosis. We also demonstrate that caspase cleavage of tau generates a truncated protein that lacks its C-terminal 20 amino acids and assembles more rapidly and more extensively into tau filaments in vitro than wild-type tau. Using a monoclonal antibody that specifically recognizes tau truncated at Asp 421 , we show that tau is proteolytically cleaved at this site in the fibrillar pathologies of AD brain. Taken together, our results suggest a novel mechanism linking amyloid deposition and neurofibrillary tangles in AD: A␤ peptides promote pathological tau filament assembly in neurons by triggering caspase cleavage of tau and generating a proteolytic product with enhanced polymerization kinetics. A lzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by accelerated neuronal cell death leading to dementia (1). Its hallmark pathologic features are extracellular amyloid plaques and intraneuronal fibrillar structures, the latter including neurofibrillary tangles (NFTs), neuropil threads, and dystrophic neurites invading amyloid plaques (2). Amyloid plaques are formed by the extracellular deposition of proteolytic fragments of the amyloid precursor protein (APP) termed amyloid-␤ (A␤) (1, 3), whereas the fibrillar pathologies are composed of the microtubule-associated protein tau assembled into polymeric filaments (paired helical and straight filaments) (2). The pathogenic role of amyloid deposition in AD is underscored by the evidence that each of the disease-causing mutations in familial AD results in enhanced production of amyloidogenic A␤ peptides; these peptides are sufficient to induce apoptosis in cultured neurons (1, 3). Furthermore, the recent observation that tau mutations cause hereditary frontotemporal dementia and parkinsonism linked to chromosome 17 (FTDP-17), a class of diseases characterized by NFT-like deposition of polymeric tau and dementia without amyloid plaques, emphasizes the critical role that tau plays in neurodegenerative events (4-6). Although amyloid plaques and NFTs have been largely regarded as independent neuropathologic entities, recent work suggests they may be functionally linked: mutation of APP that results in amyloid deposition or direct intracranial injection of A␤ peptide increase...

Neurofibrillary tangles are more numerous in medial temporal lobe regions associated with memory function and show a relationship to performance on memory tests in nondemented individuals. These results suggest that NFTs may constitute a pathological substrate for memory loss not only in AD but also in normal aging and MCI.

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Deposits of diffuse beta-amyloid (Abeta) may exist in the brain for many years before leading to neuritic degeneration and dementia. The factors that contribute to the putative transformation of the Abeta amyloid from a relatively inert to a pathogenic state remain unknown and may involve interactions with additional plaque constituents. Matching brain sections from 2 demented and 4 nondemented subjects were processed for the demonstration of Abeta immunoreactivity, butyrylcholinesterase (BChE) enzyme activity, and thioflavine S binding. Additional sections were processed for the concurrent demonstration of two or three of these markers. A comparative analysis of multiple cytoarchitectonic areas processed with each of these markers indicated that Abeta plaque deposits are likely to undergo three stages of maturation, ie, a "diffuse" thioflavine S-negative stage, a thioflavine S-positive (ie, compact) but nonneuritic stage, and a compact neuritic stage. A multiregional analysis showed that BChE-positive plaques were not found in cytoarchitectonic areas or cortical layers that contained only the thioflavine S-negative, diffuse type of Abeta plaques. The BChE-positive plaques were found only in areas containing thioflavine S-positive compact plaques, both neuritic and nonneuritic. Within such areas, almost all (>98%) BChE-containing plaques bound thioflavine S, and almost all (93%) thioflavine S plaques contained BChE. These results suggest that BChE becomes associated with amyloid plaques at approximately the same time that the Abeta deposit assumes a compact beta-pleated conformation. BChE may therefore participate in the transformation of Abeta from an initially benign form to an eventually malignant form associated with neuritic tissue degeneration and clinical dementia.

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