Presenilin 1 (PS1) plays a critical role in the ␥-secretase processing of the amyloid precursor protein to generate the -amyloid peptide, which accumulates in plaques in the pathogenesis of Alzheimer's disease (AD). Mutations in PS1 cause early onset AD, and proteins that interact with PS1 are of major functional importance. We report here the coimmunoprecipitation of PS1 and acetylcholinesterase (AChE), an enzyme associated with amyloid plaques. Binding occurs through PS1 N-terminal fragment independent of the peripheral binding site of AChE. Subcellular colocalization of PS1 and AChE in cultured cells and coexpression patterns of PS1 and AChE in brain sections from controls and subjects with sporadic or familial AD indicated that PS1 and AChE are located in the same intracellular compartments, including the perinuclear compartments. A PS1-A246E pathogenic mutation expressed in transgenic mice leads to decreased AChE activity and alteration of AChE glycosylation and the peripheral binding site, which may reflect a shift in protein conformation and disturbed AChE maturation. In both the transgenic mice and humans, mutant PS1 impairs coimmunoprecipitation with AChE. The results indicate that PS1 can interact with AChE and influence its expression, supporting the notion of cholinergic-amyloid interrelationships.Alzheimer's disease (AD) is characterized by the presence of large numbers of amyloid plaques and neurofibrillary tangles in the brain (56). The major constituent of the amyloid plaques is the -amyloid protein (A), a polypeptide generated by processing of a much larger amyloid precursor protein (APP) through the successive action of two proteolytic enzymes, -secretase and ␥-secretase (71). ␥-Secretase is a membrane protease complex comprising presenilin 1 (PS1) as a catalytic subunit (76). The importance of PS was first highlighted by genetic studies of AD. Families bearing mutations in the PS1 gene, or in the highly homologous presenilin 2 (PS2) gene, invariably develop an aggressive form of early-onset AD with an accelerated rate of A deposition (75).The accumulation of A peptide in the brain is thought to be an important step in the pathogenesis of AD, leading to a number of neurodegenerative changes (19). In particular, there is a decrease in cholinergic activity in the basal forebrain of AD patients, which affects activity of the acetylcholinesynthesizing enzyme, choline acetyltransferase, as well as the acetylcholine-hydrolyzing enzyme, acetylcholinesterase (AChE) (13, 53). The altered expression of AChE in the AD-affected brain (AD brain) is of particular interest. Despite an overall decrease in the AD brain, the activity of AChE is increased around the amyloid plaques (42,78). This may be a direct consequence of amyloid deposition, since A peptides influence AChE levels in cell cultures (25,69) and in the brains of transgenic mice that produce human A (70). Conversely, AChE may play a role in A fibrillogenesis (27,60). Finally, several investigations have argued for a strict interrelation b...