N-terminally truncated A peptides starting with pyroglutamate (ApE3) represent a major fraction of all A peptides in the brain of Alzheimer disease (AD) patients. ApE3 has a higher aggregation propensity and stability and shows increased toxicity compared with full-length A. In the present work, we generated a novel monoclonal antibody (9D5) that selectively recognizes oligomeric assemblies of ApE3 and studied the potential involvement of oligomeric ApE3 in vivo using transgenic mouse models as well as human brains from sporadic and familial AD cases. 9D5 showed an unusual staining pattern with almost nondetectable plaques in sporadic AD patients and non-demented controls. Interestingly, in sporadic and familial AD cases prominent intraneuronal and blood vessel staining was observed. Using a novel sandwich ELISA significantly decreased levels of oligomers in plasma samples from patients with AD compared with healthy controls were identified. Moreover, passive immunization of 5XFAD mice with 9D5 significantly reduced overall A plaque load and ApE3 levels, and normalized behavioral deficits. These data indicate that 9D5 is a therapeutically and diagnostically effective monoclonal antibody targeting low molecular weight ApE3 oligomers.
Alzheimer disease (AD)3 represents the most frequent form of dementia and is characterized by the presence of extracellular amyloid plaques composed of amyloid- (A) surrounded by dystrophic neurites and neurofibrillary tangles. The discovery that certain early-onset familial forms of AD may be caused by enhanced levels of A peptides have led to the hypothesis that amyloidogenic A is intimately involved in the AD pathogenic process (1). In the past extracellular A has been regarded as the major culprit, whereas more recent evidence now points to toxic effects of A in intracellular compartments (2-3). In addition, other concepts propose that the soluble oligomers and the -sheet containing amyloid fibrils are the toxic forms of A (4 -6). Supporting this notion, it has been demonstrated that soluble oligomeric A42, but not plaque-associated A, correlates best with cognitive dysfunction in AD (7-8). Oligomers are formed preferentially intracellulary within neuronal processes and synapses rather than extracellularly (9 -10). Besides full-length A peptides starting with an aspartate at position 1, a variety of different N-truncated A peptides have been identified in AD brains. Ragged peptides including phenylalanine at position 4 of A have been reported as early as 1985 by Masters et al. (11). In contrast, no N-terminal sequence could be obtained from cores purified in a sodium dodecyl sulfate-containing buffer, which led to the assumption that the N terminus could be blocked (12-13). The presence of ApE3 (N-terminally truncated A starting with pyroglutamate) in AD brain was subsequently shown using mass spectrometry of purified A peptides, explaining at least partially initial difficulties in sequencing A peptides purified from human brain tissue (14). The author...