Mitochondria contribute to shape intraneuronal Ca 2+ signals. Excessive Ca 2+ taken up by mitochondria could lead to cell death. Amyloid beta (Aβ) causes cytosolic Ca 2+ overload, but the effects of Aβ on mitochondrial Ca 2+ levels in Alzheimer's disease (AD) remain unclear. Using a ratiometric Ca 2+ indicator targeted to neuronal mitochondria and intravital multiphoton microscopy, we find increased mitochondrial Ca 2+ levels associated with plaque deposition and neuronal death in a transgenic mouse model of cerebral β-amyloidosis. Naturally secreted soluble Aβ applied onto the healthy brain increases Ca 2+ concentration in mitochondria, which is prevented by blockage of the mitochondrial calcium uniporter. RNAsequencing from post-mortem AD human brains shows downregulation in the expression of mitochondrial influx Ca 2+ transporter genes, but upregulation in the genes related to mitochondrial Ca 2+ efflux pathways, suggesting a counteracting effect to avoid Ca 2+ overload. We propose lowering neuronal mitochondrial Ca 2+ by inhibiting the mitochondrial Ca 2+ uniporter as a novel potential therapeutic target against AD.

Alzheimer’s disease (AD) is the most common form of dementia, affecting millions of people worldwide. Unfortunately, none of the current treatments are effective at improving cognitive function in AD patients and, therefore, there is an urgent need for the development of new therapies that target the early cause(s) of AD. Intracellular calcium (Ca2+) regulation is critical for proper cellular and neuronal function. It has been suggested that Ca2+ dyshomeostasis is an upstream factor of many neurodegenerative diseases, including AD. For this reason, chemical agents or small molecules aimed at targeting or correcting this Ca2+ dysregulation might serve as therapeutic strategies to prevent the development of AD. Moreover, neurons are not alone in exhibiting Ca2+ dyshomeostasis, since Ca2+ disruption is observed in other cell types in the brain in AD. In this review, we examine the distinct Ca2+ channels and compartments involved in the disease mechanisms that could be potential targets in AD.

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